How to become a surgeon

1. 1Earn a bachelor's degree with premed courses

   Time: 4 yearsCost: Varies by collegeSources 1

   No specific major is required, but medical schools expect biology, general and organic chemistry, physics with labs, and biochemistry, plus English and math. Strong science grades matter. Future surgeons should get hands-on clinical experience, for example as an EMT, scribe or hospital volunteer, and shadow surgeons in the operating room. Research experience helps applicants to competitive surgical fields later.

2. 2Take the MCAT and apply to medical school

   Time: About 1 year (application cycle)Cost: $360 MCAT registration (2027 testing year)Sources 3, 1

   The MCAT tests biology, chemistry, physics, psychology and critical reasoning. Standard registration for 2027 test dates is $360, or $145 for students approved for AAMC Fee Assistance. Applicants submit transcripts, MCAT scores, recommendation letters and essays, and most schools interview finalists. Admission is competitive, so most applicants apply to many schools. Plan the test date so scores arrive before applications open.

3. 3Complete medical school (MD or DO)

   Time: 4 yearsCost: AAMC median 4-year cost: $297,745 public, $408,150 privateSources 2, 4, 5

   The first phase covers anatomy, physiology, pharmacology and pathology. The second phase is clinical rotations in hospitals, including a surgery clerkship. Students interested in surgery take extra surgical electives and sub-internships, get to know faculty who can write strong letters, and pass USMLE Step 1 and Step 2 CK (or COMLEX Levels 1 and 2-CE) before applying to residency through the Match.

4. 4Finish a surgical residency

   Time: 4-5 years or moreCost: Paid training positionSources 6, 9, 10, 4

   General surgery residency lasts five years (60 months), and the American Board of Surgery requires at least 850 operations as surgeon, including 200 in the chief year, plus ATLS, ACLS, Fundamentals of Laparoscopic Surgery and Fundamentals of Endoscopic Surgery. Orthopedic surgery residency is also five years. Ophthalmology requires a clinical internship year plus at least 36 months of ophthalmology training. Residents take USMLE Step 3 or COMLEX Level 3 during this time.

5. 5Get a state medical license

   Time: During or right after residencyCost: State fees varySources 11, 1

   Each state medical board issues licenses. You need a degree from an accredited MD or DO school, passing scores on the full USMLE or COMLEX-USA sequence and accredited postgraduate training. The number of residency years required before a full license, the fees and the renewal rules differ by state, so check your state board through the CareerOneStop License Finder.

6. 6Complete a fellowship if you want a subspecialty

   Time: 1-3 years (optional)Cost: Paid training positionSources 12, 1

   Many surgeons add a fellowship, for example in surgical oncology, vascular, hand, spine, retina or sports medicine. Pediatric surgery requires one: after general surgery residency, candidates complete a two-year (96-week) pediatric surgery fellowship, must hold ABS general surgery certification, and pass separate American Board of Surgery qualifying and certifying exams. BLS notes fellowships generally run 1 to 3 years.

7. 7Pass your specialty board exams

   Time: Up to several years after residencyCost: Board fees vary (e.g., $1,240 ABOS Part I)Sources 6, 9, 13, 10

   Board certification is voluntary under state law, but most hospitals expect it. General surgeons take the ABS Qualifying Exam (about 300 multiple-choice questions) and then the oral Certifying Exam, which requires a full medical license. Orthopedic surgeons pass ABOS Part I, then practice for at least 17 consecutive months and submit case lists before the Part II oral exam. Ophthalmologists take a written exam and an oral exam.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Manual dexterity

Surgeons tie sutures, handle laparoscopic instruments and work under microscopes where a millimeter matters.

Decision-making under pressure

Bleeding, an unexpected finding or a crashing patient forces a surgeon to change the plan in seconds.

Physical stamina

Long operations mean hours of standing and bending over the table, often after a night on call.

Team leadership

The surgeon directs nurses, technologists, residents and anesthesia staff, and a clear voice in the room prevents errors.

Clear communication with patients

Patients and families need to understand the risks, alternatives and recovery before they consent to an operation.

O*NET 31.0 rates these skills as most important for the occupation: reading comprehension, critical thinking, active listening, writing, speaking.

Training cost

$300K–$411K

Before financial aid

Time

13-15 years

Typical path

Median pay

$300,080

All US jobs: $50,980

Payback once qualified

1.2–1.6 yrs

Pay above the all-jobs median vs. cost

Low: AAMC median 4-year cost of attendance at a public medical school (Class of 2026), $297,745, plus MCAT registration $360 (2027 testing year) and USMLE Step 1 $695, Step 2 CK $695 and Step 3 $955 = $300,450. High: private-school median $408,150 plus MCAT $360 and COMLEX-USA Level 1 $745, Level 2-CE $745 and Level 3 $950 = $410,950. Cost of attendance includes living expenses. Not included: college costs, application and interview travel, state license fees and specialty board fees (for example $1,240 for ABOS Part I or $1,550 for the 2026-27 ABS General Surgery Certifying Exam). Residents are paid during training. Median federal loan debt for medical graduates in our data is $208,644.

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Orthopedic surgeon$358,550 median

  Requires a five-year orthopaedic surgery residency after medical school and ABOS Part I and Part II exams for certification.

• Obstetrician-gynecologist$292,910 median

  A surgical specialty with its own residency after medical school, covering cesarean births, hysterectomies and other gynecologic operations.

• Dermatologist (Mohs surgery)$328,730 median

  Dermatology residency, then a fellowship in Mohs micrographic surgery for skin cancer removal.

• Physician in a nonsurgical specialty$244,180 median

  Medical school graduates who decide against surgery can match into internal medicine, family medicine and other residencies.