jane, hoss is correct and you should still apply if you are interested. Many random factors come into play during the match.
If you plan on applying out of medical school you can apply to either a combined or integrated program. The overwhelming majority of programs are combined, meaning that you do 3 years (sometimes 4 or 2) of general surgery and then 3 years (or 2 in the case of a "4+2") of plastics.
I am currently at a combined plastics program.
Integrated programs (Michigan, Wisconsin, Loma Linda, MCW, Baylor, SIU) have tailored rotations for future plastic surgeons such as hand, ent, derm, etc. In my opinion, integrated programs are better for your sanity and overall training.
Fellowships are available after 3,4, or 5 years of general surgery training. These are generally 2 year positions and are competitive to obtain, although not as competitive as say, pediatric surgery.
Approximately 300 people applied for 70 combined/integrated positions when I was applying for the match. That's a successful match rate of <25%- which by the numbers, makes it statistically the most difficult match of any field out of medical school. Most of the people who matched were AOA, possessed good board scores and LORs. However, the interview is an extremely important factor for the match- and that is where luck and personality enter. I know candidates who were AOA from top 10 schools who didn't match into combined plastics spots whereas certain very personable students who didn't have the same credentials did. Therefore, you should certainly apply for the match, but with a viable backup. IMGs do match, but they typically have research and/or connections. Hope this helps and good luck.
