Alright ... I had to comment on a few things here:
As has been said, it is competitive to get into plastic surgery as an MD but near impossible as a DO. The few that get those spots probably have strong connections.
Unfortunately, I think this makes a great deal of sense. DO are specially trained in the musculoskeletal system and to view the body as a whole. This perspective and training comes in handy in fields like orthopedics and anesthesiology. However, plastics has very little to do with this. I would think that allo school would be a better choice for what you want to do.
I think this is a misconception on two fronts:
first, the 'philosophy' and additional training endowed in Osteopathic medicine does not mean much to a lot of students at DO schools (take that anyway you'd like). In many cases, medical students are striving for the end goal - plastic surgeon, emergency med doc, dermatologist, etc, and few (though some) look toward the different training models for inspiration/guidance along the way. So, saying that the DO model offers something that would 'discourage' (in a sense) a career in plastics isn't accurate.
However, (second) let's look at some of your claims and see if they make sense or actually say the opposite:
You bring up the tenets of Osteopathy - the body is an interrelated unit, structure influences function, the body (when healthy) is able to self-regulate/maintain a level of homeostatsis, and 'rational treatment' is based of a cumulation of these ideas. So, the body is an interrelated unit and structure influences function. Okay; so if this structure, which we know is interrelated, is impeded or lessened by say trauma, a birth defect, etc, wouldn't restoring this proper structure through ... I dunno, reconstruction, allow for a proper return to a level of homeostasis?
My grandfather was in a bad car accident and suffered third degree burns on his chest, neck, and arms a few years back. I can tell you first hand that the level of 'dysfunction' created by a loss of skin and poor scarring highly reduced the structure, which took away functions like fighting off diseases, simply staying hydrated, limb movement, etc, and that fixing these issues restored the function and brought his body back to some level of homeostasis.
Furthermore, you discuss some of the musculoskeletal/OMM techniques covered in DO school. I don't want to speak for all schools, but I know that where I attend, we continually work with visual and palpatory models that test our perception, visual precision, and sense of symmetry down to 1-2mm. The 'art' of plastic surgery is often measured in these small increments, and I honestly would see any type of exercise that honed my reflexed at this level as an attribute to this.
Now, in a realistic sense, MD schools/hospitals will give you an excellent base for entering plastic surgery. In VARIOUS cases, in fact, the available research opportunities, affiliated with trauma centers, etc, will probably actually give more experience and help you network and sink your teeth into the plastic surgery world as soon as possible.
I guess my point is that the model you train in really isn't going to make any sort of philosophical difference, and that dismissing DO training as 'not suited' for plastic surgery is silly (and, as I pointed out, kind of inaccurate).
You guys are mostly on but you're missing one huge detail. Talk to anyone from the various plastic surgery professional associations and they'll all tell you the same thing: if plastics is all youve ever wanted to do all your life, do the AOA spots and be the best so you'll get them since the best 100 (or whatever) MDs will get the ACGME spots every time. BUT!!! They say if you aren't the top 7 candidates in america, dont worry....
wait for it....
plastics is actually *very* easy to get into as a fellowship.
go ahead. Tell me i'm wrong. call bs. ask any plastic surgeon. They'll tell you the same thing. I'm interested in plastics, i've talked to them ad nauseum about it. You need to be 1) better than most at surgery and 2) extremely creative/quick on your feet. From what Ive been told the plastic surgery fellowships out there sometimes (not always) dont even fill 100% because the amount of people who show interest and have sufficient manual dexterity usually is smaller than the number of fellowship spots out there.
Every plastic surgeon i've talked to (prob 10 now) said that exact same thing. The plastics residency is the most elite thing in existance and based wholly on your intelligence. The fellowship doesn't give a damn about your intelligence, they want people who can think on their feet exceptionally and wont make dumb mistakes during surgery.
They figure if youre even 'just barely above average' they can teach you to be an expert plastic surgeon, but they cant teach someone how to be artistically creative with the surgery, as is often required. Note: I'd still tell you to be as good of a candidate as you possibly can in every single way. But I'm going to dispel the ridiculous myth that the plastics fellowships are anything like the plastics residency. They target two polar opposite kind of people. The geniuses and the people who would actually make good plastic surgeons, respectively.
I've spoken to two residents (actually one resident, one getting ready to enter surg) about this issue (a while back I was interested in PRS, but don't think so anymore) and this is what they had to say:
The first surgical resident told me that in the AOA world it's all about 'who you know' and that the sheer numbers can be misleading. For example, he did some research and found out that although each program (AOA) is listed as taking a certain number of surgeons each year, some years, if they don't feel like it, they don't take any. So I think the idea of 'programs not filling' is kind of a myth because from what he told me, it's because the programs don't want to fill.
Additionally, it seems like to be considered, you almost have to do your g-surg at a program with a PRS fellowship. Obviously, this is going to cut the numbers down again.
Gotcha, ok well even if half of every AOA surgery residency graduating class wanted to go into plastics that would bring us back to our 1:4.
Like DocEspana mentions it doesn't seem that hard if you're willing to risk the fellowship route.
I think it's still quite competitive, even if you do finish five years of g-surg. PRS, altogether, is probably the most competitive thing all around right now. Whether its ACGME integrated, ACGME fellowship, or AOA fellowship, if you want plastics, be prepared to be smart, work hard, network a LOT, and do g-surg in a place with a fellowship.
Just my .02
