I don't know that I'd like it, but whether or not I have a chance at both getting into a general surgery residency, and further plastic surgery are things I have to think about right now for some choices.
From what I have seen maybe only a handful of people from even the big foreign schools come to the US to do a residency in anything but family or internal medicine. My friends who have clean records and got into US and Canadian schools have shown me their graduating class info and MOST of them are doing non-primary care.
So with that in mind all I can see is that it will be next to impossible for me to get into plastic surgery the traditional way and if all I want to do is breast augmentations instead of major reconstructions then...
The traditional way is to do GS followed by additional plastics training. There are Caribbean grads who match into GS every year; depending on your application, you may be one of them. Then again, you may not.
And whether or not you do breast augmentation rather than "major reconstruction" the fact remains that you are not taught to do either in GS or any other residency, so my comments above about credentialing, malpractice and the feasibility of doing the work without PRS training still stand.
IMHO, what you need to do is stop focusing on doing on breast augs and decide whether or not you want to be a surgeon or not. If you do, then work your hardest to match into the best GS program you can get into. Decide whether its worth trying for more than 1 year to do so.
The people that are the most disappointed in medicine are those who have blinders on (ie, "I will die if I'm not a dermatologist/plastic surgeon/Interventional Neurorads, etc.") and then fail to meet those goals. Every year we see it on SDN, so med or pre-med student claims they will drop out if they don't match into specialty X. Life is not fair and sometimes we have to make choices.
So if you will be unhappy unless you are doing breast augmentations and don't think you will match into GS, I would encourage you to revisit your goals and motivations for medicine. Be realistic about your chances but I almost always encourage students to at least try and match into their dream speciality, because you'll never know unless you try.
That being said, you have to decide whether or not you want to be a surgeon because there may be a realistic chance that you won't get into PRS training or that you can't get credentialed or insured to do breast augs (although anything is possible - I was talking with my new trainer this morning - his wife works for a local Ob-Gyn who promotes himself as a cosmetic surgeon doing "natural augmentations", Smart Lipo, etc. He lost his hospital privileges for doing things outside of his scope of practice and now does all of his operating in his office.
) and then you are stuck with your GS residency training and not wanting to be a surgeon (that is if you can stand the residency - most people who don't really want to be surgeons cannot).
