Training to become a plastic surgeon is a difficult task. To become board certified by the American Board of Plastic Surgery a physician must complete a specialized post-graduate training course of five to seven years. Background training usually includes a thorough grounding in general surgery however, a background in ENT or orthopedics may be acceptable. The final two to three years of training must be in an approved plastic surgery training center. Prior to official certification by the American Board of Plastic Surgery the physician must pass a rigorous set of both written and oral examinations. While numerous physicians use the term “plastic” surgeons only those certified by the American Board of Plastic Surgery are true plastic surgeons.