Plastic Surgery was accredited as a residency at UTMB Galveston on November 30, 1949. It continued as an independent program for three residents yearly until converting to a five-year integrated program in 1998. Six years later, the residency program was approved for expansion to a six-year integrated program, to enhance education, and to meet new ACGME requirements. In 2014, the Plastic Surgery residency was expanded from three to four residents per year, corresponding to the increase in surgical volume at UTMB. Residents are primarily based at UTMB Galveston and at Shriners Hospital for Children Galveston, located across the street. Education and training take place in Galveston and at the off-island UTMB League City Campus. Our residents also rotate at Shriners Hospital Houston, St. Joseph’s Hospital, the University of Texas MD Anderson Cancer Center and in several affiliated private practice offices. While away at rotations in Houston, our residents can stay in a well maintained nearby 3-bedroom apartment for free. Residents experience progressive complexity of cases and independence as they rotate through the services. There are no Hand, Craniofacial or Microsurgery fellowships currently at UTMB, whereby giving residents even more responsibility and exposure. After the last site visit, Plastic Surgery at UTMB was afforded full accreditation, 4-year cycle, no citations. Many residents at UTMB have multiple publications during their residency. Residents are also active participants in regional and national plastic surgical societies, with presentations at many meetings. Residents also participate in committees of national plastic and hand surgery organizations. In addition, our residents have an educational fund and full access to numerous on-line versions of plastic surgical texts. Opportunities for overseas trips are also available. Many of our recent graduates have moved on to premiere fellowship programs in hand, micro and craniofacial surgery around the country.