All a person needs is a medical degree. Doctors can choose to become certified by the American Medical Association--recognized American Board of Plastic Surgery. For that, they must complete seven years of training, including a three-year residency in general surgery and at least two additional years of a residency in plastic surgery. But many doctors don't bother with the special training and practice the surgery anyway to supplement their incomes. Only two of the five doctors in the fatal Florida cases were board-certified. The woman who died after a breast augmentation was operated on by a doctor who specialized in dentistry.