Background This study evaluates the influence and longevity of a microsurgery course on the future careers of medical students over a period of up to 10 years. The course, which has been well-established for over 15 years, aimed to impart fundamental microsurgical skills through practical exercises using non-biological and biological models. Material and methods This study was conducted as an anonymous online cross-sectional survey. Only students who have completed a microsurgical training course at our department within a ten years period between 2013 and 2023 were eligible for this online survey. This survey aimed to analyze the subjective microsurgical skills at the time of the survey and the influence of the course on further career decisions and development. Results 300 former participants were eligible and 120 answered the survey. Key findings showed that 99.2% of participants rated the course content and the balance of practice to theory as appropriate, with 100% feeling confident in their microsurgical suturing abilities post-course. A significant 87.5% felt competent to perform vascular anastomoses, though only 63.9% felt confident about nerve coaptation. Statistical analysis indicated no significant gender differences in course evaluations, though some differences were noted between semester-accompanying and block course participants. 54.2% of respondents reported using their microsurgical skills in their subsequent medical careers, and 50.4% indicated that the course influenced their medical specialization choices. Conclusions The study concludes that early exposure to microsurgical training can significantly impact students' skills and career trajectories, supporting the integration of such courses into medical education curricula to enhance surgical training and professional development.