Surgeons are physicians who make diagnoses and provide preoperative, operative, and postoperative care in surgery affecting almost any part of the body. These doctors also work with trauma victims and the critically ill. Approximately 52,930 surgeons are employed in the United States.
History of Surgeon Career
Surgery is perhaps the oldest of all medical specialties. Evidence from Egypt, Greece, China, and India suggests that humans have always performed and worked on developing surgical procedures.
The field of surgery advanced during the 18th century when knowledge of anatomy increased through developments in pathology. At this time, common procedures included amputations as well as tumor and bladder stone removal. Surgery patients were usually tied down or sedated with alcoholic beverages or opium during the procedures.
The late 19th century brought major developments that advanced surgical procedures. Anesthesia was introduced in 1846. Also, Louis Pasteur’s understanding of bacteria later resulted in the development of antiseptic by Joseph Lister in 1867. The introduction of anesthesia coupled with the use of antiseptic methods resulted in the new phase of modern surgery.
Surgical advances during the 20th century include the separation of surgical specialties, the development of surgical tools and X rays, as well as continued technological advances that create alternatives to traditional procedures, such as laproscopic surgery with lasers.
The Job of Surgeons
The work of a surgeon will vary according to his or her work environment and specialty. For example, a general surgeon who specializes in trauma care would most likely work in a large, urban hospital where he or she would spend a great deal of time in the operating room performing emergency surgical procedures at a moment’s notice. On the other hand, a general surgeon who specializes in hernia repair would probably have a more predictable work schedule and would spend much of his or her time in an ambulatory (also called outpatient) surgery center.
The surgeon is responsible for the diagnosis of the patient, for performing operations, and for providing patients with postoperative surgical care and treatment. In emergency room situations, the patient typically comes with an injury or severe pain. If the patient needs surgery, the on-duty general surgeon will schedule the surgery. Depending on the urgency of the case, surgery may be scheduled for the following day, or the patient will be operated on immediately.
A surgeon sees such cases as gunshot, stabbing, and accident victims. Other cases that often involve emergency surgery include appendectomies and removal of kidney stones. When certain problems, such as a kidney stone or inflamed appendix, are diagnosed at an early stage, the surgeon can perform nonemergency surgery.
There are several specialties of surgery and four areas of subspecialization of general surgery. For these areas, the surgeon can receive further education and training leading to certification. A few of these specializations include neurosurgery (care for disorders of the nervous system), plastic and reconstructive surgery (care for defects of the skin and underlying musculoskeletal structure), orthopaedic surgery (care for musculoskeletal disorders that are present at birth or develop later), and thoracic surgery (care for diseases and conditions of the chest). The subspecializations for general surgery are: general vascular surgery, pediatric surgery, hand surgery, and surgical critical care.
Surgeon Career Requirements
Training to become a surgeon or physician is among the most rigorous of any profession, but the pay is also among the highest. To begin preparing for the demands of college, medical school, and an internship and residency in a hospital, be sure to take as many science and mathematics courses as possible. English, communication, and psychology classes will help prepare you for the large amount of reporting and interacting with patients and staff that surgeons do on a daily basis.
Many students who want to become a physician or surgeon enroll in premedical programs at a college or university. Premedical students take classes in biology, organic and inorganic chemistry, physics, mathematics, English, and the humanities. Some students who major in other disciplines go on to pursue a medical degree, but they generally have to complete additional course work in math and science. All students must take the standardized Medical College Admission Test (MCAT) and then apply to medical schools to pursue the M.D. degree. Note than medical school admissions are fiercely competitive, so developing strong study habits, attaining good grades, and pursuing extracurricular activities are all important characteristics for a medical school applicant to have.
Physicians wishing to pursue general surgery must complete a five-year residency in surgery according to the requirements set down by the Accreditation Council for Graduate Medical Education.
Throughout the surgery residency, residents are supervised at all levels of training by assisting on and then performing basic operations, such as the removal of an appendix. As the residency years continue, residents gain responsibility through teaching and supervisory duties. Eventually the residents are allowed to perform complex operations independently.
Subspecialties require from one to three years of additional training.
Certification and Licensing
The American Board of Surgery Inc. administers board certification in surgery. While certification is a voluntary procedure, it is highly recommended. Most hospitals will not grant privileges to a surgeon without board certification. HMOs and other insurance groups will not make referrals or payments to a surgeon without board certification. Also, insurance companies are not likely to insure a surgeon for malpractice if he or she is not board certified.
To be eligible to apply for certification in surgery, a candidate must have successfully completed medical school and the requisite residency in surgery. Once a candidate’s application has been approved, the candidate may take the written examination. After passing the written exam, the candidate may then take the oral exam.
Certification in surgery is valid for 10 years. To obtain recertification, surgeons must apply to the American Board of Surgery Inc. with documentation of their continuing medical education activities and of the operations and procedures they have performed since being certified, and submit to a review by their peers. They must also pass a written exam.
Certification is available in a number of surgical specialties, including plastic surgery, colon and rectal surgery, neurological surgery, orthopaedic surgery, and thoracic surgery. The American Board of Medical Specialties and the American Medical Association (AMA) recognizes 24 specialty boards that certify physicians and surgeons.
All physicians and surgeons must be licensed by the state in which they work.
To be a successful surgeon, you should be able to think quickly and act decisively in stressful situations, enjoy helping and working with people, have strong organizational skills, be able to give clear instructions, have good hand-eye coordination, and be able to listen and communicate well.
Exploring Surgeon Career
If you are interested in becoming a surgeon, pay special attention to the work involved in your science laboratory courses. Obviously, working on a living human being is a much weightier prospect than dissecting a lab sample, but what you learn about basic handling and cleaning of tools, making incisions, and identifying and properly referring to the body’s structures will prove invaluable in your future career. Also ask your science teacher or guidance counselor to try to get a surgeon to speak to your biology class, so that he or she can help you understand more of what the job involves.
Almost half of all licensed physicians and surgeons in the United States work in private solo or group practices. Another quarter work for hospitals, and others work for federal and state government offices, educational services, and outpatient care facilities. The New England and Mid-Atlantic states have the most physicians and surgeons per capita, and the South-Central states have the least.
Many new physicians and surgeons choose to join existing practices instead of attempting to start their own. Establishing a new practice is costly, and it may take time to build a patient base. In a clinic, group practice, or partnership, physicians share the costs for medical equipment and staff salaries, and of establishing a wider patient base.
Surgeons who hope to join an existing practice may find leads through their medical school or residency. During these experiences, they work with many members of the medical community, some of whom may be able to recommend them to appropriate practices.
Another approach would be to check the various medical professional journals, which often run ads for physician positions. Aspiring physicians can also hire a medical placement agency to assist them in the job search.
Physicians who hope to work for a managed care organization or government sponsored clinic should contact the source directly for information on position availability and application procedures.
According to the U.S. Department of Labor, surgeons with over a year of experience made median salaries of $282,500 in 2004. Even the lowest-paid 10 percent of surgeons earned incomes over $116,500. Incomes may vary from specialty to specialty. Other factors influencing individual incomes include the type and size of practice, the hours worked per week, the geographic location, and the reputation a surgeon has among both patients and fellow professionals.
Surgeons work in sterile operating rooms that are well equipped, well lighted, and well ventilated. They meet patients and conduct all regular business in clean, welllit offices. There are usually several nurses, a laboratory technician, one or more secretaries, a bookkeeper, and a receptionist available to assist the surgeon.
General practitioners usually see patients by appointments that are scheduled according to individual requirements. They may reserve all mornings for hospital visits and minor surgery. They may see patients in the office only on certain days of the week. General practitioners may also visit patients in nursing homes, hospices, and home-care settings.
Most surgeons work 60 or more hours a week.
Surgeon Career Outlook
The wide-ranging skills and knowledge of the surgeon will always be in demand, whether or not the surgeon has a subspecialty. According to the Occupational Outlook Handbook, physician jobs, including surgeons, are expected to grow about as fast as the average through 2014. But, many industry experts are now predicting a shortage of general surgeons in the next decade as more students enter nonsurgical specialties, such as anesthesiology and radiology, which require less intensive training. Because of the growing and aging population, more surgeons will be required to meet medical needs.