How To Become A Surgeon – Welcome to our second installment of the So You Want to Be series: So You Want to Be a SURGEON. In this series, we focus on a specific specialty or type of healthcare provider, explaining not only what it means to be that type of provider, but also how to become one. If you would like to help us decide which specialty or healthcare provider to cover next, please leave a comment below with your request.
If you are thinking about becoming a surgeon and want to know what it would entail and whether you want it, then this post is for you. I’ll walk you through the history, types, and responsibilities of a surgeon, to help you decide if they’re right for you!
How To Become A Surgeon
Story. So pay attention. The history of addiction is a fascinating one, and my medical school actually gave us a copy of Anatomy of Addiction to read before we started our first year. This is one of my favorite medical books, about Dr. William Halsted and the Birth of Modern Surgery, and if you’re interested in any specialty in surgery, definitely check it out.
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Until the 19th century, surgeons were trained simply through apprenticeship: there were no formal specialist courses like today. The length of training can vary, usually for 5 to 7 years and starting around age 12 or 13. That’s right, imagine a tweenie opening up to you and being thankful that you live in the 21st century.
In 1890 introduced Dr. William Osler of Johns Hopkins introduced the concept of clinical internships and bedside tables to teach his medical students, which is the practice today. In the early 1900s, Dr. William Halsted to Baltimore and was named the first chief of surgery at Johns Hopkins. The modern practice and training of surgery can be largely attributed to the rectal-emptying, cocaine-addicted, incredibly strong Dr. Halsted.
Not only did he create the first formal surgical training program in the United States at Johns Hopkins, he also pioneered many other aspects of modern surgery that we take for granted today. His advances have led to new techniques and tools to reduce tissue and vascular damage, such as different types of forceps, sutures and bandages. He was also the first to introduce rubber gloves into the operating room and was the father of modern surgical hygiene. We call many of his lasting effects the Halsted Principles, including modern techniques of bleeding (ie, controlling bleeding), careful anatomical dissection, complete sterility, and gentle manipulation of tissue. If you’ve ever had surgery, or even a minor procedure with local anesthesia, you can thank Dr. Halsted for not being a barbaric disaster.
There is a wide range of surgical subspecialties, and there is no perfect agreement on what constitutes a surgeon. Let’s start with the more traditional surgeries.
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The crux of the matter is obviously general surgery, which was originally the broadest surgical category. However, over the decades, it has mostly been referred to actions in the gastrointestinal tract, or digestive system and endocrine system. In school and within medical school, we joke that general surgeons are the real masochists, as their lifestyles are nothing to envy, they don’t make as much money as other specialists, and they deal with some of the least desirable and smelly pathologies. deal with abdominal contents and faeces. Seriously, this is a really great specialty and I know some great general surgeons, like Drs. David Hindin who gave me some insight into general surgery when he wrote this post. Be sure to check out his YouTube channel.
Residency in general surgery takes 5 years, after which you can specialize further. Colon surgery lasts for one year and deals with diseases such as colon cancer or inflammatory bowel diseases. Minimally Invasive Surgery also lasts a year and focuses on procedures like laparoscopic surgery that are less invasive than traditional open abdominal surgery. Transplant operations last 1-2 years and are most often focused on kidney and liver transplants, but also pancreas transplants and access procedures such as dialysis fistulas and peritoneal dialysis catheters. Surgery takes 1 year and focuses on patients who are most medically unstable and require urgent surgery. Pediatric surgery lasts for 1-2 years, with a focus on surgery on infants and children obviously. Vascular surgery is also a 1-2 year fellowship, which deals with procedures on the aorta, carotid arteries, varicose veins, dialysis access or other procedures related to the arteries and veins.
Surgical oncology lasts for 1 year and deals with tumor diseases, i.e. excision or excision of the tumor. Breast surgery lasts 1 year and focuses on breast cancer and other breast diseases. Oncologists and breast surgeons remove the tumor, but do not cover the defect themselves. They turn to plastic surgeons for complex coverage and reconstructions. Plastic medicine is moving towards integrated specialization, which means 6 years of specialized plastic medicine training after medical school. However, there are some more traditional independent ways, viz. 3 years in plastic surgery after completing 5 years in general surgery. Cardiac and thoracic surgeries last 2-3 years, with an emphasis on cardiac and thoracic surgeries, but there is also an integrated route which, like integrated plastic surgery, lasts 6 years. Fellowships in hand surgery last for one year, although only a small proportion of practicing hand surgeons take this route after general surgery. Over 90% of hand surgeons first completed a residency in orthopedic surgery or plastic surgery and then attended the 1-year fellowship. This was the path I was going to take after I finished plastic surgery, but I said YOLO and quit in 2018.
There are other areas where surgery is done, but some surgeons would not call it surgery in the traditional sense. OB-GYN doctors perform procedures like C-sections, which are less sophisticated, much rougher, and much less complicated than standard surgeries. That said, OB-GYN doctors also perform hysterectomies, or surgical removal of the uterus, and other gynecological and oncological procedures that certainly count as surgery. Another specialty of surgery that is not actually surgery is ophthalmology. We generally believe that ophtho is more of a methodological specialty than a surgical subspecialty.
How To Become A Surgeon
When I entered medical school, surgery was not on my radar. I was fascinated by the idea of being a gastroenterologist and helping children suffering from inflammatory diseases and similar diseases. I always knew I wanted to work with my hands, because it’s something that comes naturally to me and I really enjoy it, but I quickly realized that gastroenterology is not as complex, colorful or varied as I wanted. I couldn’t imagine making sense for the rest of my career. The complexity and excitement of surgery, on the other hand, is unmatched. After seeing my first case, a neuroplastic surgery case where we created a temporary biceps from someone’s latissimus dorsi, I was fascinated. I couldn’t believe it was reality and not science fiction. If you want to hear the whole story, I talk about why I chose plastic surgery, including this amazing first case I saw, on Kevin Jubbal, M.D. my YouTube channel.
If you enjoy working with your hands and enjoy complexity, challenge and nuance, surgery may be a good fit for you. Other specialties may include procedures, such as endoscopy in gastroenterology or skin incisions in dermatology, but they certainly have nothing to do with surgery. Comparing these simple procedures to surgery is like comparing a self-driving car with paddle shifters to a real car with a manual transmission. Not that one is better than the other. It’s not really a comparison.
Another thing that comes to light is a person’s dexterity. After all, surgeons must be incredibly skilled to perform at the highest level. There are two things to say about this. First, having terrible dexterity and being incredibly clumsy has a limiting factor for some people in being able to complete residency, but that’s pretty rare. In most cases, they can learn to be more efficient and effective with their hands and surgical instruments. That said, being competent and deliberately working at it years before you first step into the operating room will serve you well. I attribute much of my dexterity to building small cars as a child, doing artistic pursuits, and even playing video games. In medical school, I was very disciplined in reading about the proper techniques for suturing, tying, and other basic operations, and I practiced religiously at home or even while listening to a lecture. I brushed my teeth and opened doors with my left hand, a habit I still practice today. This type of dedication served me well, as participants noted that I worked several years beyond my training level. In fact, the president of a very prestigious plastic surgery department even said I was performing a second or third year residency while I was a fourth year medical student. By demonstrating competence, you gain the trust of the participants and
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