You have likely heard of many different kinds of medical specialists, such as neurosurgeon, plastic surgeon and orthopedic surgeon. What might surprise you is that general surgery is one of the highest paying medical specialties a doctor could pursue. Despite the word “general” in the title, general surgery is itself a medical specialty – one that encompasses numerous subspecialties. There are merits to careers in both specialized branches of surgery and general surgery, so neither option is necessarily better than the other. What the distinction comes down to is a difference between focusing on breadth and focusing on depth of surgical knowledge and scope.
What It Means to Be a Surgeon
In any surgical specialty, doctors utilize the techniques of surgery to treat a patient’s medical conditions. Surgery means using manual and instrumental means to manipulate the body and may include making incisions, scraping or abrading tissues, suturing incisions and other procedures. Patients are given medication, called anesthesia, to numb them during surgery so that they are not in pain when a procedure is being performed.
Modern medicine allows for minimally invasive surgeries that use incisions much smaller than traditional surgical cuts, endoscopic procedures performed with catheters inserted through the body’s natural openings and even procedures performed with laser technology.
A surgery can be planned weeks in advance or may be done on an emergency basis, such as when a traumatic injury occurs or a patient’s appendix ruptures. Although extensive surgeries are usually performed in a hospital, many procedures that are less invasive and carry fewer risks can be done on an outpatient basis in an ambulatory surgery center or even in a doctor’s office.
Surgical operations and procedures are performed for many reasons, from repairing damage to organs, bones and tissues in the body to removing cancerous tumors and growths. Some surgeries, like biopsies, are diagnostic, while many are a form of treatment.
The Broad Specialty of General Surgery
What is “general” about general surgery is the array of different body parts and systems on which the surgeon is qualified to operate. Just about any area of the body can fall under the purview of general surgery, according to the American College of Surgeons. Some of the many body parts a general surgeon may operate on include the skin, the head and neck, the soft tissues, the breasts, the abdominal wall, the gastrointestinal system, the vascular system, the endocrine system, the alimentary tract and the extremities.
Although the name “surgeon” focuses on the act of performing surgeries, that isn’t all a general surgeon does. In fact, general surgeons diagnose a patient’s problem, develop the treatment plan and provide preoperative care before the surgery, and they are also responsible for post-operative patient care. A general surgeon may also be in charge of the comprehensive treatment and management for critically ill or injured patients, although there are also specialists who work in acute care and trauma surgery.
Becoming a specialist in such a broad range of body parts requires a great deal of medical knowledge and technical skill. In fact, even though the field of general surgery does not seem as “specialized” as other surgical specialties of medicine, new doctors spend a minimum of five years in training after they complete their medical school studies just to become a general surgeon, the American College of Surgeons reported.
General surgery is one of 14 surgical specialties, others of which include pediatric surgery, plastic surgery, neurological surgery, vascular surgery, orthopedic surgery, cardiothoracic surgery, urology, gynecology and obstetrics, oral surgery and ophthalmic surgery.
Ways to Further Specialize in General Surgery
There are many benefits of specialization in the field of medicine, but there are also downsides. A general surgeon enjoys a lot more variety in their work than a specialist in urology, orthopedic surgery or plastic surgery, for example. Although more specialized surgical specialties are experts with a greater depth of knowledge and experience in a particular area of medicine, they are really good at a small area of medicine, while general surgeons are good at managing a much larger range of medical conditions.
Still, specialization doesn’t have to be an either-or choice. There are subspecialties within the field of general surgery that would allow you to have the best of both worlds. Choosing a subspecialty allows you to gain a broader knowledge base than doctors who pursue other surgical specialties but more depth of expertise in one area of general surgery than the typical general surgeon has.
By choosing to complete a fellowship after your residency, you can work in a subspecialty like breast surgery, colorectal surgery, hand surgery, transplant surgery, surgical critical care, surgical oncology and minimally invasive surgery.
General surgeons who complete a breast surgery fellowship will gain an in-depth background of performing surgery on the breast, breast imaging, pathology, reconstructive surgery, radiation oncology, and medical oncology. Taking on a cardiothoracic surgery fellowship allows general surgeons to acquire experience with heart and lung transplantations as well as ventricular assist devices and extracorporeal membrane oxygenations. A hand surgery fellowship will help develop a general surgeon into an effective hand surgeon.
To help patients recover faster, a general surgeon might want to take on a minimally invasive surgery fellowship. For general surgeons that want to work with children, a pediatric surgery fellowship could be beneficial. A surgical critical care fellowship will provide the tools to manage critically ill patients from all types of surgical procedures. For general surgeons who want to focus on the circulatory system, a vascular surgery fellowship would be the right choice.
Most fellowships in subspecialties of general surgery typically take one to two years to complete.