The Path to Becoming a Surgeon: Education, Training, and Essential Skills

Surgery is a challenging but rewarding medical specialty. Surgeons are medical professionals who perform operations to treat injuries, diseases, and deformities. These procedures can range from life-saving interventions to elective surgeries that improve patients’ quality of life. Surgeons are not only skilled in technical procedures but also adept at patient care, decision-making, and collaborating with multidisciplinary teams. The journey to becoming a surgeon is long and demanding, requiring extensive education, rigorous training, and the development of specific skills and personal qualities. This article explores the steps, requirements, and considerations involved in pursuing a career in surgery.

The Role of a Surgeon

Surgeons diagnose and manage a broad array of medical conditions before, during, and after surgery (preoperative, operative, and postoperative care), often as leaders of a team. General surgeons are like family doctors who can also do surgery, if necessary. They treat a wide variety of conditions, and that treatment includes a wide variety of procedures. Some of the conditions general surgeons treat include:

Traumatic injuries.
Physical abnormalities.
Breast cancer.
Conditions involving your upper GI tract (esophagus, stomach and small intestine).
Conditions involving your biliary tract (gallbladder, bile ducts, pancreas and liver).
Endocrine conditions (involving your thyroid or adrenal glands).
Vascular conditions (involving your blood vessels).
Critical illness and terminal illness.

General surgeons today train in the latest technology-assisted operative techniques, including:

Endoscopy.
Laparoscopic surgery.
Robotic surgery.

Essential Skills and Qualities

To excel in surgery, professionals must possess a blend of technical expertise and interpersonal abilities. Beyond the extensive formal education, certain inherent qualities and acquired skills are crucial for success in this demanding field.

Temperament: To be a surgeon you have to have the right temperament. One of these is the amount of pressure you can handle. Sometimes this has to be for hours straight. Not only are you always under pressure, you have to be consistent with your mind.
Communication skills: Physicians and surgeons need to convey information effectively to their patients and to other healthcare workers.
Compassion: Patients who are sick or injured may be in extreme pain or distress.
Detail oriented: Each and every person is a little bit unique. Nothing is ever the exact same, no matter what. He sees each patient has the exact same thing, but it is still different. unique voice and individual writing style.
Dexterity: Skill-wise, you need dexterity, physical stamina, attention to detail, and problem-solving to succeed in this occupation.
Leadership skills: Physicians and surgeons must coordinate with a team of other healthcare workers to manage patient care or direct medical procedures.
Organizational skills.
Patience.
Physical stamina: Physicians and surgeons may spend many hours on their feet, including walking between patient visits or procedures. Surgeries can take a long time, and the work hours required may be long. Emergencies are also a big part of surgical practice.
Problem-solving skills: Physicians and surgeons need to evaluate patients’ symptoms to determine appropriate treatment.
A love for and knowledge of anatomy: You must love and know anatomy because you have to know where things are and what they do.
Ability to work with people: You have to be able to work with people for hours straight.
Adaptability: Each and every person is a little bit unique. Nothing is ever the exact same, no matter what. He sees each patient has the exact same thing, but it is still different.

Educational Path: A Step-by-Step Guide

The journey for aspiring surgeons is long but structured. It typically takes 12-15 years to become a surgeon. This includes four years of undergraduate education, four years of medical school and 4-7 years of residency training. If you choose to pursue a fellowship for a subspecialty, it may add another 1-3 years to your timeline.

Step 1: High School Preparation

If you know you want to become a surgeon this early in the game, you should consider high school AP courses in subjects like chemistry, biology, and physics. If you can devote your time and effort to additional AP courses, AP anatomy or AP physiology would be helpful. Though challenging, they often are worth it because AP students can opt out of some similar introductory college courses.

Step 2: Earn a Bachelor’s Degree

Becoming a surgeon requires a bachelor’s degree. You can enroll in your school’s pre-med program. If your school does not have a pre-med program, you can still earn the credits you need to qualify for medical school.

Because surgeons need many science courses, many pre-med students major in a scientific field, such as biology, chemistry, or human physiology. You could major in a social science like public health or psychology instead, as long as you fulfill the prerequisite requirements for medical school.

Step 3: Gain Practical Experience in the Healthcare Field

Hands-on exposure through internships, shadowing, or volunteering in a healthcare setting is necessary to test-drive your chosen career. Additionally, medical schools only consider applicants if you have practical experience.

Taking a “gap year” between completing a bachelor’s program and starting a medical degree can build personal character and develop maturity and professionalism. Students should inquire through their bachelor’s program about potential medical assisting, critical care, or clinical internship placement after graduation.

Read also: Education for Plastic Surgery

Step 4: Pass the MCAT Exam

To go to medical school, you must first take the Medical College Admission Test (MCAT). The exam tests the skills of aspiring med students across four core concept areas:

Biological and biochemical foundations of living systems
Chemical and physical foundations of biological systems
Psychological, social, and biological foundations of behavior
Critical analysis and reasoning skills

The MCAT contains 230 multiple-choice questions and takes just over six hours to complete. You should take the MCAT the year before you plan to apply.

Step 5: Earn a Medical Degree

Once you take the MCAT, you can apply to medical school. Medical degree programs take four years. They train students in broad medical skills, introduce them to a variety of specialties through clinical rotations in their third year, and help students gain hands-on experience in their desired specialty.

First and Second Year: You spend the first two years focusing on labs and pre-clinical training in subjects such as microbiology, biochemistry, anatomy, pharmacology, and pathology.
Third Year: According to the American College of Physicians, you would transition from the classroom to clinical training. You have a schedule of rotations in various specialties and work alongside other healthcare providers as members of a patient care team. Attending physicians would supervise you as you gain hands-on experience in a variety of specialties and patient populations. Most programs recommend, but do not require, students take their rotations in a certain order.
Fourth Year: This year is typically less structured to provide more opportunity for students to hone their skills and take additional elective coursework. This is also when you would choose your specialty and apply to residency programs through the National Resident Matching Program (NRMP). March is Match Day, where you would learn where you would start your residency training.

Step 6: Prepare for Medical Licensure

Each state has their own rules for licensure, but many have a limited medical license that residency students can apply for directly after getting their residency match. This limited license allows practice under supervision.

While you’re not expected to have your medical license when your residency starts, you’ll need one by the time you conclude the residency. Once you know your residency match, your program may have its own licensure path. The two most common licensing exam pathways are the United States Medical Licensing Examination (USMLE) and the Comprehensive Osteopathic Medical Licensure Examination (COMLEX). DO students take the (COMLEX). Both are similar in structure, but the COMLEX also includes osteopathic manipulation questions.

Read also: Guide to Orthopedic Surgery

Both licensing exams are composed of three steps:

Step 1 typically occurs during the second year of medical school and covers the fundamental science for the practice of medicine.
Step 2 occurs during the third or fourth year and is more specific to clinical skills and clinical knowledge gained during rotations
Step 3 is more comprehensive and detailed in the practice of medicine. You would complete it in the first or second year of residency after graduating from medical school.

You can take each step a limited number of times. For instance, If you have attempted a step four or more times and do not pass, you are ineligible to apply for any other steps in the USMLE sequence. You must pass Step 3 before applying to any State Medical Board

*There will be extra steps and fees if you’re a graduate of a medical school outside the United States.

Step 7: Complete a Residency Program

Most surgeons complete a general surgery residency after they finish medical school. “Residency is where you learn the specialty that you decided to go into,” said board-certified general and colorectal surgeon Dr. Kyle Eldredge. “How long it is depends on which residency you go into. For general surgery, it’s five years.”

Some specialties like obstetrics start their surgical residency in their specialty. Accredited surgical residency programs cannot require residents to work more than 80 hours a week. An important thing to keep in mind is that programs in surgical specialties can apply for an extension to increase the weekly limit to 88 hours.

To get into a surgical residency program, you’ll participate in an algorithm-like process that matches you to a residency program. Most students begin applying to residencies in their final year of medical school, but the American Colleges of Surgeons recommends you familiarize yourself and start some steps of the process in your third year. A residency helps surgeons refine their acute operating skills and on-the-spot decision-making abilities. Surgical residencies last a minimum of five years, unless you go into dental or eye surgery.

Step 8: Begin a Fellowship Program

A fellowship helps surgeons gain experience in their chosen surgical specialty. Hospitals offer fellowships in surgical specialties like orthopedic, plastic, cardio-thoracic, and neurological surgery.

“The fellowship is the more specialized version of general medicine or general surgery,” said Eldredge. “The fellowships are different lengths: Colorectal surgery is one year; cardiac surgery is two years. Cardiothoracic surgery is three years; plastic surgery is three years. So my training ended up being a total of six years. I could have just done my five years of general surgery, finish, and become a board-certified general surgeon. Instead, I decided to do specialty training, which is what a fellowship is.” Candidates can apply directly to some colleges or search for fellowships through an agency like the Fellowship Council.

Step 9: Become Board Certified in Your Surgical Specialty

Board certification is different from earning a medical license. Board certification is specialty-specific and not required by law, but medical licenses are a general requirement to legally practice medicine across specialties.

Board certification is regulated by the American Board of Medical Specialties (ABMS) and includes 24 medical and surgical specialty boards. While surgeons may be able to get a job as a board-eligible surgeon, most reputable employers require surgeons to become board certified in a timely manner after they finish residency.

When applying, surgeons must provide detailed documentation of their training and operative experience. Additionally, the director of their training program must also attest to their surgical skills, ethics, and professionalism. If the application is approved, the surgeon may take the required exam for certification for their board.

The ABMS sets the eligibility criteria that physicians must meet to take certifying examinations in their specialty. To qualify, surgeons must meet the following requirements:

Be graduates of an accredited medical school or have a certificate from the Educational Commission for Foreign Medical Graduates.
Complete about five years of residency in their specialty from a program approved by the Accreditation Council for Graduate Medical Education or the Royal College of Physicians and Surgeons of Canada.
Acquire extensive operative experience and a vast knowledge of disease management within their specialty.

Financial Considerations

Pursuing a career in surgery involves significant financial investment.

Students must pay $335 to register for the MCAT before applying to medical school. Applying to medical school requires an initial $175 application fee and $45 per additional school.
Once enrolled in a medical degree program, students at public colleges paid an average of $40,493 in first-year in-state tuition, fees, and health insurance. Out-of-state students paid an average of $64,473 to attend a public university.

Compensation

Across the spectrum of medical specialties, the top six highest-paid medical specialties are all surgical specialties. Among the top-paid surgical specialties, neurosurgeons are the top earners and also have the longest residency. This reflects the dedication and expertise required.

General Surgeon

A general surgeon is a doctor and a surgeon who’s trained to care for the whole patient in all the ways necessary, including surgery. They diagnose and manage a broad array of medical conditions before, during and after surgery (preoperative, operative and postoperative care), often as leaders of a team. General surgery is one of 14 surgical specialties recognized by the American College of Surgeons. While some surgical specialties focus on the technicalities of the heart or brain, a general surgeon is more likely to operate on your abdominal organs or musculoskeletal system, or take care of multiple injuries.

General surgeons study the nine principal components of general surgery, which include:

The gastrointestinal tract.
The abdominal and pelvic organs.
Breasts, skin and soft tissues.
Head and neck.
Cardiovascular system.
Endocrine system.
Surgical oncology (cancer treatment).
Trauma (including musculoskeletal, head and hand injuries).
Critical care and emergency surgeries.

During training, general surgeons must spend at least four-and-a-half of their five years working with patients. At least three years must be concerned with the nine principal components of surgery. They can’t spend more than 12 months in any surgical specialty or six months in any nonsurgical discipline.

Once a general surgeon is in practice, the procedures they routinely do may vary, depending on where they work. Some larger medical centers might delegate certain procedures to surgical specialists. In centers that don’t have as many specialists, general surgeons might do more of everything.

Some of the common surgical procedures you might expect a general surgeon to perform include:

Appendectomy (for appendicitis).
Cholecystectomy(for gallstones).
Gastric bypass surgery (a weight loss procedure).

Methods in Surgery

General surgeons today train in the latest technology-assisted operative techniques, including:

Endoscopy.
Laparoscopic surgery.
Robotic surgery.

Endoscopy

Endoscopy allows a surgeon to perform small operations without cutting through your skin or tissues. Instead, they operate with long, narrow tools through an endoscope, a long, flexible tube with a video camera on the end. The endoscope enters your body through your throat (upper endoscopy) or through your anus (colonoscopy). It projects video to a screen, and your surgeon operates guided by the screen.

Common endoscopic surgery procedures include:

Removing polyps or tumors (polypectomy).
Removing tissue samples (biopsy).
Cutting into a clenched muscle to release it (myotomy).

Laparoscopic surgery

Laparoscopic surgery is a minimally invasive surgery technique. A surgeon accesses your abdominal organs through small “keyhole” incisions no more than half an inch long. They place a laparoscope, which is a type of endoscope, through one of the holes to visualize the space. The camera projects to a screen, and the surgeon operates with long, narrow tools through another hole, guided by the screen.

Robotic surgery

Robotic surgery is a type of laparoscopic surgery. It uses a laparoscope and long, narrow tools through small keyhole incisions. The difference is that robotic arms operate the tools. The surgeon operates the robotic arms from a computer console within the operating room.

The Rewards of a Surgical Career

Pursuing a career as a surgeon offers profound personal and professional fulfillment. The profession challenges individuals to continually learn, master advanced techniques and contribute to medical innovation. Additionally, surgery is not just about technical skill but also about earning the trust of patients and their families, as you guide them through some of the most critical moments of their lives. One surgeon said he likes being a surgeon because most surgical problems can be removed, and the patient can be cured. This is different from other patients who have something like diabetes, where you might treat for years, but they are rarely cured.

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