How to Become a Surgeon

Overview

By Sarah Maurer
Surgeon in the operating room

Surgeons use both their hands and specialized instruments to treat illnesses and injuries. To access body structures, they must cut through the patient's skin and other body tissues. This is done while either the patient is unconscious (general anesthesia) or the area being treated is numbed (local anesthesia).

Patients might need surgery in order to:

  • Treat an acute (sudden, severe) condition such as appendicitis or trauma
  • Restore lost function (for example, by replacing a damaged hip joint with an artificial one)
  • Improve appearance (also called plastic or reconstructive surgery)
  • Confirm a medical diagnosis
  • Close a wound.

Like all physicians, surgeons also examine and assess patients; order and interpret diagnostic tests; and educate patients about health and wellness.

Surgery is a medical specialty that has many subspecialties. Examples include:

  • Oral and maxillofacial surgery
  • Orthopedic (bone) surgery
  • Neurosurgery (brain and spinal cord)
  • Cardiothoracic (heart and lungs) surgery
  • Cosmetic (appearance-enhancing) surgery
  • Oncological (cancer) surgery.

One especially rewarding aspect of surgery is that it produces fast, visible results. In a matter of hours, surgeons can remove deadly cancers, correct deformities, restore circulation, and close gaping wounds. Surgeons also enjoy considerable excitement and variety in their practice, with each day bringing new challenges. In addition, the team-based nature of the surgical practice breeds camaraderie and offers opportunities for leadership.

Work Environment

About two-thirds of surgeons are employed by hospitals or physician groups. A significant number are self-employed, either as solo practitioners or partners within a group practice. About 3 percent work in educational settings such as universities and medical schools.

A general surgeon typically works 50 to 60 hours per week. Surgeons also must spend time "on call" during evenings, weekends, and holidays in case an emergency arises. Most surgeons divide their time between their offices, hospitals, and outpatient surgery centers.

Surgery is a very interactive specialty. In the operating room, surgeons lead a team that may include anesthesiologists, nurse anesthetists, surgical technicians, and surgical nurses. Some also supervise the medical assistants and administrative staff who work in their offices.

Because surgical technology advances rapidly, surgeons are constantly upgrading their skills. Regular training in the latest tools and techniques is an essential. Surgeons must also be comfortable with technology and able to adapt as it evolves.

Surgery requires considerable stamina. Surgeons may stand and bend for several hours at time during an operation. Like all healthcare professionals, surgeons are at increased risk for contagious diseases, including bloodborne ones like hepatitis and HIV infection. To ensure their safety, they must use personal protective equipment and exercise caution when handling biological waste.

Requirements

Education

The typical path to becoming a surgeon follows these steps:

  • Undergraduate education
  • Medical school
  • Residency
  • Fellowship (for subspecialists)
  • Licensure
  • Board certification.

Students interested in a career in surgery should begin their preparation in high school. Taking advanced math and science courses is a good idea. Earning college credit through an AP, IB, and dual-option programs may allow you to advance more rapidly into higher-level science classes once you reach university.

Beginning in high school and continuing through college, it's important to demonstrate your interest in and passion for a career in medicine. Look for opportunities to shadow a doctor, work in a lab, conduct research or volunteer at your local hospital. Many universities offer summer enrichment programs for high school students pursuing medical careers.

You don't need a particular college major to apply to medical school, but you will need to take certain classes to fulfill the prerequisites:

  • One year of biology
  • One year of physics
  • One year of English
  • Two years of chemistry (including organic chemistry).

Some medical schools have additional prerequisites. Links to schools' admissions requirements can be found on the Association of American Medical Colleges (AAMC) website. Two detailed medical school guides are also available:

  • Medical School Admissions Requirements (MSAR) by AAMC for Medical Doctorate (MD) programs.
  • Osteopathic Medical College Information Book by American Association of Colleges of Osteopathic Medicine (AACOM) for Doctor of Osteopathy (DO) programs.

One year before you plan to enter medical school, you should take the Medical College Admissions Test (MCAT), a standardized assessment of problem solving ability, critical thinking, and knowledge of natural and social science concepts.

Medical school admissions are based on a number of factors, including grade point average, MCAT scores, recommendations, and an admissions interview. Both the AAMC and AACOM provide centralized application services that greatly simplify the process.

Medical school typically lasts four years. The first two years emphasize classroom- and lab-based learning. Coursework covers anatomy, physiology, biochemistry, and the various body systems.

Students spend the second two years practicing their new skills under supervision. They typically rotate through the departments of a teaching hospital, including obstetrics, family practice, internal medicine, pediatrics, neurology, and psychiatry.

Residency

Upon graduation from medical school, aspiring surgeons complete three to seven years of on-the-job training in the specialty of their choice. This period is called residency. A general surgery residency usually lasts about five years.

After completing residency, surgeons may opt to pursue an additional one to three years of training (called a fellowship) in a surgical subspecialty such as pediatric, cardiothoracic, or head-and-neck surgery. Most fellowships include a research component.

Licensing and Certification

Like all physicians, surgeons must be state-licensed in order to practice. State medical boards require physicians to pass one of the following exams:

Both USMLE and COMLEX consist of three parts that are typically completed during years 2 and 4 of medical school and during residency.

In addition, surgeons may take an optional test to become board-certified in surgery and/or a surgical subspecialty. Board certification is administered by:

Necessary Skills and Qualities

  • Compassion. Surgeons must be able to communicate effectively and put nervous patients and their families at ease.
  • Leadership. The surgeon supervises the work of the entire surgical team, including the nurses and technicians. Surgeons must know how to get the best out of their teams and be willing to accept responsibility for the patient's outcome.
  • Emotional stability. When complications arise during an operation, the surgeon must make decisions quickly and solve problems while under pressure.
  • Flexibility. Surgeons must be knowledgeable enough to respond to unexpected changes in the patient's condition and adjust the surgical plan as needed.
  • Transparency and openness. As part of a responsible practice, surgeons must be willing to review their outcomes with colleagues and make performance data available to the public.
  • Comfort with technology. Effective surgeons constantly learn and master new tools and techniques.
  • Dexterity. Sure hands and fingers help surgeons to tie knots and use instruments.
  • Physical stamina. Surgeons must be able to stand for long periods during operations.

Opportunities for Advancement

Experienced surgeons can pursue a variety of opportunities to increase their responsibilities and make their practice more rewarding:

  • Specialists. Surgeons can enhance their reputation and earnings by becoming experts in a certain procedure and achieving excellent outcomes for patients.
  • Clinical educators. Surgeons may opt to supervise residents and medical students who are completing their training.
  • Professors. Medical schools hire surgeons to teach classes, supervise practical training, conduct research, and share administrative responsibilities.
  • Researchers. Many surgeons participate in studies and clinical trials to find new treatments and improve the quality and safety of surgical care.
  • Clinical leaders. Head surgeons work to enhance the surgical care delivered by their hospital or practice. They also supervise the performance and development of newer professionals.
  • Healthcare administrators. Surgeons often transition into the leadership of medical groups, hospitals, and health systems.
  • Policymakers. Some surgeons help to shape healthcare policy at the federal, state, or local level.

If you would like to gain the necessary education to become a surgeon, we highly recommend that you check out our free School Finder Tool located HERE.

Salary and Job Outlook

during a surgical procedure

According to the US Bureau of Labor Statistics, surgeons earn a mean annual salary of $247,520. Among the most common job settings, salaries range from $140,180 (for those working for universities and medical schools) to $256,120 (for those in private practice).

Surgeon salaries also vary with experience, specialty, and reputation. Surgeons can often enhance their earnings by mastering new and in-demand procedures and by achieving good outcomes for patients. They may also be able to supplement their income by taking on leadership roles within their hospital or practice.

Job prospects for surgeons should be very good in coming years. The US Bureau of Labor Statistics estimates that employment of physicians and surgeons will grow by 14 percent between 2014 and 2024, which is a lot faster than the average for all occupations.

The aging or the American population and the expansion of healthcare coverage are increasing demand for all healthcare services. At the same time, there is currently a shortage of physicians in many areas.

Surgeons can improve their job prospects by choosing specialties such as cardiology and oncology that generally serve older patients. Willingness to relocate to rural or low-income areas is also helpful.

The American College of Surgeons posts surgical job openings on its website.

Further Reading

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