Surgical specialties

In all modern medical training programs, a surgeon must specialise in an area.

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The exact number of recognized specialties depends on one's purpose in counting them. The following specialties are often described:

• Cardiothoracic surgery
• General surgery
• Neurosurgery
• Ophthalmic surgery
• Oral and maxillofacial surgery
• Orthopedic surgery
• Otorhinolaryngology (also called Ear, Nose, and Throat; ENT)
• Paediatric surgery
• Plastic surgery
• Vascular surgery
• Urology

Additionally, the specialties of Gynaecology and Opthalmology may also involve surgical management, and the respective practitioners may be considered to be Surgeons; however they are generally not part of the Surgical College as they have their own Collegiate bodies.

Specialisation

To become a surgeon is very demanding. The process itself varies between countries. Before embarking on a career in surgery, one must have a basic medical degree from university, which takes anything from four to six years. After graduating as a doctor, they usually work as an intern, whereby they are do different clinical rotations - not necessarily all surgical. After a year or two of such work, they may apply for a position as an accredited surgical trainee, having to submit a CV, sit interviews and provide referees. Entry into a surgical program is very competitive, with far more applicants applying than available posts.

The surgical training program is variable, and often updated. Traditionally, surgeons entered a "General Surgical" training program, studying various surgical disciplines. as well as emergency medicine, critical care, and anything else the college deems important as part of training. After completing the general training, one could then subspecialise in a particular field, eg Colorectal, Plastic Surgery, Cardiac Surgery, etc. This takes an additional 3 to 4 years, and usually once again involves competitive selection into the "advanced surgical training program".

Recently, in certain countries, such as Australia, programs have been designed whereby a candidate applies directly for subspecialty training, with the aim of making training more "streamlined". The college than provides whatever basic training it deems necessary.

After completion of the training program, the doctor is usually encouraged to take a fellowship year, where they undertake research or work in a different centre to which they trained. The aim of this is for the doctor to further develop skills in a particular area of interest as well as gain an opportunity to train in a centre which might have a slightly different approach.

Surgical training is one of the most difficult programs to undertake, partly because of the commitment in time and lifestyle that a practitioner must make. It is also one of the most popular training programs.

Sub-specialisation

Within each surgical specialty, there are further specialisations. For example, an orthopaedic surgeon might develop an interest in spinal surgery, whereas another might develop an interest in hand surgery.

Overlap

It is possible for two different specialties to lay claim on a particular part of the body or type of operation. For example, the following types of operation might be performed by two or more different specialists:

• Amputation - orthopaedic surgeon or vascular surgeon
• Hand surgery - orthopaedic surgeon or plastic surgeon or general surgeon
• Nerve root decompression (spinal disc herniation repair) - neurosurgeon or orthopaedic surgeon
• Carpal tunnel repair - neurosurgeon, general surgeon, orthopaedic surgeon, and plastic surgeon
• and so on.