Frequently Asked Questions
Q. What are the surgical specialties?
The American College of Surgeons recognizes 14 surgical specialties:
cardiothoracic surgery, colon and rectal surgery, general surgery,
gynecology and obstetrics, gynecologic oncology, neurological
surgery, ophthalmic surgery, oral and maxillofacial surgery,
orthopaedic surgery, otorhinolaryngology, pediatric surgery,
plastic and maxillofacial surgery, urology, and vascular surgery.
The information that follows presents information on the various
surgical specialties. The material was adapted from definitions
put forth by the nationally recognized authority on the topic,
the American Board of Medical
Specialties (ABMS), and its approved surgical specialty boards.
- General Surgery
A general surgeon is a specialist who is trained to manage a
broad spectrum of surgical conditions affecting almost any area
of the body. The surgeon establishes the diagnosis and provides
the preoperative, operative, and post-operative care to patients
and is often responsible for the comprehensive management of
the trauma victim and the critically ill patient. During at least
a five-year educational period after obtaining a medical degree,
the surgeon acquires knowledge and technical skills in managing
medical conditions that relate to the head and neck, breast,
skin, and soft tissues, abdominal wall, extremities, and the
gastrointestinal, vascular, and endocrine systems. Link of
interest: American Board
of Surgery
- Thoracic Surgery
Thoracic surgery involves the operative management, perioperative
care, and critical care of patients with pathological conditions
within the chest. Specifically, it includes surgical care for
coronary artery disease; cancers of the lung, esophagus, and
chest wall; abnormalities of the great vessels and heart valves;
congenital anomalies; tumors of the mediastinum; and diseases
of the diaphragm. The management of the airway and injuries to
the chest are also areas of surgical practice for the thoracic
surgeon. A thoracic surgeon possesses the knowledge, experience,
and technical skill to diagnose accurately, to operate upon safely,
and to manage effectively patients with intrathoracic abnormalities
that are appropriate for surgical treatment. The ability to provide
this kind of treatment requires a substantial knowledge of cardiorespiratory
physiology and oncology, as well as capability in the use of
extracorporeal circulation, cardiac assist devices, management
of cardiac dysrhythmias, pleural drainage, respiratory support
systems, endoscopy, and other invasive and noninvasive diagnostic
techniques. Links of interest: Society of Thoracic Surgeons and The American Board of Thoracic Surgery.
- Colon and Rectal Surgery
As a result of their extensive training and experience, colon
and rectal surgeons develop the knowledge and skills necessary
to diagnose and treat various diseases of the intestinal tract,
colon, rectum, anal canal, and perianal area through medical
and surgical means. They are also able to deal surgically with
other organs and tissues (such as the liver, urinary, and female
reproductive systems) involved with primary intestinal disease.
A colon and rectal surgeon has expertise in diagnosing and often
managing anorectal conditions in the office, such as hemorrhoids,
fissures (painful tears in the anal lining), abscesses and fistulae
(infections located around the anus and rectum.)
Colon and rectal surgeons also treat problems of the intestine
and colon and perform endoscopic procedures to detect and treat
conditions of the bowel lining, such as cancer, polyps (precancerous
growths), and inflammatory conditions. Colon and rectal surgeons
also perform abdominal surgical procedures involving the small
bowel, colon, and rectum, including treatment of inflammatory
bowel diseases, such as chronic ulcerative colitis, Crohn's disease,
diverticulitis, and cancer.
Training in colon and rectal surgery also provides the surgical specialist with an in-depth knowledge of intestinal and anorectal physiology, which is required for the evaluation and treatment of problems such as constipation and incontinence (loss of bowel control). Colon and rectal surgeons are committed to the highest standards of care for patients with diseases that affect the lower gastrointestinal tract. Links of interest: American
Society of Colon and Rectal Surgeons and American Board of Colon and Rectal Surgery
- Obstetrics and Gynecology
A specialist in obstetrics and gynecology is a physician who
has been trained to provide medical and surgical care for the
pregnant patient, to deliver babies, and to provide medical and
surgical care to treat conditions that affect the female reproductive
system.
Some obstetricians/gynecologists have a strong professional
interest in a specific area such as urogynecology, pelviscopy,
adolescent/pediatric gynecology, or infectious diseases, and
they focus their practice on one or more of these particular
areas of the specialty. All of these physicians are also trained
in health maintenance and preventative care for women, and they
have a particular knowledge and skills that enable them to serve
as consultants to physicians who practice in other areas of medicine.
There are also subspecialties in obstetrics and gynecology,
which require additional training: maternal-fetal medicine specialists
are obstetricians /gynecologists who are prepared to care for,
and to consult on, patients with high-risk pregnancies; and reproductive
endocrinologists are capable of managing complex problems related
to reproductive endocrinology and infertility, including aspects
of assisted reproduction, such as in vitro fertilization (IVF).
Links of interest: American
Board of Obstetrics and Gynecology and American
College of Obstetrics and Gynecology
- Gynecologic Oncology
A Gynecologic Oncologist is a specialist trained in the comprehensive
management of patients with gynecologic cancer–cancers that
affect the female reproductive system. Surgeons practicing in
this specialty study these conditions, which differ significantly
in the cause, prevention, detection, treatment and survival rates.
Link of interest: American
Board of Obstetrics and Gynecology and Society
of Gynecologic Oncologists and Society
of Surgical Oncology
- Neurological Surgery
Neurological surgery is the discipline of medicine and the specialty
of surgery that deals with the diagnosis, evaluation, and treatment
of disorders of the central, peripheral, and autonomic nervous
systems, including their supporting structures and vascular supply.
Neurological surgery involves the evaluation and treatment of
pathological processes that modify the function or activity of
the nervous system, including the pituitary gland. Links of
interest: American Board of
Neurological Surgeons and American
Association of Neurological Surgeons
- Ophthalmic Surgery
An ophthalmologist is concerned with the comprehensive care of
the eyes and vision, and is the only medical practitioner who
is medically trained to diagnose and treat all eye and visual
problems. Ophthalmologists provide vision services (glasses and
contact lenses), treat medical disorders of the eye, and perform
surgical procedures for treatment. Links of interest:
American Board of Ophthalmology
and American Academy of Ophthalmology
- Oral and Maxillofacial Surgery
Oral and maxillofacial surgeons are trained to recognize and
treat a wide spectrum of diseases, injuries and defects in the
head, neck, face, jaws and the hard and soft tissues of the oral
and maxillofacial region. They are also trained to administer
anesthesia, and provide care in an office setting. They are trained
to treat problems such as the extraction of wisdom teeth, misaligned
jaws, tumors and cysts of the jaw and mouth, and to perform dental
implant surgery. Links of interest: American
Board of Oral and Maxillofacial Surgery and American
Association of Oral and Maxillofacial Surgeons
- Orthopaedic Surgery
Orthopaedic surgery is a surgical specialty that is specifically
devoted to the care of the musculoskeletal system. This system
includes bones, joints, muscles, associated nerves, arteries,
and the overlying skin. Much of the orthopaedic surgeon's practice
involves the performance of surgical procedures, but many conditions
are treated medically or physically through the use of braces,
casts, splints, or physical therapy.
Orthopaedic surgeons take care of a wide variety of problems
that may be present at birth, or that may develop at any time
during the lifetime of the person. Such problems can include
congenital deformities, trauma, infections, tumors, degenerative
conditions, and metabolic disturbances that fall into the category
of musculoskeletal abnormalities. Orthopaedics may also involve
the treatment of secondary muscular problems in patients who
suffer from various central or peripheral nervous system lesions
such as cerebral palsy, paraplegia, or stroke.
The field of orthopaedic surgery has become very broad and
now encompasses a number of specialty areas. Following a standard
residency experience in orthopaedic surgery, an orthopaedist
may continue with an additional one- to two-year fellowship to
achieve added qualifications in the following special interest
areas.
- Hand Surgery
This specialty focuses on the investigation and treatment of
diseases, injuries, or abnormalities affecting the upper extremities.
This specialty includes the performance of microvascular surgery,
which is necessary for reattachment of amputated fingers or limbs.
- Sports Medicine
This specialty addresses the various concerns of the person who
is involved in athletics, including conditioning, equipment,
and, of course, injuries to the musculoskeletal system.
- Pediatric Orthopaedics
Specialists in pediatric orthopaedics address their practice
to children with orthopaedic problems including scoliosis, cerebral
palsy, congenital dislocation of the hips, clubfoot, and a wide
variety of other conditions specifically seen in children–including
trauma.
- Spine Surgery
Spine surgeons work with patients who have major spine problems
as a result of disease, degeneration, or trauma. Orthopaedic
spine surgeons frequently work in conjunction with neurosurgeons.
- Foot and Ankle Orthopaedics
This specialty is concerned with problems predominantly involving
the foot and ankle that are amenable to treatment by both surgical
and nonsurgical techniques.
- Joint Replacement
Specialists in joint replacement take care of damaged or worn-out
joints usually by surgically replacing the joint with an artificial
device. The majority of cases involve the hip or knee–and
sometimes the ankle or shoulder. Most joint replacement in the
hand falls into the area of expertise of the hand surgeons.
- Trauma Surgery
Because of the complex nature of injuries seen today, a special
area of orthopaedics is now related to the management of persons
with critical or multiple injuries to the musculoskeletal system.
This specialty is largely surgical in nature and involves close
cooperative efforts with many other specialties in surgery.
- Oncology
The orthopaedic tumor surgeon specializes in the management of
benign and malignant tumors affecting the musculoskeletal system.
Options for treatment have expanded greatly in the past few years
with the advent of chemotherapy and radiotherapy coupled with
the excision of the tumor and replacement with preserved bone
or joint specimens. Links of interest: American
Board of Orthopaedic Surgery and American
Association of Orthopaedic Surgeons
- Otolaryngology
An otolaryngologist is a physician who has been trained to provide comprehensive medical and surgical care to patients who have diseases and disorders that affect the ears, the respiratory and upper alimentary systems, and related structures. The otolaryngologist has a command of the core of knowledge, skills, and understanding of: the basic medical sciences relevant to the head and neck; the respiratory and upper alimentary systems; the communication sciences, including knowledge of audiology and speech-language pathology; the chemical senses; and allergy, endocrinology, and neurology as they related to the head and neck. Head and neck oncology and facial plastic and reconstructive surgery are also fundamental areas of expertise for the otolaryngologist. Links of interest: American Board of Otolayrngology and American Academy of Otolaryngology-Head and Neck Surgery
- Pediatric Surgery
Pediatric surgeons are primarily concerned with the diagnosis,
preoperative, operative, and postoperative management of surgical
problems in children and they operate on children whose development
ranges from the newborn stage through the teenage years.
Some medical conditions in newborns are not compatible with a
good quality of life unless these problems are corrected surgically.
These conditions must be recognized immediately by neonatologists,
pediatricians, and family physicians. Pediatric surgeons cooperate
with all of the specialists involved in a child's medical care
to determine whether surgery is the best option for the child.
Pediatric surgery focuses on providing surgical care for all
problems or conditions affecting children that require surgical
intervention. They may also have particular expertise in the
following areas of responsibility:
- Neonatal
Pediatric surgeons have specialized knowledge in the surgical
repair of birth defects, some of which may be life threatening
to premature and full-term infants.
- Prenatal
In cooperation with radiologists, pediatric surgeons use ultrasound
and other technologies during the fetal stage of a child's development
to detect any abnormalities. They can then plan corrective surgery
and educated and get to now parents before their baby is born.
In addition, prenatal diagnosis may lead to fetal surgery, which
is a new forefront in the subspecialty of pediatric surgery.
Application of most fetal surgical techniques is still in the
experimental stage.
- Trauma
Because trauma is the number one killer of children in the United
States, pediatric surgeons are routinely faced with critical
care situations involving traumatic injuries sustained by children
that may or may not require surgical intervention. Many pediatric
surgeons are involved accident prevention programs in their communities
that are aimed at curbing traumatic injuries in children.
- Pediatric Oncology
Pediatric surgeons are involved in the diagnosis and surgical
care of children with malignant tumors as well as those with
benign growths. Links of interest: American
Board of Surgery, American
Pediatric Association- Surgery Section, and American
Pediatric Surgical Association
- Plastic and Maxillofacial Surgery
The specialty of plastic surgery deals with the repair, replacement,
and reconstruction of defects of the form and function of the
body covering and its underlying musculoskeletal system, with
emphasis on the craniofacial structures, the oropharynx, the
upper and lower limbs, the breast, and the external genitalia.
This surgical specialty also focuses on the aesthetic surgery
of structures with undesirable form.
Special knowledge and skill in the design and transfer of
skin flaps, in the transplantation of tissues, and in the replantation
of structures are vital to the performance of plastic surgery.
The plastic surgeon must also possess excellent skill in the
performance of excisional surgery, in the management of complex
wounds, and in the use of allopathic materials. Knowledge of
surgical design, surgical diagnosis, surgical and artistic anatomy,
surgical pathology, surgical oncology, surgical physiology, pharmacology,
bacteriology, biomechanics, embryology, and surgical instrumentation
are other fundamental areas of expertise within the specialty.
Furthermore, the judgement and technical capacity for achieving
satisfactory results are mandatory qualities for the plastic
surgeon.
After completing a residency in plastic surgery, a plastic
surgeon may
subspecialize in:
- Urology
A urologist is a physician who manages benign and malignant medical
and surgical disorders of the adrenal gland and of the genitourinary
system. Urologists have comprehensive knowledge of, and skills
in, endoscopic, percutaneous, and open surgery of congenital
and acquired conditions of the reproductive and urinary systems
and their contiguous structures. Links of interest: American Urological Association
(Note: At this time, the American Board of Urological Surgery
does not have a Web site.)
- Vascular Surgery
Vascular surgeons care for patients with diseases that affect
the arteries and veins throughout the body. Hardening of the
arteries, atherosclerosis, is the most common problem
that vascular surgeons treat. In addition, vascular surgeons
are trained to diagnose and treat strokes, which can be brought
on by a blockage or narrowing of the arteries in the neck. Because
the damage done by strokes is often irreversible, vascular surgeons
must be able to make early diagnoses of potential stroke victims.
The surgeon who treats the vascular system must also be able
to diagnose and treat aneurysms and blood clots in the arteries
and veins, as well as the after effects of conditions of the
vascular system. Links of interest: American
Board of Surgery and Vascular
Surgical Societies.
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