Section I: Surgical Traits

So, You Want to Be a Surgeon!

Consider your surgery clerkship. Did you:

• Find that long hours on surgery passed more quickly than short hours on some other clerkships?
• Appreciate the operating room teamwork during a difficult operation, when the nursing, anesthesia, and surgical staff all pulled together?
• Enjoy watching your patients improve daily after major injuries or surgical procedures?
• Feel intrigued by the challenge of managing multiple physiological and psychological problems in your critically ill surgical patients?
• Notice the excitement of your surgical team anticipating a "great case"?

If the answer to some of these questions is "Yes!", a surgical career is probably right for you.

First of all, there is no way to prove you are a born surgeon. Surgeons are trained, not born. Facility with knot-tying and sewing is handy, but in fact some of the most wise and revered surgeons in practice today were not known for their dexterity when they were medical students or junior surgery residents. Intelligence, conscientiousness, creativity, courage, and perseverance on behalf of your patients are the critical factors, and they outweigh the small differences in dexterity among most medical students. Becoming a good surgeon is a life-long process. Thoughtful reflection on the outcomes of your decisions and those of others will gradually give you the most important quality, 'good surgical judgment'. Being 'nice' is as helpful as it would be for any physician; your patients, colleagues, and other health care workers will all deserve your respect and compassion.

So does that mean that any medical student can become a surgeon?

Well, no. Use of both hands, and reasonably good mental and physical health are necessary. Most diligent students may be able to gain a spot in some sort of surgery training program, but not all students will be happy with a surgical career. First and foremost, you must thrive on being part of the surgical enterprise, and you must absolutely look forward to opportunities to go to the operating room. Additionally, you must be flexible. A surgeon's day is seldom predictable, and surgeons must view this unpredictability as an enjoyable challenge.

Why is it that some of my fellow medical students just hate being in the operating room while some find it exhilarating?

If you are a medical student reading these words, chances are you're not one of the students who hates being in the operating room. Medical students who love being in the operating room tend to be people who are comfortable with three-dimensional imagery; they often overlap with medical students who enjoyed learning anatomy. Students who love being in the operating room find doing concrete physical work for their patients truly satisfying.

Being comfortable as a surgeon also means being comfortable accepting the responsibility of a role as leader of a team. Motivating the team and facilitating their best efforts are skills you can learn in your surgery training program, but at the core surgeons must be able to accept responsibility. The surgical culture is one of continuous improvement, using the public forum of morbidity and mortality conferences to tell the stories of bad outcomes in hopes that they may be avoided in the future. So, students who are uncomfortable making quick decisions with incomplete data, occupying positions of leadership, or discussing errors in a public forum may be uncomfortable in surgical roles.

I'm still not sure if surgery is right for me. I loved my surgical rotations, but I don't want to sacrifice my family or personal life.

Surgeons are people who find it extremely rewarding to act and see the impact of their actions on behalf of their patients. If that resonates for you, and you find yourself having the time of your life on surgical rotations, a surgical career probably is right for you. Because all training programs have adopted limits such as an 80 hour/week average duty hours and at least one day/week completely free from clinical responsibilities, surgical training should not be appreciably harder on families than training in a non-surgical discipline. After residency, many options exist for limiting practice hours and playing an integral role in your family or community. Chances are the satisfaction you derive from your surgical career will be an energizing force that will not only carry you through the training process, it will be a benefit to those who are important in your personal life as well.

Is there a reason for the surgical mystique? What makes being a surgeon special?

There are some rewards to being a surgeon that are powerful and unique to surgical fields. As surgeons, we are able to test our hypotheses and see rapid, graphic results from our work. It is immensely satisfying to completely excise a cancer, convert a cold, bluish ischemic limb to one that is warm and pink, relieve the pain of an intra-abdominal catastrophe, or help a scarred patient gain better appearance and function.

The field of surgery needs a rich variety of motivated medical students to enter surgery training to continue this good work, as well as innovate and explore new directions. The American College of Surgeons is made up of individuals who were all once medical students like you wondering whether to pursue a surgical career. Now, the American College of Surgeons would like to support you on that challenging and exciting path.

The Division of Education of the American College of Surgeons wishes to acknowledge the assistance of Kimberly Ephgrave, MD, FACS, Timothy Flynn, MD, FACS, and Kathleen Liscum, MD, FACS, in revising this section of the book.

 How to Find a Surgery Residency