"General Surgery" is a discipline of surgery having a central core of knowledge embracing anatomy, physiology, metabolism, immunology, nutrition, pathology, wound healing, shock and resuscitation, intensive care, and neoplasia, which are common to all surgical specialties.
A general surgeon has specialized knowledge and experience related to the diagnosis, preoperative, operative, and postoperative management, including the management of complications, in nine primary components of surgery, all of which are essential to the education of a broadly based surgeon:
- Alimentary tract
- Abdomen and its contents
- Breast, skin, and soft tissue
- Head and neck, including trauma, vascular, endocrine, congenital and oncologic disorders - particularly tumors of the skin, salivary glands, thyroid, parathyroid, and the oral cavity
- Vascular system, excluding the intracranial vessels and heart
- Endocrine system, including thyroid, parathyroid, adrenal, and endocrine pancreas
- Surgical oncology, including coordinated multimodality management of the cancer patient by screening, surveillance, surgical adjunctive therapy, rehabilitation, and follow-up
- Comprehensive management of trauma, including musculoskeletal, hand, and head injuries. The responsibility for all phases of care of the injured patient is an essential component of general surgery.
- Complete care of critically ill patients with underlying surgical conditions, in the emergency room, intensive care unit, and trauma/burn units
The training program must consist of at least five years.
- Not more than 12 months may be devoted to education in a single surgical discipline other than the principal components of surgery.
- Not more than six months in total may be allocated to nonsurgical clinical disciplines such as internal medicine, pediatrics, gastroenterology, anesthesiology, or surgical pathology.
- At least 54 months (4.5 years) must be clinical surgery, with experience in endoscopy, surgical intensive care, and emergency care included under this category.
- Three of the clinical surgery years must be concerned with the principal components of general surgery.
For further information:, visit the American Board of Surgery. The description of this surgical specialty was adapted from a description set forth by the American Board of Medical Specialties (ABMS).
General Surgery as a Career
General surgery is on the "cutting edge" as it continues to reinvent itself to the benefit of the surgical patient. Due to today's high-tech instrumentation and advanced technology, procedures such as major abdominal surgery are now replaced with minimally invasive laparoscopic techniques that often reduce pain, accelerate recuperation, and reduce cost without sacrificing good outcomes. Surgical research into disease processes such as immunology and genetics have redefined treatment options specific to individual patients, opening doors to better understanding the etiologies of disease and its progression.
In today's environment of specialization and subspecialization, I find that as a general surgeon, my value to the patient, family physicians, and health plans grows considerably every year. General surgery affords broad, yet often very specialized training in all disciplines of surgery and medicine. After completing my residency, I became qualified to manage a wide variety of ailments, from gastrointestinal problems to endocrine surgery, from hypertensive crises to rupturing aneurysms. My training enables me to be the best person to manage patients requiring multi-system care such as major trauma, and I am frequently called upon to address complex medical and ethical issues.
General surgeons often set the standard of surgical care in a community. We choose the procedures we feel most comfortable with to provide services for our patients. When patients are referred for advanced medical intervention, general surgeons are commonly the only members of the local medical staff familiar with the procedure performed or management required.
And, of course, general surgeons provide life-saving procedures every day, such as appendectomy, splenectomy, or curative cancer surgery. We see the joy in our patient's face when we tell her that the breast lesion is benign, and suffer and console her when it isn't.
No two days are alike. Every day is a different adventure, testing my confidence, skill, and knowledge. General surgeons are valuable not only in the eyes of the patients, but also to the health-care providers. Broad training in diverse areas keeps the general surgeon essential in today's market.
General surgery continues to be a field high in public and professional demand, insuring that future general surgeons will have promising and fulfilling careers.
Gary L. Timmerman, MD, FACS
Sioux Falls, SD