Colon and rectal surgery is the surgical specialty dedicated to the prevention, diagnosis, and treatment of diseases of the colon, rectum, anus, and pelvic floor. Colon and rectal surgeons care for patients with a broad range of benign and malignant conditions, including colorectal cancer, inflammatory bowel disease, diverticular disease, anorectal disorders, hereditary colorectal cancer syndromes, pelvic floor dysfunction, and disorders of intestinal continuity.
The specialty combines advanced operative techniques with endoscopy, multidisciplinary cancer care, and longitudinal patient relationships. Colon and rectal surgeons perform minimally invasive, robotic, laparoscopic, transanal, and open procedures, as well as screening, diagnostic, and therapeutic endoscopy. They also manage complex re-operative surgery, intestinal stomas, anorectal diseases, and challenging abdominal and pelvic conditions requiring coordinated care across multiple specialties.
Successful colon and rectal surgeons possess expertise in gastrointestinal physiology, surgical oncology, minimally invasive surgery, advanced endoscopy, pelvic anatomy, wound healing, and pelvic floor disorders. They work closely with gastroenterologists, medical and radiation oncologists, radiation therapists, radiologists, pathologists, genetic counselors, urogynecologists, urologists, wound and ostomy specialists, pelvic floor physical therapists, and primary care physicians to provide comprehensive, patient-centered care.
Training begins with successful completion of an ACGME-accredited five-year general surgery residency, followed by a one-year ACGME-accredited fellowship in colon and rectal surgery. Fellowship training provides advanced experience in colorectal cancer, inflammatory bowel disease, anorectal surgery, pelvic floor disorders, advanced endoscopy, minimally invasive and robotic surgery, and complex abdominal and perineal reconstruction. Upon completion of training, surgeons are eligible for certification by the American Board of Colon and Rectal Surgery.
For more information, visit the American Board of Colon and Rectal Surgery.
Colon and Rectal Surgery as a Career
Colon and rectal surgery offers an exceptional combination of technical excellence, intellectual challenge, innovation, and meaningful patient relationships. Few surgical specialties allow physicians to care for patients across such a broad spectrum—from preventing colorectal cancer through screening and surveillance, to treating inflammatory bowel disease, restoring intestinal continuity after complex operations, and improving patients' function and quality of life.
No two days are alike. A typical day may include advanced endoscopy, robotic surgery for rectal cancer, treatment of benign anorectal disease, emergency surgery for diverticulitis, multidisciplinary cancer conferences, or helping a patient successfully adapt to—or reverse—an ostomy. The breadth of the specialty provides continuous opportunities for learning while challenging both clinical judgment and technical skill.
One unique aspect of colon and rectal surgery is the diversity of patient relationships. Some patients entrust you with their care for years as they navigate inflammatory bowel disease, hereditary cancer syndromes, or survivorship after colorectal cancer. Others arrive with a problem that has quietly affected nearly every aspect of their daily lives—hemorrhoids, an anal fissure, fecal incontinence, or rectal prolapse—and experience dramatic improvement after a single operation or office procedure. Whether caring for a patient over decades or helping them regain comfort and confidence in just one visit, the privilege of improving quality of life is one of the specialty's greatest rewards.
Because many colorectal conditions involve sensitive or embarrassing symptoms, successful colon and rectal surgeons learn to combine technical excellence with empathy, professionalism, and an approachable sense of humor. A thoughtful conversation, a reassuring smile, or the ability to make a patient laugh at exactly the right moment can transform an uncomfortable encounter into one built on trust. Few specialties offer the opportunity to make such a meaningful difference in both a patient's health and dignity.
Colon and rectal surgery is also at the forefront of surgical innovation. Surgeons in the specialty have helped advance minimally invasive and robotic surgery, advanced endoscopy, enhanced recovery pathways, and multidisciplinary cancer care. Ongoing developments in precision oncology, artificial intelligence, imaging technology, and surgical education continue to redefine what is possible and improve outcomes for patients.
Beyond the operating room, many surgeons are drawn to the culture of the specialty itself. Although broad in scope, colon and rectal surgery remains a relatively small specialty. Its size fosters an extraordinary sense of collegiality, mentorship, and collaboration. National meetings are welcoming, lifelong professional relationships are common, and trainees quickly become part of a community that is deeply committed to advancing patient care, education, and one another's success.
The specialty offers remarkable flexibility. Surgeons may build careers in academic medicine, community practice, integrated health systems, or private practice. Some focus on colorectal cancer, others on inflammatory bowel disease, advanced endoscopy, pelvic floor disorders, or complex abdominal surgery. Many combine clinical practice with research, education, quality improvement, leadership, advocacy, or global surgery. As colorectal cancer screening expands, the population ages, and the need for specialized care continues to grow, opportunities within the field remain exceptionally strong.
Colon and rectal surgery is an ideal career for physicians who enjoy solving complex problems, mastering advanced technical skills, working collaboratively across disciplines, and continually learning throughout their careers. It is a specialty defined by innovation, compassion, and excellence in patient care—but perhaps most importantly, by the privilege of restoring health, function, dignity, and hope. For those who choose this path, colon and rectal surgery offers not simply a career, but a community and a lifetime of meaningful work.
Jennifer S. Beaty, MD, FACS, FASCRS
West Des Moines, IA
July, 2026
