Anyone hoping to become a surgeon must have good hand-eye coordination, be comfortable making decisions and work incredibly well under pressure
As a surgeon, you'll operate on patients in order to treat disease or injury. You will perform operations by cutting open the patient's body to repair, remove or replace the diseased or damaged part.
Surgery is one of the most sought after careers within medicine and competition can be fierce. Becoming a surgeon can take many years and you'll need a high level of commitment to succeed. Surgery techniques are constantly evolving, so throughout your career you'll always be getting to grips with new techniques.
Types of surgeon
Surgeons usually specialise in one of the following areas:
- cardiothoracic: dealing with surgical treatments inside the chest, generally addressing conditions of the heart and lungs
- general: wide range of knowledge and skills to deal with all kinds of surgical emergencies, with an emphasis on acute abdominal problems including the stomach, small bowel, colon, liver and pancreas
- neurosurgery: performing surgery on elements of the nervous system including the brain, spinal cord and extra-cranial cerebrovascular system
- oral and maxillofacial: deals with the diagnosis and surgical treatment of patients with diseases affecting the mouth, jaws, face and neck
- otolaryngology: also known as ear, nose and throat (ENT). ENTs specialise in a wide range of diseases of the head and neck
- paediatric: dealing with surgery of premature and unborn babies, children and young adults up to the age of 19
- plastic: plastic surgeons deal with surgical restoration, reconstruction or alteration of the human body. This includes cosmetic or aesthetic surgery and the treatment of burns
- trauma and orthopaedic: these surgeons use surgical treatments to treat a wide range of conditions of the musculoskeletal system and supporting structures such as ligaments, tendons, muscles and nerves
- urology: urologists fix problems of the female urinary system and the male genitourinary tract. They diagnose and treat disorders of the kidneys, ureters and bladder using surgical techniques
- vascular: vascular surgeons concentrate on the diagnosis and surgical treatment of conditions affecting the circulation, including disease of the arteries, veins and lymphatic vessels.
As a surgeon, you'll need to:
- assess and examine patients to establish if an operation is necessary
- manage and monitor preoperative and postoperative treatments and procedures, such as use of sedatives and antibiotics
- speak to patients and their families before surgery to go through the procedures you'll be carrying out with them, providing reassurance as you do so
- operate on patients to improve or restore functions, such as repair injuries or treat diseases
- follow established surgical techniques during the operation
- direct and coordinate the activities of other health staff within the multidisciplinary team, including junior doctors, nurses and operating department practitioners
- undertake ward rounds on a regular basis and take outpatients clinics - the amount of time you spend on these activities will depend on your specialism
- refer patients to other medical specialists or other practitioners when necessary
- undertake associated administrative work.
You'll also be expected to:
- conduct research to help develop and test surgical techniques and equipment that can improve operating procedures and outcomes
- help teach and train other junior doctors and medical students and other members of the multidisciplinary team.
- Junior doctors in Foundation Year 1 (FY1) earn a basic starting salary of £26,614. This increases in Foundation Year 2 (FY2) to £30,805.
- As a doctor in specialty training, you can expect to earn between £36,461 and £46,208.
- The basic salary for specialty doctors ranges from £37,923 to £70,718.
- Newly qualified consultants earn a basic salary of £76,761, rising to £103,490 depending on length of service. Consultants may also apply for local and national Clinical Excellence Awards. Consultants working in the private sector can expect to be paid more.
Figures relate to the pay and conditions of medical doctors within the NHS, which is the largest employer of surgeons in the UK.
Income data from Health Careers – Pay for doctors. Figures are intended as a guide only.
You'll work long hours, including nights and weekends, being on call out-of-hours on a rota basis.
In some cases, less than full-time training for doctors is possible.
What to expect
- You'll have contact with a variety of patients and will also take part in ward rounds.
- Jobs are available throughout the UK, mainly in acute hospitals. You'll typically work in operating theatres, outpatient clinics and specialist units such as accident and emergency (A&E).
- You'll work within a multidisciplinary team, which includes nurses, operating department practitioners, radiologists, anaesthetists and other medical and healthcare staff.
- The work is challenging and requires a great deal of commitment and determination, but can also be very rewarding.
- You may be expected to travel to other surrounding hospitals or clinics.
The only way to get into surgery is with a degree in medicine recognised by the General Medical Council (GMC). This usually takes five years to complete, although if you've already got a degree in a subject other than medicine (usually a 2:1 or above in a science-related subject), you can apply for a four-year accelerated medical graduate entry programme (GEP).
This is followed by two years of foundation training common to all medical graduates, where you'll work in a hospital as a junior doctor on a rotational basis in different departments, including surgery. On successful completion of this, you'll be awarded a Foundation Achievement of Competency Document (FACD).
At this point, you'll start your surgery training. The route you'll follow depends on which of the ten main specialisms you decide to take. Training for most specialisms is split into two years of core training (CT1 and CT2), followed by up to six years of specialty training (ST3 to ST8).
During your core training, you'll typically work in a range of different surgical settings to give you as much experience as possible. Each post lasts four to six months. During this time you'll need to pass the MRCS (Membership of The Royal College of Surgeons) examination or equivalent.
Specialty training is the final stage of your surgical training and is highly competitive. GMC-approved curricula for the ten surgical specialties are provided by the Intercollegiate Surgical Curriculum Programme (ISCP). At the end of this training you must obtain the Certificate of Completion of Specialist Training (CCST). This allows you to join the GMC Specialist Register and to apply for surgery consultant positions, which you can start six months prior to completion. In order to obtain the CCST, you'll need to pass the RCS Intercollegiate Specialty Examination (FRCS). For more information, see the Joint Committee on Surgical Training website.
A number of surgeons are neither consultants nor trainees and take up posts as specialty doctors or associate specialists (SAS). To do this, you'll need to be registered with the GMC and have completed four years of postgraduate training, including two years of specialty training.
The GMC is in the process of introducing new standards that will make postgraduate training more flexible for all doctors, including surgeons. See the training programme pilot for general surgery for information on how surgical trainees will be offered a better training-service balance that includes working alongside professionals from other specialties to improve patient care.
Find out which qualifications are required to become a hospital doctor.
- technical knowledge and clinical expertise in order to elicit the necessary information from patients and identify key issues and the appropriate options
- good hand-eye coordination to perform operations
- communication skills, with the ability to adapt your communication style to suit the situation
- leadership and team involvement skills to positively deal with problems in a non-confrontational away
- negotiation skills in order to reach solutions to complex, and often competing, needs
- the ability to remain calm and in control under pressure
- the self-knowledge to know your limitations and use your judgement to compromise and seek help if required
- the confidence to justify your decisions in high-pressure situations
- the ability to prioritise your workload and delegate work to others
- problem-solving skills to think head and plan for different contingencies, anticipating different situations that might occur
- situational awareness, including how to deal with subtle changes in clinical conditions
- the ability to manage your time and resources effectively
- a flexible approach to work and the ability to consider all factors before reaching a decision
- professional integrity and honesty, respecting both patients and colleagues
- emotional stability and empathy
- commitment, drive and focus
- the ability to reflect and learn from your own work and a commitment to continuing professional development.
As getting into surgery training is competitive, you'll need to improve your chances of success while at medical school. You can do this by developing a portfolio to show your interest and passion for surgery and by doing your elective in a surgical area. Become a member of your university's surgical society and attend their events and skills sessions is a good first step. Try and speak to as many surgeons as you can to get a feel for their specialty. See the Royal College of Surgeons' advice on improving your chances of entering surgical training.
If you're a woman entering the world of surgery, find out more about Women in Surgery (WinS), a national initiative set up to encourage more women into the profession.
During your two-year Foundation Training as a junior doctor, you'll take at least one surgery rotation that will give you a good insight into the work. Use this time to get involved in other activities that can show your interest in surgery.
As well as the NHS, the country's largest employer of surgeons, there are opportunities to work in the private sector as well as setting up a private practice. As it stands, there's currently plenty of work available to surgeons.
Look for job vacancies at:
- BMJ Careers
- NHS jobs - for England and Wales
- NHS Scotland Recruitment
- Northern Ireland Health and Social Care jobs
Look for training posts at:
- Core Surgical Training – (England, Scotland and Wales) managed by London and South East (LaSE) Recruitment
- NHS Health Education England Specialty Training
- Northern Ireland Medical and Dental Training Agency (NIMDTA)
As a surgeon you will be expected to continue learning throughout your career. Continuing professional development (CPD) is essential if you want to remain on the GMC register. CPD activities can include attending courses, conferences, meetings and workshops, as well as pursuing research and peer-reviewing journal papers. The Royal College of Surgeons provides guidance on how much and what kind of CPD you'll need to undertake.
Additional postgraduate qualifications will be looked upon positively. If you wish to integrate more formal study into your work, you can take certificate, diploma and masters courses in medical education. Search for postgraduate courses in healthcare.
You will gradually gain more experience in your clinical duties and take on more responsibilities over time. You'll have the opportunity to move into managerial roles, initially as a medical lead (a lead consultant for a team), then as a clinical director (a lead consultant for a department), and possibly a medical director (a lead consultant for a hospital trust).
If you're working as a specialty doctor, you'll spend most of your working day on patient care and be responsible to a named consultant surgeon. There is some scope for leadership and management roles and you may also have the opportunity for teaching, research, committee work and more.
If you wish to take up scientific research and an academic career, you'll need to start early at medical school or during your Foundation Training as this field is highly competitive.
Surgeons interested in teaching future doctors may become a director of medical education, training programme director or associate dean in charge of the entire training programme.
The vast majority of doctors practising privately also work in NHS consultant posts conducting their private work outside of their NHS commitments.