The Daily Schedule Of A General Surgeon

General surgeons are trained to surgically, and to an extent medically, manage conditions that affect parts of the human body. The most common area that is focused on is the abdominal cavity that contains the organs such as the oesophagus, stomach, small and large intestines, liver, pancreas, gallbladder and biliary tree. Other areas such as the thyroid, the vascular system and breasts may also be surgically treated if needed.

General surgery can be divided into sub-specialties and these doctors may decide to train in these sub-specialties after they have become fully licensed surgeons. In a rural setup, a general surgeon may have to perform any surgical procedure, even if they haven't sub-specialised in those discipline, since they do receive training in managing these conditions. Another reason for having to perform more complex surgical procedures will include if these doctors are the only ones available to perform a procedure that would potentially save a patient's life. It would then be expected of these doctors to perform such procedures if the benefits outweigh the risks.

Training

A doctor wanting to specialise in general surgery must first complete their undergraduate degree which can take 5-6 years depending on which country you live in. A further 1-2 years of internship training in a hospital setup then needs to be completed in order to be eligible for a post in surgery.

When a doctor is ready to specialise further, they need to apply for an available surgical post at their academic institution of choice. A selection panel will then invite the doctor for an interview, and if they're successful they will then be offered the post. Surgical posts for clinical assistants will be available as long as there are consultants available in that department who will train and mentor them.

If a general surgery position is not available at the academic institution of choice, the doctor may then decide to take up working as a medical officer in the surgical department. Here, the doctor will gain surgical experience by seeing patients in the wards and by involving themselves in the operating rooms by assisting surgeons and even performing surgical procedures themselves. This experience will help a doctor to be a more favourable candidate to take up a surgery specialist post over others who don't have the same experience.  

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Sub-specialties

If a general surgeon wants to specialise further, then they will have to complete a further 1-2 years of fellowship training in their chosen sub-specialty. The sub-disciplines which they can further train in include the following:

• Trauma surgery
• Laparoscopic surgery
• Colorectal surgery
• Breast surgery
• Vascular surgery
• Endocrine surgery
• Transplant surgery
• Surgical oncology
• Cardiothoracic surgery
• Paediatric Surgery

These surgeons will focus on these areas primarily, whereas a general surgeon may end up performing procedures involving these specialties if they have to.

A General Surgeon's Diary

The daily duties of a general surgeon include consulting and managing their hospital patients on a daily basis and sometimes even twice a day where necessary. General surgeons may also have patients admitted in the surgical ICU and these patients will also be seen 1-2 times a day. A trauma surgeon may be consulted when managing these patients.

Laboratory tests and special investigations ordered by a surgeon will also have to be followed up in order to discuss any abnormalities with the patient. Further management can then be discussed with the patient and subsequently initiated.

Monday

Mondays are usually reserved as an administrative day to organize aspects such as when meetings with surgical reps and the hospital management need to take place. This day is also used to see what elective procedures have been booked on which days of the week.

Another important issue that needs to be looked at is making sure that the mornings after being on call (seeing emergency cases after hours) aren't too busy for the surgeon. The days that the surgeon is on call will depend on the availability of other surgeons and also how they choose to rotate. For this example, we shall assume the doctor is on call on a Thursday night.

After ward rounds have been completed, the doctor will start consulting patients for the day and he/she will either manage them conservatively or decide whether any further surgical intervention is needed. These patients will then be scheduled for elective surgery on the assigned surgical days. If emergency surgery is needed, then the patient will be booked for the operating theatre and the surgeon will attend to them accordingly.

Tuesday

Tuesdays are usually reserved as full surgical days where the surgeon is performing procedures the entire day. This day can be quite long, depending on how busy the list is, and the specialist can be in the operating theatre for a substantial amount of time. Emergency cases can also come in, but if there are other colleagues available then they will help handle the workload.

The morning may consist of performing major abdominal surgeries such as cholecystectomies (gallbladder removal) and hiatus hernia repairs. The afternoon may consist of performing procedures such as breast lumpectomies, abdominal hernia repairs and vascular surgeries. During the day the general surgeon may also have to perform emergency procedures such as appendectomies, repair of perforations in the stomach and removal of a segment of the colon if there's a perforation involved.

Wednesday

Wednesday mornings also tend to be reserved for performing surgical procedures similar to those mentioned already. 

If the surgeon is involved with the academic programme of the surgical department, the afternoon will then be reserved for attending meetings and also for training of under- and postgraduate students. Private general surgeons may use the afternoon for consulting further with patients, working on research articles or performing other administrative tasks. 

Thursday

Thursdays can be similar to Wednesdays as the morning may also involve consulting patients or performing surgeries, and the afternoon may be utilised for the same purpose as already mentioned. These afternoons can be interchanged or used exclusively, depending on the surgeon, as one day for academic purposes or training and the other day for consulting with patients.

If the surgeon is on call this night then they will usually be consulting with patients and will then stay close to the hospital for emergency cases. The doctor will be called by primary healthcare workers and casualty doctors to see patients in the emergency room of the hospital when needed.

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Friday

This morning will usually start later since the doctor was on call, or if they are still busy in theatre with a patient. When the doctor is ready, he/she will consult with their hospital patients and then their outpatients in their rooms. 

The afternoon will be used to resolve any pending administrative issues and they will then end their work week.

If the surgeon is on call for the weekend, then they will be responsible for the surgical patients in the hospital and will take instructions from their colleagues. If they are not on call, then they will hand over the management of their patients to their colleague who will be working the weekend.