Surgeon

Surgeons are medically qualified doctors who operate on patients to treat disease or injury

As a surgeon, you'll repair, remove or replace damaged parts of the body by performing operations. You'll also undertake ward rounds and outpatient clinics, as well as taking on administrative duties. You may also be involved in teaching and supervising junior staff.

Becoming a surgeon can take many years and you'll need a high level of commitment to succeed. Competition for places can be fierce, particularly in the later stages of training. New surgery techniques are continually evolving so you'll need to keep developing your skills throughout your career.

Types of surgeon

Surgeons usually specialise in one of the following ten main areas:

• cardiothoracic surgery - focusing on surgical treatments inside the chest, particularly the heart and lungs
• general surgery - covering a broad range of surgical emergencies, with an emphasis on acute abdominal problems involving the stomach, 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 surgery - treating diseases and injuries affecting the mouth, jaw, face and neck
• otolaryngology/ ENT (ear, nose and throat) surgery - specialising in a range of head and neck conditions and diseases
• paediatric surgery - providing surgical care for premature and unborn babies, children and young adults up to the age of 19
• plastic surgery - dealing with surgical restoration, reconstruction or alteration of the human body. This includes cosmetic or aesthetic surgery and the treatment of burns
• trauma and orthopaedic surgery - treating conditions of the musculoskeletal system (bones, joints and muscles), as well as related ligaments, tendons, nerves and soft tissue
• urology - fixing problems of the female urinary system and the male genitourinary tract, including the kidneys, ureter, bladder and prostate
• vascular surgery - concentrating on conditions affecting circulation, including disease of the arteries, veins and lymphatic vessels.

There are also opportunities to develop expertise in subspecialties such as transplant, endocrine or breast surgery.

For more information, see the Royal College of Surgeons of England Surgical Specialties Overview.

Responsibilities

Activities will vary depending on your area of specialisation. However, as a surgeon, you'll typically need to:

• assess and examine patients to decide whether surgery is necessary
• manage preoperative and postoperative care, including pain relief, sedation and infection control
• explain procedures to patients and their families to provide information and reassurance
• operate on patients to improve or restore functions, repair injuries or treat disease
• follow established surgical techniques and maintain high standards of patient safety
• lead and coordinate the work of the multidisciplinary team, including resident doctors, nurses and operating department practitioners
• carry out regular ward rounds and run outpatients clinics - the amount of time you spend on these activities depends on your specialism
• refer patients to other medical specialists when necessary
• complete associated administrative tasks, such as writing reports and updating records
• contribute to teaching, training and mentoring medical students, resident doctors and other healthcare staff
• take part in research to help develop and test surgical techniques and equipment that can improve operating procedures and outcomes.

Salary

• The basic salary during foundation training in England is £38,831 to £44,439. Salaries for doctors starting their specialist training range from £52,656 to £73,992.
• As a speciality doctor, you'll earn between £61,542 and £99,216. Salaries for specialist grade doctors range from £100,870 to £111,441.
• Salaries for newly qualified consultants start at £109,725, rising to £145,478, depending on the length of your service.

Resident doctors (formerly known as junior doctors) will earn a basic salary, plus pay for any hours over 40 per week, a pay enhancement for working nights, a weekend allowance and an availability allowance if you're on call.

High-cost supplements are available to surgeons working in London. You'll automatically be enrolled in the NHS pension scheme, but you can opt out.

Consultants in England and Wales may apply for local Clinical Excellence Awards and national Clinical Impact Awards. You should also be paid more if you take on extra responsibilities in, for example, management or education. In Scotland, you can apply for discretionary points. Consultants are also able to supplement their salary by working in private practice.

Figures relate to the pay and conditions of medical doctors within the NHS, which is the largest employer of surgeons in the UK.

Salary bands differ across the four countries of the UK. Pay negotiation happens annually at different times, so salaries will change when each country agrees their new pay award. Check your country's pay scales for doctors for the most up-to-date NHS salary information on the BMA website.

Income data from Health Careers - Pay for doctors. Figures are intended as a guide only.

Working hours

Working hours can be long and include nights, weekends and on-call shifts as part of a rota, although the pattern varies depending on your specialty. Once qualified, you may be able to take advantage of flexible working options.

What to expect

• You'll have close contact with patients, from initial consultations and ward rounds through to postoperative care.
• Jobs are available throughout the UK, mainly in NHS and private acute hospitals. You'll typically work in operating theatres, outpatient clinics and specialist units such as accident and emergency (A&E).
• You'll be part of a multidisciplinary team that may include nurses, anaesthetists, radiologists, operating department practitioners and other medical and healthcare professionals.
• The work is demanding, requiring resilience and commitment, but it can also be very rewarding.
• Depending on your specialty and employer, you may need to travel between hospitals or clinics within a trust or region.

Qualifications

To become a surgeon, you must first complete a medical degree recognised by the General Medical Council (GMC). This usually takes five to six years, or four years on an accelerated graduate-entry programme if you already hold a relevant degree (usually a 2:1 or above in a science-related subject). The British Medical Association provides further guidance on applying to medical school as a graduate.

After graduating, you'll complete the two-year paid UK Foundation Programme, working as a resident doctor on rotation in different departments, including surgery. On completion, you'll receive the Foundation Programme Certificate of Completion (FPCC) and can apply for paid specialty training to become a surgeon. Competition for places is fierce, with more applicants than posts in many areas. For more information, see surgery specialty recruitment and competition ratios.

Specialty training usually takes around eight years, with each specialty following its own GMC-approved curriculum. On successful completion, you can join the GMC Specialist Register and apply for consultant surgeon roles.

Not all surgeons become consultants - some work as specialty doctors or associate specialists (SAS). To do this, you'll need to register with the GMC and have at least four years of postgraduate training, including two years of specialty training.

For more information, see RCS Careers in Surgery.

Skills

You'll need to have:

• technical knowledge and clinical expertise to assess patients, make safe decisions and perform complex operations with precision
• excellent hand-eye coordination and manual dexterity to perform operations
• strong communication skills, adapting your style to suit patients, families and colleagues
• leadership and teamwork skills to coordinate multidisciplinary teams effectively
• the ability to stay calm, confident and decisive under pressure
• sound judgement, including knowing your limitations and when to seek advice
• problem-solving skills and the ability to anticipate and plan for different scenarios
• situational awareness to recognise and respond to subtle changes in patients' conditions
• professional integrity, empathy and respect for patients and colleagues
• commitment to learning, reflection and continuing professional development (CPD).

Work experience

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. You could also take part in audits or research and present your work at student or professional conferences.

A good first step is to become a member of your university's surgical society and attend their events and skills sessions. 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, a national initiative set up to encourage more women into the profession.

During your two-year Foundation Training as a resident 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.

Find out more about the different kinds of work experience and internships that are available.

Employers

The NHS is the largest employer of surgeons in the UK. There are also opportunities to work in the private sector and in the armed forces. 

Qualified surgeons can also work overseas with aid agencies and other medical organisations. 

Look for job vacancies at:

• BMJ Careers
• HealthJobsUK
• NHS Jobs - for England and Wales
• NHSScotland Jobs
• Northern Ireland Health and Social Care (HSC) Jobs

Jobs are also advertised on the websites of private healthcare providers, specialist recruitment agencies and individual trusts and hospitals.

Professional development

As a surgeon you'll be expected to continue learning throughout your career. Continuing professional development (CPD) is essential for remaining on the GMC register. CPD activities can include attending courses, conferences, meetings and workshops, as well as participating in audits, contributing to teaching or engaging in research and quality improvement projects. Guidance on how much and what kind of CPD you'll need to undertake is available from the Royal College of Surgeons.

Membership of a professional body related to your specialty is useful and offers access to CPD resources, events, online learning and professional networks.

Additional postgraduate qualifications will be looked upon positively. If you wish to integrate more formal teaching into your work, you can study for a qualification in medical education. Search postgraduate courses in medical education.

For an academic research career, you'll need to study for a PhD in an area of original research.

Career prospects

As a consultant, you'll gain further clinical experience and take on more responsibility, with the chance to progress into leadership roles such as lead consultant, clinical director or medical director. Many consultants also contribute to national organisations, professional bodies and guideline committees.

There are opportunities to get involved in teaching and training medical students, resident doctors and other healthcare professionals. If you're interested in education, you could become an educational supervisor and potentially progress into roles such as training programme director or director of medical education.

If you'd like to pursue research or an academic career, it's important to start early, often during Foundation Training, by applying for an academic clinical fellowship or completing a higher degree such as a PhD.

Specialty and specialist doctors mainly focus on patient care but may also contribute to teaching, research and committee work.

Many surgeons develop portfolio careers that combine NHS practice with education, leadership, research or private work. Most doctors working privately also hold NHS consultant posts, undertaking private practice alongside their NHS commitments. There are also opportunities to work abroad, whether in academic research, global health initiatives or humanitarian surgery.