What It Takes To Be A Surgeon

What it takes to be a Surgeon Have the mind of Aesculypius (= clever) The eyes of an eagle (=sharp ) The hands of a woman (=skilful) And the heart of a Lion (= determined) Often medical students ask me if I think they could become a surgeon. I suppose that they see surgeons as up on a pedestal and wonder if they could get there. There are few other jobs where a person so entrust their life to you (except an airline pilot) in such an immediate way. Think about it: a person lies down in front of you, allow themselves to become powerless and unconscious, and trust you to cut into their body. That’s TRUST. You have to earn and deserve that trust. So how to select such people to deserve such trust in them. This is a question often pondered by the Selection Committees who decide which applicants are selected to be trained to become surgeons. It’s a long and arduous process not only for the candidate but also for the other surgeon educators training them. They may have relied upon the traditional parameters they considered important in a surgeon but now want to upgrade their thinking. There is little doubt that a surgeon has to: Be reliable (CHARACTER). You can’t walk out during an operation when the “heat’ is on or you are tired etc. If matters get tough then you have to stick it out and have the resolve to see it through. And believe me things get tough in the OR. A complication occurs, those around you panic and you have to lead the charge to complete the task at hand and to make sure the patient interests are best served. It’s a ONE ‘MAN’ show in the OR. You might be surprised to hear that some doctors are just not reliable. They turn up late, panic or are lazy all too frequently. Be capable of working long hours and performing under pressure (PHYSICAL ENDURANCE). It goes without saying that you must have physical stamina and be able to deal with a lot of stress, work at odd hours and during the night. The hours of work required by surgeons are being rationalized but it will be a long time before surgeons are working a 30 or 40 hour week. If this is your work capacity then stay out of surgery. Be intelligent. Well if you have finished medical school then you have enough brains to become a surgeon. It does not take any more intelligence than other specialties. Though because

surgery, esp. orthopaedic and eye surgery are popular career choices by young doctors, then they tend to be full of very intelligent trainees. There’s a lot to learn in orthopaedics- hard knowledge of general medicine and surgery, know all about >200 different fractures ( how to manage and operate on them), how to perform > 600 cold operations( the surgical technique) and the details of > 600 implants(hip, knee, shoulder etc) PLUS the courage to decide, act and perform these operations under pressure. It’s a misconception that you have to be super intelligent to be a Brain Surgeon (after all the brain is just a lump of fat sitting on top of the far more cleverly designed musculoskeletal system and the brain is probably a big mistake in evolution), a myth that does wonders at parties when you are single and available. Gender It is still surprising that intelligent lady medical students still ask this question as to whether a woman can or should become a surgeon. In my opinion women make better surgeons as they have more brains, much better fine motor skills than men and are more diligent and caring. But I have seen too many of my female colleagues simply worn-out by the demand of orthopaedic surgery. After 35 or 40yo the after hours just gets too much and you have to ask yourself whether all this sacrifice is worth it. By 35 or 40yo there’s a good chance your marriage is on the rocks (being too long away from the home and your spouse) or it has been difficult for you to meet a man/partner to satisfy your personal or social needs (everyone needs someone else in their private life to balance the hell/madness of s surgical career and don’t overlook the option of having children, they can be an eternal source of bliss for you). Let’s be honest and not politically correct in this column so it is of use to a lady medical student asking this question rather than an exercise in careful political talk. I am most emphatic here: don’t become a surgeon to please your parents or old school headmistress. The cost will be too great. If you can’t live without being an orthopaedic surgeon then become one. Manual dexterity You might be surprised that I have put this last when you might have though it would be put first. Unless you are completely clumsy and can’t bless yourself, then shear application and good training can teach/bring manual dexterity. It’s not unusual for orthopaedic surgeons in their spare time to build boats or extensions to their home and hang around Hardware stores (instead of going to the Opera). So here’s the noble answer: If you want a great career working with your mind AND hands (hands=civilization eg music, sculpture, painting) and are prepared to fully dedicate yourself then surgery is the one for you.

Here’s the (less) noble answer: The Specialities of Medicine are divided into a continuum from: HIGH TECH/ PROCEDURAL/HIGH INCOME/HIGHLY COMPETITIVE/HIGH STATUS/FULL OF ALPHA MALES (Surgery) to LOW TECH/ALOT OF TALKING AND EXPLANANTIONS/LESS INCOME/LESS COMPETITION/LOWER STATUS/ A MIX OF PERSONALITY TYPES AND GENDERS (eg paediatrics). Choose where you lie and what you are prepared to sacrifice to join the major league. Cogito et Seco (the private opinions of ES only)