The role of surgeons in healthcare settings

The World Health Organization (WHO) describes the role of surgeons, surgery and anaesthesia as ‘essential to a comprehensive primary health care (PHC) approach and to a people-centred continuum of emergency, critical and operative care (ECO) services’.

The quality and scope of medical care provided by surgeons is life-changing, improving health outcomes and quality of life for populations the world over. Whether working in hospital wards, intensive care units, trauma centres, military surgery, private practice or any number of other settings, the work that surgeons perform is highly complex, demanding and high-risk – and an essential aspect of improving health and wellbeing.

What are a surgeon’s main responsibilities?

For most of us, describing the work of a surgeon is likely to centre around diagnosing illnesses and injuries, and then using surgical methods and tools to fix, remove or improve parts of the body. While this is the case – and the performance of surgery and their specialist expertise is what differentiates them from other doctors and health professionals – the majority of surgeons will split their time between office environments and medical facilities.

While much of their time will be spent performing operations and medical procedures to address injuries, diseases and deformities – depending on the nature of their work and specialism – a significant portion of their time is also spent assessing patients, recommending treatments and running clinics as part of their clinical responsibilities.

Aside from surgery itself, further professional responsibilities required of surgeons include:

• guiding and adhering to good medical practice and safety standards
• continuing professional development (CPD)
• upholding clinical governance and regulation
• coordinating with other members of medical staff in the healthcare team
• performing administrative tasks – for example, scheduling follow-ups, running outpatient clinics, prescribing medication, making ward rounds of inpatients, maintaining detailed records and developing post-operative treatment plans and interventions
• training and developing medical students and other health professionals
• handling complaints.

Many surgeons utilise their skills across a combination of private and public health settings in varied, multifaceted medical careers. However, regardless of setting or specialism, the role of a surgeon is characterised by leadership and responsibility. Surgeons engage in critical decision-making in terms of patient health, safety, welfare and treatment – from pre-operative diagnosis to performing operations to post-operative surgical care – and are tasked with leading the surgical team.

What are the different specialisms and clinical care settings within surgery?

The NHS outlines ten main specialisms within surgery – and there are further options for specialisation within these:

Cardiothoracic surgery which concerns the heart, lungs and other thoracic (chest organs)

• General surgery which concerns a wide range of surgery, often in emergency situations, and is the area that 25% of all consultant surgeons work within
• Neurosurgery which concerns the central nervous system (brain and spinal cord) and the peripheral nervous system
• Oral maxillofacial surgery which concerns the mouth, jaws, face and neck
• Otorhinolaryngology surgery which concerns the ears, nose and throat (ENT)
• Paediatric surgery which concerns premature and unborn babies, children, and young adults up to 19
• Plastic surgery which concerns restoring form and function following trauma or illness, as well as aesthetic and cosmetic surgery to change form or appearance
• Trauma and orthopaedic surgery which concerns the musculoskeletal system
• Urology which concerns the female urinary system and male genitourinary tract
• Vascular surgery which concerns circulation, including arteries and veins.

As well as the surgical specialism that a surgeon chooses to pursue, their exact job role and responsibilities will vary depending on the type of clinical setting in which they work.

The American College of Surgeons (ACS) highlight some of the major settings in which a surgeon can choose to work:

1.   Private practice
2.   Academic medicine
3.   Institutional practice
4.   Hospitals
5.   Ambulatory surgery
6.   Government service programmes
7.   Uniformed services

What are the roles during a surgical operation?

Success in the operating room relies on the collaboration and cohesion of a multidisciplinary team of healthcare professionals. A typical surgical team is comprised of a surgeon, another surgeon – or a suitably qualified clinician who can act in the capacity of surgical/physician assistant, an anaesthetist, and operating theatre nurses.

The primary attending surgeon is personally responsible for patient safety and welfare during the operation. As such, they should remain in the operating room, or be immediately available, for the entire procedure to ensure every aspect of patient care and surgical care is of the highest standards of quality and safety.

What skills are required to be a surgeon?

Surgery is an extremely competitive area within the medical profession, requiring a long, complex and demanding training route and advanced medical education and experience.

Aspiring surgeons must be determined, hard-working and focused. As well as the physical aspects of the role – such as the requirement for high levels of manual dexterity and stamina – surgeons require calm and confident dispositions to deal with the high-risk nature of their work and the stresses of the role. The ability to manage and lead a wider medical team of multidisciplinary professionals – which demands excellent communication skills and strong teamwork – is also a key characteristic.

Further information regarding surgical training and education can be found on the Royal College of Surgeons in England website.

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