Surgeons specialise in caring for patients who may need an operation. Their duties include:

• making a diagnosis
• deciding on the most appropriate course of action
• operating on patients
• monitoring patients after an operation.

Surgeons will carry out surgery when, for example, the patient has sustained an injury, developed a disease or degenerative condition. 

Surgeons need in-depth knowledge of physiology, biochemistry, pathology and anatomy. They work in one of nine surgical specialities which are cardiothoracic surgery, general surgery, plastic surgery, ENT, paediatric, trauma and orthopaedic, urology, neurosurgery, oral and maxillofacial surgery.

Patients are referred to surgeons by other hospital doctors, general practitioners, and through admission to accident and emergency.

The duties of senior or consultant surgeons will usually include seeing patients in outpatient clinics, leading a team of nurses and junior doctors during surgery, and making ward rounds to see patients before and after an operation. They make notes for patient records and write letters to general practitioners, advising them of their patients’ condition and treatment.

Surgeons are also responsible for training and supervising more junior doctors and other healthcare professionals in the hospital. Some surgeons carry out research and write papers for publication.

Hours and Environment

Surgeons work long and unsocial hours including nights, weekends and on-call duty. New European legislation will reduce the number of hours worked, but surgeons will still be expected to work unsocial hours as part of their working week and an out of hours rota system.

As a surgeon you will work in operating theatres, hospital wards and consulting rooms. You will wear protective clothing during operations.

Surgery can be physically demanding and stressful, requiring long periods of standing and bending.

Skills and Interests

To be a surgeon you should:

• have an interest in and concern for the well-being of patients
• have excellent communication skills
• be able to put people at their ease and inspire their trust and confidence
• work well in and be able to lead a team
• be able to work under pressure and make quick clear decisions
• work consistently to high professional standards
• be prepared to continually update your knowledge and learn new techniques
• have excellent hand-eye co-ordination and manual dexterity
• be able to train, teach and supervise staff
• have an interest and ability in anatomy and physiology.

Entry

To become a surgeon, you need to complete:

• a degree in medicine, recognised by the General Medical Council (GMC)
• a two year foundation programme of general training (see Training section for details)
• a basic and higher surgical training programme (see Training).

The GMC hold details of recognised degree courses, see Further Information for details. Each medical school has an individual approach; some degree courses will offer more opportunities for dissection work. It is important you research each school and choose a course that will prepare you best for a career in surgery. Contact The Royal College of Surgeons of England for details; see Further Information.

The entry requirements for a five-year degree in medicine usually include three A levels at grades AAB in subjects such as chemistry, biology and either physics or maths. If you have qualifications from Scotland you need H grades and Advanced Highers in subjects such as chemistry and biology. The subjects and grades you achieved at GCSE/S level will also be taken into account.

If you do not have qualifications in science, there is a six-year degree course in medicine that includes a one-year pre-medical (or foundation) course.

If you are a graduate with a first or upper second class honours degree in a science subject, you may be able to join a four-year graduate entry programme to medicine. Some universities will accept non-science graduates. The British Medical Association (BMA) website has details of course providers, see Further Information for contact details.

You may also be asked to take the UK Clinical Aptitude Test (UKCAT), which is used by 23 UK universities to identify students with the appropriate attitude, behavioural attributes and mental abilities for a degree in medicine. The university you wish to join will tell you if you need to take the test. For more details and to register for the test, go to the UKCAT website.

Before you apply for a course you can gain insight into this field by doing some relevant paid or voluntary work, for example working as a care assistant in a hospital, residential or nursing home. Some hospitals allow potential medical students to observe a qualified doctor at work. You can contact local hospitals directly to discuss these possibilities.

Training

As a medical student you are exposed to many of the specialties within medicine. You will learn basic medical science, communication skills and practical clinical techniques. You will work, under supervision, in a range of areas such as general practice, accident and emergency, and outpatient clinics.

When you have achieved your degree in medicine, you need to complete three further stages of training to become a senior (or consultant) surgeon: 

• a two-year foundation programme. This can include placements in acute care settings, mental health and general practice. Successful completion of year one (known as F1) leads to full registration with the GMC. During year two of the programme (F2) you will experience a range of specialist areas. At the end of F2 you make your career choice to pursue specialist training in surgery.
  
• basic surgical training programme. You will apply in open competition for a place on basic surgical training. During this period you will work as a Senior House Officer and sit the Intercollegiate Membership of the Royal College of Surgeons general surgical exams (MRCS). When you successfully complete this stage of training, which takes around two years, you will be awarded the Certificate of Completion of Basic Surgical Training (CCBST).
  
• higher surgical training. This stage can take between five and six years depending on your surgical specialism. During this time you will work as a Specialist Registrar and sit speciality surgical exams leading to Fellowship of the Royal College of Surgeons (FRCS). When you successfully complete this stage, you will be awarded the  Certificate of Completion of Training (CCT). This means you will be eligible to join the GMC Specialist Register and practise independently as a surgeon.

As a consultant you are expected to continue learning throughout your career. Check The Royal College of Surgeons website for details on all aspects of training and continuing medical education for practising surgeons (see Further Information).  

This new way of training is part of the NHS Modernising Medical Careers Review. For more details, check the NHS Modernising Medical Careers website.

Opportunities

Competition for promotion through the various training grades can be strong as places on specialist and higher specialist training programmes are limited in number. When you qualify you may need to relocate in order to take up more senior positions. 

As a surgeon you will find opportunities to work in both the NHS and the independent or private sector. With experience, you may go onto lead a team or manage a department.

Annual Income

Figures are intended as a guideline only.

Junior doctors, on the foundation programme, can earn between £21,000 and £26,000 a year.
Doctors in specialist training can earn up to £44,000.
Doctors in training will receive extra payments depending on the hours worked, workload, and the amount of time spent working unsocial hours.

Consultants can earn between £70,000 and £94,000 a year.
With additional payments and merit awards, consultants can earn considerably more. 

Surgeons working in private sector hospitals may negotiate higher fees.

Further information

Regent's Place
350 Euston Road
London
NW1 3JN
Tel: 0845 357 3456 35-43 Lincoln’s Inn Fields
London
WC2A 3PE
Tel: 020 7405 3474 Tavistock Square
London
WC1H 9JP
Tel: 020 7387 4499 Tel: 08000 150 850
Email: learning@nhscareers.nhs.uk