How To Become A Surgeon

How to become a surgeon

It takes nearly two decades of hard work to get there, but surgery is one of medicine’s most demanding and exciting areas. Whether it is saving or improving people’s lives or working on the cutting edge of transplant science, surgery is for many the pinnacle of what medicine can do, and as such attracts the best and brightest doctors-in-training. The rewards for these students are considerable, with extremely rewarding, high-salaried and secure jobs waiting for them across the world.

If, after your lengthy general medical training you still find yourself wanting to learn more about the more difficult areas of your field, then surgery might be for you. As well as extensive further study, surgeons need to be constantly up to date in an ever‑changing field, regularly learning new skills as surgery becomes ever more advanced.

Modern surgical practice increasingly involves minimally invasive techniques, image‑guided procedures and robotic‑assisted surgery, all of which require ongoing training. If all that has been mentioned so far excites you and leaves you wanting to know more, read on as we take you through the process by which you become a surgeon, from initial interest in your undergraduate years to that all‑important further postgraduate study.

Find your PERFECT POSTGRAD PROGRAM

Undergraduate study and medical school

The first thing you need to do is become a doctor and this means applying to study medicine at university. In the UK, most medical degrees are five or six years long and must be approved by the General Medical Council (GMC). Although medicine is highly competitive, most doctors will tell you that surgery is even more so – so you need to be prepared to work very hard from the start.

Entry requirements for medicine vary by institution but usually include strong A‑levels (or equivalent) in sciences such as chemistry and biology, relevant admissions tests (for example UCAT or BMAT) and work experience in caring or clinical settings. If you think you might be interested in surgery, it is worth seeking out surgical‑related work experience or attending surgical careers events during medical school where possible. Medical schools and organisations such as the Royal College of Surgeons of England run taster days and student surgical societies that can help you explore whether a surgical career is right for you.

Foundation training in surgery

Once you have completed your medical degree, you will enter the UK Foundation Programme, a two-year general training scheme (Foundation Year 1 and Foundation Year 2), where you work as a junior doctor rotating through the 10 recognised surgical specialties. These rotations often include posts in surgical specialties or related areas such as emergency medicine, providing early exposure to surgical practice and helping students decide whether to apply for surgical training.

During these two years, students will need to build up their portfolio, showing an interest in and commitment to surgery as well as basic medical abilities. This may include taking part in surgical audits, presenting at meetings, assisting in theatre where appropriate, engaging with a surgical mentor and joining relevant professional associations. Your performance in the Foundation Programme, alongside your portfolio, will be a key factor when you later apply for core surgical training or run‑through surgical programs.

Core surgical training and run‑through training

If you still want to go into surgery after the Foundation Programme, your next step is to enter surgical training. Broadly speaking there are two models: core surgical training followed by higher specialty training, or in some specialties an integrated “run‑through” program from an early stage.

Core Surgical Training (CST) usually lasts for two years (CT1 and CT2). During this period, trainees rotate through a number of surgical specialties and gain broad operative and non‑operative skills. Programs are designed to deliver the core surgical curriculum, with trainees undertaking four six‑month placements or similar rotations, covering areas such as general surgery, trauma and orthopaedics, vascular, ENT, urology or plastics, depending on local posts.

At the end of these two years, you are expected to have completed the requirements of the core surgical curriculum and to have passed the Membership of the Royal College of Surgeons (MRCS) examination. The MRCS exam assesses your knowledge, clinical skills and professional behaviours across the breadth of basic surgical practice and is a prerequisite for progression to higher surgical specialty training at ST3.

In some specialties (for example neurosurgery and cardiothoracic surgery), run‑through training may start from ST1 and continue without a separate core training phase, although the overall principles and duration of training are similar.

Specialty training and length of training

Whatever route you follow, all surgeons should be heading towards their Certificate of Completion of Training (CCT) (previously referred to as CCST), which confirms completion of specialist training and eligibility to be placed on the GMC’s Specialist Register in a surgical specialty. What is essential to gaining this certificate is around two years of core surgical training (or the equivalent early years of a run‑through program), followed by approximately six years of higher surgical training from ST3 to ST8, depending on the specialty.

From the beginning of medical school to the acquisition of your CCT, that makes for around 12 to 16 years of education and training for most UK surgeons, including five to six years of medical school, two years of Foundation training and at least eight years of surgical training. Not everyone who starts on this path will successfully complete it, so it’s important to understand the commitment involved. If that prospect fills you with excitement rather than the more usual response of dread, read on, you are definitely the sort of person born to be a surgeon!

During higher specialty training you focus on one branch of surgery – for example general surgery, trauma and orthopaedics, urology, plastic surgery, ENT, neurosurgery, vascular surgery or paediatric surgery – and gradually take on more responsibility. Your training is overseen through the Intercollegiate Surgical Curriculum Programme (ISCP) and the Joint Committee on Surgical Training, which sets out the competencies, workplace‑based assessments and examinations required at each stage.

What do you study at postgraduate level?

How to become a surgeon If you want to become a surgeon can vary incredibly widely from case to case, depending on which particular areas of surgery you want to specialise in and how much you want to learn about the research methods that will further the field. Here, we will try to outline a few paths that you might wish to take, but anyone with particular interest in certain types of surgery should use our guide as a stepping stone to further research into the options that will be tailored to you.

Although core surgical and specialty training can be done entirely within the NHS training system rather than with a university, if you are still reading this you are probably the sort of person who not only wants to be a surgeon, but also someone who wants to help take surgery into new fields and ever more life‑saving procedures through intense research. If being a trailblazer in the field sounds appealing, then many of Britain’s best medical schools offer MSc or MS (Master of Surgery) programs that allow you to learn about surgical research methods alongside your surgical training, in courses designed alongside leading hospitals to produce the highest calibre of research‑surgeons. Examples include research‑focused degrees in surgical sciences, minimally invasive surgery or translational medicine at leading universities, often taken part‑time alongside clinical posts.

These are undertaken after the first two years of foundation training, only accept the best candidates are accepted, those with exemplary academic results, extensive experience as well as a demonstrable interest in an aspect or area of surgical practice. Some will take them straight after two years of foundation training, but they are also worth considering later on in the route to becoming a surgeon, if a certain area of surgical practice has really fascinated you and you find yourself with a driving urge to improve the area or procedures through research.

What work experience should you consider to become a surgeon?

As we have already mentioned, work experience within a hospital or other medical establishment is essential for anyone wanting to become a surgeon, with at least a decade of it expected to be undertaken before a CCST accreditation is possible. Further to this mandatory medical training, however, candidates who are considering surgical masters or other forms of postgraduate will need to be able to demonstrate an interest in their chosen field of surgery, and additional work experience is a great way to demonstrate this.

Many companies and charities offer work experience and volunteer placements for students of surgery to work overseas in war-torn or poverty-stricken countries, that can be undertaken in the lengthy summer holidays during your study time. As well as being a great way to gain some major experience in difficult circumstances, helping those so desperately in need will definitely rekindle a love of surgery that the many years of training may have slightly knocked out of you.

Surgeon student case study

Surgeon student case study Claire, currently taking the MSc in Surgical Science and Practice at the University of Oxford, can remember the exact moment she decided she wanted to be on the cutting-edge of surgical research. “Someone showed me a Youtube video of a musician playing the banjo whilst receiving brain surgery, and at that moment I knew I wanted to be at the forefront of research just like the surgeons in that video”. Claire got accepted onto the masters program after three years of foundation work, and is loving the combination of hands-on training and intensive research, and looks forward to even further study in neurosurgery once she has completed her MSc.