Specialty of General Surgery Defined

1. The scope of general surgery
General surgery is a discipline that requires knowledge of and familiarity with a broad spectrum of diseases that may require surgical treatment. By necessity, the breadth and depth of this knowledge will vary by disease category. In most areas, the surgeon will be expected to be competent in diagnosing and treating the full spectrum of disease. However, there are some types of disease in which comprehensive knowledge and experience is not generally gained in the course of a standard surgical residency. In these areas, the surgeon will be able to recognize and treat a select group of conditions within a disease category.

2. The required residency experience for initial certification in general surgery
  • Residency training in general surgery requires experience in all of the following content areas:
  • Alimentary Tract (including Bariatric Surgery)
  • Abdomen and its Contents
  • Breast, Skin and Soft Tissue
  • Endocrine System
  • Solid Organ Transplantation
  • Pediatric Surgery
  • Surgical Critical Care
  • Surgical Oncology (including Head and Neck Surgery)
  • Trauma/Burns and Emergency Surgery
  • Vascular Surgery

  • General surgery as a field comprises, but is not limited to, the performance of operations and procedures (including endoscopies) relevant to the content areas listed above. Additional expected knowledge and experience in the above areas includes:
  • Technical proficiency in the performance of essential operations/procedures in the above areas, plus knowledge, familiarity and in some cases technical proficiency with more uncommon and complex operations in each of the above areas.
  • Clinical knowledge, including epidemiology, anatomy, physiology, clinical presentation, and pathology (including neoplasia).
  • Knowledge of wound healing; infection; fluid management; shock and resuscitation; immunology; antibiotic usage; metabolism; management of postoperative pain; and use of enteral and parenteral nutrition.
  • Experience and skill in the following areas: clinical evaluation and management, or stabilization and referral, of patients with surgical diseases; management of preoperative, operative and postoperative care; management of comorbidities and complications; and knowledge of appropriate use and interpretation of radiologic and other diagnostic imaging.

  • 3. The following disciplines have training programs related to, but separate from, general surgery. As the primary surgical practitioner in many circumstances, the certified general surgeon is required to be familiar with diseases and operative techniques in these areas. The certified general surgeon will have experience during training that will allow for diagnosis and management of a select group of conditions in these areas. However, comprehensive knowledge and management of conditions in these areas generally requires additional training.
  • Bariatric Surgery
  • Solid Organ Transplantation
  • Pediatric Surgery
  • Thoracic Surgery
  • Vascular Surgery

  • 4. In addition, the certified general surgeon is expected to be able to recognize and provide early management and appropriate referral for urgent and emergent problems in the surgical fields of:
  • Gynecology
  • Urology
  • Orthopaedic Injuries
  • Hand Surgery

  • 5. The certified general surgeon is also expected to have knowledge and skills in the management and team-based interdisciplinary care of the following specific patient groups:
  • Terminally ill patients, to include palliative care and the management of pain, weight loss and cachexia in patients with malignant and chronic conditions.
  • Morbidly obese patients, to include metabolic derangements, surgery for weight loss, and the counseling of patients and families.
  • Geriatric surgical patients, to include operative and nonoperative care, management of comorbid chronic diseases, and the counseling of patients and families.
  • Culturally diverse groups of patients.

Updated: March 2013

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