How to Become a Surgeon

In this article

What does a surgeon do?

A surgeon is a highly qualified doctor specialising in conducting operations (surgeries) and medical procedures on patients with various injuries, diseases and conditions. They can also perform surgeries to help people lose weight or for cosmetic reasons.

Surgeons can work in different departments within the National Health Service (NHS) or private hospitals. They can work in general surgery or specialise in various areas, such as plastic surgery, cardiothoracic surgery, neurosurgery, paediatric surgery, etc. They can also focus on specific medical surgeries, e.g. open, laparoscopic, micro and keyhole. Therefore, what surgeons do will depend on where they work and their specialisms.

Surgeons aim to use their medical and surgical knowledge and expertise to make or confirm diagnoses, correctly perform operations and treat patients’ illnesses, diseases, injuries and other issues. Often, surgeries are the only solution to help people in pain and those with life-limiting conditions. Therefore, surgeons improve outcomes for patients needing medical help and can even save lives.

Surgeons will have many duties, which will depend on their specialty areas. Some of their general tasks can include conducting ward rounds, taking outpatient clinics, examining patients, arranging tests and scans, determining if surgery is necessary, explaining procedures and risks to patients and relatives, performing surgeries, working with a team during surgeries and giving instructions, monitoring patients’ progress, contacting GPs and other doctors, training and supervising and conducting research. Their role will also involve administrative/IT work, such as typing notes, writing reports, keeping records, etc.

In the operating theatre, surgeons will work with a team, including other surgeons, doctors, anaesthetists, theatre nurses, operating department practitioners (ODPs) and surgical assistants/surgical care practitioners. Outside the operating theatre, they may liaise with consultant surgeons, specialist surgeons, patients and their relatives or friends, GPs, other healthcare professionals, laboratories, Care Quality Commission (CQC), etc. They may also need to work with the police, coroners and legal professionals if something happens to a patient during surgery.

Surgeons can work in various departments and areas within an NHS or private hospital, e.g. wards, operating theatres, outpatient clinics, consulting rooms, offices, laboratories, specialist units such as accident and emergency (A&E), etc. There may be limited opportunities to be a surgeon in the Armed Forces and with medical charities. Some roles enable surgeons to work or relocate overseas. They can also work as a locum or become self-employed with their own private practice.

Responsibilities

A surgeon’s responsibilities will depend on many factors, including where they work and their specialties.

Some examples of their day-to-day duties may include (this list is not exhaustive):

Carrying out ward rounds and taking outpatient clinics.
Examining patients to determine whether surgery is necessary and, if so, the appropriate procedure for their needs.
Arranging for tests and scans.
Meeting and talking to patients and their relatives before operations to explain procedures and risks.
Performing various surgeries in line with their specialties.
Using the correct surgical techniques and procedures during operations.
Working with a team of other healthcare professionals during operations and procedures and giving them appropriate instructions.
Liaising with other healthcare staff before and after operations.
Prescribing medication where required.
Monitoring patients’ progress before and after surgeries and advising them and/or their relatives on care.
Making patient referrals to other specialists where required.
Contacting GPs and other doctors regarding patients’ prognoses, conditions and treatments.
Training and supervising newly qualified doctors, medical students and other team members.
Undertaking relevant administrative tasks, e.g. updating patient records and writing reports.
Researching to improve surgical techniques, equipment, procedures and patient outcomes.

Working hours

A surgeon’s working hours are variable and will depend on their specialty. However, it is not a 9-5 job, and those looking at entering this profession must be committed to working long and unsociable hours. Surgeons usually have to work early mornings, evenings, nights, weekends and bank holidays on a rota, and some may be on-call.

Travel and overnight stays may be necessary for some surgeons. Overseas work may be an option, e.g. working for the Armed Forces or medical charities.

What to expect

Being a surgeon is not easy and definitely not for the faint-hearted. However, it is a rewarding career choice. Surgeons treat patients’ injuries, illnesses and conditions and can improve their quality of life. In some cases, their surgeries can save lives and help people to live longer and happier lives.

The role can be fulfilling when operations have gone well, patients recover, and it has changed their lives. Surgeons can go home after the working day knowing their job makes a difference to patients, their relatives and society.

People tend to admire and greatly respect individuals who become surgeons as they recognise the level of commitment, knowledge and skill needed. There is prestige associated with the role, as they are literally lifesavers.

The average salaries for surgeons are high, even at the entry level. However, it does reflect the level of education, training, time and commitment needed to become a surgeon. Individuals working for the NHS will also receive benefits, e.g. generous annual leave, pension scheme and health service discounts.

There are numerous specialties within this field, which allows surgeons to become experts in their areas. There are also hospitals across the UK and overseas, so individuals may be able to work in different areas. There are options to start their own practices.

Boredom will never be a problem for surgeons, as their work is very varied and challenging. They will see and operate on various patients from all backgrounds with different medical needs. One moment they could have a patient with an injury that requires repair, and the next, they could have someone with a life-threatening condition (depending on their specialty).

A surgeon requires a high level of technical skill, expertise and precision. Therefore, it is a good option for individuals who want a career filled with learning, development, advancement and intellectual stimulation.

Even though being a surgeon is rewarding, and there are many positives associated with the role, they may also face challenges, for example:

Life and death situations – surgeons have a lot of responsibility, and there is no room for error, as mistakes can cost lives. Complications can arise during surgeries, and some patients may not make it through procedures. In these cases, there are usually investigations into why patients died, and some surgeons can face legal proceedings if found negligent. It can be emotionally demanding to lose a patient during an operation, and then being subject to an investigation and dealing with the deceased’s family. In worse cases, the GMC can remove surgeons from the register, tarnishing their reputations and affecting their careers.
Study, exams and competition – becoming a surgeon can take over 15 years. They will need a degree in medicine (4-6 years) and must undertake foundation training (2 years), core surgical training (2 years) and specialty training (6 years). Therefore, individuals must prepare for intense study, work-based learning, tests, exams and registration. Getting into medical school and onto surgical specialty training is also highly competitive, and there are no guarantees that an individual will be successful.
Mental demands – being a surgeon is mentally demanding, as they will see many patients throughout their shifts and can carry out several operations, putting time pressures and stress on individuals when juggling different demands. Each patient will have varying needs, and some may require emergency procedures. Surgeons will need to be capable of working in these challenging environments and must be able to perform excellently during every operation.
Physical demands – being a surgeon can be physically demanding. Their hours can be long and unsociable, and they spend significant time on their feet during operations. They will need to concentrate and may carry out intricate surgeries and procedures for many hours, which can be tiring. Individuals must have good physical fitness. They also need to wear a uniform and personal protective equipment (PPE), which can get hot and uncomfortable.
Hazards and risks – surgeons can face many dangers in the operating theatre, such as working scalpels, needles and other sharp instruments, lasers and surgical smoke, exposure to anaesthetic gases, radiation, manual handling, other hazardous substances, biological fluids, noise, infectious agents and germs, work-related stress, slips, trips and falls, etc. Employers must ensure they prevent, reduce or control the risks, but individuals should be aware of the hazards of the job.

Every career choice has pros and cons, and prospective surgeons must know what to expect before deciding whether it is a suitable role. There is no doubt being a surgeon is mentally and physically demanding. There are life-and-death situations and health and safety risks. It also takes many years to qualify and get a job, which requires significant commitment and dedication. However, there are many positives and improving people’s quality of life and even saving lives is why individuals become surgeons.

Individuals should consider the pros and cons when deciding whether to be a surgeon. They should also ensure they have the necessary personal qualities to carry out the role and responsibilities required.

Personal qualities needed to be a surgeon

Some of the personal qualities a surgeon requires will include (this list is not exhaustive):

Knowledge of medicine, healthcare, biology, physiology and surgical techniques.
Knowledge of injuries, diseases, illnesses and other conditions.
Having integrity, trustworthiness, honesty, empathy, understanding and sensitivity.
Calm, confident, caring, emotionally resistant and assertive.
Committed, determined, driven, enthusiastic and motivated.
Physical stamina.
Excellent hand-eye coordination, vision and visuospatial awareness.
Excellent manual dexterity.
Excellent communication skills, both verbal and written.
Science and technical skills.
Thinking and reasoning skills.
Leadership skills.
Problem-solving and diagnostic skills.
Negotiation skills.
Organisational and time management skills.
Being thorough, accurate and having excellent attention to detail.
The ability to work well with their hands.
The ability to take criticism and accept responsibility.
The ability to give instructions clearly and delegate to others.
The ability to work well under pressure, prioritise and juggle different demands.
The ability to work well with other healthcare professionals in multidisciplinary teams.
The ability to inspire confidence in others.
The ability to make decisions and use judgement, sometimes quickly, even in difficult situations.
The ability to be patient and remain calm and confident in challenging and stressful situations.
The ability to be flexible and adapt to a changing environment.
The ability to use IT equipment, e.g. computers, hand-held devices, and software packages.

Qualifications and training

Qualifications

To become surgeons, individuals must first become doctors. They need to:

Complete paid or voluntary work experience in a healthcare environment before applying for medical school.
Complete a degree in medicine recognised by the General Medical Council.
Complete two years of foundation training.
Register with the General Medical Council (GMC).

Please visit our career guide on How To Become A Hospital Doctor for further information on work experience, the qualifications needed and the registration process to become a doctor.

Surgical training and specialist registration

A degree in a relevant subject can maximise individuals’ chances of success.

Once individuals have completed their degree and foundation training and have registered as a doctor with the GMC, they will start their surgical training, which is in two parts as follows:

Two years of core surgical training

Individuals will undertake a paid training job in a hospital setting and learn about various surgical specialties.
The aim is to give individuals the knowledge and skills for specialty training.
Some roles may focus on one particular specialty.
Individuals must pass the Intercollegiate Membership of the Royal College of Surgeons (MRCS) Examination to move on to the next training stage.
Further information on core training is on the Medical Education Hub.

Six-eight years of specialty training

If individuals pass their exams, they will move on to the next stage of training.
It is a paid training job in a hospital focusing on one surgical specialty.
Further information on higher training is on the Medical Education Hub.

After completing specialty training, individuals gain a Certificate of Completion of Training (CCT), which allows them onto the GMC’s specialist register. They must pass the Intercollegiate Specialty Fellowship Examination (JCIE) to obtain the CCT. It leads to specialty fellowship of the Royal College of Surgeons (FRCS), and individuals can then apply for consultant surgeon positions or work as Specialty and Specialist (SAS) Doctors.

Further information on the entry requirements and training is on the Royal College of Surgeons.

Training courses

Learning does not stop with experience or once someone becomes qualified. Undertaking postgraduate qualifications (part-time) and relevant short training courses can help individuals enhance their employability and keep their knowledge and skills current. It can also help them with entry to medical school.

We have many approved courses that can be useful for individuals looking for a career as a surgeon, for example (this list is not exhaustive):

Infection control.
COVID-19 awareness.
Needles and sharps.
Administering medication.
Acquired brain injuries.
Cardiovascular disease awareness.
Respiratory disease awareness.
Safeguarding.
Equality and diversity.
PPE in healthcare.
Customer service in health and social care.
Introduction to health and safety.
Workplace stress awareness.
Manual handling.
Slips, trips and falls.
COSHH awareness.
Workplace first aid.
Fire safety awareness.
Understanding GDPR.
Resilience training.
Time management.

Professional bodies, unions, associations and societies, such as the Royal College of Surgeons of England (RCSENG), the Association of Surgeons of Great Britain and Ireland (ASGBI), the Federation of Surgical Specialty Associations (FSSA), the GMC, the Doctors’ Association UK (DAUK), the Hospital Doctors’ Union (HCSA), the British Medical Association (BMA), Surgical Societies, and others can advise on reputable training courses. They also have memberships, events, support and guidance that can help surgeons and give them the means to continue their professional development. Continuing professional development (CPD) is mandatory for GMC registration renewal (revalidation). Also, see CPD courses for doctors for further guidance on CPD.

The training a surgeon will require will depend on where they want to work, their specialties and the CPD requirements for GMC registration. As well as looking at professional body websites, it is worth looking at several job advertisements to identify the qualifications and other training needed for specialist roles. Jobs are on Health Careers, NHS Jobs, BMJ Careers, JobsMedical, NHSScotland Jobs, HealthJobsUK, HSCNI Jobs, Bupa Careers and other job sites, such as GOV.UK Find a Job Service, Glassdoor, LinkedIn and Indeed. Also, look at recruitment agencies, as they may offer locum jobs.

More relevant training and competence will open up more opportunities for surgeons. Refresher training will also be required, as it is mandatory for revalidation and keeps knowledge and skills current.

Criminal records checks

Surgeons must undergo an enhanced criminal record check, as they may come into contact with children and vulnerable adults. A criminal record, caution, warning, or conviction may put off prospective employers. It can even affect GMC registration. However, employers should account for the seriousness of the crime, when it occurred and its relevance.

The organisation that holds criminal records will depend on the country within the UK, for example:

England and Wales – Disclosure and Barring Service (DBS).
Northern Ireland – AccessNI.
Scotland – Protecting Vulnerable Groups (PVG) scheme.

Driving

Some surgeons will drive as part of their role, especially when working between hospitals. Therefore, they should have a full clean driving licence.

Where do surgeons work?

Surgeons mainly work for the NHS but can also work for other employers in the private healthcare sector, the Armed Forces and the charitable sector. They can also work as a locum or be self-employed and set up their own practice.

Surgeons mainly work in the NHS or private hospitals, usually in cities and large towns. They can work in various hospital departments and areas (depending on their specialty), e.g. operating theatres, wards, clinics, offices, laboratories, consulting rooms, etc.

Some surgeons may also work overseas and outdoors in field hospitals.

How much do surgeons earn?

The exact salaries for surgeons will depend on the following:

Where they are in their training.
Their location, i.e. if they are in London, they will receive a supplement.
Their experience.
Their chosen specialty.
Whether they are employed or self-employed.
Their working hours, e.g. full-time, part-time, locum or flexible.
Whether they work for the NHS, privately or for other employers.

Here are some examples of salaries for England (these figures are a guide only and are subject to change):

Junior doctors in Foundation Year 1 (F1) – £29,384 a year.
Junior doctors in Foundation Year 2 (F2) – £34,012 a year.
Doctors starting specialty training – £40,257 to £53,398 a year.
Specialty doctors – £50,373 to £78,759 a year.
Specialist grade doctors – £80,693 to £91,584 a year.
Qualified consultants – £88,364 to £119,133 a year.

Data from NHS pay for doctors.

Doctors in training receive additional payments for overtime and an enhancement for working nights and weekends and being on-call. Salaried doctors will also receive further benefits, e.g. pension scheme, sick pay, holiday pay and maternity pay.

There is potential for surgeons to earn more if they work in the private healthcare sector or as a locum. Experienced surgeons may earn higher salaries if they combine clinical work with research and teaching or become a consultant and combine NHS work with private.

Further information on pay is also on the British Medical Association’s website.

Types of surgeon roles to specialise in

There are typically ten areas in which surgeons can specialise, which are:

Cardiothoracic – specialising in illnesses and conditions concerning the heart, lungs, oesophagus and chest. Surgeries can include cardiac surgery, thoracic surgery, congenital cardiac surgery and heart and lung transplant surgery.
General – specialising in a wide range of surgeries and sub-specialties, e.g. breast, colorectal, endocrine, upper and lower gastrointestinal (GI), transplant (of kidney, liver, pancreas) and vascular. These surgeons will conduct a large amount of emergency surgical work.
Neurosurgery – specialising in surgeries involving the brain, central nervous system and spinal cord. Surgeons in this area can also focus on various sub-specialties, such as paediatric neurosurgery, neuro-oncology, spinal surgery, etc.
Oral and maxillofacial – specialising in diseases and disorders affecting the mouth, jaws, face and neck. Some examples of surgeries include cleft surgery, facial trauma management, oral cancer, adult facial deformity, orthognathic surgery, etc.
Otorhinolaryngology (ear, nose and throat (ENT) surgery) – specialising in the head and neck region, skull base and facial plastic surgery. Surgeons diagnose, evaluate and manage associated surgical and medical disorders.
Paediatric – specialising in the surgical treatment of diseases, trauma, malformations and disorders affecting premature and unborn babies, children and young adults up to 19. Surgeons in this area can also specialise in surgeries, such as neonatal, urological, hepatobiliary, GI and oncological.
Plastic – specialising in surgical restoration, reconstruction or alteration after illnesses or trauma. They can conduct emergency work, e.g. hand trauma, burns and scalds, and soft tissue injuries involving the face, trunk or limbs. They can also do cosmetic or aesthetic surgery to change a person’s form or appearance.
Trauma and orthopaedic – specialising in diagnosing and treating musculoskeletal system conditions, i.e. the bones, joints and their associated soft tissues, including ligaments, tendons, nerves and muscles. They can specialise in trauma work, bone tumours, paediatric orthopaedics, rheumatoid surgery, sports and exercise surgery and other areas.
Urology – specialising in problems affecting the female urinary system and the male genitourinary tract. Surgeons diagnose and treat disorders and diseases of the kidneys, ureters, bladder, prostate and male reproductive organs, e.g. cancer, incontinence and urinary tract stones.
Vascular – specialising in diagnosing, surgically treating and managing diseases affecting all parts of the vascular system, including veins, arteries and lymphatic vessels. Some examples of surgeries include carotid endarterectomy, angioplasty and lower limb bypass surgery.

Further information on specialties and sub-specialties is on the Royal College of Surgeons surgical specialties and NHS Health Careers.

These surgeon roles will require differing knowledge, skills, experience and qualities. Some may need specific qualifications, e.g. postgraduate and additional training for specialised areas. All surgeons must know how to diagnose, surgically treat and manage different illnesses, injuries and conditions. They must also have the commitment and other personal qualities to succeed. Any additional areas of expertise will depend on what an organisation is looking for and the type of work a surgeon wants.

If surgeons do not carry out their role effectively and competently, it can cause a patient’s illness, injury or condition to worsen. It may even cost lives if they make mistakes in the operating theatre. It can also affect a surgeon’s reputation. In serious cases, they may have their registration and licence to practise revoked (struck off) and could also face legal action. Therefore, whatever the type of role, surgeons must have the necessary competence to carry out the work professionally and safely. They should also know the limits of their competency, i.e. asking for help when something is beyond their expertise.

Professional bodies

Standards, technologies, drugs, medications, equipment, treatments and laws are updated regularly. Therefore, surgeons must keep ahead of the latest developments and changes to remain legally compliant and carry out their roles effectively and safely. CPD gives surgeons the knowledge and skills to keep up to date with these changes and understand their responsibilities. It also helps them stay registered with the GMC and allows them to progress in their career.

Joining a professional body, union, society or association (as previously mentioned) can help prospective and current surgeons enhance their skills and overall career. These may offer different levels of membership, CPD, access to industry contacts, support, advice and networking events.

There is ample opportunity for career progression within medicine. With more qualifications and experience, a surgeon can become a consultant or senior surgeon. They could go on to lead a team or manage a department. As a consultant, there are opportunities to become a medical lead, clinical director or medical director. Alternatively, they may work as a locum, become self-employed with their own practice or move from an NHS hospital to a private one.

Knowledge, skills and experience in medicine can also lead to a career in different areas. For example, a surgeon may want to work in education and training and teach students, trainee doctors and other healthcare professionals. They could also go into research (academic surgery) or other areas of healthcare. Finally, they may also work in different sectors, such as the Armed Forces.