Although popular once upon a time, general surgery today has few takers. In the NEET counselling for postgraduate medical courses last year, only four out of the first 100 students opted for general surgery.
Whenever options are available, medical students tend to avoid surgical disciplines. General surgeons have served society for decades performing many surgeries, but are now being replaced by superspecialist surgeons. Overall, the treatment costs are also increasing.
Like family physicians, the role of general surgeons has now decreased in society. Many parents still desire their wards to be doctors, but how many would choose surgical disciplines is a question. Surgery gives the opportunity to save lives and make a decent living using hands-on skills. Artistic skills and experience attained by leading surgeons are appreciated by juniors and are also beneficial for society.
Those medical students who finally decide to pursue surgery select specific superspecialised disciplines only. The highest demand is for surgical oncology, followed by surgical gastroenterology and uro-surgery.
Important specialities like paediatric surgery or cardiac surgery are much lower in preference. Some seats in those specialities remain vacant.
These changes will affect society in future. What really needs to be assessed is why the best medical students prefer to avoid surgical disciplines.
The making
Pursuing surgery as a career is a long journey. It takes at least 15 years from the beginning of the MBBS course to be a superspecialist surgeon, like a surgical oncologist or a plastic surgeon. This includes internship, training, service bonds and multiple competitive examinations. Thereafter, it takes at least seven to eight years to be established as a superspecialist surgeon.
Though most surgeons are passionate about the discipline, they have to endure various physical and mental trauma during these two decades or more. Unfortunately, all do not succeed as they would desire. Skills, along with academic excellence and mental toughness, make a quality surgeon. A reliable and skilful mentor is indispensable during training.
Rigorous and formatted training is mandatory to be a successful surgeon. The various phases include:
- Assisting seniors to learn the correct techniques
- Independently performing surgeries under supervision
- Ability to guide juniors to perform surgeries.
Unfortunately, such training facilities are not available at all centres. Though qualifications are important, proper training is mandatory. The outcome of surgery depends on the experience and skills of the surgeon. In challenging situations instant decisions need to be taken regarding surgery, which may be life-saving.
This long-term commitment and uncertain future discourage young medical
students from taking up surgery.
Parents should rethink before spending crores of rupees in private centres to make their child a superspecialist surgeon.
Challenges
Surgery should not be considered just as a job in government or corporate hospitals. Commitment to the patients and society is absolutely important. Challenges have to be taken wherever necessary.
However, there have been many changes which discourage medical students from taking up a surgical career.
- The best residents do not join the teaching faculty probably for financial reasons. Some also allege non-medical interference.
- The profession has become high-risk and vulnerable. Although the intention of surgery is always good, negative outcomes are not accepted by most people.
- Regular equipment upgrade and training are needed.
- There are no clearly defined working hours. Also, there is a changing perspective of the common people about the medical fraternity.
- Students see some seniors struggling when faced with allegations of medical negligence. They get worried when their teacher faces the consumer court or the medical council.
Many students find the stringent rules and societal pressure too much to handle. Most prefer a better work-life balance, fewer risks and the best financial remuneration.
Present situation
Indeed, medical students should not shy away from the challenges of a career in surgery. However, society should be more tolerant and the medico-legal aspects reassessed to encourage young medical students to join surgery. A viable solution is necessary.
Modernisation and change is necessary but surgical skill, experience and honesty and integrity can never be outdated.
To err is human, is a popular statement by Alexander Pope in the 1700s. It is natural for humans to make mistakes. However, medical students do feel that a single surgical error can ruin their entire career. They contemplate whether a career in surgery would be too risky when other options are available.
Most thyroid cancers can be cured through precision surgery. Certainly, a well-trained surgeon will always be necessary.