The scope of general surgery
General surgery is a discipline that requires knowledge of and responsibility for the preoperative, operative, and postoperative management of patients with a broad spectrum of diseases, including those which may require nonoperative, elective, or emergency surgical treatment. The breadth and depth of this knowledge may vary by disease category. Surgical management requires skill in complex decision making; general surgeons should be competent in diagnosis as well as treatment and management, including operative intervention.
The certified general surgeon demonstrates broad knowledge and experience in conditions affecting the:
- Alimentary Tract
- Abdomen and its Contents
- Breast, Skin and Soft Tissue
- Endocrine System
- In addition, the certified general surgeon demonstrates broad knowledge and experience in:
- Surgical Critical Care
- Surgical Oncology
The field of general surgery as a specialty comprises, but is not limited to, the performance of operations and procedures relevant to the content areas listed above. It is expected that the certified surgeon will also have additional knowledge and experience relevant to the above areas in the following categories:
- Related disciplines, including anatomy, physiology, epidemiology, immunology, and pathology (including neoplasia).
- Clinical care domains, including wound healing; infection and antibiotic usage; fluid and electrolyte management; transfusion and disorders of coagulation; shock and resuscitation; metabolism and nutrition; minimally invasive and endoscopic intervention (including colonoscopy and upper endoscopy); appropriate use and interpretation of radiologic diagnostic and therapeutic imaging; and pain management.
The certified general surgeon also is expected to have knowledge and skills for diseases requiring team-based interdisciplinary care, including related leadership competencies. Certified general surgeons additionally must possess knowledge of the unique clinical needs of the following specific patient groups:
- Terminally ill patients, to include palliative care and pain management; nutritional deficiency; cachexia in patients with malignant and chronic conditions; and counseling and support for end-of-life decisions and care.
- Morbidly obese patients, to include metabolic derangements; surgical and non-surgical interventions for weight loss (bariatrics); and counseling of patient and families.
- Geriatric surgical patients, to include management of comorbid chronic diseases.
- Culturally diverse and vulnerable patient populations.
In some circumstances, the certified general surgeon provides care in the following disease areas. However, comprehensive knowledge and management of conditions in these areas generally requires additional training.
- Vascular Surgery
- Pediatric Surgery
- Thoracic Surgery
- Solid Organ Transplantation
In unusual circumstances, the certified general surgeon may provide care for patients with problems in adjacent fields such as obstetrics and gynecology, urology, and hand surgery.