یک مدل حرفه ای در تخصص جراحی عمومی: عقیده یکی از جراحان A model for a career in a specialty of general surgery: One surgeon’s opinion

1. Introduction Medical students, residents, fellows and young surgeons have questions about their career choices. This was true for the first author of this study who is considering a career in endocrine surgery and as a result, decided to examine what a career in endocrine surgery consists of. A common goal for students, residents, fellows and young surgeons is to enjoy a satisfying professional career. The path a surgical trainee must take in order to become a competent, skilled surgeon has been extensively debated and it is not always clear how to build and maintain a satisfying surgical career based on competence and expertise.1 The Association of American Medical Colleges predicts a deficit of 41,000 general surgeons by the year 2025.2 Despite the growing need for general surgeons, 80% of surgical residents choose to complete a fellowship in one of many specialty areas of general surgery. Although many studies attribute this to a lack of confi- dence in independent practice after residency training, many individuals are interested in limiting their practice to a very focused area.3e5 As a result, many fellowship graduates begin searching for a job with the intent of focusing only on their specialty.6,7 Endocrine surgery fellows are no exception. Over half of fellowship graduates in endocrine surgery express a desire to have a focused career path.8e11 Survey data of practicing fellowship trained endocrine surgeons, however, shows that it is not always practical nor possible to maintain an entirely specialized scope of surgical practice.8e11 Fellowship training, under certain circumstances, may be a necessity, given the expanding scope and complexity of patient care. Advanced endocrine training is needed to provide patients with high quality surgical care and to understand the rapidly expanding knowledge base of endocrine diseases and this also true for other specialties.12 Fellowship graduates, however, should be aware of the potential negative consequences of focusing exclusively on a specialty of general surgery early in their careers. It can take years to develop a successful specialty practice and during this time specialty surgeons may find themselves not operating as much as they would like and, as a result have less exposure to residents, medical students and referring faculty.