How limited can a general surgeon "tailor" their practice after residency?

I have read about how general surgeons can "tailor" how they practice after finishing residency.

So I wonder is it possible for a general surgeon to do only the most basic/routine cases (appendectomies, hernias, gallbladders)?

Misterioso said:

I have read about how general surgeons can "tailor" how they practice after finishing residency.

So I wonder is it possible for a general surgeon to do only the most basic/routine cases (appendectomies, hernias, gallbladders)?

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A GENERAL surgeon does everything, but can focus his/her attention to breast, Trauma, MIS, “Bread and better general surgery”, Pediatric, colon and rectal, …etc.

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but you need a fellowship to do peds, no?

a good general surgeon can perform bread and butter pediatric cases.

in complications, gawande talks pretty extensively about a gen. surgery group in canada (toronto, maybe) that exclusively does hernia repairs and how their results (in terms of pt outcome, infections, mistakes, etc) are far better than those of a typical group that does the normal gamet of procedures...

Yes, it is possible for a general surgeon to do mostly hernias, gallbladders, etc. This will differ greatly from surgeon to surgeon depending on the hospital and other practice settings. It really depends on the town you are in and what other surgeons around you are doing. But it is possible to work at a smaller hospital, say, where you do a few hernias, a few gallbladders, one or two breast cases, or maybe a sigmoid or so a week. But there are also some general surgeons who are the "only game in town" and who do some gyn, some ortho, and some vascular stuff, in addition to the hernias, appys, gallbladders, etc.
Also, as fishmonger said you do not need a Peds fellowship to do basic peds cases like hernias or pylorics, as long as you have significant numbers and exposure to these cases in your residency. But someone who has not trained in Peds would not/should not attempt do more complex peds cases like a Nuss bar (for pectus excavacum) or congenital diaphragmatic hernia repairs.

Goose-d said:

in complications, gawande talks pretty extensively about a gen. surgery group in canada (toronto, maybe) that exclusively does hernia repairs and how their results (in terms of pt outcome, infections, mistakes, etc) are far better than those of a typical group that does the normal gamet of procedures...

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It's the Shouldice Clinic ... and most (all?) of the physicians of whom he writes never trained as surgeons. They came from their various fields (one OB and one GP, as I recall) and were trained essentially as Shouldice technicians.

Lloyd Christmas said:

Also, as fishmonger said you do not need a Peds fellowship to do basic peds cases like hernias or pylorics, as long as you have significant numbers and exposure to these cases in your residency. But someone who has not trained in Peds would not/should not attempt do more complex peds cases like a Nuss bar (for pectus excavacum) or congenital diaphragmatic hernia repairs.

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This is a great deal of data in the surgical literature showing that outcomes of pyloromyotomies performed by Pediatric Surgeons are far better than those performed by General Surgeons. Hernias, lumps and bumps, etc, might be fine for a General Surgeon in the pediatric population, but beyond that, I would be taking my child to a board certified Pediatric Surgeon.