Is fellowship necessary for general surgery?
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Nope
For general surgery? No
But for the sub-specialties that arise from general surgery:
For vascular, CT, plastics, peds surg, transplant, HPB-surg onc? Yes
For trauma, endocrine, colorectal, breast? Depends on where you are looking to practice
But for the sub-specialties that arise from general surgery:
For vascular, CT, plastics, peds surg, transplant, HPB-surg onc? Yes
For trauma, endocrine, colorectal, breast? Depends on where you are looking to practice
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My senior residents went straight into practice out of residency and are doing well, same with some a year or two behind me. I started at my current practice with two general surgeons right out of residency and they're doing the full gamut + trauma. So no.
Are they in urban or rural locations? I heard that most general surgeons work in more rural areas and if you want to be in a desirable city, then you have to do a fellowship?
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no. It's more location dependent. Some cities are superspecialized, yes, but there are jobs to be found in most places. It depends where you want to be. I'm in an urban area and it's a mix. I'm not fellowship trained, nor are most of the general surgeons I know in town. None of my partners are either. The bigger hospitals/academic referral centers have all/mostly specialists, but there are a lot of "regular" hospitals that are staffed with surgeons who do a variety of cases. Many of the general surgeons here develop "niches" among their group as everyone learns their various strengths and interests, but still do a wide variety of cases and ER "whatever comes in the door" call. For example, I don't do thyroids and parathyroid cases, but I will give them to the guy who likes those cases. I in turn get the breast cases from the guys who don't do those cases anymore. Etc. etc.
If you want to do the above listed things this is fairly accurate. Everything else it is not required but useful if you want to only do those things, such as colorectal, endocrine, etc. If all you want to do is take out colons then do colorectal.
More in-between urban and rural. This includes myself. Desirable city is subjective. Having grown up, worked in and gone to med school in a large city; there is nothing about large city living that even remotely appeals to me. Good thing too, because I love where I live (City size approx 100K with a catch area of around 500K) and all the outdoor amenities that come with not living in a city. Plus I'm married and have kids. I don't eat out a lot and never had interest in theatre and such. My ideal weekend recently was walking out my backdoor with my kids and going cross country skiing, building a fire, eating some snacks and teaching them how to build a fort.
