Delaware Today magazine Top Doctors 2011, The Surgeons: Training includes college, medical school, residency program, internship, a fellowship, board certification

Training Camp

If a doctor has reached the status of surgeon, you can bet he or she earned it. If she has become board certified in a specialty, you’d better believe she’s worked extra hard—and continues to do so. The road to becoming a surgeon is a hard one that goes basically like this:

After four years of college and another four years of medical school, every would-be surgeon enters a hospital residency program. The programs range from three or four years to as many as seven, depending on the specialty.

Year One

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The internship consists of more medical training, observing procedures and some assisting. Ophthalmologist Paula C. Ko worked on the eyes of pigs, learning to use surgical instruments and suture. Orthopedic surgeon Eric Johnson learned patient management, “the nuts and bolts of care.”

Year Two

The second year brings more surgery, as well as rotations in other specialties. For Raymond A. DiPretoro, chief of podiatric surgery for Christiana Care, that meant learning about sports medicine, emergency medicine, infectious disease, internal medicine and plastic surgery.

The Next Step

The next two to three years consist of lots of surgery, under the guidance of an attending physician. DiPretoro did about 1,000 cases a year. Johnson estimates 400 to 600 a year. The high number provides experience and presents a range of surgical problems.

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Some physicians, such as cardiothoracic surgeons, may complete longer residencies. After residency, a surgeon may choose to complete a fellowship in a more specialized area, either to fill a perceived gap in training or to fine tune certain skills.

Board Certification

Surgeons may also elect board certification. Requirements are strict. The surgeon must have been in practice five years before he or she can qualify.

He or she submits a specified number of surgical cases to a governing body—the American Board of Podiatric Surgery for surgeons like DiPretoro—to be reviewed for diversity of problems and successful outcomes.

The surgeon must then pass written and oral exams to earn certification, which must then be renewed every 10 years through a written exam to ensure that the surgeon is delivering the current standard of care.

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Board certification is not required to practice as a surgeon, DiPretoro points out, and many excellent surgeons never seek certification, but some hospitals require it for their surgical staff members.

Why All the Training?

Though a surgeon may specialize in an area, medical issues are never isolated. A vascular issue could indicate problems in the feet, DiPretoro says. “You have to treat the whole body. Everything is connected,” he says. “You need the knowledge to make the diagnosis.” That means surgeons don’t work in a vacuum. They often work as part of a team to understand all the issues that contribute to the patient’s condition, so they must keep themselves up to date on advances in medicine, technique and technology.”

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