What is General Surgery?
General Surgery is a surgical specialty that focuses on abdominal contents including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts. General surgeons also deal with diseases involving the thyroid, skin, breast, soft tissue, trauma, peripheral vascular surgery and hernias.
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How General Surgery came about
General surgery dates back to the very origins of surgical procedures and at one stage covered literally all the then-known surgical procedures. The word for Surgery comes from the Greek word “Cheirourgia” (“cheir” meaning “hand” + “ergon” meaning “work”). The old spelling is still reflected in the New Zealand Medical degree MBChB which means Medical Bachelor and Chirurgery Bachelor (our less cultured neighbours merely have MBBS).
Prior to the mid 1700’s the most common practitioner of Surgery in Europe was the Barber Surgeon (the red stripe in a Barber pole represents blood and Surgery). In the mid 1700’s the Surgeons split from the Barbers, adopted a more scientific approach to their practice and eventually merged with medical training to form the Royal College of Surgeons in Britain (new doctors learning the art of Surgery from their non-university qualified Surgeon mentors would drop the title of Doctor on becoming a Surgeon in recognition to their Seniors which is why Surgeons in Commonwealth countries usually go by the title of Mr or Ms). Surgery however really leaped in advances following the advent of anaesthesia which allowed more invasive and intricate surgeries to be undertaken with significantly less discomfort than the prior ‘bite the bullet’ approach.
With the rapid growth of surgical techniques it was natural for surgeons to specialise in particular areas and before too long, Orthopaedics and Obstetrics/Gynaecology had split into their own specialties. Further time brought further specialisation and Plastic, ENT, Cardiothoracic, Urology, Vascular, and Neurosurgery surgery branched off. More recently General Surgeons have undergone sub specialisation in many centers, giving rise to Upper GI, Colorectal, Breast, Head and Neck, Endocrine, HPB, and Trauma sub specialties. Sub specialists tend to maintain a broad practice in other areas though have an interest in their sub specialisation. In New Zealand the General Surgical Training is broad as the majority of our centres need that sort of Surgeon. Sub Specialisation generally occurs once a Trainee has already qualified as a General Surgeon then goes to a specialty center (often abroad) to get more detailed training in that field of interest.