Exploring The Different Subspecialties Within Surgery: Part Four

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Exploring The Different Subspecialties Within Surgery: Part Four

Otolaryngology (ENT: Ear, Nose And Throat)

group of students in scrubs Otolaryngology focuses on surgery of the entire head and neck region as well as the skull base. Facial plastic surgery is also included in this category. Specialist areas include paediatric ENT, head and neck, otology (ear), voice and complex airway surgery and rhinology (nose). An ENT specialist manages all surgical and medical disorders of the ear, nose and throat in children and adults. 

A significant amount of work is performed in diagnosis. Almost 70% of otolaryngology practice is outpatient and done on a day-case basis. Elective surgical sessions are done no more than two days in a week and emergency work, though light, can often be dramatic when airway specialists are required. ENT has little emergency work and is well suited to flexible working.

Plastic surgery

Plastic surgeons specialise in the restoration of normal form and function of different parts of the body. 80% of all plastic surgery is reconstructive. Emergency work may include burns, scalds, hand trauma and soft tissue injuries involving the face, limbs or torso. Elective cases may include reconstructive surgery for cleft lip and palate and other facial deformities, congenital or acquired abnormalities, hand and upper limb surgery and breast reconstruction, reduction or augmentation.

Much of the workload in plastic surgery involves dealing with urgent or emergency cases. There is a busy on-call commitment with most out-of-hours work involving burns injury and the treatment of severe injuries of the face, hand and lower limb. UK plastic surgeons have a strong tradition of travelling abroad to work in disaster zones, helping to tackle large demands for reconstructive work.

General surgery

General surgery is a very broad specialty straddling multiple sub-specialties including breast, endocrine, vascular, upper and lower gastrointestinal (GI), colorectal and transplant surgeries. Laparoscopic surgery may also be practised as a sub-specialty and is used across all general surgery. Acute conditions of the abdomen comprise the majority of emergency general surgery cases. Other conditions, including trauma, require a more holistic approach and a diverse range of skills and experience that may involve working with colleagues from different specialty areas.

As a general surgeon, you can expect a relatively high proportion of emergency work. Vascular surgery in particular, has a significantly high volume of urgent and emergency admissions. Colorectal surgery has a heavy workload as many patients suffer from large bowel cancer and present as emergencies requiring urgent treatment. Breast surgery has a lower on-call commitment as most work is elective. General surgeons can choose how specialised to become. Whereas some smaller medical facilities hire generally trained surgeons competent in treating common conditions of the GI tract, larger hospitals may require further specialisation. Remote and rural surgery is necessary in areas where there is great geographical distance between cities. General surgeons in such areas require a wide range of competencies, including some from other surgical specialties.

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