Exploring The Different Subspecialties Within Surgery: Part Three

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Different Subspecialties Within Surgery: Part Three

Oral and Maxillofacial Surgery (OMFS)

In the middle of performing surgery in Tanzania. Oral and Maxillofacial surgeons work on the bones of the face and neck. Procedures can range from minor facial surgery to complex head and neck surgery. OMFS is unique in that it involves surgery on both hard, as well as, soft tissue. Specialist areas include cleft surgery, adult facial deformity, head and neck oncology, facial trauma management and orthognathic surgery.

Although there is a high volume of trauma cases, there is a relatively low on-call commitment in oral and maxillofacial surgery as compared to other surgical specialties. Surgeons spend most of their time in clinics or operating. Remaining time is spent on call, teaching, or doing administrative work. To enter the OMFS training pathway, you must have both a medical degree and a dental degree.

Neurosurgery

Neurosurgeons specialise in surgery of the brain, spinal cord and central nervous system. Neurosurgery covers all aspects of brain surgery, from pre-operative imaging to removal of tumours. As a neurosurgeon you may focus on spinal surgery, neuro-oncology (treating cancer of the brain), traumatology, skull-base surgery, paediatric neurosurgery or neurovascular surgery. Functional neurosurgery is another subspecialty that focuses on the surgical management of a wide array of neurological problems, ranging from epilepsy and intractable pain to movement disorders. Emergency work accounts for more than half of a neurosurgeon’s caseload, with much of this being trauma. On call work can be intensive with out-of hours emergency operating.

Most neurosurgeons spend on average about four to five sessions in the operating theatre per week. The rest of their time is spent on pre-operative and post-operative care, outpatient clinics, administrative duties and teaching. While hospitals in most major cities have neurosurgery units you may be limited in where you work outside of these facilities.

Urology

Urological surgery deals with surgery pertaining to the urogenital system as well as men’s sexual and reproductive health. Urological surgeons treat urinary tract stones, kidney diseases, cancer of the bladder, prostate, kidney or testicle, erectile dysfunction and incontinence. Investigating and treating patients with prostate symptoms or bladder cancer takes up a large amount of an urologist’s time. Specialist areas include paediatric urology, complex pelvic surgery, andrology and uro-gynaecology.

As an urological surgeon you can expect to undertake on average about three to four procedures a week, including day-case surgery. You can also expect to manage outpatient clinics and special clinics, administrative work, teaching and research. Urology treats a wide range of diseases and uses diverse operating techniques, including laparoscopy, open surgery and robotic surgery. Urological surgeons have several opportunities for working across specialties, such as with colorectal and gynaecological surgeons. ‘Office urology’ is a rapidly developing field. It typically involves day case procedures using endoscopy but no open theatre cases.

Click here to read part four of ‘Exploring The Different Subspecialties Within Surgery’

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