In 1998 after watching a news program about the death of Jay Monahan in New York City, and the interest I developed, because of this story became the reason I selected this particular profession for my final research paper. On January 24, 1998, Jay Monahan an MSNBC legal analyst and husband of NBC Today host Katie Couric, died at age 42 of colon cancer. He battled this disease for six month’s but it was a futile attempt. Colon Cancer is the second leading killer of all men and women, and all are at risk over the age of 50.
Colon Cancer can be prevented if it is diagnosed early. The medical professional that is trained to perform screenings and diagnostic tests for all colorectal diseases and conditions is called a Colorectal Surgeon. 1. The reason this professional was selected is not because of my need to become a physician, but because of the great need we as a society have, for professionals trained in this discipline. This disease of colorectal cancer is only defeated, if it is detected early enough before it metastases in the colon, and then throughout our circulatory system.
Several years ago, at the age of 51, I needed to contact a local colorectal surgeon for my first initial colonoscopy as a preventable measure as part of an annual physical examination. This was new to me, and the experience with the surgeon was actually humorous. The surgeon was Doctor Cohen, and he was quite funny because he introduced himself to me with a very friendly low-keyed attitude, and explained the procedure and the location I was to find for my procedure a week later.
I also needed to drink a gallon of a liquid bowel cleaning solution the night prior to the examination. Upon leaving the initial appointment, the surgeon told me that his patients usually referred to him as “ their pain in the ass”. This caught me off guard, but alleviated any nervousness I might have developed prior to this procedure. The history of the Colorectal Surgeon begins prior to 1899, but this was the official year that the society called The American Society of Colon and Rectal Surgeons (ASCRS) was founded.
It was previously known as the American Proctologic Society and changed names in 1973. The reason it changed names was to cover the entire scope of medical interests by its members. Currently there is 1281 board certified colorectal surgeons in the United States and Canada, with 102 being women. In the United States, Colorectal Surgeons begin the long road to certification beginning with an Undergraduate degree or Master’s degree at a college or university, specializing in heavy science curriculum.
This usually takes from four to six years of education. Upon acceptance to an accredited medical school, candidates complete another four years of medical school, and become a Medical Doctor, but cannot practice medicine. Five years completion of a general surgical residency is next in an affiliated hospital, followed by completion of a one-year colon and rectal surgery residency, usually at the same hospital. The candidate must achieve an adequate level of experience in preoperative, operative, and postoperative management of colorectal disorders.
Upon successful completion of the written qualifying examination and the oral certifying examination, administered by the American Board of Surgery, the medical candidate must provide a detailed record of colorectal surgery experience, receive recommendations from their directors of program training, and finally successfully pass the written and oral examinations given by the American Board of Colon and Rectal Surgery. All of this education takes a minimum of fourteen years to become a certified Colorectal Surgeon. 2 currently there are 36 accredited programs that exist for colon and rectal surgery.
Colorectal Surgeons are re-certified every ten years. The surgeon’s credentials are reviewed to make sure they have maintained their continuing medical education in their field, is respected by their peers in the profession, and has practiced colon and rectal surgery actively. The surgeon is re-certified only after successfully completing a written examination. Colorectal cancer strikes 140,000 people annually, and causes 60,000 deaths, but is curable if potentially detected early. The majority of patients are over the age of 40, which amounts to more than 90 percent of them.
After age 40 the chances of contracting colon cancer doubles every ten years. Colorectal Surgeons are physicians that treat conditions of the lower digestive tract, usually the large intestine. They specialize in the medical and/or surgical diagnosis of disorders in the colon, rectum, and anus. These conditions can be anal abscesses, anal fistule, or fissures, bowel incontinence, colon, rectal and anal cancer, colorectal polyps, diverticular disease such as diverticulitis, hemorrhoids, Inflammatory bowel disease , Crohn’s disease, ulcerative colitis, pelvic floor dysfunction, rectal prolepses, and irritable bowel syndrome.
2 Becoming a surgeon is one of the most demanding of medical professions. It requires the most number of years of education and practice the specialty under the supervision of established surgeons, until they reach the level of expertise to be suitable to perform operations by themselves. The Colorectal surgeon does have a demanding job, but he/she does receive a very nice salary. Usually the beginning salary can be $163,000 per year at the low end and up to $270,000 for surgeons with more experience. The amount of salary is determined as in other medical fields, by the length of time and experience in the position.
Colorectal surgeons are in high demand nationally and are compensated well. Due to the US society becoming more aged, there are many opportunities for colorectal surgeons in today’s medical system. They are usually affiliated with a local Medical Center or Hospital, but may have private offices away from the medical facility. The position and duties of a colorectal surgeon varies tremendously depending on where one practices, such as in a large HMO, university teaching hospital, cancer center, or in private solo or group practice. 3.
The average workday of a colorectal surgeon begins early in the morning at the hospital making patient rounds, attending conferences or grand rounds, being at the office to see patients, or being at the surgical center for procedures. In a single group private specialty practice, the day begins with rounds on the patients that they have in the hospital. This consists of patients that have been consulted on, or post-operative patients. By working at large teaching hospitals and participating with the surgery residents and the colorectal fellows, they give them updates on patients.
If they have minor procedures that day, the day will consist of performing colonoscopies or anorectal procdures such as hemorrhoidectomies, hernias, condyloma fulgurations, and fistula, these will be performed at the major hospital or at a surgical center. When seeing patients, they follow up on established patients, or meet new patients. They perform a few procedures in the office such as flexible sigmoidoscopies, rubber banding, hemorrhoid injections surgery, etc. There can be urgent consultations in the hospital where everything has to be dropped in order to take that patient for life-saving surgery.
If participating at a teaching hospital, they’ll attend twice a week conferences in the evening or monthly Cancer Center tumor boards. On operating days, their surgery group has an operating time and, so those days usually start at 7:15 for the major bowel cases. Some cases can take up to 6-8 hours. Weekends consist of making patient rounds in the hospital, but unless a surgeon is on call for surgery, their weekends are more relaxed than during the week. Surgeons usually spend this time with their families. The average week of a colorectal surgeon is no different than most surgeons, except for their specialty.
Most surgeons spend time with post- operative patients in the hospital, meet new patients in the office, or perform less invasive procedures on patients in the office or surgery center. The hospital setting seems like the most exciting setting because of all the particular specialties of various surgeons all under one roof. Based upon a 2010 National Institute of Health questionnaire that was sent out to all 1799 members of the American Society of Colon and Rectal Surgeons. 244 of the surgeons were female. The findings were very interesting.
The questionnaire contained 63 questions about the job perception by these surgeons towards general surgery. The mean age of the respondents was 49 years of age. Males were 51 Females were 42. Only 28 percent returned the questionnaire or 498 surgeons. As far as married versus single, 2% females were married and 12% single. Male surgeons earned more salary than females and only 11% of female surgeons earned over $350,000. Males felt that the work atmosphere and case mix was satisfactory, and 21% of female colorectal surgeons felt that they would change their career as opposed to 13% of their male counterparts.
More females responded that they felt they made a positive impact in the operating room, but female colon surgeons agreed that women mentors were few because of lack of time and also felt their views were not considered when executive decisions were made. More proportionately of the single females responded than males. 4 These findings are only a small sampling of surgeons, but this is from the society of colon and rectal surgeons across the US and Canada, and looks if gender bias is still prevalent in our hospitals as of 2010. Conclusion Colon and rectal surgeons are a very important and needed profession in our society.
With the advances being made in United States medicine, and the influx of technological advances, and introduction of robotics, and minimally invasive procedures to treat diseases of the colon and rectal areas. The surgeons still need to devote up to fourteen years of their lives involved in the education and the instruction to be called a specialist in colon and rectal surgery. In my humble opinion, although the rewards of being a certified member of a specific medical specialty, does not equal the time involved to thoroughly enjoy life to the fullest, when you just begin your career at age 35, or later.
Maybe this is the reason that most new surgeons and physicians are geographically from the Middle East, Pakistan and India. References: (1)Swierzewski,S. J. III, MD What Is a Colerectal Surgeon? healthcommunities. com 14 Nov 2008 (2)Birnbaum E. MD, Fellowship (Residency) Training in Colorectal Surgery American Journal of Surgery (01/07) (3)media@fascrs. org Colorectal Diseases and Treatments The official journal of ASCRS Diseases of the Colon and rectum, founded in 1958. (4)Zutchi, M, Hammel J, Hull T Colorectal surgeons: gender differences in perceptions of a career. J Gastrointest Surg. 2010 May;14(5):830-43.