room, having the knowledge and skills for a wide range of surgical interventions. Or

室，擁有廣泛的外科干預的知識和技能。或

maybe it's just a stepping stone for you to get to the subspecialization you're after.

也許這只是你達到你所追求的亞專業的一個墊腳石。

Let's debunk the public perception myths, and give it to you straight. This is the reality

讓我們揭穿公眾認知的神話，並直接告訴你。這就是現實

of general surgery. Dr. Jubbal, MedSchoolInsiders.com.

的普通外科。Jubbal醫生，MedSchoolInsiders.com。

Welcome to our next installment in So You Want to Be. In this series, we highlight a

歡迎來到《你想成為什麼樣的人》的下一期節目。在這個系列中，我們將重點介紹一個

specific specialty within medicine, such as general surgery, and help you decide if it's

醫學中的特定專業，如普通外科，並幫助你決定它是否是

a good fit for you. You can find the other specialties on our So You Want to Be playlist.

很適合你。你可以在我們的 "你想成為 "播放列表中找到其他專業。

If you want to vote in upcoming polls to decide what future specialties we cover, make sure

如果你想在即將舉行的投票中投票，以決定我們未來涵蓋的專業，請確保

you're subscribed. If you'd like to see what being a general

你已經訂閱了。如果你想看看作為一個普通的

surgeon looks like, check out my second channel, Kevin Jubbal, M.D., where we'll be covering

外科醫生看起來，看看我的第二個頻道，凱文-朱巴爾，醫學博士，我們將在那裡報道

a day in the life of a general surgeon in the future.

未來普通外科醫生的一天。

General surgery is the broadest of surgical fields, covering the surgical management of

普通外科是最廣泛的外科領域，包括以下的外科管理

diseases from head to toe. This may include head and neck surgeries to thoracic to interventions

從頭到腳的疾病。這可能包括從頭頸部手術到胸腔手術再到介入手術。

inside the abdomen. Operations can range from removing cancer, to treating traumatic injuries,

腹部內的手術。手術的範圍包括從切除癌症，到治療創傷性損傷。

to restoring function to diseased tissue. We think of surgeons most commonly in the

以恢復病變組織的功能。我們最常想到的外科醫生是指

act of performing surgery, but a big part of the work surgeons do is taking care of

進行手術的行為，但外科醫生所做的工作的很大一部分是照顧

surgical patients. This includes diagnosing a patient's illness, assessing various interventions,

外科病人。這包括診斷病人的疾病，評估各種干預措施。

and caring for the patient before and after surgery. Examples include staging a cancer

並在術前和術後對病人進行護理。例子包括對癌症進行分期

patient prior to surgical intervention or managing ICU patients who are postoperative

手術前的病人或管理術後的ICU病人。

yet remain very sick. Even the busiest surgeons are in the operating

但仍然病得很重。即使是最忙碌的外科醫生也在手術中

room only a couple days per week. The rest of their time is spent seeing new patients

每星期只有幾天在病房裡。其餘的時間都用來看新病人。

or postoperative patients in clinic. If the surgeon is part of an academic center, they'll

或門診中的術後病人。如果外科醫生是學術中心的一部分，他們會

also have to divide their time between academic responsibilities, including teaching and research.

他們還必須在學術責任之間分配時間，包括教學和研究。

This brings us to an important method of differentiating a general surgeon's practice.

這給我們帶來了區別普通外科醫生的一個重要方法。

In academia, general surgeons tend to be more specialized, meaning they've done a fellowship

在學術界，普通外科醫生往往更加專業，這意味著他們已經做了一個研究金。

after residency and are managing patients within a specific niche. At these larger academic

在住院醫師培訓結束後，他們正在管理一個特定領域的病人。在這些較大的學術機構

institutions, you're also more likely to see complex and rare pathologies that are infrequently

機構，你也更有可能看到複雜和罕見的病症，這些病症不常發生。

managed at smaller community practices. In community or private practice settings,

在較小的社區診所管理。在社區或私人診所環境中。

general surgeons are more likely to operate without fellowship training, although several

普通外科醫生更有可能在沒有研究金培訓的情況下進行手術，儘管有幾個

are still fellowship-trained. Compared to an academic practice, community and private

他們仍然接受過獎學金培訓。與學術實踐相比，社區和私人

practice general surgeons have higher average compensation.

執業普通外科醫生的平均報酬更高。

Let's clear up some of the misconceptions about general surgery.

讓我們來澄清一些關於普通外科的誤解。

First, some think that general surgery is the specialty for medical students who want

首先，有些人認為普通外科是醫學生的專業，他們想要

to be surgeons but aren't competitive enough to match into a more desirable surgical subspecialty,

想成為外科醫生，但沒有足夠的競爭力來匹配更理想的外科亞專業。

like plastic surgery, neurosurgery, orthopedic surgery, and so on. The truth is that general

像整形外科、神經外科、骨科手術等等。事實是，普通

surgery has a great deal to offer that is unique from other surgical fields, and for

外科有很多不同於其他外科領域的獨特之處，對於

that reason attracts a large number of candidates. Second, the challenging lifestyle aspects

這個原因吸引了大量的候選人。第二，具有挑戰性的生活方式方面

are often overstated, at least for when you're a fully trained attending physician. Ultimately,

往往被誇大了，至少在你是一個受過充分訓練的主治醫生時是如此。歸根結底。

your work-life balance comes down to the type of specialization within general surgery you

你的工作與生活的平衡取決於你在普通外科中的專業類型。

pursue, in addition to the type of job you seek out. You have the ability to negotiate

除了你所尋求的工作類型外，你還可以追求。你有能力進行談判

toward a true lifestyle specialty to something more stereotypically intense.

朝著一個真正的生活方式專業的方向發展，以更多的陳規定型的激烈的東西。

After medical school, general surgery residency is 5 years, although some programs have 2

醫學院畢業後，普通外科住院醫師是5年，儘管有些項目是2年。

mandatory research years built in for a total of 7 years. The 7 year residencies are usually

在總共7年的時間裡，有強制性的研究年限。7年的實習期通常是

at academic residency programs and are preferred by medical students who are either seeking

在學術性的住院醫師項目中，那些正在尋找新工作的醫科學生更願意選擇這種方式。

an academic career or want to apply into a more competitive fellowship.

在學術生涯中，或想申請更有競爭力的獎學金。

As a PGY1, also known as your intern year, you're usually not operating much, and are

作為PGY1，也被稱為你的實習年，你通常不怎麼操作，而且是

instead focused on managing surgical patients on the wards, meaning those staying in the

相反，他們專注於管理病房裡的外科病人，也就是說，那些留在病房裡的病人。

hospital, usually requiring post-operative care. You ensure floor work is taken care

醫院，通常需要術後護理。你確保地板工作得到照顧

of and act as the eyes and ears for the rest of the team who are usually scrubbed into

的，並充當團隊其他成員的眼睛和耳朵，他們通常被洗刷成

cases or handling clinic. Once you finish your work, you're generally welcome to join

案件或處理診所。一旦你完成你的工作，一般歡迎你加入

your team in the operating room and scrub into cases.

你的團隊在手術室和擦洗的情況下。

As a junior resident, meaning your PGY2 and PGY3 years, you'll have one intern below you

作為初級住院醫師，即你的PGY2和PGY3年，你將有一個實習生在你下面。

and one senior above you on any service. If new consults come in, you'll be seeing them.

以及比你高一級的任何服務的高級人員。如果有新的諮詢者，你就會看到他們。

If you're in the operating room, you're likely doing smaller or more straightforward cases,

如果你在手術室，你很可能在做較小或較直接的病例。

while the more complex cases are handled by the senior resident.

而更復雜的案件則由高級住院醫師處理。

As a senior resident, meaning your PGY4 and PGY5 years, you handle the most complicated

作為高級住院醫師，即你們的PGY4和PGY5年，你們處理最複雜的問題。

cases and have the most autonomy, both inside and outside of the operating room. That translates

在手術室內外，他們都擁有最大的自主權。這就意味著

to making treatment decisions and putting plans into place, and operating with less

做出治療決定並將計劃落實到位，並以較低的成本運作。

supervision. In your chief year, meaning as a 5, when you are most senior, you will also

監督。在你的首席年，即作為5級，當你是最資深的時候，你也將

have the added responsibility of handling light administrative work for the residency

有額外的責任，處理居住地的輕微行政工作

program, such as schedules and responsibilities for the residents below you.

計劃，例如你下面的居民的時間表和責任。

Research years, if required by the program, are typically done after either PGY2 or PGY3.

如果項目要求，研究年通常在PGY2或PGY3之後進行。

Residents typically maintain some level of clinical involvement during this time to keep

在這段時間裡，住院醫師通常會保持一定程度的臨床參與，以保持

their clinical acumen sharp, such as by taking call occasionally or covering overnight shifts.

他們的臨床敏銳度很高，例如偶爾接聽電話或值通宵班。

In terms of competitiveness, general surgery is middle of the pack with 70 points in our

在競爭力方面，普通外科在我們的調查中以70分位居中游。

MSI Competitive Index, ranking below vascular surgery and above med/peds. Of the surgical

MSI競爭力指數，排名低於血管外科，高於內科/兒科。外科中

specialties, general surgery is the most attainable. The match rate is 84%, average USMLE Step

專業，普通外科是最容易達到的。匹配率為84%，平均USMLE Step

1 is 235, and average Step 2CK is 247. After completing general surgery residency,

1是235，步驟2CK的平均數是247。在完成普通外科住院醫師培訓後。

you can further subspecialize with fellowship. Historically, any form of surgical specialization

你可以通過研究金進一步實現亞專業化。從歷史上看，任何形式的外科專業都有其特殊性。

through fellowship always followed a general surgery residency. This is termed the independent

在普通外科住院醫師培訓之後，他們將通過研究金的方式來完成工作。這就是所謂的獨立

pathway. If you wanted to become a plastic surgeon, you would first complete 5 years

路徑。如果你想成為一名整形外科醫生，你將首先完成5年的學習。

of general surgery residency, followed by 3 years of plastic surgery, for a total of

普通外科住院醫生，然後是3年的整形外科，總共有3年的時間。

8 years. As medicine has moved further toward specialization,

8年了。隨著醫學進一步走向專業化。

combined pathway programs cropped up, whereby you would complete 3 years of general surgery

越來越多的人開始採用組合式課程，即完成3年的普通外科課程。

residency followed by a few years of specialty training. For example, combined plastic surgery

在住院醫生的指導下，再進行幾年的專業培訓。例如，聯合整形外科

programs combined 3 years of general surgery residency with 3 years of plastic surgery,

這些項目將3年的普通外科住院醫師培訓與3年的整形外科培訓相結合。

for a total of 6 years. And finally, the integrated pathway is now

總共6年的時間。最後，綜合途徑現在是

gaining momentum, whereby you match and complete training in your surgical specialization from

越來越多的勢頭，據此，你在你的外科專業中匹配和完成培訓，從

day 1 of residency. Neurosurgery and orthopedic surgery have done the integrated pathway for

住院醫師的第1天。神經外科和骨科手術已經完成了綜合路徑，用於

some time now, and there are no independent or combined options. Plastic surgery has followed

一段時間以來，沒有獨立或合併的選擇。整形手術已經跟隨

suit, but there are still some independent and combined programs available, although

適合，但仍有一些獨立的和合並的方案可供選擇，儘管

they are declining in number. More recently, cardiothoracic surgery integrated programs

它們的數量正在減少。最近，心胸外科綜合項目

have been cropping up around the nation. Integrated pathway programs are shorter and more focused

已經在全國各地出現了。綜合途徑項目時間更短，重點更突出

on your ultimate specialization. However, they are usually substantially more competitive

在你的最終專業領域。然而，它們通常具有更大的競爭力

than going the independent pathway, and some are concerned about weaker training in the

擔心會比走獨立的道路更糟糕，而且有些人擔心會有更弱的培訓。

fundamentals of surgery. To specialize in critical care you'll complete

外科的基礎知識。要專攻重症護理，你將完成

a 1 year fellowship, although a 2nd year is usually completed for those who ultimately

1年的研究金，儘管那些最終完成了第2年的研究金的人，通常會完成第2年的研究金。

want to work at busy trauma centers. Trauma and critical care combine the best of both

希望在繁忙的創傷中心工作。創傷和重症護理結合了兩者的優點

worlds – you get both high-intensity surgeries but also clock out when you're not on shift.

世界--你既能得到高強度的手術，又能在不當班時打卡下班。

As a result, you get decent control over your lifestyle.

是以，你可以對你的生活方式有適當的控制。

Typically these surgeons also have a component of their month for elective general surgery

通常情況下，這些外科醫生在他們的月度工作中也有一部分是選擇性的普通外科。

and emergency general surgery call, which can be flexible depending on the surgeon's

和普通外科急診電話，可以根據外科醫生的情況靈活安排。

preferences. We have a full episode on trauma surgery linked below.

偏愛。我們有一個關於創傷手術的完整情節，鏈接在下面。

Colorectal surgery is a 1 year fellowship for the general surgeons who appreciate a

結直腸外科是一個為期1年的研究項目，為普通外科醫生提供了機會。

decent lifestyle and a wide variety of procedures, from colonoscopies to small outpatient procedures

體面的生活方式和多種多樣的程序，從結腸鏡檢查到小型門診手術

to bigger cancer operations, including both minimally invasive and open cases.

到更大的癌症手術，包括微創和開放病例。

Pediatric surgery is a 2 year fellowship whereby you essentially become a general surgeon for

小兒外科是一個為期2年的研究項目，你基本上成為一個普通的外科醫生。

children. Compared to adults, your patients will bounce back faster from surgeries. Your

兒童。與成人相比，你的病人從手術中反彈的速度會更快。您的

bread and butter will include a large amount of gastrointestinal surgeries, treating emergencies,

麵包和黃油將包括大量的胃腸道手術，治療急症。

and correcting congenital birth defects. Within pediatric surgery, there is a high

和糾正先天性出生缺陷。在小兒外科中，有一個高

degree of specialization. For example, a neurosurgeon or orthopedic surgeon or plastic surgeon can

專業化的程度。例如，一個神經外科醫生或骨科醫生或整形外科醫生可以

subspecialize in various pediatric-focused specialties. As a result of this specialization,

在各種以兒科為重點的專業中進行亞專業化。作為這種專業化的結果。

it is often difficult to find general pediatric surgeon job openings. You might have to take

通常很難找到普通小兒外科醫生的職位空缺。你可能不得不採取

a job in a part of the country you might not otherwise have chosen.

在這個國家的某個地方找到一份你可能不會選擇的工作。

Breast is a 1 year fellowship, focusing primarily on resecting cancer from the breast. The hours

乳腺科是一個為期一年的研究項目，主要側重於乳腺癌的切除。工作時間

are considered less intense compared to other surgical fields and its more conducive to

與其他外科領域相比，它被認為強度較低，而且更利於

a balanced lifestyle. You'll be working in close conjunction with plastic surgeons who

一個平衡的生活方式。你將與整形外科醫生緊密合作，他們會

will be reconstructing the breast usually immediately after.

通常會在之後立即進行乳房重建。

Vascular is a 2 year fellowship. With technological advances, many of your cases are endovascular,

血管科是一個為期兩年的研究項目。隨著技術的進步，你的許多病例都是血管內的。

whereby you use wires and stents to fix issues within blood vessels, from the aorta on down.

在這裡，你使用電線和支架來修復血管內的問題，從主動脈開始。

You'll also be involved in reconstructing vascular supply to the body's organs while

你還將參與重建身體器官的血管供應，同時

working in tandem with other surgeons, such as during massive tumor resections, repairs

與其他外科醫生協同工作，例如在大規模的腫瘤切除、修復過程中。

after trauma, and so on. Endocrine is a 1 year fellowship whereby you'll

外傷後，等等。內分泌科是一個為期一年的研究項目，你將會

specialize primarily in surgeries of the thyroid, adrenal gland, and to a lesser extent pancreatic

主要擅長甲狀腺、腎上腺的手術，其次是胰腺的手術。

lesions, which are more often handled by hepatobiliary or surg onc teams. Endocrine has a great lifestyle,

病變，這些病變更多的是由肝膽科或腫瘤外科團隊處理。內分泌科有一個很好的生活方式。

as there are typically few emergencies on-call and working hours are considered favorable.

因為通常很少有待命的緊急情況，工作時間被認為是有利的。

Transplant is a 2 year fellowship primarily focusing on kidney and liver transplants from

移植是一個為期2年的研究項目，主要集中在腎臟和肝臟移植上。

deceased donors to live recipients. Less commonly, you'll be performing pancreatic transplants

將已去世的捐贈者移植給活體受體。不太常見的是，你會進行胰腺移植。

or live donor liver transplants, whereby part of the liver is transplanted given the unique

或活體肝臟移植，即考慮到獨特的肝臟，移植部分肝臟。

regenerative properties of the liver. This is one of the most rigorous and challenging

肝臟的再生特性。這是最嚴格和最具挑戰性的工作之一。

specialties from an hours and technical standpoint. Not only are liver transplants extremely lengthy

從時間和技術的角度來看，這也是一個特殊的問題。不僅肝臟移植的時間非常長

and difficult to perform, but you can also get called nearly 24/7, as donor availability

而且很難執行，但你也可以得到幾乎24小時不間斷的呼叫，因為捐贈者的可用性

is usually unplanned and harvesting is highly time sensitive.

通常是無計劃的，收穫是高度時間敏感的。

Surgical oncology is a 2 year fellowship focusing on surgical management of cancer throughout

腫瘤外科是一個為期2年的研究項目，專注於整個癌症的外科治療。

the body. Bread and butter includes breast cancers, colon cancers, soft tissue cancers,

的身體。麵包和黃油包括乳腺癌、結腸癌、軟組織癌。

such as sarcomas, and other abdominal cancers including the liver or pancreas.

如肉瘤，以及其他腹部癌症，包括肝臟或胰腺。

It's a competitive fellowship, the hours can be long and demanding, but those who are

這是一個競爭激烈的獎學金，工作時間可能很長，要求很高，但那些有能力的人

drawn to this line of work find it highly rewarding.

被吸引到這一行的人發現它有很高的回報。

Minimally invasive surgery, aka “MIS,” is a 1 year fellowship where you gain additional

微創手術，又稱 "MIS"，是一項為期一年的研究項目，你將獲得更多的機會。

training in advanced laparoscopy and robotic skills. This often, but not always, translates

在高級腹腔鏡和機器人技能方面的培訓。這往往，但不總是，轉化為

to focusing on minimally invasive foregut surgery, bariatric surgery, and abdominal

專注於微創前腸手術、減肥手術和腹腔手術。

wall reconstruction. It's more on the competitive side and is considered to have a good lifestyle

牆體重建。它更偏向於競爭，被認為有良好的生活方式

after training. You can also pursue fellowships in cardiothoracic

培訓結束後。你還可以繼續攻讀心胸科的獎學金。

and plastic surgery, both of which we've done dedicated So You Want to Be episodes on. Link

和整形手術，這兩件事我們都做了專門的《你想成為什麼樣的人》一集。鏈接

in the description. There's a lot to love about general surgery.

在描述中。普通外科有很多值得喜愛的地方。

General surgeons are the ultimate physician, or the "doctor's doctor." They can broadly

普通外科醫生是終極醫生，或 "醫生的醫生"。他們可以廣泛地

diagnose, stabilize, and treat nearly any acute life threatening condition and then

診斷、穩定和治療幾乎所有威脅生命的急性疾病，然後

take it up a notch by fixing the problem with their hands. If you could pick only one type

通過用他們的手來解決問題，使它更上一層樓。如果你只能選擇一種類型

of doctor to be stranded on a boat with, you'd want a general surgeon.

擱淺在船上的醫生，你會想要一個普通的外科醫生。

General surgery is immensely satisfying. You're intervening to save someone's life on the

普通外科手術是非常令人滿意的。你是在為拯救某人的生命而進行干預。

brink of death, curing cancer, transplanting organs, and more. These are some of the most

瀕臨死亡，治癒癌症，移植器官，等等。這些是一些最

exciting and deeply meaningful things you could ever ask for in a job.

在一份工作中，你能要求的激動人心和深具意義的事情。

Compensation is in the upper half of specialties, with general surgeons pulling in approximately

報酬在各專業中處於上半區，普通外科醫生的收入約為1.5萬美元。

$373,000 per year. And there will always be a need for general

每年373,000美元。而且永遠都會有對一般

surgeons. While general surgery is awesome, it's not

外科醫生。雖然普通外科很了不起，但它並不是

for everyone. Training is lengthy, much more so than non-surgical

對每個人來說。訓練是漫長的，比非手術治療要長得多。

fields. While your non-surgical medical school classmates are finished with residency and

領域。當你的非外科醫學院的同學們完成了住院醫生的工作，而你的非外科醫學院的同學們則完成了住院醫生的工作。

living their attending lives, you'll still have another few years to complete.

過著他們參加的生活，你還有幾年的時間來完成。

The hours in training are also long. There will be plenty of early mornings, late nights,

培訓的時間也很長。將有大量的清晨和深夜。

busy overnight call, and surgeries lasting several hours. And while there is some flexibility

忙碌的通宵電話，以及持續數小時的手術。而且，雖然有一些靈活性

in your work-life balance after you finish training, know that the average surgeon still

在你完成培訓後，你的工作與生活的平衡，要知道，一般外科醫生仍然

works 60 hours per week. And finally, compared to other surgical specialties,

每星期工作60小時。最後，與其他外科專業相比。

general surgeons have the lowest compensation. How can you decide if general surgery is right

普通外科醫生的報酬最低。你如何決定普通外科是否合適

for you? They say that if you can find happiness in another specialty of medicine, then do

對你來說是什麼？他們說，如果你能在另一個醫學專業中找到幸福，那麼就做吧。

that. Only do general surgery if you couldn't imagine yourself doing anything else.

這一點。只有在你無法想象自己做其他事情的情況下才做普通外科。

If you're passionate about medicine broadly and like the idea of being a doctor's doctor,

如果你對醫學有廣泛的熱情，並喜歡成為醫生的醫生的想法。

general surgery might be for you. You should love working with your hands, thrive in having

普通外科可能適合你。你應該喜歡用你的雙手工作，在工作中茁壯成長。

a serious level of responsibility for your patients, and crave and enjoy deep, meaningful

對你的病人認真負責，並渴望和享受深入、有意義的工作。

connection with patients. The joke that surgeons just put patients under anesthesia and don't

與病人的聯繫。有人開玩笑說，外科醫生只是給病人打麻醉，並沒有

interact with them couldn't be further from the truth.

與他們的互動與事實相差無幾。

Huge shout out to my friend Dr. David Hindin for helping me with this video. He's a YouTuber,

衷心感謝我的朋友David Hindin博士幫助我完成這個視頻。他是一名優酷網友。

general surgeon, and current surgical critical care fellow at Stanford. He has an awesome

他是普通外科醫生，目前是斯坦福大學的外科重症監護研究員。他有一個了不起的

YouTube channel and is an expert on innovation in medicine. Go show him some love, link to

YouTube頻道，是醫學創新方面的專家。去給他一些愛，鏈接到

his channel in the description. Are you hoping to become a general surgeon?

他的頻道的描述中。你希望成為一名普通外科醫生嗎？

To get into medical school and match into general surgery residency, you'll need to

要想進入醫學院並匹配到普通外科住院醫師，你需要

score well on your class tests and standardized exams. As you look at resources and companies

在你的班級測試和標準化考試中取得好成績。當你看了資源和公司

to work with, seek out those who are actual MD physicians, not PhD or other types of doctors

與之合作，尋找那些真正的醫學博士醫生，而不是博士或其他類型的醫生。

that didn't go to medical school. Look for those who have achieved stellar results themselves,

沒有上過醫學院的人。尋找那些自己取得過輝煌成績的人。

a track record of success with positive ratings from customers, and a systematic approach

有成功的記錄，有客戶的積極評價，有系統的方法

so you know you'll always receive high quality service. If you decide on Med School Insiders,

所以你知道你將永遠得到高質量的服務。如果你決定選擇醫學院內部人士。

we'd love to be a part of your journey in becoming a future physician. Visit us on MedSchoolInsiders.com.

我們很願意成為你成為未來醫生的旅程的一部分。請訪問我們的MedSchoolInsiders.com。

Thank you all so much for watching! If you enjoyed this video, check out our So You Want

非常感謝大家的觀看!如果你喜歡這個視頻，請查看我們的 "你想要什麼？

to Be an Internist video, or another specialty on our So You Want to Be playlist. And go

成為一名內科醫生的視頻，或我們的 "你想成為 "播放列表中的其他專業。然後去

show Dr. Hindin some love. See you all soon.

向辛丁博士表示敬意。再見了。