Welcome to the next installment of our So You Want to Be series, where we highlight a specific specialty within medicine, and help you decide if it’s a good fit for you! You can find the entire list here. If you want to help us decide which specialty or healthcare professional to cover next, drop a comment down below with your request.
If you’d like to see what being a trauma surgeon looks like, check out my personal YouTube channel, Kevin Jubbal, M.D., where I do a second series in parallel titled a Day in the Life.
Becoming a trauma surgeon is a long and arduous journey, but it is incredibly rewarding for those who have the grit and determination to see it through. If you have a passion for saving lives and helping people in their most critical moments, trauma surgery may be the perfect career path for you.
An Overview of the Training Process
The first step to becoming a trauma surgeon is completing 4 years of medical school after your undergraduate degree. Then, you must complete a 5-year general surgery residency program. After finishing your general surgery training, you can apply for a 1-2 year fellowship program specifically in trauma surgery. So in total, the journey takes approximately 10-11 years after college.
It’s a long road, but every step builds invaluable skills and experience Here is a more in-depth look at the timeline
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4 years of medical school – The first 2 years focus on classroom lectures and labs. The last 2 years are spent doing clinical rotations in various specialties including surgery.
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5 years of general surgery residency – As a resident you will train under attendings (fully licensed surgeons) while progressively taking on more hands-on responsibilities in the OR and clinic This is an intensive period of honing your surgical skills,
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1-2 year trauma surgery fellowship – This advanced training focuses solely on trauma-related surgeries and care. You will become an expert in critical injuries from accidents, assaults, burns, gunshots, stabbings, and more.
So in total, you’re looking at about 10-11 years of training after college. It’s no small feat but the impact you can have on patients makes the long journey worthwhile.
Why It Takes So Long to Become a Trauma Surgeon
There are several key reasons why it takes about a decade to become a fully licensed trauma surgeon:
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Mastering general surgery skills – Trauma surgeons must be adept at all areas of general surgery before specializing. This includes a vast array of procedures on the GI tract, thyroid, breasts, skin, blood vessels, etc. It takes 5 years just to gain competence across the board.
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Developing trauma specialty skills – Trauma surgeons need unique skills like rapidly controlling bleeding, assessing organ damage, and making split-second decisions with limited information. The specialty fellowship hones these specific competencies.
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Training for high-acuity situations – Trauma surgeons work in intense, high-stress environments where patients are critically injured. They must keep calm under pressure when lives hang in the balance. It takes time to develop this poise and precision.
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Learning team leadership skills – Trauma cases require close collaboration between surgeons, ER doctors, anesthesiologists, nurses, and other staff. The long training process allows surgeons to become effective leaders of the trauma team.
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Gaining exposure to rare cases – Trauma surgeons must be ready for unusual, complex injury patterns that they may see only a few times in their career. Broad training exposure helps prepare them for rare cases.
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Developing research skills – Many surgeons complete research assignments or advanced degrees during residency and fellowship. This strengthens their ability to drive new discoveries in trauma care.
Becoming a licensed, board-certified trauma surgeon is a long journey, but every step builds critical skills and experience. The lengthy training period ensures you will be fully prepared to deliver top-tier, potentially life-saving care to critically injured patients. It is an incredibly meaningful and rewarding career for those dedicated to go the distance.
A Closer Look at Medical School
Medical school lays the initial groundwork for a career as a trauma surgeon. It is a challenging 4-year curriculum:
Year 1-2: Classroom Learning
- Courses in anatomy, physiology, biochemistry, pathology, pharmacology, genetics, ethics and more
- Laboratory components like dissections, microscopy, simulations
- Introduction to clinical skills like performing a history and physical
Year 3-4: Clinical Rotations
- Core rotations in internal medicine, surgery, pediatrics, psychiatry, OB-GYN
- Opportunity to do electives in trauma surgery and related fields
- “Sub-internships” acting as a resident for hands-on learning
- Study for and take the first two steps of the USMLE licensing exams
The classroom years give you a comprehensive foundation in medicine and human health. The clinical years allow you to see various specialties first-hand while developing your clinical acumen. Research opportunities and mentorship programs can further strengthen your credentials when applying to general surgery residency programs.
The Rigorous General Surgery Residency
After matching into a general surgery residency, you enter 5 arduous years of training under the supervision of senior surgeons:
Junior Resident (PGY 1-2)
- Heavy focus on inpatient care, often working over 80 hours per week
- Mastering basic procedures like suturing, catheter placement, intubations
- Learning pre-op and post-op care protocols
- Building foundational skills in the OR including tissue dissection, instrument handling, knot tying
Senior Resident (PGY 3-5)
- Increased operating as primary surgeon under attendings’ supervision
- Developing mastery in complex surgeries like bowel resections, hernia repairs, appendectomies
- Running clinics and rounding on post-op patients
- Teaching and overseeing junior residents and medical students
Throughout residency you will also study intensively for the general surgery board certification exams. Upon completion, you can either pursue the trauma surgery fellowship or work for a few years as a general surgeon before specializing. Either path leads to becoming a fully credentialed trauma surgeon.
The Trauma Surgery Fellowship
This advanced 1-2 year training is the final step to becoming a trauma surgeon. The intensive fellowship allows you to hone skills specific to treating critical, penetrating, and blunt force injuries. Common elements include:
- Running trauma resuscitations and stabilizing critically wounded patients
- Performing emergency surgeries for internal bleeding, organ damage, and severed limbs
- Managing ICU care for post-op trauma patients
- Utilizing imaging technology like CT scanning to rapidly diagnose injuries
- Implementing damage control techniques to quickly stop bleeding before complete repairs
- Developing skills in orthopedic, vascular, and neurosurgery to manage polytrauma cases
- Leading activations of the trauma team and coordinating care between specialties
Upon completing fellowship, you can sit for the trauma surgery boards to become certified in this subspecialty. Then you are ready to join a trauma center as an attending surgeon, either at a large academic hospital or a local community hospital.
Alternative Pathways
While the standard path is medical school, general surgery residency, and trauma fellowship, there are some alternative options:
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Enrolling in military programs like the Army or Air Force which fully cover your tuition in exchange for years of service
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Pursuing combined MD/PhD programs to strengthen your research background
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Completing residency and fellowship abroad in countries like India or Mexico
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Focusing solely on orthopedic trauma by entering an orthopedic surgery residency instead
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Joining the surgical staff of a nonprofit like Doctors Without Borders to gain trauma experience worldwide
These pathways have pros and cons to weigh, but may allow you to achieve your goals on an adjusted timeline.
Daily Life as an Attending Trauma Surgeon
A typical day in the life of an attending trauma surgeon may include activities like:
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Rounding on hospitalized trauma patients and coordinating care plans
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Performing scheduled surgeries like wound debridements and closure revisions
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Running clinics for follow-up appointments and minor procedures
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Responding urgently to trauma activations and resuscitating critically injured patients
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Operating emergently to control bleeding, repair organ lacerations, stabilize fractures, etc.
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Utilizing imaging and laparoscopic tools to diagnose the extent of injuries
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Coordinating smoothly with the trauma team of nurses, techs, anesthesiologists, and other surgeons
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Educating and overseeing residents during procedures and resuscitations
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Communicating with patients’ families and providing support
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Participating in research studies and clinical trials to advance the field
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Teaching medical students interested in trauma surgery
It is fast-paced, demanding work that requires excellence under pressure – and tremendous dedication over many years of training. But the privilege of saving lives and giving back to your community makes the long journey incredibly rewarding.
Frequency of Entities:
medical school: 6
general surgery residency: 5
trauma surgery fellowship: 3
residency: 4
fellowship: 4
trauma surgeon: 21
years of training: 3
What it’s Like Being a Trauma Surgeon
Doctors joke around sometimes that trauma surgery is kind of like general surgery on steroids.
All of the regular principles that we have in general surgery are still there. And many of the procedures and maneuvers are the same, too. In trauma surgery, you might find yourself removing and reconnecting different portions of the small bowel and colon. You might find yourself removing a portion of the lung, or repairing a hole in the diaphragm. And you might find yourself deep in the abdomen exposing the retroperitoneum to repair a vascular injury.
All of these are techniques, and maneuvers, and procedures that we might do in other areas of general surgery. But the difference in trauma is the urgency and often the speed at which we have to do this work.
And just as trauma surgeons may have to perform surgery in a much more urgent timeframe, these surgeons also must make decisions about patient management, and take action, often with limited information, in the blink of an eye. But more on that in a few minutes.
What is Trauma Surgery?
Trauma surgery is a subspecialty of surgery primarily dealing with patients who have undergone a physical injury, often in an acute setting. Not all trauma requires surgery and depending on the specific injury, these patients may also need further treatment from neurologists, internal medicine doctors, and more. The majority of injuries addressed by trauma surgery include those of the neck, chest, abdomen, and extremities.
In Europe, trauma surgeons treat most of the musculoskeletal trauma, whereas neurosurgeons handle injuries to the central nervous system. In the United States and the UK, however, skeletal injuries are primarily handled by orthopedic surgeons, and facial injuries are often treated by plastic surgeons or maxillofacial surgeons. Neurosurgeons typically manage injuries to the central nervous system in these countries, too.
Trauma surgeons must be familiar with a variety of general surgical, thoracic, and vascular procedures. Trauma conditions can be described as blunt or penetrating. Blunt would include injuries from a motor vehicle crash, falls, ATV rollovers, and assaults. Penetrating injuries include gunshot wounds, stab wounds, and the like. Additionally, they’re dealing with high acuity situations, often with little time and incomplete information with a patient in front of them who is rapidly decompensating.
The more traditional trauma surgical interventions often include procedures such as exploratory laparotomy, where the abdomen is opened and the abdominal organs examined for injury or disease. Thoracotomies open up the chest, and tracheostomies are procedures for insertion of a breathing tube through the throat. Over the past few decades, advances in trauma and critical care have led to more non-operative, and sometimes minimally invasive treatment modalities. This is good for patients, as less invasive therapies often have better outcomes.
So You Want to Be a TRAUMA SURGEON [Ep. 8]
How long does it take to become a trauma surgeon?
This is good for patients, as less invasive therapies often have better outcomes. To become a trauma surgeon, you’ll complete medical school and then do 5-7 years of general surgery residency, depending on whether your residency includes a two-year research block.
Should you become a trauma surgeon?
If you want your career as a physician to be fast-paced, challenging, and immensely rewarding, you might want to consider becoming a trauma surgeon. Trauma surgeons work, at times, in emergency situations, treating critically ill and injured patients.
How much does a trauma surgeon make a year?
The average salary of a surgeon is $299,445 per year. Your earning potential in the trauma specialty may depend on how long you work in the health care field. For instance, you may make more money in the tenth year of your career than you did when you first completed your fellowship.
How long does a trauma surgery fellowship take?
You’ll receive this training through a trauma surgery fellowship that will take one to two years to complete, depending on the program. During your fellowship you will work at a Level I or II trauma center and will learn how to treat a range of traumas.
