College of Surgeons renews calls for title ‘surgeon’ to be restricted

RACS Councillor and urologist Professor Mark Frydenberg said the term carried weight with the public who expect the title to have a high standard of training and patient care.

“In Australia, the use of the term ‘surgeon’ is not restricted to particular medical practitioners who have successfully completed accredited training or met other relevant registration standards. Unfortunately, we have many medical practitioners often in the cosmetic surgery sector who don’t have accredited surgical training but advertise themselves using ‘surgeon’ in their title. This lack of regulation of the title has caused confusion among members of the public.

“We strongly recommend the title ‘surgeon’ be restricted to meet the Australian public’s expectations and guarantee people advertising themselves using ‘surgeon’ in their titles have the necessary physiological, ethical, psychological, pharmacological and medical training and experience to safely diagnose, treat and manage surgical patients.

“Restricting who can use ‘surgeon’ in this way would help prevent patients from undergoing surgery under an incorrect assumption about the quality and standard of training of the person carrying out the operation. It would also help maintain public confidence in the high standards of our health system,” said Professor Frydenberg.

The Australian Medical Council (AMC) accredits specialist surgical training programs across ten different surgical specialties, nine of which are managed by RACS. The accreditation process also includes the Medical Council of New Zealand (MCNZ). The nine specialties managed by RACS are: Cardiothoracic Surgery, General Surgery, Neurosurgery, Orthopaedic Surgery, Otolaryngology Head and Neck Surgery, Paediatric Surgery, Plastic and Reconstructive Surgery, Urology, and Vascular Surgery. The training programs of these specialties are constantly reviewed, including annual reporting, in addition to an intensive accreditation process which occurs every five years.

By the time surgeons have completed their training, specialist surgeons have usually undertaken a minimum of five to six years’ worth of specialist training in addition to their medical degree and pre-vocational experience, in total well over 15 years of training.

Professor Frydenberg said surgeons during their training are assessed for many skills, not just technical skills.

“Our surgical trainees are required to train under ten competencies that provide a framework for the assessment of practising surgeons as part of the specialty training program. The competencies, which are used world-wide by eminent medical colleges, define the skills, attributes and behaviours that should be present or acquired to become a safe and competent surgeon.

“For example, trainees are not only taught how to operate, but also when not to operate. Upon completion they must demonstrate they are able to meet the very high standards required to perform as independent practitioners. They are also required to continue with their professional development, which is reviewed annually,” added Professor Frydenberg.

In addition to RACS surgeons, the College also supports the inclusion of other registered medical specialties’ practitioners to be recognised as surgeons as they are also AMC accredited, and offer rigorous training of up to six years that includes a significant component of surgery. These include the specialties of Ophthalmology, Obstetrics and Gynaecology, and Oral and Maxillofacial surgery.

RACS also supports the right of general practitioners in areas of need who have attained their qualifications through AMC accredited courses which include a significant surgical component to use the title ‘surgeon’ in combination with the words ‘Rural GP Surgeon’ or ‘Rural General Practice Surgeon’.

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