The American College of Surgeons recognizes 14 surgical specialties: general surgery, cardiothoracic surgery, colon and rectal surgery, gynecology and obstetrics, gynecologic oncology, neurological surgery, ophthalmic surgery, oral and maxillofacial surgery, orthopedic surgery, otolaryngology (ENT), pediatric surgery, plastic and maxillofacial surgery, urology, and vascular surgery. Each specialty requires its own residency training path, and most are certified by a dedicated board under the American Board of Medical Specialties.
Here’s what each type of surgeon actually does, what conditions they treat, and how long it takes to become one.
General Surgery
General surgeons are the broadest category. They operate on organs throughout the abdomen and soft tissues of the body, handling everything from emergency appendectomies to gallbladder removals, hernia repairs, and partial colon removals for conditions like cancer or diverticulitis. Many other surgical specialties build on a general surgery foundation, making it the starting point for several career paths. Residency lasts five years after medical school.
Cardiothoracic Surgery
Cardiothoracic surgeons operate inside the chest. That includes the heart, lungs, esophagus, windpipe, diaphragm, and chest wall. Coronary artery bypass grafting, the world’s most common heart surgery, falls under this specialty, along with heart valve repairs, lung tumor removals, heart and lung transplants, and repairs of stretched blood vessels called aneurysms. They also treat congenital heart defects, irregular heart rhythms, and heart failure that requires surgical intervention. Training requires completing a full general surgery residency (five years) plus two additional years focused on thoracic surgery.
Colon and Rectal Surgery
These surgeons specialize in the large intestine, rectum, and anus. They treat colorectal cancer, inflammatory bowel diseases like Crohn’s disease and ulcerative colitis, diverticulitis, hemorrhoids, anal fissures and fistulas, rectal prolapse, and fecal incontinence. They also manage hereditary conditions that raise cancer risk, such as familial adenomatous polyposis and Lynch syndrome. Training involves five years of general surgery residency plus one additional year in a colon and rectal surgery program.
Gynecology and Obstetrics
OB/GYN surgeons perform procedures on the female reproductive system. Hysterectomy, the removal of the uterus, is one of the most common, and it can be done through open abdominal incisions, laparoscopic instruments, robotic assistance, or vaginally. These surgeons also perform cesarean sections, treat endometriosis surgically, remove ovarian cysts, and carry out minimally invasive surgical staging for reproductive cancers. Residency is four years, with three years entirely in obstetrics and gynecology plus one elective year.
Gynecologic Oncology
Gynecologic oncologists are a more specialized branch, focusing exclusively on cancers of the female reproductive system: ovarian, uterine, cervical, vulvar, and vaginal cancers. They perform tumor removal, surgical staging to determine how far cancer has spread, and debulking surgeries to reduce tumor size before other treatments. Becoming one requires completing a four-year OB/GYN residency followed by two to three additional years of fellowship training in gynecologic oncology.
Neurological Surgery
Neurosurgeons operate on the brain, spinal cord, and peripheral nerves. Their scope is enormous, covering brain and spinal cord tumors, herniated discs, degenerative disc disease, brain aneurysms, stroke, traumatic brain injuries, carpal tunnel syndrome, and chronic conditions like trigeminal neuralgia. They perform everything from minimally invasive spine surgery to open brain tumor removal, complex vascular bypass procedures in the brain, and stereotactic radiosurgery (a highly focused radiation technique). Training is six years total: one year of general surgery followed by five years of neurological surgery training.
Ophthalmic Surgery
Ophthalmic surgeons, also called ophthalmologists, operate on the eyes. Cataract surgery is by far the most common procedure, with roughly 3.7 million performed in the United States each year. They also perform vision correction surgeries like LASIK, corneal transplants, surgeries for glaucoma, retinal procedures called vitrectomies, and repairs for eye injuries. Strabismus surgery, which corrects misaligned eyes, is another common procedure. Training involves one year of broad patient care (in fields like internal medicine, pediatrics, or emergency medicine) followed by three years in ophthalmology.
Oral and Maxillofacial Surgery
This specialty bridges dentistry and medicine. Oral and maxillofacial surgeons operate on the mouth, jaw, face, and skull. They handle wisdom tooth extractions and dental implants but also perform complex jaw reconstruction, treat facial fractures, remove tumors of the mouth and jaw, and correct congenital defects like cleft palate. The training path is unique: it begins with a four-year dental degree, followed by at least four years in a surgical training program.
Orthopedic Surgery
Orthopedic surgeons focus on the musculoskeletal system: bones, joints, ligaments, tendons, and muscles. Joint replacement is one of their signature procedures, most commonly for knees, hips, and shoulders, though elbows, ankles, wrists, and even fingers or toes can also be replaced. These replacements treat osteoarthritis, rheumatoid arthritis, fracture-related joint damage, and conditions where blood flow to a joint is cut off, causing bone to collapse. Beyond joint replacement, orthopedic surgeons repair fractures, torn ligaments (like ACL tears), rotator cuff injuries, and spinal conditions. Replacements can be total or partial, depending on how much of the joint is damaged. Training is five years: one year of broad clinical work plus four in orthopedic surgery.
Otolaryngology (ENT Surgery)
ENT surgeons, formally called otolaryngologists, operate on the ears, nose, throat, and structures of the head and neck. Their range includes sinus surgery, tonsillectomies, thyroid removal, cochlear implants for hearing loss, and cancer surgery in the throat or larynx. More complex work includes endoscopic surgery for pituitary tumors, robotic surgery for throat cancer, and microsurgery for tumors on the hearing nerve. Residency is five years: one year of general surgery training, three years of otolaryngology, and one elective year.
Pediatric Surgery
Pediatric surgeons operate on patients from before birth through young adulthood. They repair birth defects and congenital malformations, perform emergency procedures like appendectomies in children, fix inguinal hernias (one of the most common childhood surgical problems), and work alongside transplant teams. Some subspecialize further into fetal and neonatal surgery, pediatric trauma, pediatric cancer surgery, or minimally invasive techniques adapted for smaller bodies. The path requires finishing a full five-year general surgery residency, then completing two more years of fellowship in pediatric surgery.
Plastic and Maxillofacial Surgery
Plastic surgeons work in two broad categories: reconstructive and cosmetic. Reconstructive surgery repairs parts of the body affected by birth defects, disease, or injury, aiming to restore normal form and function. Common reconstructive procedures include cleft lip and palate repair, breast reconstruction after mastectomy, facial reconstruction after tumor removal or trauma, hand surgery to improve strength and flexibility, and limb salvage procedures that use tissue grafts to prevent amputation. Cosmetic surgery, by contrast, enhances appearance beyond what’s medically necessary. Many plastic surgeons add six to twelve months of extra training to subspecialize in a particular area of interest.
Urology
Urologists operate on the urinary system in both men and women, plus the male reproductive system. They treat kidney stones (using shock waves, lasers, or endoscopic tools to break them up), bladder cancer, kidney cancer, and prostate cancer. A radical prostatectomy removes the prostate gland for cancer that hasn’t spread. For an enlarged prostate causing urinary blockage, they can remove just the inner portion to restore flow. They also perform full kidney removal when tumors or non-functioning kidneys require it, bladder removal for cancer, and reconstructive procedures on the tubes that carry urine from the kidneys. Much of modern urologic surgery is minimally invasive, using robotic or laparoscopic techniques. Training is five to six years: two years of general surgery followed by three to four years in urology.
Vascular Surgery
Vascular surgeons treat diseases of arteries and veins throughout the body, excluding the heart and brain (which fall to cardiothoracic and neurosurgeons, respectively). They repair aneurysms, remove plaque buildup from blood vessels, perform bypass surgery to reroute blood flow around blockages, and use balloon angioplasty or stents to open narrowed arteries. They handle both minimally invasive catheter-based procedures and complex open surgeries, and increasingly perform hybrid procedures that combine elements of both. Training builds on a general surgery residency with one to two additional years in vascular surgery.
How Training Lengths Compare
All 14 specialties require four years of medical school before residency begins (oral and maxillofacial surgery requires dental school instead). After that, total postgraduate training ranges from four years on the shorter end to eight or more on the longer end.
- 4 years: Obstetrics and gynecology, ophthalmic surgery
- 5 years: General surgery, orthopedic surgery, otolaryngology
- 5–6 years: Urology
- 6 years: Neurological surgery, colon and rectal surgery (5+1)
- 6–7 years: Vascular surgery (5+1 or 5+2), gynecologic oncology (4+2 or 4+3)
- 7 years: Cardiothoracic surgery (5+2), pediatric surgery (5+2)
- 8+ years: Oral and maxillofacial surgery (4-year dental degree + 4+ years surgical training)
Each specialty has its own certifying board under the American Board of Medical Specialties. General surgery and vascular surgery are both certified by the American Board of Surgery, while the remaining specialties each have a dedicated board, from the American Board of Neurological Surgery to the American Board of Urology.