"An education in medicine will change your life," says Dr. Paul Cobza, a surgical resident for the Ingham Regional Medical Center of Lansing, Michigan. "You'll grow up fast and you'll be disciplined. You'll study hard, work hard, and become a better you. You'll make a lot of sacrifices, and hopefully feel that it was worth it when you're done."

Born in 1970 and originally from Merrillville, Indiana, Dr. Cobza is an orthopedic surgical resident in his third year of residency as an osteopathic surgeon. The Indiana University (NW) graduate made Kirksville College in Kirksville, Missouri, his home for medical school. "It was comparable to any other medical school," he says. "The academics were second to none. The people were nice and very helpful." Although he suggests that the location was rural, boring even, he insists he had a good educational experience.

After medical school, Dr. Cobza spent three years in the Dallas/Fort Worth area completing his rotations at the Dallas/Fort Worth Medical Center. He recently moved to Lansing to serve his fourth year in residency at the Ingham Regional Medical Center as a general surgical resident.

"I was attracted to the surgical field because it allows you to manage a variety of patient treatments," he says, "trauma, vascular surgery, cosmetics, pediatrics, urology, gynecology, or a general management setting. There's many directions and alternatives in the surgical field." Currently, he is considering a surgical fellowship in cosmetic surgery or upper hand extremity.

The ability to "operate on someone and make him or her better" is what Doctor Cobza likes most about his chosen career path. "There's a lot of heartache and sleepless nights, too," he says. "But seeing people get well and improve is a very rewarding experience."

Being unable to help people and watching them die is the most difficult part of the career for him. "I'm not sure how I deal with the disappointment internally. I guess I remind myself that for every person that I don't help, there's another that I do. And, in this career, there's no time to dwell on the bad stuff."

What advice does Dr. Cobza have for students considering a medical career?

"Job shadow a physician or a resident for a day, a week or month, if you can. Get permission to observe surgery in action. Get into the day of a doctor and see if you can handle it. A lot of people go into the medical field blindly, before they know whether they'll like it or not. It's very demanding. Medical school is study and sleep. There's no time for anything else. There's a lot of sacrifice, but if you're a responsible and driven person, it will be a great career for you. The satisfaction of seeing people get better is a great payoff. "

Demanding Job, High Satisfaction
Treating injuries, correcting serious health impairments, preventing health problems and saving lives - such is the daily routine of a surgeon. The single largest group of medical specialists, surgeons render an array of health care duties. They can practice general surgery and perform a variety of operations, or specialize within one area of health care such as vascular surgery, nuerosurgery, plastic surgery, or orthopedic (bone and joint) surgery. Surgeons typically work long hours, using a myriad of surgical instruments and employing advanced surgical techniques for five to eight hours daily. Although the work is time depleting, exhaustive, and grueling, most surgeons are invigorated by their career and report a high degree of job satisfaction.

It takes years of education and dedication to become a surgeon, which starts with four years of undergraduate study. Pre-medical students are required to complete a coursework of physics, biology, mathematics, English, and chemistry. Medical career hopefuls must then apply for enrollment at an accredited a medical school for another four years of specialized study consisting of two years of classroom work, followed by two years of clinical study. Medical schoolwork will include pathology, pharmacology, biochemistry, physiology, and neuroanatomy. Clinical studies are conducted in a hospital or clinic where students are trained to make examinations, take medical histories, make accurate diagnoses, and offer treatments for a variety of health-related concerns. Once medical school is done, graduates must complete medical board exams and serve a 12-month, on-the-job rotating internship, rotating their responsibilities amongst several differing areas of medical practice. Thereafter, interns apply for a residency at a board approved medical facility.

According to Sarah Brotherton, Ph.D., Director for the Department of Data Acquisition Services, Division of Undergraduate and Graduate Medical Education Policy and Standards for the American Medical Association, the training schedule is grueling indeed. "Five years of training in a surgery program accredited by the Accreditation Council for Graduate Medical Education (ACGME) is required to acquire the skills and knowledge to be become a board-certified general surgeon in the United States," she says, "after, of course, graduation from medical school.

"During the training, the resident will acquire balanced experience in the principal components of general surgery, namely, head and neck; breast; skin and soft tissues; alimentary tract; abdomen; vascular system; endocrine system; the comprehensive management of trauma, burns, emergency surgery; and surgical critical care. The number of major operations performed by each resident should range from 500 to 1,000 major cases over the five years of training.

"While all residency training is demanding in terms of time and stamina, training in surgery is considered one of the most demanding," Dr. Brotherton says. "Continuity of care for the patient is required regardless of the time of day, day of week, number of hours already worked, or on-call schedules. These requirements are carefully balanced with the need to provide the patient with a healthy, alert, and responsive physician. Residents are required to have at least one day out of seven free of routine responsibilities, and be on call in the hospital no more than every third night."

Might Surgery Suit You?
Dr. Brotherton runs down the myriad types of surgery that can become a medical student's specialty: "There are several subspecialties of general surgery: surgical critical care, hand surgery, pediatric surgery and vascular surgery. The training for each of these specialties lasts one year, with the exception of pediatric surgery, which is two.

"In addition, there are other surgical specialties: colon and rectal surgery, neurological surgery, orthopedic surgery, plastic surgery, and thoracic surgery. Training in colon and rectal surgery is available to those who have completed the five years of general surgery training, and is one year in length. Training in neurological surgery is six years in length, including one year of general surgery. Orthopedic surgery training is four to five years, and there are many subspecialties to this specialty, each an additional year in training. Training in plastic surgery is five to six years in length, and may include three years in general surgery, or other surgical programs. Thoracic surgery training requires completion of the five years in general surgery, followed by two years in thoracic surgery."

Currently, there are 144 medical schools in the United States. Nineteen award osteopathic, D.O. degrees and 125 offer allopathic, M.D. degrees in the U.S. and Puerto Rico.

The many career alternatives associated with surgical expertise include internal medicine, nursing, surgical assistant, family practice medicine, radiology, oncology, obstetrics, pediatrics, surgical technologist, and more. Dr. Cobza likes the surgical field "because it allows me to manage patients in a variety of settings such as trauma, general medicine, urology, gynecology, or cardiovascular. You can manage a lot of different things."

The medical profession is a competitive field. An oversupply of medical practitioners in previous decades has limited the availability of medical related careers. According to the U.S. Department of Labor, Bureau of Labor statistics, however, the need for surgeons will grow through the next 10 years because of continued expansion in the health care industry overall. An aging population and emerging technologies will drive additional demand for physicians with a surgical specialty. Educational expenses for this career field remain quite high, and starting salaries for residents is low, starting in the mid-$30,000 range.

There are currently 86,550 surgeons in practice, 80% of them male, working an average of 65 hours per week. Starting salaries reflect the surgeon's delicate job and the difficult road to get there; compensation begins at $164,000, grows to $175,000 after five years and $247,000 after 10. To peek into the world of a surgeon, browse professional publications such as Journal of American Medical Association, New England Journal of Medicine, and Surgical Services Management Magazine. It's a world in which lives are saved on an everyday basis.