According to the surgical grading management methods of Jiangsu Province and the surgical grading management requirements of Nantong Hospital of Traditional Chinese Medicine, the surgical grading system of the Department of Anorectal Medicine is formulated: I. Surgical and invasive operation grading According to the technical difficulty, complexity and risk degree, the surgeries are divided into four levels: (a) Level 4 surgeries: various surgeries with high technical difficulty, complex surgical procedures and high risk degree. (2) Level 3 surgery: various surgeries with greater technical difficulty, more complex surgical procedures and greater risk. Zhao Aimin, Department of Anorectal Medicine, Nantong Hospital of Traditional Chinese Medicine (c) Level II surgery: various surgeries with average technical difficulty, uncomplicated surgical procedures and moderate risk. (iv) Level I surgery: various surgeries with lower technical difficulty, simple surgical procedures and less risk. All surgeons should be qualified to practice medicine according to the law. (A) resident 1, low seniority resident: engaged in residency within 3 years, or received a master’s degree, had been engaged in residency within 2 years. 2, seniority resident: engaged in residency for more than 3 years, or received a master’s degree, obtained a license to practice medicine, and had been engaged in residency for more than 2 years. (2) Attending physicians 1. Low seniority attending physicians: those who have been working as attending physicians for less than 3 years, or those who have obtained a clinical doctorate and have been working as attending physicians for less than 2 years. 2. Senior seniority attending physicians: those who have been working as attending physicians for more than 3 years, or those who have obtained a clinical doctorate and have been working as attending physicians for more than 2 years. (3) Associate chief physician: 1. Low senior associate chief physician: those who have been working as associate chief physician for less than 3 years, or those who have postdoctoral degree and have been working as associate chief physician for more than 2 years. 2. Senior associate chief physician: those who have been working in this position for more than 3 years. (4) Chief physician: those who are employed in the post of chief physician. (3) Surgical authority of physicians at all levels (a) low-grade resident: under the guidance of the senior physician, can preside over the first level of surgery. Senior residents: skilled in primary surgery, and can gradually carry out secondary surgery under the supervision of senior physicians on the spot. (2) Junior attending physician: can perform level II surgery, and gradually perform level III surgery under the supervision of a senior physician on site. Senior attending physician: can preside over tertiary surgery. (3) Low senior associate chief physician: can preside over level 3 surgery, and gradually carry out level 4 surgery under the supervision of senior physician on the spot. Senior deputy chief physician: can preside over level 4 surgery, and under the supervision of senior physician or according to the actual situation, can preside over new technology, new project surgery and research project surgery. (4) Chief physician: can preside over level 4 surgery as well as general new technology, new project surgery or high-risk scientific research project surgery approved by the competent department. (4) Surgery approval authority (a) Routine surgery 1. Level 4 surgery: The chief of the department shall approve the surgery, and the senior deputy chief physician or above shall submit the surgery notice for approval. 2.Tertiary surgery: the chief of the department for approval, the deputy chief physician or above for approval of the surgery notice. 3.Secondary surgery: approval by the chief of the department and approval of the surgery notice by the senior attending physician or above. 4.Tier I surgery: approval by attending physician or above, and may issue a surgery notification order. (2) High-risk surgery refers to any level of surgery with high risk as determined by the quality control team of the surgical department and the chief of the department. It must be discussed within the department, signed and agreed by the chief of the department and reported to the medical department, and the chief of the medical department will decide to approve it by himself or submit it to the vice president of business or to the president for approval if necessary, and after approval, the chief of the surgical department will be responsible for issuing the operation notice. (3) Emergency surgery When the expected level of surgery is within the level of surgical authority of the doctor on duty, the surgery can be notified and performed. If it is a high-risk operation or the expected operation is beyond the level of one’s own surgical authority, it should be reported urgently to the superior physician who is responsible for the regulations for approval, and then reported up the hierarchy if necessary. In principle, a physician with the appropriate level to perform the surgery should perform the surgery. However, in the case of emergency life-saving surgery, the doctor on duty at any level has the right to and must preside over any rescue surgery he/she deems reasonable according to the specific situation, without delaying the time of rescue, provided that the doctor on duty does not violate the verbal instructions of the superior doctor. If it is found that the operation to be performed in emergency surgery is beyond their own surgical authority, they should immediately report verbally for instructions. (4) New technology, new projects, scientific research surgery 1. General new technology, new project surgery, major surgery and surgery for disability must be discussed within the department, fill out the “Surgery Approval Form”, sign the opinion and submit it to the Medical Department, which will submit it to the Vice President of Operations for approval. 2. High-risk new technologies, new projects and scientific research surgeries should be submitted to the technical committee of the hospital for consideration and approval. For major surgical projects involving life safety and social environment, they should also be reported to the competent health administrative department according to the regulations. (E) Outgoing consultation surgery The physician of the hospital is invited to the lower level hospital to instruct the surgery, must go through the relevant approval procedures in accordance with the relevant regulations. The surgery conducted by the outgoing surgeon shall not exceed the corresponding surgical level stipulated by him/her according to this specification. (a) Two or more physicians of the hospital must participate in the second level and above surgery. (2) Pre-operative summary shall be required for primary and secondary surgery, and pre-operative discussion shall be required for tertiary surgery and above. The medical department is responsible for supervision and inspection, and those found to have violated the above regulations have the right to stop the operation and deal with it according to the relevant regulations.