You should concatenate the two columns with doctor name and operation first in column C. To split out the number from the doctor name, you might want to use a string function like =RIGHT(cell, LEN(cell)-2). If the numbers go over 1 character in length you will need to replace the LEN part with a FIND function for the space character after the number.
After that you can used the COUNTIF function on the range of concatenations to return the number of unique doctor/operation pairs.
