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Ortho Lifestyle

Discussion in 'Orthopaedic Surgery' started by Fuarky, Sep 4, 2011.

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  1. Fuarky

    Fuarky

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    I am aware that ortho residency is brutal and demanding, but am curious to know what the lifestyle/hours are like post residency. i would like to also have time to possibly work out and spend time on leisure activities as well, but am a committed guy.
  2. skiz knot

    skiz knot Legendary Dr. X

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    Ortho leaves me less than 16 hours a day to fit in strip clubs, drink until I'm black-out drunk, F Hoes, clock bitches, get my swole-on, make fun of fleas, spend Gs, and otherwise get my muthafukin' roll-on.
  3. Tired

    Tired Boned. Again.

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    Word. I was talking to this Trauma guy the other day, and he told me he had to stop with a threesome one Friday because some DB open-booked his pelvis. WTF is that?! Most programs promise five-somes when you sign your contract, so he was like hella pissed. It took his hoes like a whole weekend at the Bellagio to calm him down.
  4. neandurthal

    neandurthal

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    Quite possibly the funniest post I've ever seen on here.
  5. pinipig523

    pinipig523 I like my job!

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    I shoulda been an orthopod. :laugh:
  6. Fifty 3rds

    Fifty 3rds tertium quid

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    lol
  7. jmillski

    jmillski

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    These replies are great, but on a serious note ima bump this. I'm deciding between ophtho ortho (plusminus ENT). Can anyone speak to the differences? Plus for ortho is that it's raw mechanics and I grew up wanting to be an engineer, I love physically constructing things, etc. For ophtho, I love that immediate ginormous gratitude you get by fixing vision, as well as the famous work hours (of old). Any input would be incredible.
  8. Just Applied

    Just Applied Senior Member

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    Ortho and Ophtho are great fields but totally different. Macro vs microscopic surgery is 2 different beasts as well. Gotta see what you like first. Just had an Ortho Attending the other day who had a retinal detachment and now repaired. 6'7" started crying a few months post op after he realized he could see again. Guy is seeing perfectly now and is able to go back to work and do his thing. Pretty amazing S*** if you think about it.
  9. jmillski

    jmillski

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    also... one of the main reasons i'm in medicine in the first place is to make people happy..literally. can't do onc, gen surg, etc. I want to see benefits of my actions in a timely matter and I want the benefit to be known to the patient and literally make them happier. That said- can any ortho people speak to the gratitude they receive from their surgeries? Are most patients extraordinarily grateful for joint replacements or hand surgeries?
  10. DHT

    DHT The Most Potent Androgen

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    Sounds like ortho is exactly what you are looking for. Ortho patients tend to be some of the most grateful and satisfied patients in all of medicine. The excellent outcomes and great surgeries are what brought me into ortho in the first place.
  11. DoctwoB

    DoctwoB

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    What do you think about interest in the science vs. the day to day procedures? I've been torn between ortho and neurosurgery for a while now. I find the science behind neurosurgery much more interesting, and it has much more of a visceral "whoah cool" response for me then joints and bones. That being said, I think I would enjoy the combination of scope and macrosurgery (and outcomes) in ortho much more then the meticulous microsurgery of neuro. Do you think that not having super interest in the basic science of a field should outweigh loving the procedural aspects?
  12. DHT

    DHT The Most Potent Androgen

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    I think enjoying what you do on a daily basis is the single most important thing when picking a career. The "whoa cool" factor will wear off fast, trust me. Every specialty has those "great saves," but you have to figure out if those are frequent enough to justify all the misery and heartache in between. Also, once you know the science cold, it gets stale. Remember how fun it was when you were 3 or 4 learning the ABCs? Well how fun is it now to sing them? What about singing them 14 hours a day? Once you know something well enough that people are willing to pay you for your knowledge, it has already become routine and much of the excitement will be gone.

    Like you, I went into medical school thinking I was going to do Neurosurgery or Cardiothoracics(peds) - Ortho wasn't even on my radar. I loved cardiovascular physiology (and still do), but it wasn't enough to make me happy on my CT rotations. The chair of CT surgery at my med school told me that if he could do it over again, he would be a radiologist. This was a HUGE red flag (and so were his two divorces). Taking care of super sick people got old fast for me. I got angry at the patients for smoking and not controlling their weight. I could feel myself become a different person, bitter and angry all the time. Well, at least there's peds right? Spending time with the peds CT surgeon made me realize that yes, they are truely badasses, but I did not want his life. He was Q1 call for his entire career. He was beloved by the hospital, but I never ever saw him smile once.

    Neurosurgery was a smilar situation. I loved neuroanatomy, but every day was tragedy after tragedy. It wore on me so much that I would come home super depressed. Neurosurgery is not as technical as the general public thinks. The majority of neurosurgery is spine, which aside from microdiscs, is one of the most barbaric surgical specialties. Spine patients tended to have a high incidence of mental illness and I would say less than 50% were happy with their surgery. I hated spine clinic and wasn't terribly interested in the surgeries either. Then there was the brain. Neuro trauma was terrible. Once in a while you'll get an epidural that you catch in time and literally save someone's life. Thats great...the first two times. And its terribly outweighed by all the absolute tragedies that despite all your hard work in the middle of the night, these people and families would be destroyed forever. Tumor - Well this is what most people think of when they think of technical neurosurgery (but they should think cerebrovascular). Most common tumor - mets. Second most common - GBM. Wow, AWESOME! I'm sure pulling out a meningioma or low grade astrocytoma is amazing - especially if you leave them with no deficits, but this was not common enough for me to make it worth it (or make me happy at the end of the day). Maybe if I got desensitized by doing it day in and day out to the point where I could just focus on the big saves, neurosurgery would have been for me. But I didn't want to risk having that not happen and having a miserable life. Another big thing for me was I wanted to actually repair what I was working on. Well you don't repair brains or spinal cords (yet), you just minimize the damage.

    In both of these rotations I learned that all lives are not worth saving (to me at least). Some of the great saves went on to be completely devastated to the point where they and their families would be better of if they hadn't lived. I began to realize that quality of life is EVERYTHING. Ortho, to me, was a specialty dedicated to preserving quality of life in every person they operate on. Ortho had everything - large open surgeries, arthroscopic, and extremely technical microsurgery. Ortho patients were the most grateful as a whole that I came across in all medicine. Its hard to find someone happier than a total joint patient - they end up loving you and say the biggest mistake was waiting so long to have it done. If you want to save lives - there is always ortho oncology. Badass surgeries and the common tumors have an 80%+ cure rate (with chemo/radiation in addition to the surgery). You can argue that most amputations are done to save the person's life (over their limb). I also felt that ortho made life worth living for their patients and by extension, prolonged their lives by allowing them to be more active and less depressed.

    These were my impressions based off my observations throughout medical school and beyond. Maybe I had some especially depressing weeks on Neuro and CT surg, but thats what I had to go with (and I WANTED to love both). But even my wife (fiancee at the time) could tell how much happier I was on my ortho rotations compared to the other two. Ultimately, I realized being happy was the most important thing to me and its why I chose my specialty.

    I have a ton of respect for all of my surgical colleagues (especially General/Neuro/CT) and I hope my post doesn't come across too negative on CT/Neuro - it was just MY perception of the very limited time (2 weeks each) I had with each. I am extremely grateful they are able to do what they do, but it just wasn't for me.

    I don't know where you are in your training, but the best advice I could give you is to go in with a VERY open mind because you don't know what you will like (or what you can put up with) until you are actually there doing it.
    Tipp likes this.
  13. DoctwoB

    DoctwoB

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    Thanks a lot DHT. That post was probably the most illuminating and helpful one I've seen on this site and makes me feel a lot better about continuing to pursue a career in Ortho. :thumbup:
  14. bucks2010

    bucks2010

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    +1 ... thanks a lot for the perspective, DHT.
  15. gooze

    gooze Removed

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    great points about neurosurg/ct surgery about but was wondering what your thoughts are on urology and ENT?? esp. compared to ortho. thanks.
  16. rigid

    rigid

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    Thanks for that post, i think that's an important thing for everybody to consider.

    On the neurosurgery point something that rang true for me was that the residents had become so desensitised to the type of catastrophic outcomes to the point where it wasn't normal (was hard for me to hear them joking about the 16 year old girl with diffuse axonal shift from MVA). Decided despite how cool/awesome/interesting it might be that it wasn't the type of person i want to become.
  17. tantacles

    tantacles Moderator Lifetime Donor

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    Definitely one of the most informative and interesting posts i've read on sdn despite not having any particular interest in any of these specialties.

    Thank you.
  18. DHT

    DHT The Most Potent Androgen

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    I think the biggest travesty in medical education is the extremely limited amount of time one has to experience the medical specialties and make a decision on what they will do for the rest of their career. Because of the limited time, I was only able to experience Ortho, Neuro, CT, Plastics, GenTrauma, General surgery. I did not rotate on ENT, Urology, or Ophtho. The reason was I didn't have enough general interest in those areas to justify passing up a rotation on the other ones I did. I also thought I would prefer 3 OR days and 2 Clinic instead of 2 OR days and 3 clinic (and I still do).

    I can say that every urologist I've met has been really great and happy with their lives. They seem to have a good variety in their work and most really enjoy what they do. They also seem to have a good work/life balance. Urology is one of those fields that unless something turns you onto it (like a family member or mentor as a urologist) you never really think about it.

    My perception of ENT is very similar to that of Urology. I didn't spend much time at all with any ENT's but I felt that they were very happy with their careers as well. Ultimately I didn't have enough initial interest to justify using a rotation on it.

    Without having actually spent time in urology or ENT, any comparisons I can make would be anecdotal at best. However, I do feel safe to make a few observations:

    1. Relatively few emergencies. This is probably what determines lifestyle more than anything else. Ortho may have a few more emergencies to come in for, but in general most things in ENT, Urology, and Ortho can wait until the morning. You may be a little more likely to come in on a call night for Ortho than the other two, but ultimately it is very manageable (especially if you are not at a level 1 trauma center or if you have residents).

    2. Lots of elective procedures. Having a practice based on elective procedures is nice for a few reasons. 1. Less emergencies. 2. More predictable days. 3. Building an elective practice by having a great bedside manner and good report with other physicians (for referrals) seems like it would be very rewarding to me (still just a resident so I don't know this first hand). Instead of a treadmill of work, it feels like you are working toward something when people actively seek you out and you become well known in your community.

    3. Doing something people will pay cash for. I'm pretty sure ENT has the most things people will and can pay cash for. But I would say all 3 have a handful of operations that people can and will pay for. I don't know where the future of healthcare is going, but this is nice to have this to serve as a hedge against reimbursement cuts.

    4. Plenty of outpatient work. Rounding sucks. All specialties have plenty of operations where the patients go home. But all have plenty of big whacks if you are into that. You can tailor your practice to fit what you are looking for.

    5. Patients love you. Its pretty common to hear someone say they love their ENT, their orthopaedist, and to a lesser extent their Urologist (lesser only because they are less likely to talk about problems in that area). Its a great feeling.

    6. Patients will see you for multiple things. People are more likely to have multiple conditions in their lifetime that necessitate the care of these specialties (because they deal with more common ailments). For this reason you see them several times for different issues and I think its always nice to see a familiar face in clinic, and it reaffirms your hard work and good bedside manner. It also makes you feel appreciated.

    These are just a few things I can think of off the top of my head based on my observations. Like I said before, I did not rotate on ENT or Urology, but I do think these similarities are pretty accurate. I hope some of this helps.
  19. Just Applied

    Just Applied Senior Member

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    I will chime in here for ophtho since most people do not have a great grasp as to what we do. I would say that it the feeling of satisfaction is along the same lines as Ortho. More and more people are getting retinal detachments, AMD, central retinal vein occlusions, intra-ocular and orbital tumors which have much better outcomes and treatment modalities compared to 10-20 years ago.

    Most emergencies can wait until the morning.
    Very little if any rounding.
    Patients love you because...well you are giving them their sight back ('Nuff said)
    Most procedures are elective.
    Great variety of surgery. You can go from common cataract surgeries, to very sensitive retinal surgery, to big surgeries like doing retrobulbar removal of tumors, vascular malformations. You can also do bracytherapy in ophtho which is very cool.
    Great lifestyle for the most part. Retina surgeons and Occuloplastics surgeons are pretty busy but still have decent lifestyles.

    Most Subspecialist operate once a week with 3-4 days of clinic.

    You can never tell what is going to happen with reimbursements. But this is just a little taste of ophtho from a resident prospective.
  20. Just Applied

    Just Applied Senior Member

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    I forgot to mention...

    Some ophthalmology subspecialists do procedures every day for more than half the day. This includes lasers, intraocular injections, and etc.. SO you are in the OR once a week but are doing procedures most of the other days, but these are typically done in clinic.
  21. gooze

    gooze Removed

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    hey, thanks for the reply. great insight and information. just wanted to add something and get ur opinions...so right now, i'm thinking b/w ortho, ent, or uro. honestly, i am leaning towards ent or uro mainly because i just feel (and please let me know if i'm wrong in this) that those two fields will give me a little more flexibility in my career in the respect that they have both medical and surgical aspects to them. based on that, I feel that ent or uro will allow me to focus on surgeries earlier in my career and then as I become older, I can possibly slowly stop doing as many surgeries and focus on an office based practice and treat things medically and do small office procedures. when I think of ortho, it seems to me that you really need to operate your entire career in that there isn't maybe as much flexibility to have a office-based practice only and just not operate as there is in ent or uro....is this a correct notion?? what do you think??
  22. TheCatHerder

    TheCatHerder

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    Wow. I sift through a lot of these threads and this post has been one of the most helpful and insightful I have read over the past two years. Thank you for taking the time to draft and post this excellent commentary. Definitely reaffirmed my interest in ortho.
  23. Wiscobadger13

    Wiscobadger13

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    Great posts everyone. Many times after reading a thread on SDN, I suddenly start debating (not super seriously but enough to drive you crazy) if I really want to apply to medical school. This thread actually gets made me excited to apply this summer.
  24. Fuarky

    Fuarky

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    You guys think it is possible to find time to lift 3x a week during residency and post residency??? I'm an avid bodybuilder as well, and love to lift in my free time when I'm not studying.
  25. DHT

    DHT The Most Potent Androgen

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    Yes.
  26. Fuarky

    Fuarky

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    I was expecting an answer of no with all the hours that you guys put in during residency and all. Really surprised, but could you expand for me there on how it's possible with all these long hours???
  27. ddmo

    ddmo BMF

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    It's all about priorities. There are 168 hours in a week. 168 minus hours your work = free time. If you want to lift that badly, you will use those remaining hours to do so. Some of us like to sleep, some do research, some watch tv, etc.
  28. ddmo

    ddmo BMF

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    Speaking of wasting time, I just noticed the following message from Fuarky in my inbox:

    Please read your posts with the same titles. I appreciate your enthusiasm, but like I mentioned in those posts, there are 168 hours a week, which leaves me about 88 to spend on things other than work. Some of those hours are spent helping people learn about orthopaedic surgery on these forums. Asking my colleagues and me questions that can be answered with a google search is rude.
  29. KinasePro

    KinasePro Das it mane

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    Check out Medscape's "lifestyle survey" of orthopaedic surgeons.

    http://www.medscape.com/sites/public/lifestyle/2012

    Cliff's notes: Except for urology, they're the happiest surgical sub-specialty. The majority of orthopedists age >30 exercise 2-3 times a week, they're a fiscally & socially conservative bunch, generally take less than 4 wks of vacation per year, and have an affinity for toyotas. Also >70% were still in their first marriage (so much for that stereotype, haters).

    There's an absurd response bias (<10% response), but it's an interesting data set nonetheless.
  30. Buckeye(OH)

    Buckeye(OH) 5K+ Member

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    This is completely sub-specialty dependent. A trauma guy isn't going to have the lifestyle freedom that a hand guy is going to have, though there is a shift these days in trauma guys working 9-5 hours. Then there are the joint guys that are inevitably going to have the infected total joint that rolls into the ER on Saturday morning.

    With that said, I think I am going to do a Peds fellowship. Ugh, that was hard to admit.
  31. jls34

    jls34

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    How is the lifestyle in peds?
  32. Fuarky

    Fuarky

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    Which sub specialties you think offers the best lifestyle of ortho, maybe answer this for the other guys wondering about this.
  33. DHT

    DHT The Most Potent Androgen

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    Lifestyle is farm more dependent on practice setup and individual priorities than anything else. I think that specialties that have fewer inpatients and fewer emergencies will have the most flexibility and potentially the best lifestyle.

    Sports: probably the specialty with the fewest inpatients and fewest emergencies.
    Hand + Foot/Ankle: Few inpatients but can have some time consuming emergencies on call. Hand has replants (if you choose to do them) can eat up a whole night and foot and ankle will have infected/dead feet to cut off emergently if the patients are septic.

    That being said there are sports guys that kill themselves to make more money and there are spine guys that work 4 days a week. I can't emphasize how much more important practice set up and the values of you and your partners are in determining your lifestyle.
  34. Buckeye(OH)

    Buckeye(OH) 5K+ Member

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    Peds
    Hand
    F&A
    Sports

    Joints tends to have a lot of inpatient and a lot of rounding, spine probably isn't terrible either but I wouldn't put it up there with the above four. I am not sure about Ortho Onc. Trauma for obvious reasons is hit or miss.

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