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So what do you think made the difference in your application? Did you have a lot of research?
Orthopedic Surgery, ask a resident anything
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So what do you think made the difference in your application? Did you have a lot of research?
So it will be very hard to match into Ortho without ANY research, but people do it. And right now the ACGME requires orthopedic residents to complete at least one project during residency. After that, nobody is going to make you do research if you don't want to. You can just work in a private practice or community hospital, do your surgery, and go home to be with your fam.
I freaking rock
Jk. I'm not sure to tell you the truth. I did an away rotation and I think that helped. I also had a couple papers.
I also took step 2 early and got 260+. Some programs look at this and others only look at step 1.
Would you mind answering my previous post please? Much appreciated!
"Relatively-speaking, how important is AOA for ortho residency applications? Does not being AOA significantly hinder an applicant's chances at an academic program in a large city on either coast, eg. Manhattan, Philly, DC, Boston, SF, Seattle, LA?"
"Relatively-speaking, how important is AOA for ortho residency applications? Does not being AOA significantly hinder an applicant's chances at an academic program in a large city on either coast, eg. Manhattan, Philly, DC, Boston, SF, Seattle, LA?"
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I'm in my gap year working on an outcomes study for a relatively new ortho surgery, and I'm wondering:
1) How is research pre-med school considered (if at all)?
2) Does research (pre- or post-matriculation) have to be bench research (aka are certain types of research viewed more favorably)?
Thanks for all the answers
1) How is research pre-med school considered (if at all)?
2) Does research (pre- or post-matriculation) have to be bench research (aka are certain types of research viewed more favorably)?
Thanks for all the answers
Being AOA is certainly going to help your chances. Not being AOA can be overcome by having other exceptional parts of your application (step 2 scores, LORs, research, strong away rotations and clinical grades). I think if you look at the charting outcome stats around 30 % of Matched ortho applicants are AOA. I would guess it's more like 50-60% at the competitive academic programs you are looking into.
Your question doesn't make sense, but I'll try anyway.
1) if it's published and relevant to Ortho it will be considered. If its four year old research and you have nothing to fill the gap, that won't look good.
2) no, it doesn't have to be basic science/bench research. Clinical research is just as good.
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I thought the Neuro Surgery Residents were the arrogant ones. Guess not
The question i'm asking is 100% serious, answer it if you'd like my feelings won't get hurt if you don't. Do you think you're better than other people because you're a doctor now? I don't want to ever attain a complex like that, I doubt I ever will. I will be the most humble resident there ever was in history. I know i've got to get into Medical School first. And here comes the bashing
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Is AOA particularly strongly favored by ortho residency programs or is it as important as any other specialty?
The most recent data from the NRMP shows that the % matched into Ortho who were AOA was 27%. Radiology, IM and neurosurg were similar with percentages in the high 20s Derm, plastics, rad onc, and ENT were higher in the 30s. This data is the most recent, but it's still from 2011.
Not arrogant, just confident and happy
Your question is odd and the answer for me is no. I don't feel better than anyone for any reason really, least of all my profession. That being said it does feel good being a doc in a this field. Im excited almost every day to go to work. You get a lot of respect and many people will congratulate you on your accomplishment to get to this point. But that really doesn't mean anything in the grand scheme. It's still all about trying to learn as much as possible and hone your skills so that after residency you can do right by your patients.
By the way, The fact that you asked that question and then defended yourself so strongly should concern you. It really has nothing to do with the purpose of this thread
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Thank you for replying i'm not worried trust me. The part I highlighted in my previous quote made me cringe a bit. Also you posted, "I rock". No hate towards you, becoming a doctor is a great achievement and you should obviously be proud and confident. As you can tell i'm politically incorrect poster on this forum and I get a lot of heat for it. Good luck
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He hasn't shown concern for much of anything around here. Don't worry though we're all concerned for him...
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Says he'll never develop a superiority complex.
Says he'll never consider himself better than others.
Says, in fact, he'll be better that everyone else at not believing he's better.
(I'm seriously debating whether or not this account is a fake.)
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How long are your typical cases? I know that you do a wide variety of procedures, but do you have a ballpark estimate (or what are the shortest/longest procedures that you have done recently)? Also, how much brute strength is actually needed? As a petite female, I'm a little worried about not being able to keep up physically, despite being in pretty good shape.
I haven't decided what I'm going to do. Most of us will do a one year fellowship after residency. Fellowships are available in sports, joints, trauma, peds, spine, foot/ankle, hand, and shoulder/elbow.
A simple carpal tunnel or a hardware removal case may just be 10-20 minutes. I was just in a spine deformity case that lasted 12+ hours, so yes there is a lot of variety. A fast joint surgeon can do a THA in 45min and a TKA in 1hr. The good news is you can tailor your practice to doing just the cases you want to in the area of the body you want to do them. The trauma can be variable tho
Brute strength is not a big part of Ortho. Some of the best Ortho surgeons are petite females and small guys. There is no brute strenght required for most of the surgery, especially upper extremity and peds. The brute strength thing is a myth in my opinion. Being a savvy and technically sound surgeon is far more important than being strong.
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Pretty sure he was saying it like a sports fan says their team is "the best."
Either way...it's a good thing if an orthopod, a neurologist, a cardiologist, etc, all think their job is the best. That means they love what they do and have no regrets on their specialty of choice.
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Is it possible to ease up on the hours once you're an attending, like 50 hours a week, or do you expect to be forced into working 60-70 hours a week for most of the rest of your life?
I expect to will choose to work a lot, especially in the early part of my career. Productivity is king right now and orthopedist make a lot of money for their hospitals and groups they work for. No doubt whoever I work for will want me to operate a lot and that means long hours and more money in my pocket too. You can certainly still have a balanced life, a family, etc.
The trick is being productive with your time so you aren't in the clinic past 5 and not in the OR late at night for scheduled cases. Obviously your call structure will play a big role in how many hours you put in. It all depends on what type of job you have.
Lots of guys are able to have at least one half day clinic in the middle of every week and that is a big help.
Later on in life when things settle down and I'm in more of a senior partner role I can slow down and see fewer patients.
The trick is being productive with your time so you aren't in the clinic past 5 and not in the OR late at night for scheduled cases. Obviously your call structure will play a big role in how many hours you put in. It all depends on what type of job you have.
Lots of guys are able to have at least one half day clinic in the middle of every week and that is a big help.
Later on in life when things settle down and I'm in more of a senior partner role I can slow down and see fewer patients.
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No offense, but you are kind of arrogant about being humble.
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I've watched a few videos of orthopedic procedures and it's really interesting. Surgeries involving the hands however, seem a bit less exciting. Any thoughts/opinions on orthopedic procedures involving the hands? Do you find them to be of equal interest with other procedures such as shoulder arthroplasty?
I happen to think hand surgery is very interesting. There is a lot of anatomy packed into a small place. You can do a lot of different procedures in the same day because many of them are short. You do a lot of soft tissue procedures as well which is interesting. Wearing loupes and using the operating microscope is fun too.
That being said, a lot of orthorhombic residents dislike hand. The important for a general orthopedist is to be comfortable taking care of hand trauma and infections when on call. Other than that, if you don't like hand, you won't do hand. Anyone who wants to focus on hand surgery these days will do a fellowship in hand.
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Did you do Ortho-relevant research during medical school or did you work on something else?
What's a typical week for an orthopedist in private practice, ie. no research or teaching? Eg. 3 days in clinic and 3 days in OR, or alternatively 3 days in clinic, 2 days in OR, and a day doing administrative work, doing reading on the latest research news, catching up on patient stuff.
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Why not neurosurgery?
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I like ortho, I also like a lot of other surgery residencies too. How did you know you wanted to do ortho vs the other surgery specialties?
Also how would you describe ortho surgeries vs other types of surgery. For example, I imagine vascular surgery involves being very meticulous, does ortho require a little less finesse?
Also how would you describe ortho surgeries vs other types of surgery. For example, I imagine vascular surgery involves being very meticulous, does ortho require a little less finesse?
I did research with the Ortho chairman at my med school. This ended up being a huge help later on. Research is a great way to get the residents on your side if you work hard.
Extremely variable and dependent on the setting where you work, but you basically have the gist. You have to do clinic to get to the OR so that means 1.5-3 days/ week. Then 2-3 days in the OR. Ortho clinic is one of the least painful clinics you can do though. It's fast paced, the problems are very focused so event the work ups typically do not require lot of long history taking and chronic problem management. Each patient takes 10-20min. We use a lot of imaging and focused msk exams. We also do a lot of injections in the clinic, staple/suture removal, casting, etc. It goes by quickly.
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What did you think about the other surgical subspecialties? ENT/Uro/Optha/Colorectal specifically.
I liked neurosurg for a long time. The fields certainly overlap when it comes to spine, brachial plexus, and even peripheral nerve surgery. If not Ortho, I probably would have done neurosurg. But I decided I was more interested in musculoskeletal anatomy. Also, You can't beat the outcomes in Ortho. Patients are very happy and they are generally more healthy than the neurosurg patients, which means shorter hospital stays, less emergent surgery, and overall less stress. Neurosurg deals with a lot of heavy $&@! . The hours are a bit more intense and the residency is also longer.
These were some of my considerations, but at the end of the day I just wanted to do Ortho.
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RESPECT
Yea so it doesn't really matter what I think of these fields. They are all interesting and many people are happy doing them. See what you think when you rotate and have an open mind would be my advice.
ENT and URO both have a lot of medicine which is cool, but I didn't like how focused you were on one area of the body. Also, I never got all that hyped about male genitourinary pathology, but that's just me. Too much mucus and nasty pharynx for me in ENT.
Optho just never seemed like real surgery to me and again, you are so focused on one spot.
Colorectal surgery is great if you don't mind doing a general surgery residency, and if you want to operate in the abdomen. After my gens surge experience in med school, I am happy to steer clear of both.
Take no offense if your dream job is one of these, there are plenty of stereotypes and one liners about Ortho as we all know.
What's so different between ortho & gen surgery? (aside from the obvious)
It's a mix really. Hips, knees, trauma, and big spine cases can be something of a bloodbath and appear to require little finesse. This of course is not true as the devil is in the details and there are many fine points to master before you can perform these well. That being said you could certainly make and argument that less "finesse" is required for these types of cases. Then you have foot/ankle, hand and upper extremity, and peds ortho where the need for finesse is much more apparent.
Shoulder and hip arthroscopy are also very challenging and require a lot of training/practice. Lots of variety in Ortho so your question is difficult to answer.
Happiness
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I am recently accepted to multiple schools and in the process of waiting to hear back from more schools and decide where to attend. I am strongly interested in orthopedic surgery simply because I worked in an ortho docs office for 6 months and I loved every minute of it. He gave me permission to essentially 'shadow' him whenever I wanted, including during his surgeries. He practiced general orthopedics, and I really enjoyed the diversity of the work he performed. He let me do a lot of 'hands on' work. Most of his time was simply examining patients, counseling them, casting broken wrists on little kids, etc. He also was on-call at our local Level 1 trauma center, because he absolutely loved the work. (didn't get to see any of that...)
Anyways, while I have shadowed other specialties, there are just so many things that stand out about the nature of orthopedic surgery that I am attracted to. Much of which has been discussed here. However, I don't want to pigeonhole myself at such an early stage of my career by focusing so much on it.
My question is this: given my current interest in the field, should this affect which school I choose to attend? In what way? And beyond simply destroying Step 1 in a couple years and perhaps ortho research, are there more nuanced things I can be doing currently (or early on in medical school) to give myself an advantage later on while applying for residency?
And lastly, every time I bring this up with another prospective medical student, or a current medical student, they almost always mention the surgeon stereotypes. Indeed, I've met many older ortho docs who fit those stereotypes well, but I also know I currently do not fit those stereotypes. I am not an extremely competitive person, I am not 'obsessed' with sports and the like (although I am very active), and I am not a 'gunner'. Can I survive in this field?
Even if you address only one of my questions, thank you for your time here!
Anyways, while I have shadowed other specialties, there are just so many things that stand out about the nature of orthopedic surgery that I am attracted to. Much of which has been discussed here. However, I don't want to pigeonhole myself at such an early stage of my career by focusing so much on it.
My question is this: given my current interest in the field, should this affect which school I choose to attend? In what way? And beyond simply destroying Step 1 in a couple years and perhaps ortho research, are there more nuanced things I can be doing currently (or early on in medical school) to give myself an advantage later on while applying for residency?
And lastly, every time I bring this up with another prospective medical student, or a current medical student, they almost always mention the surgeon stereotypes. Indeed, I've met many older ortho docs who fit those stereotypes well, but I also know I currently do not fit those stereotypes. I am not an extremely competitive person, I am not 'obsessed' with sports and the like (although I am very active), and I am not a 'gunner'. Can I survive in this field?
Even if you address only one of my questions, thank you for your time here!
Congrats and good luck! Even if you are set on Ortho, you would be wise to keep your eyes open to other specialties as you go through med school. I wouldn't commit to Ortho until you have some tangible Ortho research and clinical experience that occurs in med school. Truth is you have a lot more info you need to gather before you make this big decision.
It's Hard to give advice on specific schools without knowing what they are. Feel free to pm me if u like. I would take a look at the match lists for the different schools over the last few years to see how many match into Ortho and where they are going (regions, big names, community programs, etc). Also look at the Ortho residency websites for the schools so you can compare program size, where they go for rotations, and read about the faculty. There are pretty extensive residency reviews on the orthogate.org forums, which may be interesting to you. At the end of the day your performance and stats in med school will be far more important that the school you are coming from (with a few exceptions of course).
When you get to school just find out when/where the Ortho conferences are and showing up to a few. You will meat some residents, they will get to know you a little bit early which is great because no one will expect anything of you. They will just be glad you are interested. You may score some good advice on which faculty to seek out for research and mentorship and more importantly who to avoid. A really great time to get involved in research is summer after m1 year.
Just make sure they see you as someone who is hardworking, easy going, and not annoying. Do this and you will be fine.
Don't read into stereotypes.
One other important point. You need to find good MS3 and MS4 student mentors who are going into Ortho. There are a lot of nuances with when to apply, how to set up away rotations, how to realistically evaluate your competitiveness. The senior med students are invaluable because they are going through it all before you and will know the process better than anyone. They will have the best insights for you and you have absolutely no competition with them so use em.
You should ask your faculty mentor 1% of your questions (and make sure they are well thought out and carefully articulated) ask the senior med students 99% of your questions.
You should ask your faculty mentor 1% of your questions (and make sure they are well thought out and carefully articulated) ask the senior med students 99% of your questions.
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@RueTay Is there any point of doing a sports medicine fellowship if you want to to end up doing that? I was reading the goals and characteristics of Stanford's sports medicine fellowship and it seems like the stuff you will be doing is the same thing you learn on your Ortho residency.
http://ortho.stanford.edu/education/sports_medicine.html
"Exposure to arthroscopic sports medicine procedures as well as open reconstructive procedures of the knee, shoulder, ankle, hip and elbow comprise the operative experience."
" Offers exposure to all areas of sports medicine, including knee, shoulder, elbow, and ankle surgery as well as hip arthroscopy."
http://ortho.stanford.edu/education/sports_medicine.html
"Exposure to arthroscopic sports medicine procedures as well as open reconstructive procedures of the knee, shoulder, ankle, hip and elbow comprise the operative experience."
" Offers exposure to all areas of sports medicine, including knee, shoulder, elbow, and ankle surgery as well as hip arthroscopy."
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Like most things, It depends...
Yes, as a resident you will be exposed to all of the types of sports cases you listed above. You will hopefully feel comfortably doing straight forward knee/shoulder arthroscopy as well as meniscectomies, rotator cuff repair, maybe even ACL repairs. If you are going to be a general orthopod in the community then you probably don’t need a sports fellowship to take care of straight forward sports injuries in not so high level athletes.
On the other hand, if you want to market yourself as a “fellowship trained” Ortho surgeon who specializes in sports related injuries. You darn well better go do a fellowship if you want to get a job in a competitive market and certainly if you ever hope to work on high level athletes. You also need the extra year focused SPECIFICALLY on SPORTS-RELATED injuries of the knees, hips, ankles, shoulders, etc. In your 5 year residency you will be exposed to these procedures, but you also do so much spine, adult recon, trauma, peds, etc that is NOT sports related. A typical ortho residency may only boil down to 3-6months where you are working on a sports service that specifically treats sporting injuries in athletes. How much of that surgery you actually do and feel comfortable doing on your own out in practice will depend on the residency program and on you.
Doing a 1 year sports fellowship would therefore double or even quadruple your sports experience. You would hone your arthroscopy skills, physical exam, overall knowledge/confidence, etc. It is also a critical time to make connections and get the recommendations you need to land the job you want as the “sports guy” for some ortho group.
The same principle holds true for the other subspecialties in orthopedics which are: hand, peds, joints, upper extremity, spine, foot/ankle, and trauma. I believe around 90% of people do a fellowship now and the ones who don't typically work in rural settings. Nice thing is that all fellowships are just 1 yr. That means after 6 total years of pgy training you are a fellowship trained subspecialist. When you consider that most medical and gensurg fellowships are 2-3 years (so 6-8 years total), it's really not a bad deal.
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Maybe you can add to this, but I asked the ortho doc that i work for the same thing about the point of a sports med fellowship and he said that in sports med you have a lot more trauma related cases vs. the degenerative cases you see in general ortho residency. Though, of course, there is crossover
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A study showed that meniscectomies may not be effective at treating knee pain:
http://www.nejm.org/doi/full/10.1056/NEJMoa1305189
How will this effect ortho, has it had an effect yet, etc.?
http://www.nejm.org/doi/full/10.1056/NEJMoa1305189
How will this effect ortho, has it had an effect yet, etc.?
Nice find, this is an interesting article.
A few things to point out...
This was only looking at degenerative meniscal tears, not traumatic ones. It is also excludes all patients with mechanical symptoms (like catching, locking, or poping). Mechanical symptoms occur when a piece of the meniscus flips into the joint and disrupts the smooth motion of the joint. They specifically took these two very GOOD indications for arthoscopic meniscectomy in order to look at a specific cohort of patients. It has long been argued whether or not these patients with degenerative tears, without mechanical symptoms or a traumatic insult should or should not have a meniscectomy just to try and treat their medial joint line pain. By itself, pain alone is a marginal indication and this studie supports nonoperative managment nicely. Its important to know that a degenerative meniscus tear is one of the first signs of osteoarthritis. As such, many of these pateints are going to get a uni or total knee arthroplasty down the road, and some docs think that an arthroscopic meniscectomy is a good and minimally invasive way to delay the bigger surgery (this is also controversial).
Another important thing to realize about this article is that their "Sham" procedure was actually a diagnostic arthroscopy. The put the ports in, put the shaver down on the patella, ran a bunch of fluid through the knee, etc. This has the potential to be therapeutic in that it performs a microscopic debridement, washes out the knee synovium, and potentially the removes of loose bodies. Maybe not such a sham after all.
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Thank you for your answer, @RueTay.
