I had such low expectations going in, but that video delivered
Especially black guy lifting in the park!
Orthopedic Surgery, ask a resident anything
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I had such low expectations going in, but that video delivered
Especially black guy lifting in the park!
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Thanks for the reply and the insight. Those are all very interesting points.
Is there a very heavy region bias when it comes to ortho residency matching? Eg. Emory preferring someone who either grew up or went to medical school in Florida over someone from Philly. What about a strong preference for students from its own medical school?
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I understand there is a stereotype about ortho docs "liking fitness" more so than many other specialties. Has this been true in your experience? If someone who is gym rat ends up doing grueling ortho residency, how does he manage to get all of the meals in and work out on the regular? Are there residencies out there that attract/accommodate those type of people?
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Ok less serious question that an IM doc that I was shadowing came up with: how do surgeons go to the bathroom? You guys are in surgery for a ridiculously long time.
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Do you know guys actually get any training in the biomechanics of lifting? I hear stories of docs telling patients not to squat deep or overhead press. It's often tough as someone who has studied lifting biomechanics at a really detailed level to train someone efficiently when they stick with things like "well my doc said deadlifts are too dangerous for people over 30"
Unrelated, do you not mind working such long weeks because the job is interesting/what you enjoy doing? AKA is 60 hrs/week doing orthopedic surgery, to you, equivalent of 40 hrs/week of a specialty you didn't like as much (derm)
Unrelated, do you not mind working such long weeks because the job is interesting/what you enjoy doing? AKA is 60 hrs/week doing orthopedic surgery, to you, equivalent of 40 hrs/week of a specialty you didn't like as much (derm)
Certainly most programs take a resident or two each year from their own program. They will also look strongly at whoever comes to do an away rotation. Most med students who want to match Ortho will do two or three away rotations at the programs they most want to match at. You do these early 4th year.
There is definitely some selection bias based on region, but it probably has more to do with the applicant's rank list than the program's list. Seems like most programs are looking for geographic diversity.
If you want a lot of time on your hands to sculpt your body, do PM&R. Working out is all about where your priorities lie. If you make fitness a priority in your life you can definitely make time for it, but it's going to be later at nigh or very early AM. I could workout more than I do. I go just enough to not get fat.
We just go man, we just go.
In actuality if you are in surgery all day you also aren't drinking anything so it isn't too bad. You do get real hungry and have killer headaches tho. Fortunately the vast majority of our cases are less than 4 hours, which is manageable.
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The only workout recommendations I've seen orthopedic surgeons make are postoperative. These are aimed at protecting our repairs and implants. Revision surgery is bad deal and lifestyle modifications, particularly surrounding what a patient does for exercise, can make a big difference. For example, I'm not sure why any doc would tell a healthy 30 year old not to do deadlifts, but if he had hip dysplasia and I had operated on him, that's a different story. I would certainly recommend exercises other than power lifting for his lower extremity fitness if that we're the case.
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Is there a good method for skiing during a femoral nail? I can't do it without sweating like a pig. Should I just not wear lead and sacrifice my nads?
Also, any tips for not being annoying on aways? Seems like the line is pretty thin. I've heard you should be interested and eager, but not TOO interested or eager. Be helpful, but not obtrusive. Always be around, but give the residents space. Read about cases, but don't ask questions etc... Seems like it might be pretty easy to get under people's skin. It's easy to be helpful during 3rd year rotations, because you actually have skills that the team can capitalize on (seeing consults, doing H&Ps, social work scut, etc...) but for ortho, most of us will be practically useless on our early rotations.
Also, any tips for not being annoying on aways? Seems like the line is pretty thin. I've heard you should be interested and eager, but not TOO interested or eager. Be helpful, but not obtrusive. Always be around, but give the residents space. Read about cases, but don't ask questions etc... Seems like it might be pretty easy to get under people's skin. It's easy to be helpful during 3rd year rotations, because you actually have skills that the team can capitalize on (seeing consults, doing H&Ps, social work scut, etc...) but for ortho, most of us will be practically useless on our early rotations.
Ha.
Nope, you just have to sweat it out, but it gets easier.
In terms of being a med student on always, all of those things are true. But, you can't spend all your time thinking about that crap or you will miss the boat. Just be yourself, work hard, and try and figure out if you are a good fit for the program. Make sure you come away with a good letter so even if you don't like the program or if they don't like you you at least have something to show for your time spent.
Early med school Ortho rotations are pretty much just shadow experiences, and that's ok. Don't mess stuff up if you don't know what you are doing, especially in the OR. Make sure you have completed your gen surg rotation prior to doing your Ortho rotations if you want to impress. At least by then you will be reasonably self sufficient in the OR, able to tie knots and help close, help with positioning the patient, etc. If you can do these things and if you can do a good msk physical exam and take efficient and concise histories, then you will be helpful in the clinic and OR and be a contributing member of the team.
At this point your personality is your personality, no changing anything now. They will be able to tell over the course of a month if you are someone they want around for 5 years.
Nope, you just have to sweat it out, but it gets easier.
In terms of being a med student on always, all of those things are true. But, you can't spend all your time thinking about that crap or you will miss the boat. Just be yourself, work hard, and try and figure out if you are a good fit for the program. Make sure you come away with a good letter so even if you don't like the program or if they don't like you you at least have something to show for your time spent.
Early med school Ortho rotations are pretty much just shadow experiences, and that's ok. Don't mess stuff up if you don't know what you are doing, especially in the OR. Make sure you have completed your gen surg rotation prior to doing your Ortho rotations if you want to impress. At least by then you will be reasonably self sufficient in the OR, able to tie knots and help close, help with positioning the patient, etc. If you can do these things and if you can do a good msk physical exam and take efficient and concise histories, then you will be helpful in the clinic and OR and be a contributing member of the team.
At this point your personality is your personality, no changing anything now. They will be able to tell over the course of a month if you are someone they want around for 5 years.
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Oh touché. I forgot you guys probably aren't drinking much either. No this doctor and I were joking around about it because apparently that is the reason she didn't want to go into surgery lol. She was like 'um I want to be able to go to the bathroom on my own schedule' Hahahaha!
Well everyone has their priorities I guess
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Thanks for your reply. I am not planning on being a competitive bodybuilder but would like to continue eating clean and lifting at least couple times a week while doing residency. I can certainly sacrifice days in the gym but would hate to not be able to come weeks at a time.
Good, you should plan on being an orthopedic surgeon. Far more upside.
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is it possible to get accommodations for an individual with physical disabilities that make it difficult to stand for long periods of time (hypothetically)? are there obvious biases against these individuals that are interested in pursuing ortho (or any other surgical specialties)? thanks for your time.
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Dang! Does everyone lift on this forum? lol
What sort of accommodations are you thinking of? In hand cases you can sit, but most surgery requires standing for at least a few hours and if a case takes 8 hours it takes 8 hours. If based on a physical disability you need to take some breaks to rest or something (hypothetically speaking) I'm sure that is possible. The downside here is that if you are a senior resident or attending surgeon who needs to take lots of breaks, that means the patient will have to be under anesthesia longer, their incision time is longer, and their risk of infection and other complications increases accordingly.
When you start med school and residency you have to sign a document stating that you are physically fit and able to perform all the tasks required of you. For some specialties (mainly medical ones) the physical requirements are very minimal. For surgery, the demands can be grueling. Every accommodation can and should be made for doctors with physical disabilities, as long as they don't come at expends to the patient. That's my opinion.
To answer your question about potential bias against individuals who are perceived to have physical disabilities that are pursuing Ortho or other surgical sub specialties... I'd be willing to bet that bias does exist. For better or worse, I'm sure there are programs who would be unlikely to hire someone if they had a physical disability for worry that it might affect patient care. Now if there are simple accommodations that make sense and that don't impact patient safety, that's a different story.
The hypothetical scenarios here are endless really and it should probably be approached on a case by case basis.
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If you didn't go into ortho what other specialty would you have done?
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for real? =/
Probably urology, maybe neurosurgery. Definitely would have stayed in a surgical sub specialty.
First and foremost, thank you for taking time out of your undoubtedly busy schedule to answer our questions - very honorable.
On the topic of research, how much merit would research before entering medical school hold in building future CV/application? All done at well known orthopedic research institute and all studies being ortho related. Quite a few retrospective demographic studies (8+ publications as a primary author), a couple review articles on different therapeutic interventions (think stem cells) for various procedures, etc. Would love to continue this while in med school (DO) which I begin in August. By no means am I a gunner of any sort, just really took a liking to the specialty and love seeing the gratifying patient-surgeon interaction during pre and post-op.
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Thanks for doing this- does doing a joint degree help to get a residency? I've heard that it helps you stand out during residency interviews
This will likely be very very helpful for MD residency apps, especially if you keep a hand in the research during med school. Nothing will make up for poor scores tho so make that your first priority. I can't speak to the DO residency programs in terms of research importance. The residency training is great and in sure some programs do value research, I just don't think as a whole the research will be as important fort he DO route compared to matching at a top tier academic ACGME program. You will have to look into it.
Onequote="sstackhouse, post: 14916947, member: 566500"]Thanks for doing this- does doing a joint degree help to get a residency? I've heard that it helps you stand out during residency interviews[/quote]
Stand out... yes. But it's up to you to make sure you stand out for the right reasons. Everyone is interested in a dual degree, but you need to do a good job on your application of showcasing what you did with that degree and how it makes you a better Ortho candidate than everyone else. Even more important will be backing it all up on interview day by knowing your sh$t and not being a dbag with fancy letters after your name.
I have a dual degree and It definitely got me some interview invites at places I had no business going to based on my scores alone
Stand out... yes. But it's up to you to make sure you stand out for the right reasons. Everyone is interested in a dual degree, but you need to do a good job on your application of showcasing what you did with that degree and how it makes you a better Ortho candidate than everyone else. Even more important will be backing it all up on interview day by knowing your sh$t and not being a dbag with fancy letters after your name.
I have a dual degree and It definitely got me some interview invites at places I had no business going to based on my scores alone
Stand out... yes. But it's up to you to make sure you stand out for the right reasons. Everyone is interested in a dual degree, but you need to do a good job on your application of showcasing what you did with that degree and how it makes you a better Ortho candidate than everyone else. Even more important will be backing it all up on interview day by knowing your sh$t and not being a dbag with fancy letters after your name.
I have a dual degree and It definitely got me some interview invites at places I had no business going to based on my scores alone[/quote]
What dual degree do you have?
People ask this all the time, but I really would like to know a real answer, straight up. Do you need to have been a college athlete, major high school athlete, or big-time lifter to get into ortho? I can't tell the degree to which this is a joke versus a reality (I know it's at least partially a joke, but still). Please only answer seriously.
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What's your dream car?
Straight up, no. You don't need to be an athlete or lift to match Ortho.
However, being an athlete and having an interest in sports may attract you to the field. Joints and trauma surgery can be physically demanding, we use power tools, and we like sports and sports injuries which is why we get the big/ dumb/ tuff jock stereotype. In reality orthopedic surgery is no more physically demanding and no less intellectually stimulating than general surgery. Most Spine, upper extremity, foot/ankle, hand, shoulder, and pediatric Ortho surgery is actually pretty small scale. We use loupes and operating microscopes often.
Every field has their own stereotype and I am perfectly happy with ours just as it is. It's nice to not have two worry about the complex medical management of chronically ill patients.
Anyone who matches Ortho is certainly smart enough to go into any field of medicine they want to. We make the conscious (and I think very wise) decision to forgo/forget a lot of medical training in order to focus on doing kickass surgery that benefits patients immensely. Very gratifying work.
I don't know to tell you the truth and it wasn't always the case.
Some of my thoughts are:
1)Ortho is one of the most well compensated surgical sub specialties. It is itself a specialty field with a number of avenues to further subspecialize. Job security is good because Arthroplasty is a booming field with demand on the rise as baby boomers retire and obesity destroys America's joints. Also, trauma will always need surgery.
2)Med students decide they like surgery but are wary of the future of general surgery and don't like the culture on their rotations. This drives them to the sub specialties where they find a more relaxed atmosphere, nicer people, more prestige, and more money. At least this is the case right now.
3)There aren't that many spots
4)It's sexy, chicks dig the long ball.
Some of my thoughts are:
1)Ortho is one of the most well compensated surgical sub specialties. It is itself a specialty field with a number of avenues to further subspecialize. Job security is good because Arthroplasty is a booming field with demand on the rise as baby boomers retire and obesity destroys America's joints. Also, trauma will always need surgery.
2)Med students decide they like surgery but are wary of the future of general surgery and don't like the culture on their rotations. This drives them to the sub specialties where they find a more relaxed atmosphere, nicer people, more prestige, and more money. At least this is the case right now.
3)There aren't that many spots
4)It's sexy, chicks dig the long ball.
Would working for a year as a medical assistant for an orthopedic surgeon before medical school be considered a favorable factor when applying to ortho residency? The knowledge gained would clearly be helpful when on audition rotations but beyond that would it been seen as a major positive by program directors?
Sounds like a nice way to begin to answer the "why orthopedics?" Question you will get when you interview for residency. I'm sure you had a great experience and if you are able to articulate how that motivated you and led you to do x,y,z IN medical school, then yes it will be a favorable factor.
It will certainly NOT stand alone. You will primarily be evaluated by what you accomplish in med school via your scores, letters, grades, audition rotation grades, etc.
Good news is you are certainly ahead of the game at this point. I'm sure you know more about ortho than pretty
Much everyone else entering med school.
Thanks for the input. Definitely agree it not enough alone. Will take the appropriate steps during med school as well.
On a side note, how important is research during medical school? I assume the more ortho/muskoskeletal related the research the better...
Ah research.
There is nothing I have to say about research that is specific to ortho compared to other competitive specialties and it has certainly been discussed at length on these forums. Still and all, I will say my piece just so its on this forum and I don't have to say anything about it again.
Research is important and can help you in many ways. Research in general, and certianly ortho specific research, is not by any means required if you have a strong application otherwise. Consider that lots of people decide on ortho later in medical school and simply don't have time to do ortho research. If they have good scores, work ethic, interview skills etc they will do fine.
Here is why you should consider doing research in your competitive specialty of interest EARLY in med school...
1) Most importantly, it is the best way to get involved in the department, meet residents, and develop a relationship with faculty mentors. Residents will be very happy with you if you can do some of their scut work on a research project. It is very helpfull for them to know you a little bit BEFORE you take 4th year career rotaitons. You want to be the med stud who has been doing good work and been a helpfull presence around the department for a couple years not a couple weeks. This is how great LORs are born. They will keep their eye on you and tell faculty good things about you. Plus there is not much to do between M1 and M2 year anyway (and somtimes you can find paid research fellowships depending on your school). Everyone knows you don't know anything so the expectations are very low. They will just be happy that you are interested and there to help.
2) You might acutally publish something, and that will help you no matter what you do. Even if you change specialties later in med school, you can tell them how this research experience shaped your interests and guided you toward blah blah whatever.
3) You might find out that you actually like research. This does happen. Now you are more informed on what you are looking for in a residency program and you can start to tailor your application toward an academic career.
4) You might find out you hate research. But at least if you work hard you can still accomplish #'s 1 and 2 above. You also check a box and move on so that when it comes to applying for residency at least you have SOME research experience.
** Just keep in mind that you have to make Step 1 your first priority. Your goal should be 240+, and if you are <235, you will have a difficult application process. No matter what research you have you will still look like a below average applicant for ortho. You may still match, but it will be an uphill battle and you will be scared $hitless the whole way**
There is nothing I have to say about research that is specific to ortho compared to other competitive specialties and it has certainly been discussed at length on these forums. Still and all, I will say my piece just so its on this forum and I don't have to say anything about it again.
Research is important and can help you in many ways. Research in general, and certianly ortho specific research, is not by any means required if you have a strong application otherwise. Consider that lots of people decide on ortho later in medical school and simply don't have time to do ortho research. If they have good scores, work ethic, interview skills etc they will do fine.
Here is why you should consider doing research in your competitive specialty of interest EARLY in med school...
1) Most importantly, it is the best way to get involved in the department, meet residents, and develop a relationship with faculty mentors. Residents will be very happy with you if you can do some of their scut work on a research project. It is very helpfull for them to know you a little bit BEFORE you take 4th year career rotaitons. You want to be the med stud who has been doing good work and been a helpfull presence around the department for a couple years not a couple weeks. This is how great LORs are born. They will keep their eye on you and tell faculty good things about you. Plus there is not much to do between M1 and M2 year anyway (and somtimes you can find paid research fellowships depending on your school). Everyone knows you don't know anything so the expectations are very low. They will just be happy that you are interested and there to help.
2) You might acutally publish something, and that will help you no matter what you do. Even if you change specialties later in med school, you can tell them how this research experience shaped your interests and guided you toward blah blah whatever.
3) You might find out that you actually like research. This does happen. Now you are more informed on what you are looking for in a residency program and you can start to tailor your application toward an academic career.
4) You might find out you hate research. But at least if you work hard you can still accomplish #'s 1 and 2 above. You also check a box and move on so that when it comes to applying for residency at least you have SOME research experience.
** Just keep in mind that you have to make Step 1 your first priority. Your goal should be 240+, and if you are <235, you will have a difficult application process. No matter what research you have you will still look like a below average applicant for ortho. You may still match, but it will be an uphill battle and you will be scared $hitless the whole way**
I posted on this recently in a different thread
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Awesome that makes me feel so much better. Do you remember how you chose medical schools to apply to? I get my mcat scores tomorrow and had an avg of 29 on the practice tests going in and counselors have been a bit discouraging. Any more words of advice you have would be great.
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If I bench 500+ and have a few powerlifting world records at the time of application, how much of a bonus is it? (serious) (pls don't ignore)
Where'd you hear that? Those are two of the most legit strength and mass building exercises that virtually no one does anymore. Flat bench, pffft.... how much can you military press? I see guys pull up to the squat rack and make a big show and get like three of their buddies around to spot them while they put up 800 or so. Yeah, they take it down about six inches. Nice. Although, truth told, I did ruin a meniscus squatting 250 to the floor.
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With the grueling time and energy demands of an orthopedic surgery residency, do you find any time for a social life? Is there time to hang out with friends or go out drinking once/twice a week, or is there too little time and energy to care?
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If time permits, I was wondering if you might be able to shed some light on how orthopaedic residency programs look at applicants who have graduated from US MD schools with pass/fail (no AOA or class rank) grading systems. I know that some programs require AOA for an interview, but how does this work if one's medical school does not have AOA?
Thank you for your time and advice!
Thank you for your time and advice!
Absolutely. Some residencies are tougher than others, and all of them have rotations that are VERY busy. Typically trauma for example. But at my program there are plenty of services where you are done at 5 or 6 when you aren't oncall. I drink.
