Aiming for ortho -->give up?

[Athina]

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Hi,

Third year medical student up in Canada, aiming for ortho. Did an away at a competitive program and got feedback that ranged from very negative to meh. The very negative feedback was along the lines of "you're decent but not great. You struggle with spacial reasoning and it takes you longer than other students to see the structures and the plan in the OR. This will make residency difficult for you and I think you should pursue another field." I operated a lot with this guy. He has high standards (rarely writes LORs for people) but his comment really brought out my insecurities about pursuing ortho.

What if he is right and I will struggle in residency and ultimately either remediate or be kicked out? Should I pursue another specialty? I have other interests that are non-surgical. While I have a very surgical personality, maybe I'm not suited for the OR?

 

[MrChance2]

How can strangers on the internet make this call for you?

Let me dissect this anyway though.

1. I don't think getting kicked out of residency is the issue, I think getting one is the issue.
2. Become a surgeon first then get the "surgical personality". Having a "surgical personality" and not being a surgeon doesn't seem like a good thing to me, maybe I'm misinterpreting it though. Which leads me to #3
3. OB/GYN?
4. Still want ortho and other than this guys opinion you have what it takes and are getting good feedback from surgeons? Fix what this guy said and do another rotation. Maybe he's just a jerk.

 

[Athina]

Ya, I get that strangers on the net can't make this call for me but I'm seriously wondering if I have what it takes to do ortho. Thinking that if I'm not suited for this, it's still early enough to change fields.

1. Ortho in Canada isn't as competitive as the States. 70%+ chance of matching.
2. People tell me I have a surgical personality and I'm suited for a surgical field.
3. I didn't like OB/GYN. I liked the consults and the floor but not the actual deliveries nor the surgeries. The only thing that appealed to me was gynecology-oncology in terms of surgeries.
4. Have done another two week rotation in ortho that went well although, I operated way less on that one and mostly did clinic/floor/consults. I think what bothers me is that this guy might be right. I was never the best in spatial reasoning and I didn't think it would be much of a problem but it apparently might be.

 

[futuremdforme]

4. Still want ortho and other than this guys opinion you have what it takes and are getting good feedback from surgeons? Fix what this guy said and do another rotation. Maybe he's just a jerk.

This!

 

[URHere]

A few questions that may have a big impact on what you decide:

1) Are you otherwise competitive for ortho in terms of board scores, clinical grades, etc?

2) Do you have anyone at this competitive program who evaluated you very positively and would be willing to write you a LOR? You may have killed your chances at the competitive program with a "meh" away, but if other programs see your transcript, they will expect you to have a LOR from that away rotation. If you can get one, it's positive, and your overall rotation grade was high, then the opinion of that one particular doc won't matter very much if at all.

3) Would you be open to applying in ortho + another specialty as a back-up?

4) Do you actually enjoy surgery more than other fields? It doesn't matter whether or not you have a surgical personality. What matters is that you find a field that is enjoyable for you.

My advice would be to try some out some other surgical fields if you have any sort of interest in them (ENT, optho, cardiothoracic, etc). By now, you should already know whether or not you would enjoy gen surg. If you find a good fit for you, do a sub-I and go for the new field. If not, do another ortho rotation, and double apply in ortho + something else as a back-up.

 

[madchemist89]

Surgeons are not born. They are made. Talent matters little. Skill is what matters, and it is developed through hours and hours of training. I guarantee that even the greatest surgeons of all time were at one point where you are now. Take reassurance from that. If you want to be great, the question is not was I born to be great, but will I commit myself to greatness? You must be ready to
go all the way. There is no half in-half out: that is the road to failure.

 

[Athina]

A few questions that may have a big impact on what you decide:

1) Are you otherwise competitive for ortho in terms of board scores, clinical grades, etc?

2) Do you have anyone at this competitive program who evaluated you very positively and would be willing to write you a LOR? You may have killed your chances at the competitive program with a "meh" away, but if other programs see your transcript, they will expect you to have a LOR from that away rotation. If you can get one, it's positive, and your overall rotation grade was high, then the opinion of that one particular doc won't matter very much if at all.

3) Would you be open to applying in ortho + another specialty as a back-up?

4) Do you actually enjoy surgery more than other fields? It doesn't matter whether or not you have a surgical personality. What matters is that you find a field that is enjoyable for you.

My advice would be to try some out some other surgical fields if you have any sort of interest in them (ENT, optho, cardiothoracic, etc). By now, you should already know whether or not you would enjoy gen surg. If you find a good fit for you, do a sub-I and go for the new field. If not, do another ortho rotation, and double apply in ortho + something else as a back-up.

1) Yes, I have a competitive application.

2) I only worked with 2 people and I don't think either would write me a good LOR. I have definitely killed my chances there but it's fine: clearly, I'm not a good fit. I don't necessarily need the LOR because I only need to submit 3 for my applications and I have those secured already.

3) I'm not sure I enjoy the OR that much. I always thought I did but lately, I have doubts. It's starting to become clear to me that I might like consults better... I did gen surg. Hated all of it: the pathologies, the hierarchy, the people. None of it appealed to me.

 

[Athina]

Surgeons are not born. They are made. Talent matters little. Skill is what matters, and it is developed through hours and hours of training. I guarantee that even the greatest surgeons of all time were at one point where you are now. Take reassurance from that. If you want to be great, the question is not was I born to be great, but will I commit myself to greatness? You must be ready to
go all the way. There is no half in-half out: that is the road to failure.

I agree that anyone can get better by practicing and by committing themselves to their craft however, if person A starts off being mediocre and person B starts off being excellent, A has so much more work to do to catch up. That's not necessarily a bad thing if A has the motivation but in a competitive specialty where the job market sucks (178 unemployed orthopaedic surgeons in Canada), how much leeway does one have?

 

[Brorthopedic]

If Ortho is what you want, take the criticism, improve on it and do it anyways. Not to sound cliche, but don't let other's opinions deter you from your dreams. You might have to work harder than your average Ortho resident, but at least you're doing what makes you happy.

If you can match Ortho, you deserve to be there. Nobody accidentally stumbles their way into the specialty.

 

[KinasePro]

Ortho bro, checking in.

1- We have many assh*oles in this field, sorry about that. Sounds like you found one lol.
2- Unless he was letting you find the starting point on a TFN/IM nail, do perfect circles on interlocking screws, or scope a knee/shoulder than frankly I think this guy was just being a douche. It's impossible to assess a med students triangulating/3D skills bc we barely let you guys do anything beyond closing and splinting. If you were lucky enough to throw in a nail, I'm sure it was under such close supervision that they can't honestly evaluate you anyway. Just take what he said with a gigantic block of salt.
3- Surgical personality is an important thing to pay attention to, bc it will drive your happiness. Surgical personalities like making decisions, being done with the debate after the decision is made, and dealing with the results afterward for better or for worse. Another less competitive field that has this mentality is (surprisingly) EM, just food for thought.
4- If you want to evaluate your skills, consider taking up woodworking in your spare time. Oddly enough, there is a lot crossover dexterity skills. And if you hate woodworking you will definitely hate ortho. You can find groupons for weekend woodworking classes where you wont have to drop a ton of cash on the equipment/supplies. Worst case scenario, you'd have a enw interesting hobby for ERAS.
5- If you like consults better and don't like the OR then definitely pay attention to that too. Bc i loathe consults and cannot wait until I am no longer a minion and can dump them on my future minions with reckless abandon. If you just like the subject matter and making decisions, consider some of the non-op pathways into ortho subject matter. PM&R is actually a fantastic field that is s u p e r chill compared to ortho. Yet they ultimately know the anatomy deeply, deal with the same issues, and have more time for fun/family/vacation than we do. It has it's own downsides, but I'd consider that if I were you.

 

[Bobdabuilda14]

 

[Dires]

That experience must be demoralizing. Sorry you're going through this. If you want ortho don't let that douche stop you. Chances are your surgical skills (or whatever she/ he evaluated) are on target for your level. Try to focus on the future and make new contacts.

 

[Psai]

What did other people say? Everyone deserves a second opinion

I nearly switched fields after having a really terrible attending. But turns out they were just a miserable person and it would have been a mistake to have someone like that affect my life

 

[W19]

Ya, I get that strangers on the net can't make this call for me but I'm seriously wondering if I have what it takes to do ortho. Thinking that if I'm not suited for this, it's still early enough to change fields.

1. Ortho in Canada isn't as competitive as the States. 70%+ chance of matching.
2. People tell me I have a surgical personality and I'm suited for a surgical field.
3. I didn't like OB/GYN. I liked the consults and the floor but not the actual deliveries nor the surgeries. The only thing that appealed to me was gynecology-oncology in terms of surgeries.
4. Have done another two week rotation in ortho that went well although, I operated way less on that one and mostly did clinic/floor/consults. I think what bothers me is that this guy might be right. I was never the best in spatial reasoning and I didn't think it would be much of a problem but it apparently might be.

How come? They don't make 600k+ in Canada!

 

[Brahnold Bloodaxe]

How come? They don't make 600k+ in Canada!

They struggle just getting jobs. Ortho procedures tend to be highly elective, and Canada being a Single Payer government controlled system means there is a fixed yearly healthcare budget. Means only so many knee replacements are to be done in a given year before the hospital budget for the same runs out.

Welcome to socialized medicine.

 

[gracie369]

Ortho never give up! Ortho show them. Ortho lift even bigger rocks. Make leg feel like feather.

 

[charmiedermie]

How come? They don't make 600k+ in Canada!

Single payer, a lot of ortho can then be labeled as elective or not urgent, so you're then put on a waitlist for a knee replacement, like that one guy said he'd be ok with me living in pain, for his dream healthcare system.

 

[charmiedermie]

They struggle just getting jobs. Ortho procedures tend to be highly elective, and Canada being a Single Payer government controlled system means there is a fixed yearly healthcare budget. Means only so many knee replacements are to be done in a given year before the hospital budget for the same runs out.

Welcome to socialized medicine.

I've heard they just stop doing them for the year, once they reach that cutoff of the number of knee replacements they do, that's already been decided.

 

[FiveOClock]

I've heard they just stop doing them for the year, once they reach that cutoff of the number of knee replacements they do, that's already been decided.

That must be the process. No one is going to do a risky procedure without covering the opportunity cost.

 

[Sam212]

How come? They don't make 600k+ in Canada!

Actually they make just as much if not more. I have talked to a few guys that have successful practices, all clear 600k easy.

Problem is that many jobs are in undesirable areas in Canada, where no one wants to work. And that's why it's very competitive to get jobs in more desirable area, which is like 5% of the total area.

 

[Redpancreas]

Ortho bro, checking in.

1- We have many assh*oles in this field, sorry about that. Sounds like you found one lol.
2- Unless he was letting you find the starting point on a TFN/IM nail, do perfect circles on interlocking screws, or scope a knee/shoulder than frankly I think this guy was just being a douche. It's impossible to assess a med students triangulating/3D skills bc we barely let you guys do anything beyond closing and splinting. If you were lucky enough to throw in a nail, I'm sure it was under such close supervision that they can't honestly evaluate you anyway. Just take what he said with a gigantic block of salt.
3- Surgical personality is an important thing to pay attention to, bc it will drive your happiness. Surgical personalities like making decisions, being done with the debate after the decision is made, and dealing with the results afterward for better or for worse. Another less competitive field that has this mentality is (surprisingly) EM, just food for thought.
4- If you want to evaluate your skills, consider taking up woodworking in your spare time. Oddly enough, there is a lot crossover dexterity skills. And if you hate woodworking you will definitely hate ortho. You can find groupons for weekend woodworking classes where you wont have to drop a ton of cash on the equipment/supplies. Worst case scenario, you'd have a enw interesting hobby for ERAS.
5- If you like consults better and don't like the OR then definitely pay attention to that too. Bc i loathe consults and cannot wait until I am no longer a minion and can dump them on my future minions with reckless abandon. If you just like the subject matter and making decisions, consider some of the non-op pathways into ortho subject matter. PM&R is actually a fantastic field that is s u p e r chill compared to ortho. Yet they ultimately know the anatomy deeply, deal with the same issues, and have more time for fun/family/vacation than we do. It has it's own downsides, but I'd consider that if I were you.

This is one of the most empathetic yet substantial SDN post I've ever seen .


Sent from my iPhone using SDN mobile

 

[deleted245139]

I am an ortho attending; kind of fitting that my first post on this forum is so relevant to my own past. When I was a medical student, I had a surgeon I worked with tell me something similar. I think he woke up on the wrong side of the coffin that day. Anyway, I didn't listen. Three years later, as a resident, I won a national award for my work. I mailed that @$$hole my invite to the reception. 😉 Point is, if you love something, don't let one person's opinion steer you away. What's more concerning is your statement that you don't love the OR. Any surgeon should live for the OR, it is our lifeblood-- otherwise it's too hard of a path to take and you should do something else. Take a little more time and scrub cases. If you really couldn't care less about never being in the OR ever again, don't do ortho or anything surgical. But if the thought of never scrubbing makes you ill, you have your answer.

Awesome haha.

 

[cbrons]

2. People tell me I have a surgical personality and I'm suited for a surgical field.

There is no such thing. There are plenty of different personalities in surgery, there is no one "surgical personality." That sounds like a pre-med concept.

That being said there are attitudes and attributes which are helpful (or harmful) in surgery.