End up loving ortho more?

[Step1EKG]

3rd year's coming to a close and I have a handful of ortho audition rotations lined up for 4th year. I like ortho - definitely more than anything else. I'm just not sure if the demanding life of a surgeon is what I want out of life so I've considered taking a year off to take some time doing research in EM or radiology, two specialties I haven't had a chance to experience.

I love working at the hospital and in the OR. I enjoy the cases, surgeries and even clinic.

My question is this: has anyone gone into ortho not 100% sold on it, with some reservations/uncertainties about the specialty, but ended up loving it as a career?

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[Forever Geebs]

If your uncertainties are that you may not enjoy the demands of a surgeon, it's hard to kick that. To say you enjoy clinic, I've never heard an ortho say that!

Given the length of training, demanding schedule, and such, I think it comes down to knowing whether that's something you can endure (or are OK with enduring) in pursuit of a career as an ortho.

 

[Step1EKG]

If your uncertainties are that you may not enjoy the demands of a surgeon, it's hard to kick that. To say you enjoy clinic, I've never heard an ortho say that!

Given the length of training, demanding schedule, and such, I think it comes down to knowing whether that's something you can endure (or are OK with enduring) in pursuit of a career as an ortho.

Haha it's not that I'm afraid of the demands of surgery, I have no qualms about working hard. But working hard and not loving it is another issue. And to clarify, I mean ortho clinic! Not clinic in general. Ortho clinic ties together the cases for me so I can appreciate it.

So my point isn't really to have anyone help me figure out if ortho is for me or not. I'm wanting insight from those who are ortho attendings that may have started in a similar place as me and now loves their career. I also ask this because it seems like every ortho doc I've met has zero regrets about their specialty choice - there must be some who weren't 100% sure at the start...right?

 

[Forever Geebs]

Yeah, I’ve yet to meet an ortho attending who has regretted the decision. It’s what speciality I’m pursuing. I wasn’t sure if you were on the fence or not be I’ve met folks who are, and it doesn’t take long for them to realize there something else that suits them better.

All the best of luck to you!


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[DarkHorizon]

3rd year's coming to a close and I have a handful of ortho audition rotations lined up for 4th year. I like ortho - definitely more than anything else. I'm just not sure if the demanding life of a surgeon is what I want out of life so I've considered taking a year off to take some time doing research in EM or radiology, two specialties I haven't had a chance to experience.

I love working at the hospital and in the OR. I enjoy the cases, surgeries and even clinic.

My question is this: has anyone gone into ortho not 100% sold on it, with some reservations/uncertainties about the specialty, but ended up loving it as a career?

You should probably pursue another field if you’re having doubts. Ortho is a lot of fun but demanding and hard work. It’s harsh, but I don’t think you like it enough to go through all that. To me, it’s more of a hobby than a job, I would say most orthopedic surgeons would agree with that.

 

[OrthoTraumaMD]

3rd year's coming to a close and I have a handful of ortho audition rotations lined up for 4th year. I like ortho - definitely more than anything else. I'm just not sure if the demanding life of a surgeon is what I want out of life so I've considered taking a year off to take some time doing research in EM or radiology, two specialties I haven't had a chance to experience.

I love working at the hospital and in the OR. I enjoy the cases, surgeries and even clinic.

My question is this: has anyone gone into ortho not 100% sold on it, with some reservations/uncertainties about the specialty, but ended up loving it as a career?

I always knew I wanted to be a surgeon, but I didn’t end up truly loving orthopaedics until I was already a second-year resident. So yes, it is possible.


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[Step1EKG]

I always knew I wanted to be a surgeon, but I didn’t end up truly loving orthopaedics until I was already a second-year resident. So yes, it is possible.


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I was between gen surg and ortho for a while -- I feel that I haven't spent enough time in ortho to have a real appreciation for it. My first four months of 4th year are set up for ortho so hopefully it becomes clearer for me.

And thank you for sharing! I knew there had to be others.

 

[militaryPHYS]

Decide if you want to be a surgeon first and foremost. Next, decide whether you want a good lifestyle or bad lifestyle as a surgeon.

Bad Lifestyle (but higher-acuity things) for Surgeons: Gen Surg, OB/GYN, CT surgery, Neurosurg (ish)
GOOD Lifestyle For Surgeons: ORTHO, ENT, Plastics

Then, within ortho you can choose to have a GREAT lifestyle or Not so Great:
Great: Ortho Sports, hand, foot and ankle, spine
Not so Great: Ortho Trauma, pediatrics, joints

Lifestyle is all based on level of acuity (how often you may or may not have to deal with stuff after hours).

For the most part you get to decide your own fate. Choose wisely

 

[Step1EKG]

Decide if you want to be a surgeon first and foremost. Next, decide whether you want a good lifestyle or bad lifestyle as a surgeon.

Bad Lifestyle (but higher-acuity things) for Surgeons: Gen Surg, OB/GYN, CT surgery, Neurosurg (ish)
GOOD Lifestyle For Surgeons: ORTHO, ENT, Plastics

Then, within ortho you can choose to have a GREAT lifestyle or Not so Great:
Great: Ortho Sports, hand, foot and ankle, spine
Not so Great: Ortho Trauma, pediatrics, joints

Lifestyle is all based on level of acuity (how often you may or may not have to deal with stuff after hours).

For the most part you get to decide your own fate. Choose wisely

Really appreciate this breakdown!

Surgeon: check
(Relatively) Good lifestyle: check
Within ortho: I have a question about trauma. I've heard from a couple attendings that trauma is moving toward shift-work. Any thoughts?

 

[OrthoTraumaMD]

Really appreciate this breakdown!

Surgeon: check
(Relatively) Good lifestyle: check
Within ortho: I have a question about trauma. I've heard from a couple attendings that trauma is moving toward shift-work. Any thoughts?

That depends on what you mean by shift work. We still come in in the middle of the night to do stuff if we have to. But for years now, there have been trauma rooms which made our lives easier. All the cases that come in overnight get put into the trauma room. But we stay until the work is done. So that’s not really shift work.


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[Step1EKG]

That depends on what you mean by shift work. We still come in in the middle of the night to do stuff if we have to. But for years now, there have been trauma rooms which made our lives easier. All the cases that come in overnight get put into the trauma room. But we stay until the work is done. So that’s not really shift work.


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Ah. I was told some iteration of "~10 in-house 24-hour shifts a month with clinic days for postop visits".

@OrthoTraumaMD, I know you're in academics. Any idea if these kind of gigs exist in community medicine?

 

[OrthoBod]

Decide if you want to be a surgeon first and foremost. Next, decide whether you want a good lifestyle or bad lifestyle as a surgeon.

Bad Lifestyle (but higher-acuity things) for Surgeons: Gen Surg, OB/GYN, CT surgery, Neurosurg (ish)
GOOD Lifestyle For Surgeons: ORTHO, ENT, Plastics

Then, within ortho you can choose to have a GREAT lifestyle or Not so Great:
Great: Ortho Sports, hand, foot and ankle, spine
Not so Great: Ortho Trauma, pediatrics, joints

Lifestyle is all based on level of acuity (how often you may or may not have to deal with stuff after hours).

For the most part you get to decide your own fate. Choose wisely

That is a nice break down. I want to know details =)
Would be great for me and others if you expand it a bit so we understand.
How exactly are spine, sports, hand, foot and ankle 'great' SubS and why is pediatrics and joints not so great.
I always thought joint guy had the best planned schedule and would work only till work hours and spine was the worst among all subS.

Would be great to hear input from others also about any way of going about deciding for your subS.
Hopefully i am not hijacking the OPs threat. Should be helpful to all of us.

 

[ERDOC555]

Decide if you want to be a surgeon first and foremost. Next, decide whether you want a good lifestyle or bad lifestyle as a surgeon.

Bad Lifestyle (but higher-acuity things) for Surgeons: Gen Surg, OB/GYN, CT surgery, Neurosurg (ish)
GOOD Lifestyle For Surgeons: ORTHO, ENT, Plastics

Then, within ortho you can choose to have a GREAT lifestyle or Not so Great:
Great: Ortho Sports, hand, foot and ankle, spine
Not so Great: Ortho Trauma, pediatrics, joints

Lifestyle is all based on level of acuity (how often you may or may not have to deal with stuff after hours).

For the most part you get to decide your own fate. Choose wisely

I'm sure some fellowships may be more competitive than others, but do most people have their choice of whatever fellowship area they desire, or are some people boxed out of what they ultimately want to do?

 

[OrthoTraumaMD]

I'm sure some fellowships may be more competitive than others, but do most people have their choice of whatever fellowship area they desire, or are some people boxed out of what they ultimately want to do?

I talk a little bit about this in my AMA thread, but most people go into the subspecialty they want. In the case of more competitive ones, they may not get their first choice however.


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[OrthoTraumaMD]

Ah. I was told some iteration of "~10 in-house 24-hour shifts a month with clinic days for postop visits".

@OrthoTraumaMD, I know you're in academics. Any idea if these kind of gigs exist in community medicine?

Yes, they do exist. You can make it whatever you want if you find the right practice. But those gigs come with their own pluses and minuses.


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[Step1EKG]

Yes, they do exist. You can make it whatever you want if you find the right practice. But those gigs come with their own pluses and minuses.


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Got it, thank you. I always appreciate your input and guidance!

 

[militaryPHYS]

Would be great for me and others if you expand it a bit so we understand.
How exactly are spine, sports, hand, foot and ankle 'great' SubS and why is pediatrics and joints not so great.

Many of my comments are generalized and of course have some military influence but I will expound a bit more:

Pediatrics often places you in a one of one position depending on where you are in the world. Therefore some guys are on call all of the time even if they don't want to be. i.e. phone call over dinner, "Hey, I've got this kid with ...."

Joints guys are often plagued by inevitable complications (infections, revisions, etc.). They also have many more inpatients post-operatively which means additional requirement of rounding, etc. If they are good surgeons and take ownership for their patients then that means rounding on many weekends they aren't on call.

Sports and hand have very few inpatient post-ops. They also have very few "emergencies" after hours (vice a spaghetti wrist or dysvascular hand). There are also a lot more of them to go around. To some this might seem like a good thing, to others it is not. It all depends on what floats your boat and gets you out of bed in the morning.

Again, these are all very broad generalizations...you really have to follow around the surgeons who are practicing in an area of the country and in a practice you want to emulate to get a more specific idea of what your life will be like.

 

[TheOther]

I was between gen surg and ortho for a while -- I feel that I haven't spent enough time in ortho to have a real appreciation for it. My first four months of 4th year are set up for ortho so hopefully it becomes clearer for me.

And thank you for sharing! I knew there had to be others.

I was in a very similar place of having the scores to be competitive for ortho but being unsure about it because of limited exposure. I knew I wanted something surgical (also considered general surgery). I'm finally finishing up an ortho elective and absolutely love it.

 

[Poet& a Scholar]

Also don't want to hijack the thread, but the information being offered here is extremely helpful. Recent detailed info on ortho oncology seems to be sparse. While I understand it may vary depending on where you practice, could someone kindly expand on lifestyle (call, hours), job availability, and case diversity/acuity for attending ortho oncs in the academic setting?

 

[DarkHorizon]

Also don't want to hijack the thread, but the information being offered here is extremely helpful. Recent detailed info on ortho oncology seems to be sparse. While I understand it may vary depending on where you practice, could someone kindly expand on lifestyle (call, hours), job availability, and case diversity/acuity for attending ortho oncs in the academic setting?

Less than 1000 new osteosarcoma cases a year in the US, therefore, pretty much all ortho oncologists are at large academic centers. Even then, most of them are not busy doing just onc, do quite a bit of trauma and joints. Of course, guys working at Sloan Kettering or MD Anderson are exclusively onc, but that’s not the case for most guys. Jobs are sparse, surgeries are long, sometimes very long. Patients are really sick. But you do make a lot of difference in patients’ lives and cases are pretty cool (for about 3 hours, then they become painful).

 

[OrthoBod]

Interesting.
Exactly what I was looking for. Your answers are very helpful.
What are your opinions on:
- Spine
- Foot and Ankle
- Upper limb?

- How different is it to work in Hand with a background of ortho VS background of plastic surgery?

- Any route to be in an academic setting but have a research position with orthopaedic background?

Many thanks

 

[DarkHorizon]

Interesting.
Exactly what I was looking for. Your answers are very helpful.
What are your opinions on:
- Spine
- Foot and Ankle
- Upper limb?

- How different is it to work in Hand with a background of ortho VS background of plastic surgery?

- Any route to be in an academic setting but have a research position with orthopaedic background?

Many thanks

Spine: I don’t like it personally, but it makes a boat load of cash and there are plenty of jobs out there. Almost every group is looking for a spine guy. Patients are miserable, for the most part. Surgeries can be very long and painful, and often futile. Almost all spine guys have exclusive spine practice and don’t do any ortho. Great lifestyle in elective spine practice, if you can put up with all the other ****. Fellowships go unfilled, not a lot of demand. It attracts a certain crowd IMO....$$ bills. Grain of salt tho.

Foot and ankle: Again, high demand, lots of jobs, you can pretty much go anywhere and you’ll get a job. Lots of competition from chiropedists, who think they can do as good a job as you. You do take ortho trauma call tho, and do quite a bit of foot and ankle trauma. Lifestyle can be sweet. Another specialty where you pretty much exclusively do feet and ankles all day because low low supply and high demand. Reimbursement is a bit low for foot procedures but you make it up in the volume.

Hand: Can be very sweet or very painful, depending on where you work. But most hand guys are in private practice, and that is very Cush. Academic guys at trauma centers do big cases including replants and microsurgery, and combined with hand call, that can be brutal. Another specialty where you pretty much only do hand/upper extremity, not much of General ortho. Fellowships are competitive due to PRS and gen surgeons also applying. In my limited experience, difference between plastics and ortho hand is amount of soft tissue vs bony cases. Pay is a bit low, but almost everything is outpatient, and most hand guys that are partners in private practice are killing it.

 

[OrthoBod]

Nice.
Thanks for the reply