General Surgery or Orthopaedic Surgery!??

[runeofmajesty]

Hey, I'm a 3rd year med student finishing up my first semester. Next semester, I have surgery followed by med followed by ortho elective followed by neurology. I know that I want to be a surgeon (lots of surgery shadowing, both general and ortho, surgeon mentors, and research and publications in gen surg), but I'm having a dilemma on whether I want to do general or ortho. I love both the abdomen and the musculoskeletal system in terms of anatomy and pathophysiology; I find them both fascinating, which makes the decision even harder.
I think that either way I will go, I will probably end up sub-specializing into oncology. Part of this stems from my interest in cancer, but I think another part of it has to do with a preference for more open procedures as opposed to laparoscopic/robotic ones. Now, there are onc fellowships in both gen surg and orth, so once again, that complicates things.
Now, I'm not like a huge athletic stereotypical ortho guy, but I'm in shape and relatively chill and laid back, though I don't know much about sports. From my shadowing in ortho, I don't think that would make too much of a difference because I've seen plenty of "nerdier" ortho residents.
I guess the reason I'm worried is because I know that people start applying for ortho away rotations in April, but I won't get to my ortho elective rotation until May of this year, so I'm worried that if I end of liking ortho it will be too late in the end of May to apply for away rotations in ortho at more quality locations. At the same time, I think it would be prudent to rotate through both ortho and gen surg before blindly applying for away rotations before knowing which I love more. Any suggestions on what to do?? Thanks so much.

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[gstrub]

Now, I'm not like a huge athletic stereotypical ortho guy, but I'm in shape and relatively chill and laid back, though I don't know much about sports.

hahahahahhahaha

 

[JackShephard MD]

General has more oncology opportunities.

 

[Sheldor]

If you know you want to do Oncology afterwards, in my opinion, this makes it an easy choice for general. Surg Oncs do some crazy open cases!

 

[DoctwoB]

Orthopedic oncology is an awesome field but an extremely small one that is largely limited to major academic centers (much more so then general surg onc). That means that there will be few job openings at any given time and you'll need to be more flexible about where in the country you want to practice.

The plus sides is that you'll probably get there much faster (5 years of ortho + 2 year fellowship vs. 7 years gensurg + 2 year fellowship), ortho oncology fellowships are generally less competitive (though this varies highly year to year because there are so few spots), and you'll probably make more in orthopedics, though I don't have any numbers to back this up.

 

[235009]

tl;dr ...what's your step 1 score? is it competitive for ortho? if not then you might be forced into gen surg or you might want to stay in a certain geographic area where you won't be able to match into ortho. if you've got the step 1 score i'd choose ortho over gen surg in a heartbeat. the people are great and it's ok if you don't care about sports, i don't either and i still enjoyed the rotation and got along with the guys.

The plus sides is that you'll probably get there much faster (5 years of ortho + 2 year fellowship vs. 7 years gensurg + 2 year fellowship)

gen surg is also 5 years. idk where you're getting 7

 

[JackShephard MD]

Using a Step 1 score to determine your specialty probably isn't wise.

Maybe to rule out something, but not to make the decision.

 

[runeofmajesty]

Hey, thanks for the feedback! I believe my step 1 score is definitely competitive enough to match into orthopaedics, but like it was said before, I don't want my numbers to make the decision for me. As of right now, I want to work in a large urban center (I live in Chicago IL), and I think I want to do academic med, so I think both ortho onc and surg onc would be able to work there. However, you bring up a good point with job availability for ortho onc...I know University of Chicago is the orth onc hotspot in Chicago, but lord knows if they'll be hiring 8 years from now lol. Do you guys have any advice on what to do about away rotation situation? I know aways for ortho get filled up pretty quick. Should I just apply for them, and then if I end up not liking my ortho rotation as much as gen surg come May, I can cancel them? Or should I just wait until after May?

 

[Winged Scapula]

gen surg is also 5 years. idk where you're getting 7

Probably from the fact that it is very rare to match into Surg Onc without 2 years in the lab during your general surgery residency (5+2=7). Surg Onc is highly academic and research oriented.