How Much Medicine Do You Know?

[RJGOP]

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As someone strongly considering a career in orthopedics, I am curious as to how much medicine orthopedic surgeons generally know. From my understanding, orthopedic surgeons are considerably less experienced in medical management of patients than, say, a general surgeon, and therefore forget a lot of the medicine of patient management and things of that nature.

I'm only asking because, like I previously mentioned, I am strongly considering orthopedics, but I do still love medicine and hope to retain much of it even after residency and subsequent years of practice.

P.S. I don't want to do general surgery in case it is suggested to me. 🙂

 

[massmocha]

Yes, you will forget most of your medicine progressively after intern year. When it comes down to it, you are a doctor and you need to know how to manage basic medical issues as they apply to the perioperative period. However, orthopedics is a highly technical field and your patients come to you for your surgical skill, not for your ability to adjust their diabetes medications.

Most of the hospitalists laugh at us for the consults we ask them for and joke about how we score higher than the medicine residents on the Steps, so why don't we manage these things on our own. And it is true, most orthopedic residents know what to do, but our attendings are so far removed from these matters that they are not going to be liable for taking the interns word for the best management of postop hypotension or afib with RVR or hyponatremia or hyperglycemia or whatever silly thing we ask medicine about. And if your attending does not know the answer, they are the one ultimately responsible for the patient's care, so we ask medicine for their guidance.

If you have an undying love for management of medical issues, orthopedics will not fulfill that void for you. Maybe do EM.

 

[joker2400]

Yes, you will forget most of your medicine progressively after intern year. When it comes down to it, you are a doctor and you need to know how to manage basic medical issues as they apply to the perioperative period. However, orthopedics is a highly technical field and your patients come to you for your surgical skill, not for your ability to adjust their diabetes medications.

Most of the hospitalists laugh at us for the consults we ask them for and joke about how we score higher than the medicine residents on the Steps, so why don't we manage these things on our own. And it is true, most orthopedic residents know what to do, but our attendings are so far removed from these matters that they are not going to be liable for taking the interns word for the best management of postop hypotension or afib with RVR or hyponatremia or hyperglycemia or whatever silly thing we ask medicine about. And if your attending does not know the answer, they are the one ultimately responsible for the patient's care, so we ask medicine for their guidance.

If you have an undying love for management of medical issues, orthopedics will not fulfill that void for you. Maybe do EM.

Ortho's medicine consults are no stupider than an inpatient consult for OA.

Also, like you said depends on the attending. I've been with attendings that are comfortable with a lot of medicine issues and some that consult IM the second they find out a patient has diabetes

 

[4thQTHailMary]

Ortho's medicine consults are no stupider than an inpatient consult for OA.

Also, like you said depends on the attending. I've been with attendings that are comfortable with a lot of medicine issues and some that consult IM the second they find out a patient has diabetes

If they're doing it right once in private practice medicine will be the primary for all admitted post op patients. Medicine should be happy to do it as well as that's how they make a living. Just like there's no stupid consults; we make a living off being consultants. I wouldn't ask a hospitalist to nail a femur so they shouldn't ask me to manage a COPD exacerbation.