Interested in Orthopedic Hand Surgery: Will I be selling my life force/ soul to make this happen?

[Cheyenne2313]

I am currently a graduate student in occupational therapy, wrapping up my "book based" learning in preparation to go out on clinical fieldwork rotations. I am very interested in hand and upper extremity therapy, and this has translated into a very strong medical interest. I have done some research and watched some hand surgeries, and I am just astonished at the work and how it can immediately return some patients to function. I am considering practicing OT for a few years and potentially shooting for medical school to become an orthopedic hand surgeon.

I understand that becoming a physician (and eventually practicing) is very challenging to say the least, and the amount of time spent on the job varies by specialty area. It is my understanding that surgeons have very long and sporadic hours which makes it difficult to maintain a work/ personal life balance. My question is: by pursing my interest in orthopedic hand surgery, will I be selling my life force/ soul to this career? In other words, what are the chances that I could spend a Thanksgiving dinner with my family, take a weekend vacation out of town, or curl up with a book at night on the couch?

Is it a choice between career OR lifestyle, or could I have both? I understand that this is a sensitive topic; some argue that doctors should dedicate their lives and time to practicing because they have a moral obligation, while others advocate for better work/ life balance for all physicians to improve QOL for doctor and potentially influence their service quality. What are your thoughts?

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[massmocha]

You can have free time when you're an attending. That would be in at least 10 years. Lots of down time during medical school post exams to read a book and see family at the holidays.

Disclaimer: Must score well on standardized tests to achieve this goal

 

[Cheyenne2313]

Massmocha, thanks for the response! I have asked this question on other forums, and that seems to be the general consensus. I asked the question to kind of feel out the "lifestyle" of an orthopedic surgeon, and from my understanding: medical school is brutal but there are breaks for holidays, time as an intern and resident are just as brutal if not more so, but once you become an attending you can somewhat choose your lifestyle based on what facility you work at (level of trauma cases). I guess I have a lot more thinking to do

 

[GoGreen2014]

I work for an orthopedic hand and micro-vascular surgeon. He lives an awesome life outside of work. Kids, vacations , family life... you name it. If he wants a day off, he can take it (outside of call ). When he is working, he is busting his a** , but when he is off he plays just as hard. I'm reminded everyday how long and grueling the process is to become a hand surgeon. But in the end, it pays off undoubtedly

 

[Cheyenne2313]

Wow GoGreen2014, so far you have had the most positive response! While I certainly expect orthopedics to be intense and hardcore (I would expect that of any medical profession), I want to be realistic in not entering something that I will quickly burn out in. I don't want to give up who I am to pursue this, and just from a human level, I want to spend holidays with the family and have enough time to grocery shop and get more than three hours of sleep a night.

 

[4thQTHailMary]

Can also do hand via general surgery + fellowship or plastics, not that the latter is any easier to get than ortho. Point being is if you want to do hand and upper extremity, you can make it happen.

 

[PhillyMed777]

Hello, with regards to using the general surgery route I would not recommend as ortho groups would rather have an ortho trained person (many reasons, for one, to share ortho trauma call with)

Also, I need to throw this out there that you arn't even in med school yet. Do NOT try to go to med school with only one specialty in mind. That would lead to disaster considering it is ortho. There are some 27k PGY 1 position and only 700 ortho spots (rough cuts) in the country all of which are heavily coveted. There's no saying you have what it takes to acquire such a spot, to be blunt. That is likely why no one "higher up" is commenting but I of course cannot speak for them. And yes, ortho residency is a real time drain. You need to spend a lot of time training so that you are really good at what you do ( i know this not first hand, but pretty directly).

As an attending, lifestyle varies... a lot. Can be lighter or heavier.

 

[numberwunn]

Second massmocha. I've seen some attendings who have pretty sweet lives - but this is after busting your butt through med school (in which work ebbs and flows), 5 years residency, 1 yr fellowship, and a few years to set up your practice. Also depends greatly on your practice set-up - will you take hand call? Big level 1 trauma center or quiet community hospital?

You have to get good scores to get into med school, and then get good scores on your step score. I'd be very hesitant to go to med school if you'd only be happy in hand -- make sure you'd be happy if things didn't pan out and you had to choose a different specialty.

I don't know where you're at in life, but I'd recommend counting the costs very closely, and think about what the next decade may hold in your life. I was a non-trad and when I applied I was married w/o kids, but didn't really think about how it would impact my family in the future. Now I'm an intern with a few kids. Generally I love what I do and think I made the right choice- but on nights like tonight, when after my family visited me in the hospital and I had to hold my daughter and explain to her that daddy wouldn't be home to put her to bed tonight ... there's a cost.

 

[Cheyenne2313]

Thank you everyone for your input. It is great to hear from a spectrum of people. My curiosity is (for current med students, residents, fellows, attendings): When you were considering medicine as a career, did you enter with a specific area of medicine in mind? I am learning from several people that it is important to go in with an open mind in case you do not match to your preferred setting. It seems as quite a few people go into medicine with the idea of "I want to be a pediatrician" or "I want to be a surgeon". To what extent were you knowledgeable about the other areas of medicine? Is it partly going in blind and finding your interest area as you proceed through the first couple years of med school? I feel like if I was not able to go into ortho hands, I could be interested in pathology, PM&R, preventive medicine, anethesiology, or interventional radiology.

numberwunn, thank you for sharing about your lifestyle and the challenges you face. I can't imagine how tough that must be to explain to your daughter... I am sure she understands that you love her very much and that you work hard to provide for her. You are right, it is so important to consider lifestyle before entering any field. I am at a point where I am not in a relationship and do not plan to be anytime soon, and I also do not have any children. School has been my "spouse" for the better part of my life, and if I choose this path, we will not be separating any time soon

 

[4thQTHailMary]

I went into Med school wanting to do ortho, and now I'm a 4th year competivetly pursuing a match in it. Know yourself, your work ethic and what you're capable of doing. Sure it's competitive, but if you've got the goods, you can make it happen. A non-traditional background with an interesting story can help you stand out from the pack.

 

[massmocha]

I thought I was going to do medicine/cardiology going into med school. Hated rounding and writing notes all day on medicine and loved the people in surgery. The days are longer but go by twice as quick. Did my elective in ortho and realized there was nothing else I'd rather to do with my life.

Now paying my dues as an intern, but learning some valuable lessons and looking forward to actually learning to be a surgeon after I get through this grind.

 

[bonedrone14]

I'll throw in my hat since I posted quite a few of these threads.

I came to med school thinking 100% I would do ortho. I never waivered through 2.5 years. During surgery, I ended up not liking the or environment and mindset, but still loved ortho.

I think the answer to your question is different for everyone which is why you'll get suchvvarying answers. Everyone is looking for something slightly different and everyone's view of life is unique. To some people putting in 60 hours in the or is a dream and makes the extra 20-30 of paperwork/clinic worth it. Some people still have energy to play with the kids or go out with friends after all this. Some feel beat down but realize there's a light at the end of the tunnel. And some just feel beat down. Without going through med school its hard to know where you fall on this continuum. Shadowing is great but waking up every morning for 8 weeks and doing something is much different and more telling of whether or not you're passionate about it.

I still love ortho. But I also love my family. I also love working out. I also love learning new, non medical things. After 8 weeks of surgery I realized I didn't love ortho enough to make it my one thing. I don't have the energy to work a surgeons schedule and then still do my hobbies. So for me it wasn't a good fit.

All that said...its a tough decision. Being set on one thing going into med school doesn't mean you won't be happy if you don't do it. Granted I chose not to do it rather than not being able to do it. But you never know what will catch your interest...I was the typical ortho stereotype and then I realized I love people, the things they do, why they do them, and now I'm going into pscyh. So...hopefully that's helpful and not more confusing lol. Good luck! If you have any questions feel free to message me.

 

[Cheyenne2313]

Bonedrone14, could you tell me a little bit more about your experience in the OR environment and a surgeon's mindset? You are absolutely right in saying that shadowing helps you find your fit, but it is different than waking up every morning and doing it long term. I am at the point where I have this strong medical interest (hand surgery) but am examining what other areas of medicine I may be interested in if in fact, I did not match, or if I "wavered" after finding out more about surgery.

 

[bonedrone14]

Bonedrone14, could you tell me a little bit more about your experience in the OR environment and a surgeon's mindset? You are absolutely right in saying that shadowing helps you find your fit, but it is different than waking up every morning and doing it long term. I am at the point where I have this strong medical interest (hand surgery) but am examining what other areas of medicine I may be interested in if in fact, I did not match, or if I "wavered" after finding out more about surgery.

I think my experience was largely colored by where I'm at for medical school. The or staff was generally not happy or friendly. They pretty much saw students as a pain and in the way, and most of the time would only speak to me to yell at me. The mindset of a surgeon, from my experience, and rightly so since you're basically responsible for this persons life, is patient before everything else. Very noble and honorable. But I also liked eating, and having time to care for myself. I also didn't like that of there was a family emergency I was pretty inflexible about being able to leave the hospital if I was scrubbed. Again, this is all provably institution specific. But for me, I loved the idea of surgery and fixing someone. The reality of it was just too different for my personality from what I wanted in life.

Maybe the best advice I heard when trying to decide was super cliche but actually rang pretty true. If your favorite place in the world is the or, be a surgeon. If your favorite place in the hospital is the or, do anesthesia. Surgery is an incredible skill and an incredible responsibility with which comes an incredible burden that I wasn't willing to bear. You just have to do the pros/cons for your life and decide what's most important to you. Good luck!

Also, take my advice with the frame of reference that I didn't choose surgery, so my opinion is biased that direction.

 

[Bull's eye]

It's been a long time since I have been on this site, good to see it's still doing well. As far as hand surgery goes, It takes a lot of hard work and some good luck, but it is worth the journey.

 

[numberwunn]

I think my experience was largely colored by where I'm at for medical school. The or staff was generally not happy or friendly. They pretty much saw students as a pain and in the way, and most of the time would only speak to me to yell at me. The mindset of a surgeon, from my experience, and rightly so since you're basically responsible for this persons life, is patient before everything else. Very noble and honorable. But I also liked eating, and having time to care for myself. I also didn't like that of there was a family emergency I was pretty inflexible about being able to leave the hospital if I was scrubbed. Again, this is all provably institution specific. But for me, I loved the idea of surgery and fixing someone. The reality of it was just too different for my personality from what I wanted in life.

This is likely a reflection of where you trained and who you trained with (and possibly more true of "surgeons" ie Gen surg but not all of the sub specialties which tend to each have their own culture ). Where I train, the staff attendings are very friendly, love to teach, and have families and lives outside the hospital.

I will agree that the theory of a specialty and the lifestyle ate totally different. I.e. I loved learning cardiac physiology, but the constant rounding and mental games of internal medicine bored me to tears. As one mentor advised me - doing x may be fun to learn about now and exciting to do, but would you still want to be doing it in 20 years? (He did this to tout the benefits of an all outpt practice)

 

[Cheyenne2313]

It's been a long time since I have been on this site, good to see it's still doing well. As far as hand surgery goes, It takes a lot of hard work and some good luck, but it is worth the journey.

Thank you for your input! I have been doing quite a bit of research on the field, and it sounds very challenging to enter but it sounds as though the vast majority are happy they did it and they feel they are making a real difference for people. For practical and financial reasons, I have decided to continue my education as an occupational therapist (only a few more months left until I enter fieldwork and clinical rotations) and I was lucky enough to land a rotation within a major hand clinic. My hope is that the close relationship between hand surgeons and the therapists will give me some perspective and a better idea of whether I should move forward with pursuing a medical career with the goal of UE surgery in mind.