Lots of orthopods in class

[HtSht2BoneDoc]

So I go to a small school 100 lets say in CA. There are like 6 people in my class going into it all have good credentials( 240-260s, research, yada, yada, yada). Any thoughts on this? matching? does it make it less likely that the lower scores will get interviews . Seems like alot to me from one school... Just wanted to hera some thoughts, comments, ideas about this.

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[moquito_17]

So I go to a small school 100 lets say in CA. There are like 6 people in my class going into it all have good credentials( 240-260s, research, yada, yada, yada). Any thoughts on this? matching? does it make it less likely that the lower scores will get interviews . Seems like alot to me from one school... Just wanted to hera some thoughts, comments, ideas about this.

I hear that Georgetown puts something like 15 people per year into ortho. That is a lot for one school. But nonetheless, they put 15 per year into ortho...

There are 150+ programs--there are lots of places for your school name to go around. I wouldn't worry about it.

 

[motox]

My question is not about the amount of orthopedic schools but rather what happens to them when they finish residency. Everything I have been able to find points to the fact that there will be a surplus of ortho surgeons by 2010. How hard is it going to be to find a job as an ortho surgeon? And what will happen to the pay taking into acount supply and demand?

 

[moquito_17]

My question is not about the amount of orthopedic schools but rather what happens to them when they finish residency. Everything I have been able to find points to the fact that there will be a surplus of ortho surgeons by 2010. How hard is it going to be to find a job as an ortho surgeon? And what will happen to the pay taking into acount supply and demand?

The AAOS commisioned a study by the RAND corporation in 1997-1998 to look at just this, and you are correct in quoting their conclusions.

However, there is a lot of discussion in the literature about the limitations of these types of studies and models. To name a few:

1) Population demographics can change dramatically. For example. it is impossible to know the degree of resources that the aging baby-boomers will require. This may drive demand quite high. There is some discussion in the total joint literature that there is an impending shortage of surgeons who will revise all of the total joints that are being put in baby boomers now. So this is one example.
2) We can't know how the health care system will affect demand for specialty care. It used to be that HMOs kept patients from seeing specialists, thus keeping demand lower. This is changing as the health care consumer is demanding more access and the nature of the system is changing.

With that being said, I seriously doubt that there will be any difficulty finding work after residency, especially since a lot of what we treat is degenerative disease. Personally, I think that the baby-boomers are going to live longer, and generate far more patient visits than the models are predicting. In addition, every area of orthopaedics, except maybe tumor, peds and trauma, is substantially composed of treating degenrative disease.

Think about what we see and do most: total joints (and their sequlae), spinal stenosis, microdiscectomies, rotator cuff tears, intertroch fractures, DR fractures, CMC arthritis, etc. These are all conditions that are going to be even MORE common when the population gets older.

I just have a hard time beleiving that there will be no work for us.

As far as the money goes, that is a different beast all together. That depends on many, many factors, few of which are controlable by us. With the primary care world changing the way that billing is done, our income generation is changing. In some clinics, with some patients, a 1/2 day in the office can generate as much income as a morning in the OR!

Unlike the rest of the world, supply and demand only goes so far in medicine, and there are many factors beyond our control. But like I said with finding work, I dont think that we'll ever drop below 'making a very comfortable living' and that we'll always be some of the highest earners in medicine.

Just one man's thoughts...

 

[mrdarthvader]

My question is not about the amount of orthopedic schools but rather what happens to them when they finish residency. Everything I have been able to find points to the fact that there will be a surplus of ortho surgeons by 2010. How hard is it going to be to find a job as an ortho surgeon? And what will happen to the pay taking into acount supply and demand?

One of the things that I look at and found interesting was looking up actual job offers with salaries that are available now. Granted things can change but you certainly can get a good feel for how things are right now and keep an eye on the market by looking at actual numbers and opportunities instead of studies which may or may not be true.

For instance I look at http://www.physicianrecruiting.com/ and have looked at various surgery specialties all over the country. There are none or very few CT openings, but lots of neuro, and ortho all over the country and with very good offers.

Not a perfect way to look at things since they are always changing, but at least it will give you some idea of how things actual are and give you a way to keep up on the current trend of the job market...

 

[bonefixr]

I think that there are several truths that have been spoken on both sides of the fence, but I am leaning toward thinking that ortho will still be a great field to get in to in the future for several reasons.

First, I think that the baby boomers will require a large amount of services due to their age, their relative active lifestyles, and their demand for all to be right with the world. Also their hip fractures.

Second, I think that the trend in students is leaning toward the less demanding fields such as rads, anes, PM and R, ER, etc. If we aren't getting paid that much more, why do all that work?

Third, the nation is still remaining quite active in sports and rec activities so that demand remains.

Fourth, those who aren't active are usually quite overweight and will be wearing those joints out faster and falling more.

Just some anectdotal evidence and opinions...

 

[Wahoos]

Motox,

I am currently a resident in orthopedics and just wanted to comment on a few things. 1.) There will NOT be a surplus of Orthopedics surgeons, in fact, there will be a huge shortage of Orthopods in the next 10-15 years. You know why, the number of people over 65 will double from 35 million to 70 million by 2010, from the baby boomers. And that population gives you a ton of ortho cases, joints, hip fxs, etc. People are becoming more active = ton of sport cases, and there will always be trauma from car accidents. No one will be able to compete with the ortho speciality..... like how cardiology have competed/taken a huge amount of cases available from CT surgeon (that is why you don't see many jobs for CT surgeons now, in fact, this yr, there is over 100 fellowship programs for CT, but with only 43 applications, and most of programs did not fill). When you break your long bone, you will never be able to fix it "min invasive" and no other specialty will take the case from you. One of the reasons why there are <600 spots each yr for ortho residencies is b/c our profession is trying to control the number of orthopods that grad vs demand, so that the supply will be short = better pay. I wouldn't worry about finding a job as a Orthopod or your pay. You will be one of the highest paid physician out there, maybe 2nd to neurosurg. If you go into spine surg, then you will be the highest paid physician, period. At this point in your career, if you are sure of Ortho, I would do everything possible to increase your chances of matching. The process is not getting any easier and it is very hard to secure a spot in Orthopedics. Almost all of the places that I interviewed, there were ~100-150 apps per spot.

2.) 6 people in your class is not a lot. My class had 7 people apply out 130. These 7 had 3 AOA, one Jr AOA, all were in the top 30% of my med school, with research, great letters, and 5 had boards >240, 2 > 260 and one was 269, the other 2 had boards in the 230s. We applied all over the country. 6 matched, and 1 did not (this person that did not match graduated #1 out of Univ of Georgia, based on GPA and weighted major). I think the more people in your class apply Ortho, the tougher it is for you to match or get interviews, if you are a border line applicant. The reason why Georgetown matchs 15-20 in ortho each year is that they have a great system (one of the interns with me is from GW so he told me this), the PD will meet with every one, he looks at your app and determines how competitive you will be in the process, and also based on what region you want to end up, then he will tell them what school to apply, instead of the shotgun approach. The apps are spread out, but you don't have 20 people applying to 1 school. This way, GW applicants can max there chances. If you have 20 people all do the shotgun approach, then you will have 3-5 top kids that will interview at all the schools, while the other ones will have min number of interviews.
Hope this helps.

 

[Orthodoc40]

Motox,

I am currently a resident in orthopedics and just wanted to comment on a few things. 1.) There will NOT be a surplus of Orthopedics surgeons, in fact, there will be a huge shortage of Orthopods in the next 10-15 years. You know why, the number of people over 65 will double from 35 million to 70 million by 2010, from the baby boomers. And that population gives you a ton of ortho cases, joints, hip fxs, etc. People are becoming more active = ton of sport cases, and there will always be trauma from car accidents. No one will be able to compete with the ortho speciality..... like how cardiology have competed/taken a huge amount of cases available from CT surgeon (that is why you don't see many jobs for CT surgeons now, in fact, this yr, there is over 100 fellowship programs for CT, but with only 43 applications, and most of programs did not fill). When you break your long bone, you will never be able to fix it "min invasive" and no other specialty will take the case from you. One of the reasons why there are <600 spots each yr for ortho residencies is b/c our profession is trying to control the number of orthopods that grad vs demand, so that the supply will be short = better pay. I wouldn't worry about finding a job as a Orthopod or your pay. You will be one of the highest paid physician out there, maybe 2nd to neurosurg. If you go into spine surg, then you will be the highest paid physician, period. At this point in your career, if you are sure of Ortho, I would do everything possible to increase your chances of matching. The process is not getting any easier and it is very hard to secure a spot in Orthopedics. Almost all of the places that I interviewed, there were ~100-150 apps per spot.

2.) 6 people in your class is not a lot. My class had 7 people apply out 130. These 7 had 3 AOA, one Jr AOA, all were in the top 30% of my med school, with research, great letters, and 5 had boards >240, 2 > 260 and one was 269, the other 2 had boards in the 230s. We applied all over the country. 6 matched, and 1 did not (this person that did not match graduated #1 out of Univ of Georgia, based on GPA and weighted major). I think the more people in your class apply Ortho, the tougher it is for you to match or get interviews, if you are a border line applicant. The reason why Georgetown matchs 15-20 in ortho each year is that they have a great system (one of the interns with me is from GW so he told me this), the PD will meet with every one, he looks at your app and determines how competitive you will be in the process, and also based on what region you want to end up, then he will tell them what school to apply, instead of the shotgun approach. The apps are spread out, but you don't have 20 people applying to 1 school. This way, GW applicants can max there chances. If you have 20 people all do the shotgun approach, then you will have 3-5 top kids that will interview at all the schools, while the other ones will have min number of interviews.
Hope this helps.

Well it helped me, anyway. Thanks!