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To be fair, those are numbers spent at the hospital/clinic. Derm involves considerably more outside reading than most other specialties, so you make up most of that time in other ways.
Ortho "ask me anything" thread
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To be fair, those are numbers spent at the hospital/clinic. Derm involves considerably more outside reading than most other specialties, so you make up most of that time in other ways.
D
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Is the ortho library really just a gym?
Traumatologist I just worked with for 4 weeks at large trauma 1 center downtown pheonix typical day.
x-ray conf at 6:00, rounds at 6:30-7 with residents/students and census about 7-10. OR three days a week with 2 days clinic/followup. On call every 4 days. In OR from 7:30-4ish. Only once did we operate past 6 and in four weeks (6 on call nights) only twice did we operate past 2ish or before 5ish. The residents and I would take care of the patients in ED, touch base with doc and then schedule most for next day OR.
I also have two physician recruiters who peruse the Ortho posts to let me know what is out there and salary changes. I have seen multiple posts for traumatologist at a large university with residents a schedule similar to this. I have also seen schedules where they are on 5 days off 7 days.
Head of trauma at St elizabeths youngstown ohio, also had similar schedule. I sat down with him and chatted extensively about why he chose trauma and the misconception that traumotologists have horrible lifestyles.
Maybe the docs I worked with happen to be skewed on one direction but hey - if they can do it then I could too. (although I am not interested in being a traumatologist).
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agreed with above, that doesnt track work outside of hospital. the only way to know what the lifestyle will be like is to rotate through and live the lifestyle. thus the importance of your third year clinicals.
Look all residencies are HARD and TIME CONSUMING!!! There will be days you are dead tired and exhausted and days that were short and easy. I get really frustrated in these conversations when the talk about choosing a residency comes down to time and lifestyle (those in my opinion are secondary). I am not a resident but lived like one over the last 6 months and was very observant of all the residents, chatted with tons of them and became good friends with many of them.
medicine is hard! every field. You work with very little thanks and gratitude, long hours are a norm (particularly with new regulations coming into effect), we make decisions in the dark often going with just the "gut" feeling, often our mistakes can lead to fatal outcomes.. THis is an emotional and tough job. If you go in with the idea of getting a residency based solely on lifestyle and prestige please get out!! That's a serious problem in my opinion, you will not be happy, you will be complaining that you dont make enough money and you'll add to the problems physicians already face in health care.
Let me make myself clear again... I may be way over stepping my bounds here but I believe many of the upcoming medical students and pre-med students are getting into medicine for the wrong reason. Doctors are no longer "gods" and doctors no longer make gobs of cash for little work (example, cardiologist used to get reimbursed 2000 for pacemaker placement which is about a 45 min procedure, optho used to get paid between 2-3K for cataracts).
Please please please get into medicine because you love physiology, anatomy, musculoskeletal etc, helping sick people and teaching patients healthy habits.. with that attitude you'll find the right residency for you, save and help tons of people and get paid well with a solid stable job!!! As I stated before, as an attending I 100% believe you can make your lifestyle the way you want it. It may be tough at first to get there but it can be done..
I feel those who hate their residency or what they do, those who complain they should have done "derm" or those telling young students not to go into medicine because of "obama" got in for the wrong reasons or lost their passion for medicine somewhere along the line (burnout is a real problem and I understand that may be the issue as well).
sorry for the rant.. I'm just passionate about improving our health care system and it starts with creating the right environment for students to choose medicine appropriately. I also feel medical school should be combined with undergrad and created into a 6 year program. (most European and Asian countries do it this way, some can go to med school right out of high school equivalent).
misconception
but funny nonetheless."wasted five years" ???
Look at subpecialty IM -- they are in it longer than 5 years.
its only wasted if you go into medicine thinking you are going to be the "bees knees" and make gobs of money. radiology is 4 year residency, if you want IR tack on an additional year. Most do fellowships now that take you past original residency commitment. So 5 years to become a specialist is pretty good in my opinion.
60 hours a week not bad either. there are 168 hours in a week. average 7 hours of sleep a week (cant remember when I got that last) that's 109 hours for work and sleep leaving 59 "other" hours. Not sure about you but I can do a lot in 59 hours. The key is time managment.
I think, in my opionion, obviously, it's just a wasted life if you don't love it.
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I am also, as I'm sure most of us are, much more interested in understanding the material than just strictly memorizing.
How did you select the textbooks you used? Were they the school suggested ones?
Also, did you pretty much go through the textbooks, or would you just supplement the notes with textbook info when needed?
Thanks.
got it - agreed!!
But doesn't that apply whether its three years or five. Whether u spend 50 hours a week or 70?
That's been the point of my posts. Focus on what u want to do first, get some real experience in at and see if its for you. I believe the lifestyle issue can be solved after residency.
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Orthojoe -
1) What are the salaries like for a newly minted ortho surgeon, who just finished residency?
2) Is there any bias by employers against AOA trained ortho/general surgeons compared to ACGME trained surgeons?
3) Which geographical locations currently have more demand for ortho surgeons?
1) What are the salaries like for a newly minted ortho surgeon, who just finished residency?
2) Is there any bias by employers against AOA trained ortho/general surgeons compared to ACGME trained surgeons?
3) Which geographical locations currently have more demand for ortho surgeons?
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Joe,
Thanks for taking the time to help and encourage your future colleagues.
1. Are you planning on pursuing a fellowship after your residency? is having a fellowship necessary to find a job in desirable locations? How being an AOA-trained orthopedic surgeon is going affect your chances of landing a fellowship?
2. If you don't mind, how much debt have accumulated throughout your education? Are you going to do IBR?
thank you,
Thanks for taking the time to help and encourage your future colleagues.
1. Are you planning on pursuing a fellowship after your residency? is having a fellowship necessary to find a job in desirable locations? How being an AOA-trained orthopedic surgeon is going affect your chances of landing a fellowship?
2. If you don't mind, how much debt have accumulated throughout your education? Are you going to do IBR?
thank you,
youll be surprised how often "survival" mode can come in med school. If you fall behind in material the natural default is to do just the bare minimum and pass the test.
As to the the textbooks that is a hard one to answer. Sometimes Id use the recommended text and other times I'd use a book I found in the library. basically id just find a book that seemed to make sense to me. For example I struggled with the caudate nucleaus tracts and it wasnt until I found an old neuro book with awesome pictures that it clicked. Now I could have just taken the test because I had the information memorized, but thats not how I roll.
Its because I was always ahead that I could spend time doing these things and not just studying the bare minimum. Work your tail off the first 2-3 weeks of your semester/quarter, ask professors for their lectures or notes in advance. just get ahead! I once read through all the reading assignments in our physiology course three weeks into the semester. I had a basic understanding of everything covered so when it was lecture time I didnt struggle picking up the basics and applying them to more advanced topics.
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I think the most important question is:
How is 4th year now that you have already matched??
I imagine it is the best period of med school bar none, without a doubt, no questions asked.
As I sit here studying GI physiology, the endocrine system, male and female reproduction all combined with immunology and microbiology all for a test on Monday......I can only dream of my 4th year after I have matched. I imagine it will be glorious.
How is 4th year now that you have already matched??
I imagine it is the best period of med school bar none, without a doubt, no questions asked.
As I sit here studying GI physiology, the endocrine system, male and female reproduction all combined with immunology and microbiology all for a test on Monday......I can only dream of my 4th year after I have matched. I imagine it will be glorious.
good questions. Medscape's compensation reports are the best. As a side note, ortho is still ranked one of the highest professions where the docs are still satisfied and would pick the same specialty if they had to do it again.
http://www.medscape.com/sites/public/physician-comp/2012
Not sure on the bias between AOA and ACGME trained docs. I rotated at large universities that had both types of physicians and taught both types of students. So I didnt see any, but there may be. I will let my work speak for itself though when the time comes and I feel confident I will obtain a phenom job. My current program has both MD and DO attendings and they both treated me with respect and a strong desire to teach.
see previous post on compensation, here is link again though.
http://www.medscape.com/sites/public/physician-comp/2012
NO I in no way feel being AOA trained will effect me, not to mention ACGME and AOA combine. I actualy feel going DO in ortho is hand and foot (pun intended) better for ortho.
fellowship? not sure. I loved doing general ortho. The only field I havent rotated through was pediatric ortho, so we will see. I also loved ortho onc - man you can make such a huge difference here and the anatomy is so awesome! Most do choose to move on into a specialty, which is why I may stay general, As I stated before I have a few head hunters and they send me the ortho jobs that get posted. There has been a huge demand for general ortho and smaller communities are trying hard to recruit them. I am a small town kind of guy so I'll probably end up in a smaller community doing general. But I wont rule anything at yet.
Debt -- wow its crazy how expensive school is now. AZCOM is 52k a year. I started at 43. So its roughly 300K (took out extra because I have a wife and three kids). I will do IBR during residency absolutely.
lets look at the math using medscapes numbers of avg salary around 350k
350k minus 175 for taxes (50% is a large number and not really accurate but I'm just using round numbers) - take home is $175
my wife and I have pre-budgeted a great life at 100K a year - (I dont care about lavish living, I care about providing a good home and opportunities for my kids). so in 5 years I will have paid off student loans fully (400K - i added 100k of interest). That means I now have 175k take home pay, no debt except for house. That will provide a lot for my kids.
Now I truly believe I will do better than 350k and will be more upwards of high 400s. But thats just me. Also a lot of the smaller community (200k population) are offering huge signing bonuses to pay off student debt. I plan on taking advantage of that.
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Nice to finally see someone on sdn with a sense of optimism. Good luck on your endeavors
hahah. Yes it is much better. However, I hate wasting time and am one of those personalities that could prove newtons first law of thermodynamics.
I finished audition rotations in november, december I did ED at maricopa which we had two tests so It was busy but at least it was a good rotaiton. january I did PM&R. I did chose a doc known to have mellow hours so I took a lot of time off in January. February I did ENT which was way cool. Those two were my fun rotations that I know Id never really get to do and I was interested in them. Both were mellow and low hours.
Now I'm back to work because I want to be prepared for intern year and NOT be like many interns that I felt I had more knowledge during my 4th year. Many take off from any studying/learning after match, which is just not me. I tone it down but now I get to study things I LIKE!!
So Im doing critical care which applies so many fields in one. I also have an awesome doc. We work half day however I feel like Im learning so much compared to some preceptors i spent all day with. Its really preparing me and Im taking it serious. I then do cardiology - high proportion of patients I will see as an intern- then finish it off with radiology because I just want to be better at reading films. Done first week of may!!!!!
So yea its awesome but its awesome because I get to do and learn what I want to and spend the time that I want to. this is the last time I get to do these things.
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You know, brah, you're the type of person I'd like to be talking like this after med school. Thanks for sharing all this sincere info.
Thanks!!Nice to finally see someone on sdn with a sense of optimism. Good luck on your endeavors
I was a director of a pediatric medical center before going back to medical school, so I understand the negativity and lack of optimism that regulation and cuts in reimbursement causes. However I also feel it comes from doctors who already have a standard of living and have expenses that justify such. So when their salary gets cut and they have to work harder to meet their standard of living... problem. with outside help (those not in medicine) we evaluated our overhead and cut it significantly down without extra demands on the physicians. The business of medicine is a problem as well that most blame the government/insurance regulation. I believe a high proportion is to be blamed on the lack of business savvy physicians often dont have and due to time often cant learn. I am toying with the idea of getting and MBA in health care systems.
Yes I will not make nearly as much as ortho docs over the past 10 years. BUT WHO CARES! I will have a phenom job that is in high demand, extremely secure and will provide a great salary thats higher than so so many out there.
We in medicine are truly blessed with an awesome opportunity. Take the problems and fix them, no point in being grumpy about things you cant control.
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You obviously have an athletic background, but that doesn't necessarily make someone want to pursue orthopedic surgery from the beginning. When and what made you realize you wanted to go into this? And what did you have to do during medical school to ensure you were very competitive to apply? Did you have to start from the first day by getting involved? What happens if we realize we want to enter a specialty later on during medical school?
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Not really a question, more of an observation. I've shadowed a couple orthopods in both rural and suburban settings, and the hours always seemed insane to me. Rural especially, as the guy would normally pull 90 hour weeks and told me that this wasn't far away from the norm. The summer I shadowed him he went on a stretch of 22 or 23 consecutive days of work. He also makes $800k/year.
With my shadowing of ortho surgery, I really liked it. I like using my hands, I enjoy seeing results in my work, and I appreciate the technology and anatomy involved. But, I really want to have a home life. All three of the orthopods I shadowed were going through or had gone through a divorce. I got close enough to 2 of them, and they told me the long hours were a major contributor.
Is there a way to be an orthopedic surgeon and still have a home life? Having time for my family will be top priority for me, ahead of earnings. This is a big reason why EM and FM are very appealing to me.
With my shadowing of ortho surgery, I really liked it. I like using my hands, I enjoy seeing results in my work, and I appreciate the technology and anatomy involved. But, I really want to have a home life. All three of the orthopods I shadowed were going through or had gone through a divorce. I got close enough to 2 of them, and they told me the long hours were a major contributor.
Is there a way to be an orthopedic surgeon and still have a home life? Having time for my family will be top priority for me, ahead of earnings. This is a big reason why EM and FM are very appealing to me.
true... I would go in with an open idea because fields I thought I'd like ended up being a drag. It was great on paper but the logistics made it a nightmare and I ended up liking fields I thought I'd never like(OB/GYN for one). I thought ortho would be cool because I had experiences with ortho as an athlete. I initially thought pediatrics was my field because I had worked in peds for almost 6 years before.
First decision in deciding your medical path is to do medicine vs surgery.. Do you want to be in the OR or do you like the complicated patients managing medicine. try hard to forget about the lifestyle compoennet. focus on what you like as a doctor
I made sure that my first rotation in my third year was IM inpatient. It exposed me to pretty much every medicine field out there and gave me a good idea of lifestyle, complexity of patients and demand. I feel that was the best thing I decided to do because it eliminated tons!! I learned I couldn't stand the GI patients, liked the complicated cardio and really enjoyed the trauma and peds.
I did a few primary care fields after in FM, Pediatrics. Did not like FM at all and although I enjoyed pediatrics there were days I really struggled to pay attention as I found doing well child care over and over was a drain - so i at least thought that I'd be more interested in specializing in pediatrics or become a ped hospitalist.
Finally got my gen surg rotation in November. Loved Loved Loved the OR, the atmosphere, the complexity and the camaraderie. The patient demographics weren't my favorite but managing from consult to OR to discharge was my idea of fun. The patients were sick coming in, we took them to OR and they left usually much better (a generalization). I figured out I hated the medicine aspect of managing sick people who really never got better or were chronically sick. My personality needed to see a difference. I also didn't like the "it might be this so lets run these tests and put them on these meds just in case" Instead I liked the "sounds like appendicitis - run the CT.. ok it is, book the OR and lets fix them."
So I decided something surgical would be in my future after my gen surg rotation. Gen surg leads to tons of specialties but what else is high procedure or OR based - well there is IR, PM&R, ENT, Urology, Ortho, OBY/GYN (wasnt interested at the time so I scratched that off). I looked at what type of patient demographics and opportunities were for each one, fellowships, lifestyle, etc. I decided on following up with Ortho
I quickly contacted my coordinator and asked for an ortho rotation. Again because I was super kind, nice and became friends with my coordinator we found a rotation about 2 hours from home and switched out a previous elective I had for this one. I took it because I know beggers cant be choosers. I paid for my own housing while there and it was the best decision I ever did.
I rotated through 3 specialties during the 4 weeks. sports, spine and joints. I was the only student and the docs were so kind and nice. I also learned their lifestyle, in a small community of prescott arizona, was very good. Yes we had some long nights but in general, very very nice compared to what everyone told me. But those long nights, we were doing cool things. Again, I loved the "here's the xray, it shows distal radial fracture, lets book OR for volar plate, here is the post op films and look at the great reduction!" The immediate gratification of fixing something fit me. the anatomy is way cool, we have to know everything anatomically and that appealed to me. but often the anatomy is obscured due to trauma so identifying and figuring out this muscle is this, what is the internervous plane, etc was cool. Like a treasure hunt. Also, tons and tons of "trauma" was booked for the morning. I would take call with the PA at night, the doc rarely had to come in at night with how they set things up (they were one of two major ortho practices in prescott). the sports side was great too because we had these high school athletes trying to get into college coming in, trying to solve pain so they could continue to compete. man it was a good feeling when we helped them.
So ortho jumped to the top after that rotation. However i didnt make a decision to actually do ortho 100% until late my third year. However that didnt stop me from continuing to try and "match" ortho as I knew it was a competitive field. While I was still trying to determine if ortho was for me, I set up my fourth year auditions. I wasn't going to take the risk. I also didnt feel bad about doing this because I knew ortho was probably the way for me and I also knew that the waiting list to get on auditions is huge so if I happened to cancel a program it wouldn't suffer too bad. I would be in a bad situation if I had not started setting up ortho auditions early january of my third year.
I had inpatient pediatrics my next rotation - Loved loved loved it.. so it made it tough to decide immediately about ortho.
in a nut shell what it came down to was that after doing a bunch of ortho audition rotations (still hadn't made up my mind until a month before rank order list is due), the lifestyle was way better than what I thought, the days were much quicker, I loved the OR atmosphere and I felt I would be happier in ortho. I definitely could do inpatient peds, which was a potential back up for me. I interviewed at about 4 pediatric programs and i wasnt quite as happy about when imagining the next couple years. I think had I not matched ortho I would have tried to do a research year and reapply, if I didnt match again I would have followed pediatrics.
Yes I've heard this a lot and discussed this concept tons over the last couple of months. I wonder if it comes down to what people think an insane amount of work is? I also know plenty of IM,pediatrics, FM, etc docs who are divorced citing their profession and long hours as a contributor, but their are also plenty who aren't.
Over 6 months of doing ortho rotations I am 100% confident i will have an awesome family life. yes I will miss some of my childrens sports games/recitals, or other important events, but that's to be expected in any job. You can set and/or find jobs that you don't have to be a slave.
By the way, I had three kids during these audition rotations (just had my fourth). creativity and a phenomenal committed spouse is a must. my wife is 100% behind me and behind making sure I see my kids. there were quite a few times that my wife brought my kids to the hospital and we ate dinner together, then ran around outside kicking the soccer ball or something (by the way this occurred on my OB and pediatrics rotation most, never on ortho).
I could give you tons and tons of examples of ortho docs I know who have awesome lifestyles. Residency is tough and often long but once out you really can set things up the way you want
Example - sports med doc in practice his 5th year, started at 8- done at 4, we saw around 60 patients a day (efficiency!), three days in OR. mondays were joints starting at 7 and ending around 4, wednesday OR ouptatient starting at 7 and ending around 2 (we would knock out 15-20 procedures, he had two rooms and we would have patient set up and ready before he even came in and would close so he could move on to the next room). fridays were hit and miss but usually half day OR because he went out of town with his family. He pulls in high 500s from his own work. Now he has 4 other physicians in his office, from profit sharing he pulls in an additional 400k....
--- every other weekend he was gone somewhere with his three kids. Never takes call.The spectrum can swing in both ways. from never having a life to having a phenom life. I will be the later guaranteed, however I most likely will be somewhere in the middle. I could give you an additional 4-5 ortho docs I know who have lifestyles like this. things are changing, PA's and ortho techs are having a larger role. Large practices for call are a must now a days to share overhead.
so yes- you can have a great lifestyle in orthopedics. Look at the medscape link I provided earlier. Out of all the satisfied physicians saying they would do it again in the same field ortho is up at the top. Yes you will probably have a smaller paycheck compared to the crazy ortho docs who work all day long. But I dont care.. I will be doing what I love and still providing a paycheck that well above the majority
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FYI, Rads is 5 years plus 1 year fellowships.
Not ortho specific but is it hard to find housing rotating here, there, and elsewhere? Moving every month, possibly hours away. The school I'm going to offers me the ability to choose and set up a lot of my rotations which I think is fantastic but unsure how well/easy it will be to set up what I want and find a place to live. I imagine due to ortho wanting audition rotations they have housing set up for students? I know you had a family so maybe didn't travel as far as I'd be willing to for rotations, but still seems like you traveled quite a distance for a few and maybe lived away from your family for a bit.
Do operations go straight through for hours or are there breaks if needed? I always imagine people working for hours with no breaks but they must stop if they need to go to the bathroom right? People pass gas without thinking twice? Now that I think about it people must get VERY comfortable with others after a bunch of operations together.
Do operations go straight through for hours or are there breaks if needed? I always imagine people working for hours with no breaks but they must stop if they need to go to the bathroom right? People pass gas without thinking twice? Now that I think about it people must get VERY comfortable with others after a bunch of operations together.
I went to school in AZ and my ortho auditions were in ohio, oklahoma, nevada, california and one in arizona. So i traveled a lot. Some programs had "cheap" housing. others didn't. I ended up living in an extended stay hotel for quite some time, multiple times! I didnt physically "move" every time.
As to OR etiquette: on real long trauma cases we could break scrub and take a quick break at certain points that required a position change or redraping. ie - after a complex distal radius fracture we scrubed out, went to the bathroom and got water, then rescrubbed in for some complex tendon transfers and gamekeepers thumb repair. So yea you can technically take breaks, but usually you dont. Im sure lots of people "pass gas" while in the OR and yes you are often saddled up to the surgeon, PA, scrub tech, etc for long periods. Not all OR work is long. One of the joints guys I worked with did a total knee from tourniquet to tourniquet of 45 minutes (compare that to another total joint fellow who consistently did them in 3 hours). FAST!! I'd actually rather have the first surgeon do it because he was just awesome and had it down to a "science". knee scopes can be short, distal phalanx repairs can be short (or long depending). So there is a lot of variability depending on surgeons expertise and the type of surgery.
my bad...
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Thanks for the last response. It was very helpful and allows me to be a little more optimistic about entering a surgery, if I want to. While rotating, did other surgical specialties interest you? You mentioned surgery in oncology and I am wondering what you thought about this. I know I shouldn't worry about the commitment of a specialty, but that is probably my biggest worry. Long list of things including lack of the typical family dynamic has led me to want that for my future family. Surgery comes with this stigma that there is an intense time commitment, no matter what kind. Did you also find that other surgical specialties offered a better life away from work? Not that I will choose based on this, I just want to know if it is even a possibility int he surgical realm.
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Orthojoe -
It must be impossible to start paying back the student loans during residency with a family with kid(s). How can you defer paying back your student loans during residency?
It must be impossible to start paying back the student loans during residency with a family with kid(s). How can you defer paying back your student loans during residency?
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There is a one time 3 year general deferment that is available. There are also income/hardship deferments available (if you qualify). However I think most people just begin paying back their loans using IBR (income based repayment) which lowers your payment based upon your income.
correct, I will be doing the income based repayment(IBR) program and basically just paying the interest. The great thing is that the IBR program not only takes into account your salary but also the cost of living and dependents. Since I have 4 kids I actually dont have to pay anything at all until my 5th year when my salary is high enough. But I will at least be paying the interest that accrues.
I liked most everything surgically except for the bowel resections and rectal abscesses. I really didnt like messing with the adominal cavity which is why I probably wouldnt have gone into general surgery.
What do you mean by time commitment, how do you quantify this? If you expect to be home every day by 5 then medicine isn't the right field for you. You'll be very frustrated and unhappy during your third and fourth years, not to mention during residency. If you are going to struggle working at least one day out of the weekend for your 3-4th years and residency then look for another career. If one in 4 call will put too much strain on your family, look for another field. If forgoing a date night with your spouse or missing a child's sports event is too much, go into another field. If taking home your work, charts and thinking about patients often in the middle of the night is too much (happened often to me, I'd for some reason have an idea pop into my head about a sick patient which woke me up), medicine may not be for you.
I'm not trying to be mean here, but that was most of my schedule and the reality during 3-4th year (except last two months as I wind down my fourth year) and its what I expect for residency. As an attending I will have more control of my schedule. My wife and I are very realistic about the time demands of a physician and have committed to this path together so our children's future will be brighter. One of my mentors was a cardiologist and was instrumental in the first heart transplant, he is one of my religious leaders and knowing how important his family is to him and listening to him talk about how he and his spouse dealt with the demands has given me a lot of strength. I know I can do the same. Its just where I put my priorities.
Yes there are some other surgical fields that are "known" to have better hours - ENT and urology are the two most often talked about in this category.
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OrthoJoe,
Could you comment on the DO discrimination in matching or in the workplace environment? Is there any?
I have heard stories of DOs having to pay alot of money for audition rotations at certain DO schools while MD students dont. Have you witnessed this?
Id you had to pick a DO school again, would you pick AZCOM? I bet the weather is nice
what were your stats when you applied to medical school?
How many schools did you apply to?
What was your previous work experience/ healthcare exposure prior to going to school?
Thanks again for doing this.
Could you comment on the DO discrimination in matching or in the workplace environment? Is there any?
I have heard stories of DOs having to pay alot of money for audition rotations at certain DO schools while MD students dont. Have you witnessed this?
Id you had to pick a DO school again, would you pick AZCOM? I bet the weather is nice
what were your stats when you applied to medical school?
How many schools did you apply to?
What was your previous work experience/ healthcare exposure prior to going to school?
Thanks again for doing this.
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No worries, I know you what you are getting at. I wasn't looking for an easy 9-5, just to know if there were specialties within surgery that didn't fit within that stigma. I followed neurosurgery for multiple months and though it was extremely intriguing, the constant commitment put me off a bit. Did you get a chance to observe cancer specific surgeries? How did you like that?
Yes I rotated with an ortho oncologist in July of last year.. one of my best experiences. The great thing is that he also did a lot of general too so it was a good mix.I am highly considering this as a fellowship but know it is extremely competitive.
There was a friend of mine that calculated the average pay of neurosurgery residents and it came up around $7.35 and hour. That was about 6 years ago so with the new residency hour changes that may not be the case anymore. I dont know much about that field
yes there is DO discrimination but it wasn't as bad as people made it out to be. But it is definitely there. I experienced it a few times during my clinicals at large university hospitals with comments such as "Oh couldn't get into MD school huh? not smart enough to be a real doctor? Hey, your an osteopathic go do some of that voodo stuff on that CHF patient" etc, etc However after spending a week with me they quickly realized I was just as competent and often more so than the MD students. I just laughed with them and brushed it off. although OMM does have some voodo crazy stuff. The residents and attendings didnt seem to have as much of an issue as the MD students. I had one student really pester me and finally I said -"hey, how about we share our USMLE scores, that will settle the issue won't it?" He didnt bother me about being an osteopathic again. This is rare though and I think we as osteopaths read into it and "LOOK FOR THE DISCRIMINATION" to continue to play the victim card.OrthoJoe,
Could you comment on the DO discrimination in matching or in the workplace environment? Is there any?
I have heard stories of DOs having to pay alot of money for audition rotations at certain DO schools while MD students dont. Have you witnessed this?
Id you had to pick a DO school again, would you pick AZCOM? I bet the weather is nice
what were your stats when you applied to medical school?
How many schools did you apply to?
What was your previous work experience/ healthcare exposure prior to going to school?
Thanks again for doing this.
Being really supportive with the other students makes a big difference. I would often tell another student that I would cover his patients the last few hours of the day since I was on long call. Or I would pick up a shift or so to help another student meet an obligation (family party, date, kids activity, etc). So I made tons of friends with my MD colleagues. I rotated with one a few times and it was a blast working together.
There is definitely animosity between the MD and DO worlds at certain programs though, particularly some of prestigious universities/hospitals and competitive fields. I wasnt shy about asking though. I asked two program directors during my interviews if their was a bias towads osteopathic, making note that they had either never had a DO or only one DO had been through the program. I asked nicely, and we had a good chat about it. They told me I was definitely at a disadvantage being a DO because the reality is that competitive MD programs have plenty of applications so why would they dip out of their own profession.
Yes there are hospital programs that require DOs to pay for a rotation. I ran into this many times but its not from DO based programs, more from MD programs. For example the University of Utah has a list of 4th year electives that DOs are NOT allowed to rotate through (pediatrics being one of them). I asked why and they said they didnt have enough funding, not sure what that meant. I even offered to send them my USMLE score so that they could determine I was competent. THe lady just laughed at me and said "if it was only that easy." University of Denver i tried to rotate through and it was going to cost me $4,000 for a 4 week rotation -(NO THANKS!).
MCAT 31, GPA 3.7, 2 research publications, BS in microbiology
worked in the medical field after college for 6 years before going to medical school
I had kids so I wanted to apply locally so my wife could have family to help (she is from utah). Applied to the schools surrounding utah, interviewed at UofU and AZCOM,, after leaving AZCOm i cancelled all my other interviews (I had 2 more at kirksville and yakima).
Would I go to AZCOM again - probably, it allowed me to do so many things other schools would have controlled. I had a lot more autonomy which was needed being married with three kids. however if I was single I probably would have gone elsewhere - remember I wanted to do pediatrics.
If I knew I wanted to do ortho, knowing what I know now I definitely would have gone DO. I think DO ortho programs put out a higher proportion of good surgeons compared to our MD counterparts (hang me now and call me a heretic or give me a gold star, depending on whose reading that last statement).
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Orthojoe -
Have you ever done (or seen done) OMM pre-op/post-op to any ortho patient? Do you think there's any set of OMM techniques that might be used by the ortho/general surgeons?
Have you ever done (or seen done) OMM pre-op/post-op to any ortho patient? Do you think there's any set of OMM techniques that might be used by the ortho/general surgeons?
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I have done OMM in an Ortho office but never on a preop/postop patient. And that too was just an something easy for the surgeon to bill hence he asked me to do it while he saw other patients.
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Word
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Orthojoe,
Your a rock star. Thanks for taking the time to do this and thanks for answering each question so completely. I'm starting OMS this fall, and although I don't plan on choosing a career path anytime soon, Ortho is a definite area of interest. It has been great to read about your perspective coming from an osteopathic school and about your journey to where you are now. If I had any Ortho questions coming into this thread, I certainly don't anymore.
You are a testament to hard work and perseverance, I wish you the best of luck with your family and in your career.
Your a rock star. Thanks for taking the time to do this and thanks for answering each question so completely. I'm starting OMS this fall, and although I don't plan on choosing a career path anytime soon, Ortho is a definite area of interest. It has been great to read about your perspective coming from an osteopathic school and about your journey to where you are now. If I had any Ortho questions coming into this thread, I certainly don't anymore.
You are a testament to hard work and perseverance, I wish you the best of luck with your family and in your career.
the idea of OMM and osteopathic principles are huge for me. The bodies ability to heal itself needs more attention and credence. Treating the cause needs more attention as well. Often medicine is symptomatic treatment - oh you have some congestion, here take pseudoephedrine.. I want to think "why does this patient have congestion, is it allergies, could there be a polyp, viral or bacterial infection??
Why do kids have chronic ear infections, due tubes really solve the issue or does the "infection" continue to happen and the tympanostomy just prevents fluid build up and thus reduce symptoms. coudl it be allergies, could it be milk causing excessive mucus productions....
In ortho - why impingement syndrome, is it supraspinatis arthorpathy or posterior joint capsule tightness? I dont just want to give a cortisone shot, write a script for PT and send em packing... there has got to be an identifiable cause and it may be different for each patient.
That is the principle of OMM and osteopathic medicine that needs to be drilled into the students. A.t. Still's driving force for osteopathic medicine was the "why" question. He didnt just want to give mercury for everything (ie antibiotics in this day and age)
So yes, I think there are definitely OMM principles and techniques that make a huge difference. You cant operate and get to the fascia layer of the muscles and not realize that a restriction or myofascial tightness not affect function. could a disturbed fascial layer effect edema, lymphatics - yes. could releasing this tightness or helping distribute the edema help.. yes..maybe we need to do a study on post op limb edema,, are infections more common in limbs where lymphatics arent working as well. could a total knee do much better with some gentle lymphatics treatment... Lets get the funding and see (research is sorely lacking with OMM).
How about trigger points. Geeze just press on one and you'll feel pain radiate all over the place. Could a headache be a cause of this, and could just releasing this trigger point help - YES!
Will I incorporate OMM into orthopedics.. sure going to try because it has its place. Im not going to go overboard and do it on every patient, but for those whose "why" brings out an OMM indication. a simple counter strain treatment on posterior joint capsule could improve range of motion and provide relief. So lets do it in the office- make some extra money as well. Gonna be a extra tool in the belt that I will use.
I am a doctor FIRST,, surgeon second.
BUT.. and its a big BUT.. there is also so much junk that OMM brings as well. Frustrating, the profession wants equality, but has yet to show OMM curriculum equality and efficacy. Heck cranial therapy has got to be the most debunked idea, yet its taught and tested on our boards. MOVE ON AOA. sorry, i dont like cranial. I know a lot of people who do but I think its just too far out there with no data supporting it.
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Your experiences with discrimination against your degree are certainly disheartening. I think you did a better job keeping your cool than most.
And I have to ask...why do you think a DO makes a better orthopod than an MD. Them's fightin' words.
And I have to ask...why do you think a DO makes a better orthopod than an MD. Them's fightin' words.
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You talking about Elder Russell M. Nelson?
Hhaha. Yea- he gave a great talk a few conferences ago about priorities, family and time; using his experience as a physician and it rang true with my wife and I. Since then I've searched a lot of his talks for things similar.
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I knew it! He also spoke at a premed conference at UVU a few years ago that I was able to attend. Good stuff.
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Love Elder Nelson! He came and spoke at a pre-med conference at UVU about 2 yrs ago and it was an awesome experience! Where'd you do your undergrad? Did you find that the Micro major (though 6 years removed) was beneficial in a good amount of classes during school? I'm a Micro major about to graduate from Weber State.
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Ha! You posted this as I was writing the same thing!
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Your experiences with discrimination against your degree are certainly disheartening. I think you did a better job keeping your cool than most.
And I have to ask...why do you think a DO makes a better orthopod than an MD. Them's fightin' words.
Agreed. Makes me really determined to know my stuff.
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