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ortho attending AMA

Discussion in 'Medical Students - MD' started by OrthoTraumaMD, Jan 2, 2017.

  1. Hi SDNers,

    I have some free time and so am happy to answer any questions you may have about the myths and realities of orthopaedics, resident life, and general questions. Just avoid the "what are my chances with score X" questions-- so many better posts and options on this site for that. Orthogate is also a good site for their "ask the attending" section.

    A bit about me: orthopaedic trauma attending, female, in my 30s, practicing in an academic setting in the US. Did my med school (allopathic/MD, if that matters), residency and fellowship training in the Northeast (though not all in the same place/state). My practice includes admin/research/education/mentorship responsibilities as well.

    Ask away.
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  3. cbrons

    cbrons Ratatoskr! *Roar* 10+ Year Member

    Jul 29, 2007
    Ur a female in ortho?

    Sent from my SM-N910P using SDN mobile
    Mr. Worldwide likes this.
  4. FindMeOnTheLinks

    FindMeOnTheLinks 2+ Year Member

    Jan 25, 2014
    Thanks for doing this, it is always helpful for med students. I'm an M2 not really interested in surgery at this point, but curious what made you choose orthopedics over other surgical fields? And why surgery vs non-surgery? Thanks.

    Sent from my iPhone using SDN mobile
  5. Yes.
  6. Surgery vs non-surgery really is all about whether you can picture yourself living without ever setting foot in the OR again. If yes, then you should definitely do something else because it's a tough path unless you really love it. I loved surgery because of its immediacy, because of how you YOURSELF could do something to "fix" the problem, not wait for medications etc. And as for why ortho vs other surgical fields-- because I loved ortho trauma and the idea of creating "perfect" xrays when treating fractures, because the patients are (for the most part) healthy, and because the residents had a level of camaraderie that I didn't see in the other surgical subspecialties. I had wanted to do vascular, but my med school mentor talked me out of it with the phrase, "Vascular patients don't get better, they just get shorter." (for those of you, like me, who were initially slow to get that, it means amputations!) Hehe.
    Last edited: Mar 11, 2017
  7. Brorthopedic

    Brorthopedic 2+ Year Member

    Oct 6, 2015
    Doctor's Lounge
    What are the hours like as a trauma orthopod?
  8. I still work 80 hours/week but much of it consists of admin/research/educational efforts. Clinically it's anywhere from 40-50 depending on how much trauma comes in. Trauma is seasonal so summer is worse for the polytraumas, winter worse for fragility fx (wrists, ankles, hips). Changes from week to week. Some days I have lots of free time, other days I work all day. Not predictable, unlike the rest of ortho.
    Last edited: Jan 2, 2017
  9. doggydog

    doggydog Woof.

    Mar 20, 2016
    How much do you bench?
  10. SunsFun

    SunsFun VICE president 5+ Year Member

    Jun 22, 2011
    How's the ortho job market in costal cities like NYC, LA, SF? Are there any openings at all and what kind of a pay-cut are we looking at?

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  11. No idea. Never tried.
    On a serious note, if any women (or smaller men) are reading this, sedation and technique (and in some cases, good assistants in the ER) trump brute force every time. I'm a slightly built woman, weigh 120 lbs, and there has never been a hip i wasn't able to reduce, even in patients three times my size. the bro stereotype doesn't apply to all of us.
  12. tymont12

    tymont12 But it can't be two illnesses! 5+ Year Member

    Jun 28, 2011
    I've recently heard a number of orthopods saying the work can be more rote than people think: two hips before noon, two hips after. Rinse, wash, repeat. What are your thoughts on the variety of ortho?
  13. Depends on your subspecialty and whether you want to do private practice or academics. Without a more specific set of criteria, I can tell you the fastest growing markets are in the midwest and central US. On the coast, expect lots of competition, especially in academics, and as much as 100-200K less pay than if you go somewhere less "desirable." The major cities are saturated and if you practice something very specific (such as myself), those job openings may not be available. However, if you absolutely must live in a major city, be prepared to give up some of your wish list items -- I rejected a job offer that was in a major city but would not offer me opportunity for research, which was important to me.
    AlteredScale and SunsFun like this.
  14. SunsFun

    SunsFun VICE president 5+ Year Member

    Jun 22, 2011
    Thanks for your reply!

    Yeah I've lived in a smaller town for undergrad and Med school (1 mil) and I am tired of endless driving and suburban nightmare along with patients asking me at least monthly whether I am planning on "going back" to where I came from after training. I don't expect all of this to go away but idea of living in a city appeals to me more and more. I know it's gonna be tough regardless of specialty and I will be making some big sacrifices.

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  15. The joint replacement subspecialty is much more "rote" than the other seven ortho subspecialties (some would argue there are more, but the basic ones are: joints, spine, sports, trauma, hand, tumor, peds, and foot+ankle). total hips and knees are, for the most part, indistinguishable. But the variety within your daily life in other subspecialties knows no bounds. You can make your job whatever you want--- if you are bored of joints, take trauma call. You will wish for the "boring" life really fast after that. But some of the issue is that most patients and hospitals want "fellowship-trained" surgeons, so we are pigeon-holed into doing certain things (hence the joke about being a surgeon for "just the left hand"), and it's harder to have variety in your work that way. (>95% of ortho residents go on to subspecialize, some doing more than one fellowship.) That lack of versatility is part of why I went into trauma -- fracture care is not as restricted to body part or procedure, and there are dozens of ways to fix even a simple ankle fracture. I'd kill myself if I had to do only total joints every day-- although I'd probably be home for dinner every night! So everything has its pluses and minuses. I hope that answers your qn adequately.
  16. Docility

    Docility SDN Lifetime Donor Lifetime Donor Classifieds Approved 7+ Year Member

    Dec 13, 2008
    First of all, thank you so much for doing this! :)

    It’s my understanding that the gender disparity in orthopaedic surgery is largely due to self-selection. However, considering that it is such a male-dominated field, do you feel that you have encountered barriers throughout your journey to becoming an orthopaedic surgeon that your male counterparts did not face?
  17. HybridEarth

    HybridEarth 2+ Year Member

    Mar 27, 2015
    Thank you for doing this! I am very interested in innovation/research and coupling it with patient care, and I'd like to become a leader in the field. As such, I would like to know what you think are some brand new or up-and-coming areas in ortho (stem cell therapy, cartilage restoration, etc.) that have relatively unexplored waters that will have plenty of opportunity for people such as myself. Thanks again!
  18. Yes, self-selection is correct. Despite a push from programs to recruit more women, the number of ortho residents who are female has plateau'd somewhat at around 10%. (Currently number of ortho female attendings is 3-7% depending on what you read.) And that's how it should be. Only those willing to do the work and sacrifice what needs to be sacrificed should get in. Gender should not matter, only work ethic should (hence, neither being male nor female should be an advantage when applying, although the reality is that as a woman applicant, you are much more likely to stand out and more likely to be recruited if a program has a goal to diversify--- which in my mind is ridiculous-- the best applicants should be selected regardless of gender). But I digress... About your question on barriers, the answer is no. Ortho is very accepting as long as you pull your own weight, work hard, and don't mind d**k jokes, endless sports discussions (you don't need to participate, though), or being chest-bumped if a case goes well (that did happen to me once as an intern, LOL). If I can define any barriers, they mostly came not from orthopods themselves but from either people around me (family members questioning if it was a fitting job) or my own fears ("am i OK with having kids later in life?"). I also encountered some unsavory characters when I was a medical student (two attendings who hit on me aggressively), but they were older and not orthopods. Thankfully, regressive attitudes are dying out--- my own father said upon hearing my stories, "Don't worry, all those geezers are gonna retire and die soon, and their attitudes will die with them."
  19. CornFed

    CornFed Fool me once...

    Oct 17, 2016
    Everyone is always worried about hrs/wk, yet rarely mention overall lifestyle. Do you feel 80+ hrs/wk still allows you family time, time for hobbies, life outside of medicine, etc? Or is most of your time outside of the hospital still consumed by reading up on cases/preparing for the next day?

    Also, going into ortho, was lifestyle an important factor for you?

    Thank you very much for taking the time to do this!
    sarpdarp likes this.
  20. mvenus929

    mvenus929 Physician 10+ Year Member

    Jul 6, 2006
    The only all female OR I have been in was when I was on ortho as a med student. Two of my classmates are females who went into Ortho. It's not as weird as you make it sound.
    Backtothebasics8 and cbrons like this.
  21. Look up OREF (the Orthopaedic Research and Education Foundation), they have some opportunities for residents, and under "research profiles," you can see what kind of work people are doing that the foundation felt deserved grant money. There is great interest in basic science these days: orthobiologics, etc. Within trauma, it's mostly new techniques and implants that make cases easier, as well as fracture healing adjuncts (grafts, BMP), and the research that deals with prevention and treatment of osteoporotic and geriatric fractures.
  22. username456789

    username456789 7+ Year Member

    May 24, 2009
    Well it's not "weird", but only about 1/10 orthopods are women, possibly fewer in academics. So I can understand the surprise.
  23. I am extremely type A, and work is very fun for me, so my perspective on it is a little different. I enjoy reading ortho journals even in my free time, and our field is growing so fast that as a researcher and educator I won't be able to keep up if I don't. Also, patients need me to know the latest clinical data so I can give them actual percentages etc when discussing different surgical options (you have a X% chance of failure with this procedure, etc). I would say that outside of work, about half my time is ortho-related and half is devoted to "life" - sleep, hobbies, family etc. I will say that you can't have TONS of hobbies as a surgeon, so you have to choose those you care about the most: gym, art, whatever. I write fiction, it gives me pleasure and although i don't have hours and hours every day for it anymore like i did in college, I still devote some time each weekend to write. The key to living life successfully as a surgeon AND not being overwhelmed by work is planning. I plan everything: grocery shopping, date nights. It can feel a bit ridiculous, and the downside is that few things in my life are spontaneous-- but at least I feel like I have time for a little bit of everything, because otherwise work grows like a weed and consumes everything else. It happened to me as a resident, and I make an effort on a daily basis to ensure that I remain "human."
    As for whether lifestyle was an important factor--- no. If it were, I wouldn't have chosen a surgical field and would have done pretend surgery (also known as derm). ;)
  24. Docility

    Docility SDN Lifetime Donor Lifetime Donor Classifieds Approved 7+ Year Member

    Dec 13, 2008
    That’s great to hear! Thank you so much for sharing your experience and taking the time to do this. :thumbup:
    OrthoTraumaMD likes this.
  25. SunsFun

    SunsFun VICE president 5+ Year Member

    Jun 22, 2011
    What's with the tongue-in-cheek derm hate? I noticed several surgeons on SDN have a propensity to "sarcastically" look down on dermatology, especially Mohs surgery.

    I can't quite put a finger on it, but it seems all too often that when someone asks "can I have a good lifestyle?" question, there is often some vague reply along the lines of "since you asked, I assume you may not be that committed (aka hard-working) and maybe should explore fields like derm". I am not saying that what you said here, but my impression of this post + other similar replies leads me to feel like there is some degree of snobbism that comes across quite often from docs in surgical specialties. Am I completely off base here and ortho culture is nothing like that?
  26. Nah, I think there is a bit of projection here. I make no assumptions about how hardworking someone is. I've been in this field long enough to know that no surgical specialty is truly a "lifestyle" specialty-- particularly during residency. When someone asks about lifestyle, I imagine someone who wants to work 9-5. Not that there is anything wrong with that, but I don't know any surgeon who does. Maybe some exist out there. So maybe I (and other surgeons) need a better explanation of what someone means when they ask about lifestyle.

    As for why the derm sarcasm, I have a problem with dermatologists calling themselves "surgeons." Being a surgeon carries the implication that you underwent the grueling hours of a surgical residency. Sorry, but if you're barely going beyond dermis, it isn't surgery. But who knows, maybe I have my own biases. When I was a resident, starving and sleep-deprived after 30 hours of call, too dizzy from sleep deprivation to drive home safely, and trying instead to catch a few quiet minutes in the resident library, I was awoken by two giggling, dressed-to-the-nines derm residents, with fully done hair and makeup, loudly complaining about how 730am was too early to come in to work. (I had to be in by 430am, by comparison, and left at 9pm when they left at 3). So seeing these people call themselves "surgeons" when they weren't in the trenches pisses me off.
  27. Do you find any difference between MD and DO orthopedic surgeons? And also chances of program matching between the two?
    porc likes this.
  28. CornFed

    CornFed Fool me once...

    Oct 17, 2016
    I suppose I should've clarified further when I asked. I meant more along the lines of "will I be able to have a solid relationship with my family if I chose to pursue ortho?" I am not looking for a 9-5 career by any means, but am looking to have solid relationships with my future children and wife as well as some other interest outside of medicine.
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  29. I know quite a few ortho surgeons personally who have great lifestyles. I would assume it depends on the practice and also the person individually.
  30. I have only met a few DO surgeons in my life, so I can't speak to their quality. Unfortunately I can't answer the second question either, as I have zero experience with DO programs. The only thing I can say is than ortho in an MD program is one of the top 5 toughest specialties to match into.
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  31. SunsFun

    SunsFun VICE president 5+ Year Member

    Jun 22, 2011
    Very interesting. Thanks for the insight. With regard to lifestyle, that's kind of what I was getting at. There seem to be some sort of "don't ask don't tell" type of thing going on with surgeons. Like as if you're not supposed to be thinking about that and asking questions. When you do ask, you get some variation of "chose something else (derm)" reply from many surgeons. Maybe that's what I meant by my perception of ortho culture...not sure.

    Your sentiment regarding dermatological surgery reminds me of similar arguments made in multiple MD vs NP/PA threads in here with one important difference. You do reflect on the question of whether it's your own biases or if those "in the trenches" do indeed "deserve" the title over others.
  32. Then my answer is yes. If you want to have that relationship with your family, as well as hobbies, then you will. Ortho will not stop you. The one caveat is that you may have to have a few hobbies as opposed to many, and could only go to, let's say, a few of your kids' games instead of all of them. If you choose to spend more time with your family, something will have to be given up at work (say, not publishing as much). Most of us don't notice what we give up, because being an orthopod compensates for it. It is just that good. :)
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  33. Let me put it this way. When someone gets close enough to ask me that question, they're usually a med student doing the ortho rotation. And on an ortho rotation, you should be thinking about ortho, not how much free time you will have after your residency. Many attendings will misunderstand what you are asking, and will assume you are asking because you don't want to work hard. It's just the knee-jerk reaction. Blame it on those who came before you, whose questions about lifestyle were usually accompanied by a less-than-stellar work ethic on the rotation.
  34. Dr. Death

    Dr. Death 2+ Year Member

    Feb 11, 2015
    Who runs the traumas at your hospital? Are there general surgery trained trauma docs or is it predominantly run by ortho traumas?
  35. Initially, if the patient comes through the ER, the ER physician is the responsible party unless the trauma response is called. And then it goes to the trauma team, headed by a general surgery trauma surgeon. If the determination is made that it's an isolated ortho injury without other stuff going on, then it's me.
  36. AlteredScale

    AlteredScale Administrator Moderator 2+ Year Member

    May 10, 2013
    A beautiful cubicle space.
    Did you pursue ortho research early on in medical school? What attracted you to academics?

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  37. Bancrofti

    Bancrofti 7+ Year Member

    Dec 21, 2010
    2 questions:

    1) Where does the stigma against trauma come from and is it something people should still be wary of? I I had been debating peds for a while for the ability to operate all over and general happiness of dealing with kids (tumor as well, but it seems like the job market isn't great) but after doing trauma, I think it bumped up on my list. Just want to make sure my perspective isn't jaded as I haven't had super volume heavy trauma rotations and I was normally out of the OR by 6-7 most days.

    2) What's your take on uniquely female experiences in residency, largely, getting pregnant as a resident? I'm assuming it isn't very common, but is this something you've heard of? I believe PDs can't ask you about your plans for family and kids during residency interviews, but did you get the feeling it was something that was looked down upon for female residents? And as an extension... had a resident tell me once, the higher then # of females in a program, the less likely he would have been to go to it. I don't feel that way at all, and actually prefer a diverse atmosphere with respect to sex/race, but what are the general misconceptions you think the "bro" male might have about having female co-residents.
  38. I did research between first and second year of med school, but mostly because I heard you needed to start early to get into ortho. Then I gave it up for a while during my brief but ultimately failed love affair with vascular surgery. I didn't really enjoy research until I became a resident, and my mentor and I did projects together. I used to think research was mostly benchwork and cadaver work, which did not attract me much. But the bulk of ortho trauma projects are clinical, and that was much more fun. Through working with him, and watching him teach and inspire other residents, I also became convinced I needed to be an educator as well as a clinician. I wanted to go to conferences and present my work; being among that crowd fit my personality and made me feel like I belonged and was part of something important-- the advancement of our field. Academic ortho was the best way to get involved with resident and med student education, so for me and my personality it was a no-brainer. Orthopaedics, as all of surgery, still functions under an apprenticeship model, and academics/education is an integral part of that in my mind.
  39. Burla

    Burla 2+ Year Member

    Aug 4, 2013
    1. What aspects of a residency program should I look at when ranking programs to match?
    2. Is Doximity a good resource for ranking programs by reputation?
    3. Are fellowships essentially required now? At this point, I'm most interested in doing general ortho. A PGY5 at my med school wants to do the same but is doing a fellowship in adult recon "just to be more marketable".
    porc likes this.
  40. 1) Trauma is very unpredictable, and after surviving residency, most people want to enjoy the fruits of their labor, have reasonable hours, and have family time. Ortho trauma can be very intense, particularly during the summer and at a Level 1 trauma center. You can work all day and night, and then not be able to go home because attendings don't have work hour restrictions. If you don't plan on practicing in a trauma-heavy Level 1, or a busy Level 2, I suppose your experience can be normal. My days are mostly like you described, out by 6-7. But it is the unpredictability that bothers people. Also trauma patients are not elective--- you don't get to choose (for the most part) whom you operate on. So you can be stuck with the crazies, drug addicts, violent people, noncompliant people, etc.... some people just want "nice" patients. As far as peds, it's a good field but for every patient, you deal with two-- the kid and the parent, and the latter is much worse. Tumor is so depressing I thought I would kill myself during my rotation. Sarcomas are horrible and make perfectly healthy young people die. I give props to tumor guys because they are universally [email protected]$$-- no one else does hemipelvectomies, at least not that I've seen.

    2) Will split this answer into parts.
    2A. I would not recommend pregnancy as a resident, although I know some people who did. If you must do it, do it as an intern and never as a PGY2 (that's the hardest year). Just remember that when you are absent, everyone else has to pick up the slack. It will breed resentment, whether you like it or not, even in the nicest of people, if they have to keep covering you because you have to go to a doctor's appt. And then, what if something goes wrong during the pregnancy like preecclampsia when you have to stay in bed for long periods of time? Of course, s**t happens and people deal. Pregnancy is a natural part of human life, and if starting a family during that time is absolutely important to you, then do it--- but once it happens, don't hide it. Give your program time to plan for your eventual absence--- but also be prepared that you may not be able to finish with the rest of your class if you take more than your vacation time off; the ACGME has rules about how many months you have to work to legally be able to graduate.

    2B. You are correct in saying that PDs cannot ask you about family plans during interviews, but I've done plenty of interviews and let me tell you, they have ways of figuring it out using more subtle questioning. And I've been asked directly in the past, when I've interviewed. Most people don't have a problem with answering because they don't care. One good way of scoping out if a program is family friendly is asking how many of the residents have families, and how many of them started families during residency.

    2C. As for the resident who said he'd be uncomfortable with too many women in the program, I can sort of understand. It has little to do with him being a "bro" and everything to do with reality and what people talk about. Ortho is very small, and when I was a resident, all of us knew the "horror stories" from other programs, of female residents who caused trouble--everything from sexual harassment lawsuits to gross incompetence. And these were not tall tales -- I myself have personal experience of such a resident who, when faced with expulsion, started telling everyone that people were out to get her because she was a woman. Women are generally more emotional -- many of the ones I worked with had interpersonal issues that were simply not present in the men--- crying when criticized, difficulty working because their boyfriend broke up with them, etc. (Interestingly enough, though, it's the guys that gossip more.) But there is another side to it: because women are such a small percentage of our field, any "bad egg" among them seems so much worse, and any story about them becomes that much more memorable. If 1/20 guys is bad, it's like "meh." But if only 2 women in the program and one sucks, you're much more likely to assume all female residents suck. It's sad, and it is why I always caution my female students that their failures may be judged more harshly. It's not anyone's fault--- it will always happen when you're such a small minority. Which is also why I remind them what my mentor taught me: "there's no crying in orthopaedics." For anyone. (And yes, I've seen male residents do their version of crying-- throwing rage tantrums, punching things etc. Just as bad.)
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  41. 1) Resident camaraderie, how much and how early you start operating, amount of faculty members and residents present at the interview day (if you don't see any residents, RUN!), and of course things that are important to you, like location. Remember, any ortho residency in the US can train you to be a good orthopod. The match works both ways, the program has to match you as much as you match the program. Do you see yourself going out for a beer with these people after work? That's the ultimate question I ask myself when I do interviews, and it's a question you should be asking yourself when you leave interview day. Ortho residency is 5 years, and these people will become your family, like it or not. I can teach a monkey how to operate. Ortho isn't that hard. Figuring out if this person is a reasonable, honest, normal human who won't push off work on co-residents, who won't lie to me about patient care, and who won't commit mass murder -- now that's what I really want to know when I interview people.

    2) I've never used Doximity. Looking at the list now, certainly these programs are impressive, but so are others that are not on the list. It goes back to my first answer. I would never rank a program by reputation. Interview and see what your gut feeling is. I interviewed at an extremely prestigious program, and found them so snobbish and arrogant that I ranked them on the bottom of the list--- below my general surgery backups.

    3) You can do general ortho if you want, but if you want to do academics, a fellowship is essentially required. One of my other posts has more info on this but essentially patients and hospitals want fellowship-trained surgeons, so >95% of us do fellowships. Still, I know people who didn't do a fellowship, and they were mostly the types that went back to their small hometown to practice and be the jack-of-all-trades out there.
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  42. MarshallW

    MarshallW 5+ Year Member

    Apr 8, 2011
    Any experiences with older non-traditional students? Do you feel like ortho has an age bias because of the physical nature of the work? Would starting an ortho residency at 35 be crazy?
  43. SilverLining1853


    Jan 2, 2017
    Thank you for doing this! I'm a female applying to ortho next year so this is awesome.

    I had my daughter several years prior to starting medical school. Do you think the fact that I already have a child/family is going to be held against me even though my husband and I have absolutely no intention of having another child during residency? Honestly, I would rather be asked directly than have anyone assume that I would even consider having a child during a demanding surgical residency. Is there anything I can say to make this clear without seeming...well, a little crazy? LOL Thanks in advance!
    OrthoTraumaMD likes this.
  44. premed1234567891011


    Apr 3, 2016
    Do you feel you're fairly compensated?
  45. The oldest resident I've personally dealt with was in his late 30s. So no, it's not crazy. You'd be 40 when you graduate, and maybe 41 or 42 if you do a fellowship. Just be prepared for questions on interviews about gaps in your timing or, if you switched, why you switched, etc etc. There is no "age bias" to my knowledge -- a man can maintain strength and stamina well into his 50s and 60s if he works out. The guys I know in trauma who I count as friends and mentors are all in their late 40s/early 50s, and some even older. They could outrun/out-lift any resident. My 65 yo fellowship director used to run 8 flights of stairs without breaking a sweat and the rest of us looked like dying animals in the sahara desert trying to keep up with him...
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  46. Having a child actually makes you a safer bet for a program, because unlike a young single woman, your biological clock isn't pressuring you as much, in their eyes. As for your other question, unless you are asked, I wouldn't mention it. If they are willing to discriminate against you based on what they think you MIGHT do, it's not a program worth your time anyway. All programs consider women of childbearing age to be a "risk," but it doesn't deter most of them from hiring women. Plus, anyone can say "oh, I promise I'm not gonna have a kid" and then end up pregnant anyway, by either intent/change of heart or accident. Then you look like a liar at worst or an irresponsible person at best. So just don't worry about it. Worry about making a good impression on the interview trail and working hard at away rotations. This is one thing you can't control. But I understand your concern... so one thing I would say is don't "overdress" for interview day. Don't cake on makeup or bright jewelry, wear heels that are sky-high, or do your hair too elaborately. In other words, to put it bluntly, don't look too high-maintenance or "wifey." Most orthopods (male and female) associate that stuff with femininity and may subconsciously dismiss you as potentially being focused more on yourself/family/outside things than work. That is not to say that you should look sloppy or not wear makeup. Just keep it simple and clean, a la Olivia Benson in Law and Order: SVU.
  47. Yes. Would I like more money? Yes of course, and I could probably argue for more as I become a bit more established academically-- but for right now, I'm getting exactly what I deserve (and to be honest, probably more than I deserve, haha).
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  48. FutureDoc1088

    FutureDoc1088 2+ Year Member

    Jun 12, 2015
    Regarding making rank lists - you say to go with your "gut" feeling about a program, etc. and to not worry about reputation. Do you think reputation plays a bigger role if you want to go into academics as an attending? Does your fellowship reputation matter more for getting an academic job?

    Thank you for your time!
  49. If your residency has something very specific with big names in the subspecialty you wish to enter (ex. MGH and tumor), then sure, reputation matters. But most people I know got their jobs in academia due to their fellowship connections. All fellowships want their graduates to find jobs, and they will actively work to make it happen because if they don't, they look bad to future applicants. Residencies don't put as much stock in it, in my experience.
    AlteredScale likes this.
  50. Levrone

    Levrone 2+ Year Member

    Oct 13, 2014
    I am very interested in ortho

    Can ortho be a field where you can make meaningful relationships with patients and spend a decent amount of time with them during appointments? i guess since you're trauma, it'd be pretty different from the other sub specialties. (i was thinking possibly sports med for myself but open to everything)
    tankster1 likes this.
  51. Yes. Tumor most of all, and then peds, but any subspecialty can. The appointment time is more iffy, and varies highly by subspecialty and also by how busy you are. Joints guys hustle patients in and out too. But spending a lot of time with patients does not equal better or more meaningful relationships. Just because I don't spend a lot of time with them in clinic doesn't mean I don't get to know them. I talk to them during their initial hospitalization, when they're inpatients etc. They need to be able to trust me during what may be the most painful and frightening moment of their lives...sometimes quite expediently. Or entrust their family members to me. Either way, I place a lot of value in making sure the patient understands the procedure and why I'm doing, or not doing, the surgery. That actually requires fairly involved explanations and the rationale behind them. I know their names and their families, and I hug them if they had a really bad fracture and I see them in clinic and their wound that I spent a week treating with a vac has stopped draining, or some aspect of their care that I worried about ended up doing well. (I only hug little old ladies though, because they're cute). Patient relationships are really what you make of them. If you choose to allow that into your life (and not everyone does, or should, because it blurs the lines between the personal and professional, and you end up thinking about them much more than you ever expected or wanted), then you will make time for it, even in a surgical field.
    Gurby and Levrone like this.

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