ortho attending AMA

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Status
Not open for further replies.
DarkHorizon said:
Spine.
Click to expand...

What do you think the reasons for that are? I don't remember if it was OrthoTraumaMD that said it or if it was her and someone else, but I remember that someone said that it's the least "ortho" kind of subspecialty because of the long surgeries. It can be very high stakes because of the tiny margin for error. The pts are also the most difficult to deal with.
 
OrthoTraumaMD said:
The patients in spine are terrible and the surgeries are long, and that’s why I didn’t pick it. But as a resident your job on spine is pretty easy (at least the places I’ve been/worked) Generally when I did it, I didn’t have to stay for the whole time; the fellow did the long cases.


Sent from my iPhone using SDN mobile
Click to expand...

No spine fellows at our program. 12 hour front and back fusion marathons. Between that and spine clinic, it was pretty miserable. The blatant exaggeration of indications for fusions by our spine surgeons didn’t help either.
 
  • Like
Reactions: 1 user
Members don't see this ad :)
DarkHorizon said:
No spine fellows at our program. 12 hour front and back fusion marathons. Between that and spine clinic, it was pretty miserable. The blatant exaggeration of indications for fusions by our spine surgeons didn’t help either.
Click to expand...

That's another issue I've heard about. Spine at times seems to have some murky indications, like it may or may not help, but we're gonna do it anyway.
 
  • Like
Reactions: 1 user
DarkHorizon said:
No spine fellows at our program. 12 hour front and back fusion marathons. Between that and spine clinic, it was pretty miserable. The blatant exaggeration of indications for fusions by our spine surgeons didn’t help either.
Click to expand...

God that sounds miserable. Nothing is worse than turning a spine patient
 
  • Like
Reactions: 1 users
Do programs actually avoid sending out interview invites to those who turned down away rotations? Is it worth taking the risk applying to many places per block vs not getting an away if we're going for something like ortho?
 
Hypothetically, if someone going into ortho wanted to medically manage their patients, would that be possible/practical? Like would they get push back from their seniors? Because I know the culture basically tells you to punt any non-ortho issue to another service. I'm asking because I know this is a concern of some people when it comes to ortho.
 
Fracture said:
Hypothetically, if someone going into ortho wanted to medically manage their patients, would that be possible/practical? Like would they get push back from their seniors? Because I know the culture basically tells you to punt any non-ortho issue to another service. I'm asking because I know this is a concern of some people when it comes to ortho.
Click to expand...

Why would you wanna do this?
 
Fracture said:
Hypothetically, if someone going into ortho wanted to medically manage their patients, would that be possible/practical? Like would they get push back from their seniors? Because I know the culture basically tells you to punt any non-ortho issue to another service. I'm asking because I know this is a concern of some people when it comes to ortho.
Click to expand...
Depends on the type of management. Basic things yes sure you can do, but liability wise it’s not a great idea. If it’s something like giving meds for constipation or whatever, sure go ahead. But I wouldn’t play around with BP or diabetes stuff, or more serious things. Medicine co-manages your patients, so depending on the hospital you’re in, that means either they’re called for any medical issue and the patient is still on ortho, or they are on the medical service.
 
  • Like
Reactions: 1 user
DarkHorizon said:
Why would you wanna do this?
Click to expand...

Because they want to be "well rounded" as a physician. They want to be able to manage stuff that they believe that every physician should be able to manage. Personally, that's not a concern of mine; I just want to deal with ortho stuff, but I know it's a concern for some people.
 
OrthoTraumaMD said:
Depends on the type of management. Basic things yes sure you can do, but liability wise it’s not a great idea. If it’s something like giving meds for constipation or whatever, sure go ahead. But I wouldn’t play around with BP or diabetes stuff, or more serious things. Medicine co-manages your patients, so depending on the hospital you’re in, that means either they’re called for any medical issue and the patient is still on ortho, or they are on the medical service.
Click to expand...

Yeah, this makes sense. So when you call medicine, would they come and do the management themselves, or would you be able to ask them questions and do it yourself? I'm only asking for details because someone I know going into ortho strongly feels that they should be able to manage them medically.
 
Fracture said:
Yeah, this makes sense. So when you call medicine, would they come and do the management themselves, or would you be able to ask them questions and do it yourself? I'm only asking for details because someone I know going into ortho strongly feels that they should be able to manage them medically.
Click to expand...

Either way. Usually medicine deals with it themselves. The person you’re describing will be so busy they won’t want to manage things for long.


Sent from my iPhone using SDN mobile
 
  • Like
Reactions: 1 user
Members don't see this ad :)
Fracture said:
Because they want to be "well rounded" as a physician. They want to be able to manage stuff that they believe that every physician should be able to manage. Personally, that's not a concern of mine; I just want to deal with ortho stuff, but I know it's a concern for some people.
Click to expand...

The reason I did ortho is so I don’t have to deal with all that stuff. No thanks. Medicine on call.
 
  • Like
Reactions: 1 users
Do you think there's racial bias (not sure if this is the right term) involved in programs ranking students and vice versa? I was looking at the residents at some of the programs Im interested in and some of them are <90% white or <70% south Asian. Not sure if it's just the four programs I looked at or if it's like this at most academic programs.
 
Dox4lyfe said:
Do you think there's racial bias (not sure if this is the right term) involved in programs ranking students and vice versa? I was looking at the residents at some of the programs Im interested in and some of them are <90% white or <70% south Asian. Not sure if it's just the four programs I looked at or if it's like this at most academic programs.
Click to expand...

No.


Sent from my iPhone using SDN mobile
 
  • Like
Reactions: 1 user
Dox4lyfe said:
Do you think there's racial bias (not sure if this is the right term) involved in programs ranking students and vice versa? I was looking at the residents at some of the programs Im interested in and some of them are <90% white or <70% south Asian. Not sure if it's just the four programs I looked at or if it's like this at most academic programs.
Click to expand...

Not outright racial bias but some programs are still good ole boy system. It’s Changed quite a bit, even in last 5 years.
 
  • Like
Reactions: 1 user
Dox4lyfe said:
Do you think there's racial bias (not sure if this is the right term) involved in programs ranking students and vice versa? I was looking at the residents at some of the programs Im interested in and some of them are <90% white or <70% south Asian. Not sure if it's just the four programs I looked at or if it's like this at most academic programs.
Click to expand...

The qualifications that program directors use is very obvious


bicep radius^3 x (yaw of thighs) + (step score/age) x hotness from 1-10 (+2 if female)

All in freedom units of course
 
Psai said:
The qualifications that program directors use is very obvious


bicep radius^3 x (yaw of thighs) + (step score/age) x hotness from 1-10 (+2 if female)

All in freedom units of course
Click to expand...
Lmfao gotta start throwing in more arm days now
 
Input appreciated: trying to figure out what book to get this year through the Synthes book program. Trying to balance best for an intern vs best throughout residency vs something to have on the shelf as an attending.

Primary options in alphabetical order:

AAOS Comprehensive Review, 3 vol set
Campells Operative Orthopaedics vol 1&2
Operative Techniques in Orthopaedic Surgery vol 1&2
Rockwood & Green Fractures in Adults vol 1
Skeletal Trauma vol 1

They obviously have other options as well, but these seem like the big hitters. Hoppenfeld is there too, but there's a copy in the resident room and on ebook, so seems unnecessary.
 
Chillbo Baggins said:
Input appreciated: trying to figure out what book to get this year through the Synthes book program. Trying to balance best for an intern vs best throughout residency vs something to have on the shelf as an attending.

Primary options in alphabetical order:

AAOS Comprehensive Review, 3 vol set
Campells Operative Orthopaedics vol 1&2
Operative Techniques in Orthopaedic Surgery vol 1&2
Rockwood & Green Fractures in Adults vol 1
Skeletal Trauma vol 1

They obviously have other options as well, but these seem like the big hitters. Hoppenfeld is there too, but there's a copy in the resident room and on ebook, so seems unnecessary.
Click to expand...

Rockwood or operative techniques.
But I thought the synthes program ended and you couldn’t do that anymore.


Sent from my iPhone using SDN mobile
 
OrthoTraumaMD said:
Rockwood or operative techniques.
But I thought the synthes program ended and you couldn’t do that anymore.


Sent from my iPhone using SDN mobile
Click to expand...
Apparently the difference is now that it's capped. I believe previously if you just continued doing their modules, you could get unlimited credits and buy as many books as you wanted. Now, the credits are capped at like 450/year or something like that, with a book like Rockwood's costing you roughly 300 or so credits. So opposed to back in the day when you could get everything, now we can only get complete volumes of 1-2 of the major books. It sucks, ain't nobody got money for textbooks.

It's weird though, I remember covering some paper about the sunshine act back as a Sub-I and it made me think all this kind of stuff was done also... but I've also been on a few rep dinners already so I'm not really sure what is and isn't allowed to happen.
 
Bancrofti said:
Apparently the difference is now that it's capped. I believe previously if you just continued doing their modules, you could get unlimited credits and buy as many books as you wanted. Now, the credits are capped at like 450/year or something like that, with a book like Rockwood's costing you roughly 300 or so credits. So opposed to back in the day when you could get everything, now we can only get complete volumes of 1-2 of the major books. It sucks, ain't nobody got money for textbooks.

It's weird though, I remember covering some paper about the sunshine act back as a Sub-I and it made me think all this kind of stuff was done also... but I've also been on a few rep dinners already so I'm not really sure what is and isn't allowed to happen.
Click to expand...

Haha. Yes, rep dinners fly under the radar. Thank God. I would have been hungry otherwise ;)


Sent from my iPhone using SDN mobile
 
Thank you for such a wonderful thread. Your thought out advice and hilarious comments have made it so enjoyable to read through it!

I did not see anyone ask about global health opportunities for orthopods. Are there any? Is there an ortho equivalent to the optho/plastics teams going abroad for a week or two and doing cataracts and cleft lips? Do you have any colleagues who have volunteered abroad?
 
Boz_med said:
Thank you for such a wonderful thread. Your thought out advice and hilarious comments have made it so enjoyable to read through it!

I did not see anyone ask about global health opportunities for orthopods. Are there any? Is there an ortho equivalent to the optho/plastics teams going abroad for a week or two and doing cataracts and cleft lips? Do you have any colleagues who have volunteered abroad?
Click to expand...

You’re welcome.
I have known some people who went abroad for volunteering, yes. The opportunities are not many, but they are there.


Sent from my iPhone using SDN mobile
 
  • Like
Reactions: 1 user
Hi, what advice would you give to someone looking to get into Spine surgery? I'd like to probably focus more on deformities but spinal tumors/pathology etc could also be interesting so i'm not really sure yet but would you recommend I find Ortho research or Neurosurg research? Or both even? (Currently have 1 publication on the spinal dura mater)

Lets pretend I was going to try follow this path in the US, which residency would you recommend I pursue Ortho or Neuro? I read an article how Neurosurg has a lot of spine cases during residency (~60% of cases) unsure of the validity of that article though and I read that in an Ortho residency there's very limited spine work which leads many to complete a Spine fellowship if they wish to pursue that area.

Could you just shed some light on this :)

Thanks, I'll ask a Neuro attending/resident as well
 
Last edited:
IMG69 said:
Hi, what advice would you give to someone looking to get into Spine surgery? I'd like to probably focus more on deformities but spinal tumors/pathology etc could also be interesting so i'm not really sure yet but would you recommend I find Ortho research or Neurosurg research? Or both even? (Currently have 1 publication on the spinal dura mater)

Lets pretend I was going to try follow this path in the US, which residency would you recommend I pursue Ortho or Neuro? I read an article how Neurosurg has a lot of spine cases during residency (~60% of cases) unsure of the validity of that article though and I read that in an Ortho residency there's very limited spine work which leads many to complete a Spine fellowship if they wish to pursue that area.

Could you just shed some light on this :)

Thanks, I'll ask a Neuro attending/resident as well
Click to expand...

You need a spine fellowship if you do spine through ortho. Most hospitals will not grant OR privileges unless you do due to the risk. As for ortho vs neuro, both can do spine depending on where they practice. The real question is 1) if you would be able to go through the other parts of the residency, whether it’s ortho or neuro; spine is a small part of overall ortho, so if you have no other interest in the musculoskeletal system, I suggest you don’t do ortho....and 2) why you would ever want to deal with spine patients. yikes. Oh and also 3) as an img, it is extremely difficult if not impossible to get either of those residencies, as they are competitive.


Sent from my iPhone using SDN mobile
 
  • Like
Reactions: 2 users
OrthoTraumaMD said:
You need a spine fellowship if you do spine through ortho. Most hospitals will not grant OR privileges unless you do due to the risk. As for ortho vs neuro, both can do spine depending on where they practice. The real question is 1) if you would be able to go through the other parts of the residency, whether it’s ortho or neuro; spine is a small part of overall ortho, so if you have no other interest in the musculoskeletal system, I suggest you don’t do ortho....and 2) why you would ever want to deal with spine patients. yikes. Oh and also 3) as an img, it is extremely difficult if not impossible to get either of those residencies, as they are competitive.


Sent from my iPhone using SDN mobile
Click to expand...

Thanks for the quick reply!

Oh I love Ortho and the musculoskeletal system I would much rather go through that than Neuro (not totally appealing). So sounds like going via Ortho then fellowship would be the best route for me, which is what I hoped. Well I had to give up high level sport due to a back injury when I was younger which really sparked my interest along with various other reasons plus I wouldn't mind going into academics where I think there would be some very interesting cases from MVA's etc. rather than doing diskectomies or small fusions all the time.

I'll be pursuing this in my own country unless I fluke a freak step 1 score, just wanted to get some insight into how to approach the field and what the best angle to get into it is :)

It seems like it would just be best to build an application for Ortho (research-wise; knees, hips etc) since i'll have to go through Ortho regardless of which country and try accumulate 3-4 specific spine pubs along the way?

Thanks a lot :)
 
IMG69 said:
Thanks for the quick reply!

Oh I love Ortho and the musculoskeletal system I would much rather go through that than Neuro (not totally appealing). So sounds like going via Ortho then fellowship would be the best route for me, which is what I hoped. Well I had to give up high level sport due to a back injury when I was younger which really sparked my interest along with various other reasons plus I wouldn't mind going into academics where I think there would be some very interesting cases from MVA's etc. rather than doing diskectomies or small fusions all the time.

I'll be pursuing this in my own country unless I fluke a freak step 1 score, just wanted to get some insight into how to approach the field and what the best angle to get into it is :)

It seems like it would just be best to build an application for Ortho (research-wise; knees, hips etc) since i'll have to go through Ortho regardless of which country and try accumulate 3-4 specific spine pubs along the way?

Thanks a lot :)
Click to expand...

Most spine surgeons I know hate spine trauma and don’t want to do it. Just FYI.


Sent from my iPhone using SDN mobile
 
  • Like
Reactions: 1 user
Are orthopedic surgeons appreciated and admired by their patients just like a Cardiologist or Neurosurgeon would be? Or is there something about "saving someone's life" that isn't replicated in ortho?

I know that sounds a bit immature but here me out.

I've shadowed many physicians including Cardiologists, neurosurgeons, etc. and seen not only the impact they make on their patients and their families but the huge appreciation and admiration they get from it. One of my main reasons of going into medicine is that I love the impact you can make in someone's life and the recognition you get for it. Orthopedic surgeons restore function and mobility to patients which saves their livelihood and subsequent life. However, the issues are clearly not as acute as some other docs manage, even if it may be as important in the long run.

I just wonder if you see a difference in how much patients appreciate you in ortho vs. other surgical or procedural specialties? Do you ever feel like patients don't appreciate you as much because "its just a bone problem that I wouldn't have died from?" Maybe I'm completely off base and it is the opposite where patients actually appreciate orthopedic surgeons more because they feel the physical effect of the procedure more than.. say an angioplasty
 
LebronManning said:
Are orthopedic surgeons appreciated and admired by their patients just like a Cardiologist or Neurosurgeon would be? Or is there something about "saving someone's life" that isn't replicated in ortho?

I know that sounds a bit immature but here me out.

I've shadowed many physicians including Cardiologists, neurosurgeons, etc. and seen not only the impact they make on their patients and their families but the huge appreciation and admiration they get from it. One of my main reasons of going into medicine is that I love the impact you can make in someone's life and the recognition you get for it. Orthopedic surgeons restore function and mobility to patients which saves their livelihood and subsequent life. However, the issues are clearly not as acute as some other docs manage, even if it may be as important in the long run.

I just wonder if you see a difference in how much patients appreciate you in ortho vs. other surgical or procedural specialties? Do you ever feel like patients don't appreciate you as much because "its just a bone problem that I wouldn't have died from?" Maybe I'm completely off base and it is the opposite where patients actually appreciate orthopedic surgeons more because they feel the physical effect of the procedure more than.. say an angioplasty
Click to expand...

There is an immediacy to my work in trauma that is almost impossible not to generate recognition or admiration. A bad car accident with an open fracture, an older person with a hip fracture—-one surgery and I make them walk again. In bad pelvic fractures, I can save a life but yes it isn’t as common. In joint replacement, you give someone their life back. A person who could barely get around can play tennis with their knee replacement. People, as you said, feel the aftereffects of our work much more than “medical” aftereffects.
Even if no one ever said thank you to me again, I’d still do the job. I think the most important thing is to be good at what you do, to love it, and the recognition will come. After all, if you’re a bad cardiologist or neurosurgeon, patients won’t like you regardless of how many lives you save.


Sent from my iPhone using SDN mobile
 
  • Like
Reactions: 1 users
OrthoTraumaMD said:
There is an immediacy to my work in trauma that is almost impossible not to generate recognition or admiration. A bad car accident with an open fracture, an older person with a hip fracture—-one surgery and I make them walk again. In bad pelvic fractures, I can save a life but yes it isn’t as common. In joint replacement, you give someone their life back. A person who could barely get around can play tennis with their knee replacement. People, as you said, feel the aftereffects of our work much more than “medical” aftereffects.
Even if no one ever said thank you to me again, I’d still do the job. I think the most important thing is to be good at what you do, to love it, and the recognition will come. After all, if you’re a bad cardiologist or neurosurgeon, patients won’t like you regardless of how many lives you save.


Sent from my iPhone using SDN mobile
Click to expand...

So true! Thank you for the perspective.
 
LebronManning said:
Are orthopedic surgeons appreciated and admired by their patients just like a Cardiologist or Neurosurgeon would be? Or is there something about "saving someone's life" that isn't replicated in ortho?

I know that sounds a bit immature but here me out.

I've shadowed many physicians including Cardiologists, neurosurgeons, etc. and seen not only the impact they make on their patients and their families but the huge appreciation and admiration they get from it. One of my main reasons of going into medicine is that I love the impact you can make in someone's life and the recognition you get for it. Orthopedic surgeons restore function and mobility to patients which saves their livelihood and subsequent life. However, the issues are clearly not as acute as some other docs manage, even if it may be as important in the long run.

I just wonder if you see a difference in how much patients appreciate you in ortho vs. other surgical or procedural specialties? Do you ever feel like patients don't appreciate you as much because "its just a bone problem that I wouldn't have died from?" Maybe I'm completely off base and it is the opposite where patients actually appreciate orthopedic surgeons more because they feel the physical effect of the procedure more than.. say an angioplasty
Click to expand...

As mentioned, the effects of orthopaedics intervention can be easily seen by the patient so compliance and motivation to get better can be high, whereas things like nephro or cardiology it’s sometimes more challenging. Interestingly, the two other specialties that I would say compare to ortho in terms of patient satisfaction/gratefulness and the easily visible effects of physician intervention are plastic surgery and dermatology. Maybe not so surprisingly, all 3 are very competitive.
 
  • Like
Reactions: 2 users
LoGo said:
As mentioned, the effects of orthopaedics intervention can be easily seen by the patient so compliance and motivation to get better can be high, whereas things like nephro or cardiology it’s sometimes more challenging. Interestingly, the two other specialties that I would say compare to ortho in terms of patient satisfaction/gratefulness and the easily visible effects of physician intervention are plastic surgery and dermatology. Maybe not so surprisingly, all 3 are very competitive.
Click to expand...

While I agree with you to some extent, I think the competitiveness of those three specialties stems from the fact that each can make a lot of money. Plastics does it through cash only business and cosmetics, ortho does it through the sheer amount of implants we use and the amount of money we make for the hospital, and dermatology does it through their office procedures and the ability to see many more patients a day than the average physician.


Sent from my iPhone using SDN mobile
 
@OrthoTraumaMD how much research is being done on new bone graft materials, antimicrobial implants, cartilage regrowth, etc... by actual orthopedic surgeons? I know those are hot areas for research but is it generally feasible (possible, sure) for a practicing ortho surgeon to also be heavily involved in the basic science/innovation side of orthopedics?
Is it realistic to want to do that type of research while also being a full time surgeon and having a family life? how hard would this be?

Thanks!
 
bonemann said:
@OrthoTraumaMD how much research is being done on new bone graft materials, antimicrobial implants, cartilage regrowth, etc... by actual orthopedic surgeons? I know those are hot areas for research but is it generally feasible (possible, sure) for a practicing ortho surgeon to also be heavily involved in the basic science/innovation side of orthopedics?
Is it realistic to want to do that type of research while also being a full time surgeon and having a family life? how hard would this be?

Thanks!
Click to expand...

Some surgeons are involved with that stuff, but most surgeons who run labs themselves are no longer in heavy clinical practice. It is not uncommon in the larger academic centers for a practicing surgeon to have a PhD partner who runs the lab on their behalf. But no, it is not exactly realistic to have all three things.


Sent from my iPhone using SDN mobile
 
  • Like
Reactions: 1 user
Thank you for this extended AMA! I am a DO student actively going for orthopedics. I have decent research and pretty good scores, but I know I'll be fighting an uphill battle for traditionally ACGME programs, so I am doing many aways in osteopathic/initially ACGME accredited programs. That being said, one of the most common pieces of advice I've heard from mentors familiar with the match, and with the relative dearth of AOA programs (esp this year), is that I need a backup specialty.

The problem is my interest in other specialties is relatively WAY less than in ortho. I would really rather not do general surgery other than to eventually do hand, so I am leaning towards radiology -> msk/IR fellowship or IM to cards/GI. The sad thing is, I just can't set my heart on any of these pathways. Some have suggested anesthesia or PM&R but my anesthesia rotation is what brought me closer to ortho and PM&R doesn't interest me as much. Any advice for the ortho-minded applicant in need of a backup?

Thank you and sorry for the long-winded question!
 
Would you say ortho or neurosurgery is harder to match?
 
How many residents come in with a certain sub-specialty in mind? I am curious how people decide on which fellowships to pursue.
 
Allfreeclear14 said:
How many residents come in with a certain sub-specialty in mind? I am curious how people decide on which fellowships to pursue.
Click to expand...

Most people know by the middle of their third year. It really varies, just like medical school. Some people are certain they want to go into a certain subspecialty and stick with that, others change their mind a million times. I would say about 20% know going in.

As for how people decide which fellowships to pursue, it again depends on many factors and really depends on the person. Some people decide by lifestyle, others by the mentors they work with. Others just just dislike every other subspecialty except the one they are going into. And still others go general and don’t do fellowship at all.

Sent from my iPhone using SDN mobile
 
OrthoTraumaMD said:
Most people know by the middle of their third year. It really varies, just like medical school. Some people are certain they want to go into a certain subspecialty and stick with that, others change their mind a million times. I would say about 20% know going in.

As for how people decide which fellowships to pursue, it again depends on many factors and really depends on the person. Some people decide by lifestyle, others by the mentors they work with. Others just just dislike every other subspecialty except the one they are going into. And still others go general and don’t do fellowship at all.

Sent from my iPhone using SDN mobile
Click to expand...

Thank you for your reply. For a better match possibility, would you advise to have a more genenral ortho experience rather than more specific types (spine only per say)? I would see that this could vary on the type of app, ppl you know etc but was curious to hear from an attending in the academia.
 
  • Like
Reactions: 1 user
How is the lifestyle for Ortho after graduation? I shadowed an ortho who saw patients 3 days a week and performed surgery 2 days of the week. How common is this?
 
Status
Not open for further replies.
Next unread thread

Similar threads

BonezBonezBonez
  • Locked
Chances at Orthopedic Surgery?
Replies
6
Views
2K
RJ McReady
RJ McReady
F
Chances for ortho? - failed third block of MS1
Replies
12
Views
2K
voxveritatisetlucis
V
CuriousMDStudent
Orthopedic Surgery vs. Anesthesiology vs. Internal Medicine
Replies
9
Views
2K
operaman
O
Styrene
Psychiatry resident - ask me anything
Replies
24
Views
2K
DOswag
DOswag
P
MD Chances of matching ortho?
Replies
2
Views
1K
RJ McReady
RJ McReady
Top