ortho attending AMA

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OrthoTraumaMD said:
Hahahaha.
Yes @Fracture did change it..... but it’s still not great lol!! I’m dying.
The nail is too short. Distally it should be at the physeal scar (where the growth plate was).
@Fracture do you need my help finding a pic? I don’t mean to rag on you but I find this hilarious and I ran out of residents to torture today 😉


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Yes, I'll pm you! Loool. The new pic is from orthobullets btw lol
 
Fracture said:
Yes, I'll pm you! Loool. The new pic is from orthobullets btw lol
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Here is one, a case my partner had. A fun little ankle fracture dislocation where the talus basically looks like it’s in the syndesmosis between the tibia and fibula. Not actually bad to fix (it’s traveling with the distal fibula) but Xray is impressively painful looking, haha.
If you want you can use.

ImageUploadedBySDN1548468762.024366.jpg



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OrthoTraumaMD said:
Here is one, a case my partner had. A fun little ankle fracture dislocation where the talus basically looks like it’s in the syndesmosis between the tibia and fibula. Not actually bad to fix (it’s traveling with the distal fibula) but Xray is impressively painful looking, haha.
If you want you can use.

View attachment 248703


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Haha, thanks!
 
Would you say there is time to exercise in ortho residency? Around 3-4 times/hours per week if you make it a priority? Worried about surgery taking away the one thing I enjoy most which is staying fit.
 
Throwaway92 said:
Would you say there is time to exercise in ortho residency? Around 3-4 times/hours per week if you make it a priority? Worried about surgery taking away the one thing I enjoy most which is staying fit.
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Yes. In residency I knew many people who were professional lifters etc, and continued to work out regularly. Many were runners/joggers and did marathons.

As an aside, in residency you have work hour restrictions so you know you will have at least some free time. As an attending that luxury is gone, but I work out more even now than I did in residency because it helps me with endurance. I do an hour (at least) a day, six days a week.

Whether in residency or beyond, it’s all about the discipline to go even when you are tired. If you enjoy the gym (I don’t), you should have even less of an issue than those of us poor bastards who do it because they have to.


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Do you need to be a republican to be an ortho?
 
Thank you very much @OrthoTraumaMD for this AMA. Definitely one of the best AMAs that I have seen on this site!

I am interested in some of the academic aspects of ortho (MSK, biomechanics, sports medicine, etc) but I don't have much experience being in an OR, shadowing during a case, etc.

As an incoming M1 who is looking to shadow a bunch during M1 and explore the surgery in general as well as the surgical subs, are there any recommendations that you might have for an individual that is at-least superficially interested at the moment but wants to truly see what the field is about in real life and day-to-day? I was thinking of reaching out to ortho attendings and/or residents during M1 to try to shadow over a weekend or something to get a glimpse of the life (cases in the OR, night call, etc). If I end up interested in an competitive speciality like ortho, I'd ideally like to figure that out as soon as possible in order to put together the best residency application in the future.
 
Unlimited Apps said:
Thank you very much @OrthoTraumaMD for this AMA. Definitely one of the best AMAs that I have seen on this site!

I am interested in some of the academic aspects of ortho (MSK, biomechanics, sports medicine, etc) but I don't have much experience being in an OR, shadowing during a case, etc.

As an incoming M1 who is looking to shadow a bunch during M1 and explore the surgery in general as well as the surgical subs, are there any recommendations that you might have for an individual that is at-least superficially interested at the moment but wants to truly see what the field is about in real life and day-to-day? I was thinking of reaching out to ortho attendings and/or residents during M1 to try to shadow over a weekend or something to get a glimpse of the life (cases in the OR, night call, etc). If I end up interested in an competitive speciality like ortho, I'd ideally like to figure that out as soon as possible in order to put together the best residency application in the future.
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Yes. We love our work, and we love to brag about it. Reach out to residents if you have them, or directly to attendings. See if somebody would let you shadow in the OR; weekdays are higher yield, but weekends are good too. I have some people come and spend time with me when I’m on call.

Also reached 150K views!! Thank you everyone for your interest.

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This is a random question (might even be stupid) but do surgeons/surgical residents utilize caffeine or is that generally frowned upon on OR days? I can't imagine going through late night call in something like trauma without caffeine if you've already been up for a while!

Only reason I ask is cause I have figured out during UG how to use caffeine effectively (caffeine pills) without any of unrelated symptoms that come with coffee/energy drinks and probably will be utilizing them to some extent during med school!
 
Unlimited Apps said:
This is a random question (might even be stupid) but do surgeons/surgical residents utilize caffeine or is that generally frowned upon on OR days? I can't imagine going through late night call in something like trauma without caffeine if you've already been up for a while!

Only reason I ask is cause I have figured out during UG how to use caffeine effectively (caffeine pills) without any of unrelated symptoms that come with coffee/energy drinks and probably will be utilizing them to some extent during med school!
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with extremely few exceptions, everyone in the medical world mainlines coffee.


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In your experience, how important is it to have Step 2 CS results back by the time it is rank deadline? I understand that this is program-dependent but most programs have no information on this for their websites. Do you think not having it in time might affect an applicant's position on many rank lists?
 
TexasMeds said:
In your experience, how important is it to have Step 2 CS results back by the time it is rank deadline? I understand that this is program-dependent but most programs have no information on this for their websites. Do you think not having it in time might affect an applicant's position on many rank lists?
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CS, no.
CK, could be... but if your ck score is lower than step 1, it could hurt you.
 
OrthoTraumaMD said:
I would list the abstract, and then in parentheses that it was also an e-poster. Unless you’re presenting the same thing at two different conferences, that to me is double dipping.


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Is presenting the same thing at multiple conferences looked down upon?

What about presenting the same abstract with a slightly different title so it looks like a separate project? bc I've seen pple do that as well.

Is there any real value in local conferences or should I be focused on national/international conferences?
 
Dox4lyfe said:
Is presenting the same thing at multiple conferences looked down upon?

What about presenting the same abstract with a slightly different title so it looks like a separate project? bc I've seen pple do that as well.
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You just summarized 99 percent of academic medicine.
 
Dox4lyfe said:
Is presenting the same thing at multiple conferences looked down upon?

What about presenting the same abstract with a slightly different title so it looks like a separate project? bc I've seen pple do that as well.

Is there any real value in local conferences or should I be focused on national/international conferences?
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So I’m going to revise what I said a little bit. If it is a real project that was accepted at PODIUM at two major conferences (example for me: Aaos and ota), feel free to list them both. That’s a big accomplishment that not even many residents have. Or if one is a national and the other is a dinky local conference, then list the most prestigious of the conferences and in parentheses list the other conference that it was presented at. If it is a podium and a poster, or a podium and just an abstract or something like that… Then only list the podium, and do the rest in parentheses.

I would not change the title to make it look different. We can pick up on that.

As far as national versus local, national are always better, but as a student any conference is good.
 
OrthoTraumaMD said:
So I’m going to revise what I said a little bit. If it is a real project that was accepted at PODIUM at two major conferences (example for me: Aaos and ota), feel free to list them both. That’s a big accomplishment that not even many residents have. Or if one is a national and the other is a dinky local conference, then list the most prestigious of the conferences and in parentheses list the other conference that it was presented at. If it is a podium and a poster, or a podium and just an abstract or something like that… Then only list the podium, and do the rest in parentheses.

I would not change the title to make it look different. We can pick up on that.

As far as national versus local, national are always better, but as a student any conference is good.
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Thank you so much! I was asking bc my classmate is presenting the exact same project at five different local conferences due to his project overlapping between multiple fields. Would you advise someone to do this? Or just to stick to one local conference per project unless they're large national/international conferences?
 
Dox4lyfe said:
Thank you so much! I was asking bc my classmate is presenting the exact same project at five different local conferences due to his project overlapping between multiple fields. Would you advise someone to do this? Or just to stick to one local conference per project unless they're large national/international conferences?
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Depends on amount of overlap. I would need more info but it sounds like if it’s local should just be listed once and the other conferences in parentheses.
 
I know your a trauma surgeon, but do you have any idea about how much hand surgeons work?

The ones at my school seem to pretty much do a 7-5 thing. Sometimes they leave at 3. In my head I’m like oh my gosh, these guys are working like primary care hours (minus call) but they’re still surgeons. Is this common for this sub speciality or are these type of hours the outlier?
 
bad bunny said:
I know your a trauma surgeon, but do you have any idea about how much hand surgeons work?

The ones at my school seem to pretty much do a 7-5 thing. Sometimes they leave at 3. In my head I’m like oh my gosh, these guys are working like primary care hours (minus call) but they’re still surgeons. Is this common for this sub speciality or are these type of hours the outlier?
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I answered this on your other post.
 
Looking at my future M3 year rotation schedule. I have 2 4 week elective rotations and 1 2 week elective available. In the ideal situation in which every elective is available to me what electives would you suggest if I am interested in ortho/would an orthopedic residency like to see? Some options I originally considered were Radiology, and PM&R but depending on scheduling those may not be available to me then so I wanted to know what other elective rotations would be good substitutes.
 
How much would you say research during residency and names/faculty at program factor into fellowship matches? Academic fellowship matches?
 
When asked about the importance of auditions, an ortho PD commented on a rotator, saying:

“He would be looking at football scores while other people worked, and he wasn’t prepared.”

This just made me laugh so hard, lol. Do you have any stories of rotators that just failed to impress, or impressed you with their poor performance?
 
Fracture said:
When asked about the importance of auditions, an ortho PD commented on a rotator, saying:

“He would be looking at football scores while other people worked, and he wasn’t prepared.”

This just made me laugh so hard, lol. Do you have any stories of rotators that just failed to impress, or impressed you with their poor performance?
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Not really. I give most people the benefit of the doubt, and they try hard. There are some that are worse than others, but they don’t stick out in my mind for obvious reasons; I have better things to think about.
 
Fracture said:
When asked about the importance of auditions, an ortho PD commented on a rotator, saying:

“He would be looking at football scores while other people worked, and he wasn’t prepared.”

This just made me laugh so hard, lol. Do you have any stories of rotators that just failed to impress, or impressed you with their poor performance?
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When on call with a resident, if called upon, please show up. We had issues with this a couple of times. One guy literally refused to show up stating that he was studying for the cases the following day and he “ain’t” coming in. Another girl asked why she had to come and if she really needed to come in.

Edit: Also, Abductor Magnus is not the primary hip abductor.
 
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DarkHorizon said:
When on call with a resident, if called upon, please show up. We had issues with this a couple of times. One guy literally refused to show up stating that he was studying for the cases the following day and he “ain’t” coming in. Another girl asked why she had to come and if she really needed to come in.

Edit: Also, Abductor Magnus is not the primary hip abductor.
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Your program sends students home and then expects people to come back in?? Did you just mean you send them to the call room and then call them when you get a consult?
 
Bancrofti said:
Your program sends students home and then expects people to come back in?? Did you just mean you send them to the call room and then call them when you get a consult?
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If the residents take calls from home, then they have to come in if a consult comes in. I would expect the same of the students.
 
Any advice for a woman looking at Orthopaedics/other surgical specialties? I want to start a family at some point as well. Sorry if this was already answered at some point.
 
Melanogaster said:
Any advice for a woman looking at Orthopaedics/other surgical specialties? I want to start a family at some point as well. Sorry if this was already answered at some point.
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Check the first few pages of the AMA, I talk about it at length. It is not advisable to have children in residency, it is too difficult and a burden on you and your colleagues. I would do it in medical school, or after residency.
 
[disclaimer: I know literally nothing, just would like to read your opinion]--
What are your thoughts on the Ilizarov procedure for (non-traumatic) external tibial torsion? Have you performed this procedure?
What are the pros/cons of this procedure vs other methods (if any)- any complications that you see regularly?
How long does the patient typically stay in the tsf and how mobile/active can the patient expect to be while in the frame, in your experience?

Thanks in advance-- this entire thread is awesome
 
omalleyalley said:
[disclaimer: I know literally nothing, just would like to read your opinion]--
What are your thoughts on the Ilizarov procedure for (non-traumatic) external tibial torsion? Have you performed this procedure?
What are the pros/cons of this procedure vs other methods (if any)- any complications that you see regularly?
How long does the patient typically stay in the tsf and how mobile/active can the patient expect to be while in the frame, in your experience?

Thanks in advance-- this entire thread is awesome
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Sounds like medical advice, which I cannot give. Generally pin infection is the major complication. That, and having a giant device on your leg for months. If you want to read more, you can go on pubmed or orthobullets.
 
DarkHorizon said:
When on call with a resident, if called upon, please show up. We had issues with this a couple of times. One guy literally refused to show up stating that he was studying for the cases the following day and he “ain’t” coming in. Another girl asked why she had to come and if she really needed to come in.
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This just seems unprofessional on the part of the students. You're training to be a doctor -- this is someone's life at stake. The resident is being called for a reason. if you're interested in the specialty, then, you'll be interested in all parts of it, both the cushy parts and the inconveniences.

Also, common sense? If a superior tells you to do something, you do it. Ask questions later, and ask it in a way that doesn't make you seem like a petulant child. "Do I really need to come in?", seriously? Yes! That's why the resident is being called!

If I were a resident and had a student on a sub-i, I would immediately write that student off and not give him or her any real responsibility.
 
Hi @OrthoTraumaMD thank you very much for this thread. I am an incoming MS1 and ortho has always been my goal. I definitely see myself doing surgery as opposed to a non-surgical speciality, but I plan to keep an open-mind throughout medical school. I know that I still have a long ways to go and have much to learn and see before I pick a speciality, but...

My question is: how can I as a medical student go about really learning what the different options for an orthopedic surgeon are? It seems like in medical school I will be seeing the academic/research options, but I feel like seeing a trauma ortho attending's life in medical school would give a drastically different impression vs what some private practice surgeons are doing, yet both are options for my future. Do medical students often reach out to private practice surgeons to see the breadth of opportunities? How do I know what to expect when there are so many different options for what a career in ortho could look like?

I have shadowed different surgical and non surgical specialties and I feel like I can never really ask what the lifestyle is like or what the different academic/private practice options are like because people respond with 'if you are thinking of lifestyle you shouldn't be a surgeon' etc. For me, I don't feel like I'm asking from a place of laziness - it is just that I want to be making an informed decision. How can I gather info from attendings about the ways my career could go without these sort of short/not helpful comments?
 
lalalallala said:
Hi @OrthoTraumaMD thank you very much for this thread. I am an incoming MS1 and ortho has always been my goal. I definitely see myself doing surgery as opposed to a non-surgical speciality, but I plan to keep an open-mind throughout medical school. I know that I still have a long ways to go and have much to learn and see before I pick a speciality, but...

My question is: how can I as a medical student go about really learning what the different options for an orthopedic surgeon are? It seems like in medical school I will be seeing the academic/research options, but I feel like seeing a trauma ortho attending's life in medical school would give a drastically different impression vs what some private practice surgeons are doing, yet both are options for my future. Do medical students often reach out to private practice surgeons to see the breadth of opportunities? How do I know what to expect when there are so many different options for what a career in ortho could look like?

I have shadowed different surgical and non surgical specialties and I feel like I can never really ask what the lifestyle is like or what the different academic/private practice options are like because people respond with 'if you are thinking of lifestyle you shouldn't be a surgeon' etc. For me, I don't feel like I'm asking from a place of laziness - it is just that I want to be making an informed decision. How can I gather info from attendings about the ways my career could go without these sort of short/not helpful comments?
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It’s hard to rotate in private practice, because most private guys went there so they wouldn’t have to deal with students and residents. Realistically you won’t know until you get into residency and interact with attendings and hear their stories on a daily basis, and get a chance to ask them your questions during downtime. I have a private group in town who is very malignant and predatory. I also know some private guys who are conscientious and competent. Who you meet along the way will also color your opinions of their work.

The best advice I can give you is don’t be afraid to ask questions about lifestyle or anything else. Just couch it in the way that you did here; make sure it is clear that you are asking in order to learn about the different styles of practice, and not just looking for the easiest way.
 
OrthoTraumaMD said:
If the residents take calls from home, then they have to come in if a consult comes in. I would expect the same of the students.
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VincentAdultman said:
If it’s an away hell yeah. You do what the on call resident does. You want to match there right?
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Idk. I was always around and never left and now expect the same of students. I just feel like I vaguely remember at some point in medical school, whether it was on an ortho rotation or at some point during third year, that it was explicitly stated that once med students were allowed to go home, they shouldn't come back for a call situation. Aside from the liability issue of having a student drive back and forth, I'm also just not a fan of making people jump through unnecessary hoops. The med student should be there to learn and to assist the junior on call. If your center isn't even busy enough to have call be in-house, making them come in once during the middle of the night just to see if they do it seems pointless. Half the time you can do things more efficiently without them anyway, especially when it isn't an extremely busy call night.

Granted, if I were at a program where that was the culture, I'd jump without hesitation when called in. I just think there are more effective ways to assess their work ethic while on a rotation. If med students are on call, they should be given a call room in the hospital so that they don't need to leave.
 
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