ortho attending AMA

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Light at end of tunnel said:
I'm not a moderator, so I can't speak to what you all discussed here, but looking through psai's recent posts its mostly sarcastic/fun posts that are typical of psai.

If there is more to it than that, then I respectfully defer to you all. But, if it is these comments alone, then for what it is worth, the action seems harsh.

I dunno man, I just dont think psai deserves all of this. It is just what makes psai, psai. We should learn to appreciate him as we do TG's incessant meme posting, bannie's out of the left field comments, my anti establishmentesque posts, etc.
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OrthoTraumaMD said:
Netflix and chill, mostly without the chill because I'm tired. :) I'm kind of a homebody and not really the stereotypical sports loving orthopod. I read journals for work because I find it fascinating, am online a lot, play videogames, and hang out with friends and family. I love going out to eat too, especially to somewhere I have never been before. I recently moved to a new city so I am always exploring it.

I am very happy with my financial situation. I am salaried instead of RVU based. So the downside of that is I will be unlikely to get a salary increase because my productivity doesn't matter, and I will never make as much as someone in private practice. But the upside is that I still get paid the same while focusing on other things I like (research, teaching) without worrying that my pay will be docked, and I don't have to stretch my surgical indications or operate on unnecessary things to be "more productive." Plus I am known as a leader in my hospital due to those things (teaching etc), and the administrators are happy with the academic value I bring, even if I don't operate as much as my partners. That fits me just fine; and I get paid a lot anyway. A lot. Lol. For someone who grew up trying to stretch 50 bucks to buy Christmas presents for 10 people, the amount I make is almost unfathomable to me. I am still shocked when I go to the ATM, I remember getting my first check and going to HR to make sure it was right because I have worked so hard for so long and finally the payoff has come. But the feeling of not being able to have things has protected me from going crazy buying stuff like many surgeons I know. I am careful with my money; the only thing I splurged on is my sweet car. Otherwise I live thrifty and am saving for a future family. Anyway, if I become unhappy with my salary, I'll do something to change it; but for now, it is perfectly commensurate with my lifestyle. Ortho trauma lifestyle is not what it used to be. We take more call, but rarely come in at night. Next day trauma rooms are a godsend. And everyone loves us because we take all the traumas off their hands while they focus on elective stuff.
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What kind of car?! :D
 
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OrthoTraumaMD said:
I think answering that would compromise my anonymity as there can't be too many chicks driving around in one.
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Where on the spectrum? Like toward an Aston Martin or Maserati Ghibli? Lol, truth be told my knowledge on car is very limited.
 
OrthoTraumaMD said:
I gathered that lol...the ghibli is a small fry compared to an Aston Martin! It's like 4x cheaper.
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Lol, based on your post I'm going to say top notch Tesla with falcon wing doors. *Just throwing a bunch of random things at this point*
 
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OrthoTraumaMD said:
Netflix and chill, mostly without the chill because I'm tired. :) I'm kind of a homebody and not really the stereotypical sports loving orthopod. I read journals for work because I find it fascinating, am online a lot, play videogames, and hang out with friends and family. I love going out to eat too, especially to somewhere I have never been before. I recently moved to a new city so I am always exploring it.

I am very happy with my financial situation. I am salaried instead of RVU based. So the downside of that is I will be unlikely to get a salary increase because my productivity doesn't matter, and I will never make as much as someone in private practice. But the upside is that I still get paid the same while focusing on other things I like (research, teaching) without worrying that my pay will be docked, and I don't have to stretch my surgical indications or operate on unnecessary things to be "more productive." Plus I am known as a leader in my hospital due to those things (teaching etc), and the administrators are happy with the academic value I bring, even if I don't operate as much as my partners. That fits me just fine; and I get paid a lot anyway. A lot. Lol. For someone who grew up trying to stretch 50 bucks to buy Christmas presents for 10 people, the amount I make is almost unfathomable to me. I am still shocked when I go to the ATM, I remember getting my first check and going to HR to make sure it was right because I have worked so hard for so long and finally the payoff has come. But the feeling of not being able to have things has protected me from going crazy buying stuff like many surgeons I know. I am careful with my money; the only thing I splurged on is my sweet car. Otherwise I live thrifty and am saving for a future family. Anyway, if I become unhappy with my salary, I'll do something to change it; but for now, it is perfectly commensurate with my lifestyle. Ortho trauma lifestyle is not what it used to be. We take more call, but rarely come in at night. Next day trauma rooms are a godsend. And everyone loves us because we take all the traumas off their hands while they focus on elective stuff.
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What kind of videogames?


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DoctorCrush said:
I'm gonna bet she's a PS4 Uncharted 4!
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OrthoTraumaMD said:
Different stuff. But I was really into Assassin's Creed for a while.
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I was gonna put my money on NCAA, Fifa, or NHL (becuz ortho, and the fact that theyre games you can pick up and play for 30ish mins and put back down. So not much of a time sink like some games lol). But assassins creed is definitely a respectable answer


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Scrubs101 said:
I was gonna put my money on NCAA, Fifa, or NHL (becuz ortho, and the fact that theyre games you can pick up and play for 30ish mins and put back down. So not much of a time sink like some games lol). But assassins creed is definitely a respectable answer


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You've obviously never played FIFA then.
 
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Not a question but thank you for doing this AMA. I'm always highly appreciative of our practicing members who have so much to contribute like the gems you've given us throughout the last few pages. I'm not interested in orthopedics but much of what you've said can be applicable to medicine culture in general or for those of just starting med school.

Also,
OrthoTraumaMD said:
I think people are too sensitive these days.
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Can I like this twice? Many students appreciate faculty/physician candor.
 
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Scrubs101 said:
I was gonna put my money on NCAA, Fifa, or NHL (becuz ortho, and the fact that theyre games you can pick up and play for 30ish mins and put back down. So not much of a time sink like some games lol). But assassins creed is definitely a respectable answer


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Haha I guess you don't recall that I said multiple times on this thread that I'm not a sports person ;)
I love anything with a storyline and pretty visuals.
 
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LutGholein said:
Not a question but thank you for doing this AMA. I'm always highly appreciative of our practicing members who have so much to contribute like the gems you've given us throughout the last few pages. I'm not interested in orthopedics but much of what you've said can be applicable to medicine culture in general or for those of just starting med school.

Also,

Can I like this twice? Many students appreciate faculty/physician candor.
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Thank you! Happy to help.
 
unless @OrthoTraumaMD wants to reveal what sweet whip she is driving ;), I'm gonna fire away with another question.

I see a lot of orthopods work well into their 60s/70s because they genuinely love what they do. In a perfect world, how do you envision your career progressing? How long do you think you'll practice? What differences will you expect to see in your everyday practice (hours, types of cases, more administrative/teaching, etc)?

Quick question prior to answering the one above to give some context: I saw you mentioned prior that you operate less than some of your colleagues due to other interests such as teaching. What does your current schedule look like (how many days you operate, etc)?
 
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@OrthoTraumaMD

Hypothetical time: If you could be in a place today that allowed you the same income and lifestyle but did not require you to go through the hell of orthopadedic training (and pay the price for it in the ways you described above), do you still think you would do it all over again?

Is it worth it?
 
Hey OP, out of curiosity, how is the dating life of a female ortho? Do you find men to be taken back or intimidated? Are you looking for/already found someone who is also a surgeon?


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Frogger27 said:
unless @OrthoTraumaMD wants to reveal what sweet whip she is driving ;), I'm gonna fire away with another question.

I see a lot of orthopods work well into their 60s/70s because they genuinely love what they do. In a perfect world, how do you envision your career progressing? How long do you think you'll practice? What differences will you expect to see in your everyday practice (hours, types of cases, more administrative/teaching, etc)?

Quick question prior to answering the one above to give some context: I saw you mentioned prior that you operate less than some of your colleagues due to other interests such as teaching. What does your current schedule look like (how many days you operate, etc)?
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You guys are hilarious. If I'd known there was so much interest in my car, I wouldn't have mentioned it.

In a perfect world, I will operate until I drop dead/am no longer able to perform at an acceptable physical/mental level. As I grow older, I will do more admin and teaching, and maybe less complex/long cases, just stick with basic bread and butter ortho trauma.

Right now by "less operating" i mean that unlike most trauma orthopods who operate 4 days a week and have 1 day of clinic, I operate 3 days a week because one day is reserved for my admin/teaching/research duties.
 
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Light at end of tunnel said:
@OrthoTraumaMD

Hypothetical time: If you could be in a place today that allowed you the same income and lifestyle but did not require you to go through the hell of orthopadedic training (and pay the price for it in the ways you described above), do you still think you would do it all over again?

Is it worth it?
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Yes it is worth it.
As for your other question, the hell of orthopedic training is partly what makes it worth it. If it were easy, I don't think that my successes would've been as sweet. To be dramatic for a moment, I feel like a blade that was forged in fire. If I had not gone through that, I would not have the confidence to know that I can handle whatever comes my way at work. Maybe hindsight is 20/20, and if you had asked me that during residency, I would've told you something different, but now that it is over, I think it is a requirement to be able to do surgery.
 
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OrthoTraumaMD said:
When I am not mistaken for a nurse or a tech, you mean? :) My job has been kryptonite when it comes to dating. I used to think it was my crappy personality that turned people off, until one man flat out said that he was not comfortable with a woman who made more than he did. Most men feel confident when they are able to provide something for the woman that she herself cannot. It is just the nature of humanity--men are wired to be the provider, the strength, the support. And that's great, that is how it should be. A man should feel that way. But I don't really need anything from them, and they can see it. I have the money, the car, the house, in addition to being attractive (by western standards) and reasonably intelligent. Additionally, I have zero problem with being alone, and am not one of those women who needs to be in a relationship to feel "complete." I am not douchey or self-centered, and do not rub my successes in a man's face, but being a surgeon comes with a certain set of traits: a directness and a sense of independence that I just have never been able to hide well. Most men do not respond to that positively, despite the perceived attractiveness of having a mate who is financially successful. In short, both alpha and beta men rarely want an alpha female. We are truly the most unfortunate of women; too successful for our own good, too proud to admit we need someone, too inflexible to understand that we cannot always run the show. That is why I have said many times that I should've been born a male, my life would have been much easier. However, I will not deny that I enjoy being a woman, despite the troubles it has brought me during my dating life. And I am fortunate enough that I have found a man (not a doctor) who is not only not intimidated by my successes, but is my biggest cheerleader. He has zero problem with making less than I do, because his value to me is not financial, but personal. Without him, my life would be much less loving, and much less sweet. The way he cares about me cannot be replaced by any amount of accolades or personal successes. Because in the end, nobody wants to be alone long term with a bunch of cats and awards on the walls that will crumble to dust when you die. And he makes me feel like I am not alone in the world. Most of us surgeons don't get along well with other surgeons, we might date or be super attracted to one another, and even sleep together, but I have found that we are too similar to each other and too competitive to live in a symbiotic relationship. On the other hand, my SO is complementary to me, where I am harsh he is kind etc. So no, I would not look for another surgeon even if I got the chance. Not for anything long term anyway. ;)
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Yo can I put in app in 4 years so learn under you or...?

Cool post for sure. Great perspective and wisdom :idea: you just seem so humble and down to earth.
 
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Being in academia, do you feel like you have ample time to see patients in clinic? Like I've noticed that the orthopods I've gone to in private practice rush and don't really have much of a conversation (from the patient perspective, lol). Or maybe it's just their personality because surgeons tend to not like clinic? I don't know.

Also, is it possible to have zero research requirements in academia? I haven't done any research yet, but I'm liking the idea of having a strictly patient care and resident/med student education focused practice. I know it's possible in the "privademic" practices.
 
thefleetfooted said:
Being in academia, do you feel like you have ample time to see patients in clinic? Like I've noticed that the orthopods I've gone to in private practice rush and don't really have much of a conversation (from the patient perspective, lol). Or maybe it's just their personality because surgeons tend to not like clinic? I don't know.

Also, is it possible to have zero research requirements in academia? I haven't done any research yet, but I'm liking the idea of having a strictly patient care and resident/med student education focused practice. I know it's possible in the "privademic" practices.
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Trauma clinic is pretty simple, so a few minutes suffices for me to get things done. My techs and PAs do the rest. Most surgeons do hate clinic. For me, time-wise, it tends to even out; I block out an equal amount of time for each patient, i do the "quick in and out" thing with most people, and then spend the extra time with the ones who are more complex or who need the extra TLC.

You don't need to do research to be in academia, but you won't go very far there without it. You're better off being in private practice and operating somewhere where you occasionally get residents, but don't need to deal with the rest of the academic stuff.
 
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OrthoTraumaMD said:
Trauma clinic is pretty simple, so a few minutes suffices for me to get things done. My techs and PAs do the rest. Most surgeons do hate clinic. For me, time-wise, it tends to even out; I block out an equal amount of time for each patient, i do the "quick in and out" thing with most people, and then spend the extra time with the ones who are more complex or who need the extra TLC.

You don't need to do research to be in academia, but you won't go very far there without it. You're better off being in private practice and operating somewhere where you occasionally get residents, but don't need to deal with the rest of the academic stuff.
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That makes a lot of sense. Thank you.
 
bobjonesbob said:
Are there any other surgical specialties that commonly have this high of an OR to clinic ratio? I feel like most surgeons I've shadowed or talked to had 2 or 3 days of clinic per week.
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No. Only trauma orthopods do this to my knowledge, because of daily trauma rooms and our need to be available 24/7 during the day. The rest of ortho subspecialties generally do two days of clinic. I don't know about general surgery as much, but I have not seen anyone else so far.

Keep in mind, though, that for an orthopedic trauma surgeon, clinic day is not a picnic. It can mean seeing as many as 90 patients. Most of us do somewhere between 45 and 60.
 
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Thoughts on an applicant couples matching if their partner is OBGYN?
 
How much do you love acetabulum fractures? Small sample size but every traumapod I've seen and resident pursuing trauma just creams themselves talking about Judet Letournel stuff and tabs
 
TheFutureFatMan said:
Thoughts on an applicant couples matching if their partner is OBGYN?
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Couples matching is fine if both partners are strong candidates. Otherwise one will have to "carry" the other--i have seen directors call the program of the spouse to ensure they got in, because they really wanted that Ortho candidate. But if one of the partners is very weak, it will hurt the other.
 
masaraksh said:
How much do you love acetabulum fractures? Small sample size but every traumapod I've seen and resident pursuing trauma just creams themselves talking about Judet Letournel stuff and tabs
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I am not actually a big fan. Short of a simple posterior wall, tabs are difficult, and any surgery around the pelvis carries a big risk for infection, nerve and vessel damage, etc. Conceptually they are indeed very interesting, the letournel and judet text is fascinating, the amount of thought and work that went into making the classification and following the patients is astounding...doing these cases is another thing altogether.
You gave a bit of a crude description, but it's hard to "cream yourself" around a tab/pelvis case when you have your first large venous tear and suddenly there is an entire lake of blood that wasn't there two seconds ago and the pressure drops and everyone is freaking out, running around and you're digging trying to control it and trying not to crap your pants in the process. People are very cavalier about this stuff...we have to respect the fact that we can easily kill someone if we are not careful.
 
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Yeah, sorry twas a bit crude. I have seen some pretty scary moments and some absolutely unreal (>3L) EBL in just the approx 10 tabs I've seen, fortunately all the patients did well.

I definitely just noticed the traumapods and 4/5s being pretty into discussing them, so was just curious on your thoughts.

I've actually really liked a few weeks ago when a resident went through them with me and it made me that much more confident in describing an AP pelvis.
 
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masaraksh said:
Yeah, sorry twas a bit crude. I have seen some pretty scary moments and some absolutely unreal (>3L) EBL in just the approx 10 tabs I've seen, fortunately all the patients did well.

I definitely just noticed the traumapods and 4/5s being pretty into discussing them, so was just curious on your thoughts.

I've actually really liked a few weeks ago when a resident went through them with me and it made me that much more confident in describing an AP pelvis.
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Yeah. As I said, conceptually it's very interesting. :) and it's fun to teach as well.
 
@OrthoTraumaMD thanks so much for doing this!

What fields or topics in orthopedics do you think are hot or interesting?

What topics would you recommend students to get involved in? There are some areas that are difficult to pursue, but as a student interested in ortho research I'm wondering what you think are good projects for stusnts. I'm working on a few right now, but want to take on a project of my own.

Thanks again!
 
OrthoTraumaMD said:
Couples matching is fine if both partners are strong candidates. Otherwise one will have to "carry" the other--i have seen directors call the program of the spouse to ensure they got in, because they really wanted that Ortho candidate. But if one of the partners is very weak, it will hurt the other.
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What does it take, either from an away rotation or interview day, for your program to be like, "We NEED this applicant."?

You kind of answered this before, but I thought I'd ask more directly in case there are some other nuances or things besides the usual "Hard working, fits in well."

ortho attending AMA
 
pbrocks15 said:
@OrthoTraumaMD thanks so much for doing this!

What fields or topics in orthopedics do you think are hot or interesting?

What topics would you recommend students to get involved in? There are some areas that are difficult to pursue, but as a student interested in ortho research I'm wondering what you think are good projects for stusnts. I'm working on a few right now, but want to take on a project of my own.

Thanks again!
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Since I know mostly ortho trauma, I'll answer the "hot or interesting" part from that perspective. Let's see...syndesmotic injury, soft tissue coverage, healing adjuvants (such as bmp), bisphosphonate fractures, proximal humerus fracture management, clavicle fracture management, to name a few.

As far as interesting projects for students, it's anything that you like and can stick with, and hopefully can finish on time so you can have a publication out of it. There are some labs that have long running projects, which are easy to join but may not yield a paper until much later. I would recommend clinical retrospective studies, cadaver or anatomic studies, or radiologic review studies---things that you can finish in a year or less. The same advice goes to residents, and they're always doing these types of projects--and always looking for students to help. But I have seen some students do projects on their own too, when none of the residents volunteered to help whatever faculty member thought of the idea. That's the best scenario, because you get to work one on one with an attending and if they are nice, you will get first author too. So always ask if there are projects like that available--ideas which faculty may have but the residents don't want to do it.
 
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A question of my own for the students who are reading this thread:
I've often agonized when asked for recommendation letters if the student is average/not good. In residency interviews, "average" cookie-cutter letters are instantly recognizable and can hurt people. So my question is this: as a student, would you prefer to have that letter regardless even if it is impersonal/short, or would you rather just have me tell you I don't feel comfortable with writing one? I'm not a chairman so I have the leeway to go both routes, and have taken the latter route as a rule for myself, but recently I've been feeling that it's kind of mean because denying a student a letter isn't nice, either. For the purposes of this question, assume that I'm not an "unknown person" in ortho, but not ultra-famous either.
 
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OrthoTraumaMD said:
A question of my own for the students who are reading this thread:
I've often agonized when asked for recommendation letters if the student is average/not good. In residency interviews, "average" cookie-cutter letters are instantly recognizable and can hurt people. So my question is this: as a student, would you prefer to have that letter regardless even if it is impersonal/short, or would you rather just have me tell you I don't feel comfortable with writing one? I'm not a chairman so I have the leeway to go both routes, and have taken the latter route as a rule for myself, but recently I've been feeling that it's kind of mean because denying a student a letter isn't nice, either. For the purposes of this question, assume that I'm not an "unknown person" in ortho, but not ultra-famous either.
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Please, please, please tell students that you're not comfortable. I would dread thinking I have good letters for my specialty only to not match because I have a generic/bad letter due to someone being worried about hurting my feelings. N=1 but I would much rather be told upfront about this and my performance. I can't stand people that say "you're doing great!" to your face to in the end getting average evals and comment on ways I could have improved.
 
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OrthoTraumaMD said:
A question of my own for the students who are reading this thread:
I've often agonized when asked for recommendation letters if the student is average/not good. In residency interviews, "average" cookie-cutter letters are instantly recognizable and can hurt people. So my question is this: as a student, would you prefer to have that letter regardless even if it is impersonal/short, or would you rather just have me tell you I don't feel comfortable with writing one? I'm not a chairman so I have the leeway to go both routes, and have taken the latter route as a rule for myself, but recently I've been feeling that it's kind of mean because denying a student a letter isn't nice, either. For the purposes of this question, assume that I'm not an "unknown person" in ortho, but not ultra-famous either.
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If you told me up front that it would be an average letter, but also gave me the option to proceed or not, I may initially be upset at "how come ortho stunna doc does not think I'm the most amazing medical student ever."

Then after that major ego hit wears off and the tears dry up, I will be eternally gratefully that you did not simply say yes, only to then end up hurting my chances more than helping them.

Informed consent for LOR's is what I would prefer: sure light, I can write you a letter but it will be an "average" letter. This typically is a red flag to programs, so you may not actually want it.
 
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OrthoTraumaMD said:
A question of my own for the students who are reading this thread:
I've often agonized when asked for recommendation letters if the student is average/not good. In residency interviews, "average" cookie-cutter letters are instantly recognizable and can hurt people. So my question is this: as a student, would you prefer to have that letter regardless even if it is impersonal/short, or would you rather just have me tell you I don't feel comfortable with writing one? I'm not a chairman so I have the leeway to go both routes, and have taken the latter route as a rule for myself, but recently I've been feeling that it's kind of mean because denying a student a letter isn't nice, either. For the purposes of this question, assume that I'm not an "unknown person" in ortho, but not ultra-famous either.
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100% the latter, with the option of still getting the letter if it's the student's only option.
 
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