PA or MD for Orthopedics

[moose13]

Hello!

I am currently in the process of deciding between PA or MD. I have always wanted to be a doctor and have been set on going to med school for orthopedics since I was diagnosed with a rare shoulder condition as a kid. As I have been realistically weighing the pros and cons of both options, I have a couple questions:

• What is the reality of an orthopedic residency? Is there really no way to have a family, relationship, enjoyable quality of life during residency?
• What is the reality of being a female in orthopedics?

I have wanted to do orthopedics for a long time and have never doubted this. What makes me hesitate is after doing a lot of research on ortho surgery, shadowed physicians and spoke with PAs, but I am still mildly unsure on the reality of the 5-year residency and the quality of life that accompanies and ortho resident. I want to specifically work with pediatric orthopedics as either an MD or PA, but before I make the decision on which route, I would love to gain some insight on what an orthopedic residency is truly like (the good and the bad) and how being a woman impacts this.

Thank you in advance!!

---

Members don't see this ad.

 

[chunkyfilms]

@OrthoTraumaMD

 

[MCATLasagna]

Just in general as I warn every applicant, the highly competitive nature of certain residencies and the focus/job of med schools to help guide students to where the faculty feel they serve would best, make thwart their plans. While the goals and hopes are always to be striven for, you must go in to medical school with eyes wide open that you may wind in as an IM in a suburban midwest town

Can you expand on that point @gonnif ? Genuinely curious as to how that manifests - is it a formal "you should do this" or more subtle?

 

[Shunsui]

Hello!

I am currently in the process of deciding between PA or MD. I have always wanted to be a doctor and have been set on going to med school for orthopedics since I was diagnosed with a rare shoulder condition as a kid. As I have been realistically weighing the pros and cons of both options, I have a couple questions:

• What is the reality of an orthopedic residency? Is there really no way to have a family, relationship, enjoyable quality of life during residency?
• What is the reality of being a female in orthopedics?

I have wanted to do orthopedics for a long time and have never doubted this. What makes me hesitate is after doing a lot of research on ortho surgery, shadowed physicians and spoke with PAs, but I am still mildly unsure on the reality of the 5-year residency and the quality of life that accompanies and ortho resident. I want to specifically work with pediatric orthopedics as either an MD or PA, but before I make the decision on which route, I would love to gain some insight on what an orthopedic residency is truly like (the good and the bad) and how being a woman impacts this.

Thank you in advance!!

Dr. Antonio Webb on Youtube is in his spine fellowship for ortho. I would check out his content for answers to your questions. Best of luck!

 

[Angus Avagadro]

Can you expand on that point @gonnif ? Genuinely curious as to how that manifests - is it a formal "you should do this" or more subtle?

Not to speak for @gonnif, but I believe they are saying the faculty should help guide the student by setting realistic goals. We dont want students to end up in the SOAP by not matching due to being a lackluster candidate . You definitely would want a frank and honest discussion about the students chances and the risks of not matching. I would not say with a step 1 score of 223, you should only apply to FM, but help the student target programs where they might be competetive in their desired specialty. If they are only competetive for primary care, you have to face that fact. Maybe plan B ia a year doing research , then reapply.

 

[Angus Avagadro]

This is an awfully broad question. How about just examining PA vs MD?
We dont know your age or academic status. Say you are competitive for both.
PA ia a 6 year program
MD is 4 yrs med school and 3-5 yr residency/fellowship at about half the compensation of a PA.
You should do the math regarding student loans,(about 350k for colleg and med school) plus lost income as a PA.
PAs are gaining more autonomy.
Ortho has a high rate of being sued for malpractice.
I believe this should be your starting point, to see if medical school or becoming a PA is right for you. You might not end up in ortho . My wife and I started out to do FM, and now are subspecialists. You never know where you will end up. Good luck and best wishes!

 

[getdown]

To be blunt. Orthopedics is very competitive specialty and many qualified applicants. Some specific programs may even be biased towards males candidates. You need to understand that if you're not a competitive applicant for that specialty your chances of matching are extremely low. And your chances of matching every year after that drops precipitously. Facutly are not there to be your cheering section but to provide you with a realistic look of which specialties you have the best chance of matching into.

I've worked with plenty of orthopods and have friends in that specialty. The lifestyle is brutal during residency with minimal free time and very steep learning curve and multiple 24 hour calls. OrthoTrauma talks a little bit about her experience here:

It’s worth it. (And a story.)

 

[Angus Avagadro]

Just to add to @Angus Avagadro, the other side of this equation is that networking and recommendations play a very strong part in residency. The medical school and the faculty have ability to influence residency placement on their reputation of how previous candidates worked out. This becomes more important when med school and residency are close either physical or some other way. Since most students do rotations in the city/area where med school is and practicing faculty may be working with residency attendings, they have strong incentive to recommend people who they feel are highly qualified for the program. Ultimately residency is a job and training, under intense condition with a small team. They want to make damn sure you can a supportive and contributing member of the team. If recommended students dont work out well, it will impact the medical school and reduce their influence to place students

Agree completely. I wrote a LOR for one of my students and just emailed my old Chief endorsing his application. He is the only student I ever endorsed to this program.

 

[LizzyM]

Hello!

I am currently in the process of deciding between PA or MD. I have always wanted to be a doctor and have been set on going to med school for orthopedics since I was diagnosed with a rare shoulder condition as a kid. As I have been realistically weighing the pros and cons of both options, I have a couple questions:

• What is the reality of an orthopedic residency? Is there really no way to have a family, relationship, enjoyable quality of life during residency?
• What is the reality of being a female in orthopedics?

I have wanted to do orthopedics for a long time and have never doubted this. What makes me hesitate is after doing a lot of research on ortho surgery, shadowed physicians and spoke with PAs, but I am still mildly unsure on the reality of the 5-year residency and the quality of life that accompanies and ortho resident. I want to specifically work with pediatric orthopedics as either an MD or PA, but before I make the decision on which route, I would love to gain some insight on what an orthopedic residency is truly like (the good and the bad) and how being a woman impacts this.

Thank you in advance!!

What do you want to be able to do? Is it important to you to be able to be independent in the OR? Is it important to you to be able to be autonomous in caring for complex patients or carrying out complex procedures? Do you enjoy doing routine tasks over and over again or do you need a lot of out of the ordinary experiences?

How important is it to you to be the leader vs taking direction from the leader?

How important is it to you to have more money and free time and less debt in your early years of professional life but holding steady in that regard vs. having little money and free time and more debt in your youth but having greater earning potential in middle age?

It is interesting that your own shoulder issue got you interested in ortho but what makes you want to take care of other people's ortho problems? Have you had any experience with direct patient care? To be competitive for PA, you need some serious hands-on activity. This is less essential for med admissions but doesn't hurt to have. How far along are you in your college career?

 

[longhaul3]

@LizzyM mentions this obliquely above but I'm surprised it hasn't been the theme of this thread:

Ortho is a surgical subspecialty, and as far as I know, PAs do not commonly perform surgery. They may assist or prep or do wound care, simple lacs etc., but they are not surgeons. So, if you want to do surgery, you will have to become a physician.

I may be completely ignorant about this, as ortho is not my field, but in my experience, when a surgical service has PAs, they do H&Ps, maybe help out with pre-op and prep, and see patients on the floors/PACU if it's a non-teaching service. That is to say, an ortho PA is missing out on the essence of ortho.

 

[sunshinefl]

@LizzyM mentions this obliquely above but I'm surprised it hasn't been the theme of this thread:

Ortho is a surgical subspecialty, and as far as I know, PAs do not commonly perform surgery. They may assist or prep or do wound care, simple lacs etc., but they are not surgeons. So, if you want to do surgery, you will have to become a physician.

I may be completely ignorant about this, as ortho is not my field, but in my experience, when a surgical service has PAs, they do H&Ps, maybe help out with pre-op and prep, and see patients on the floors/PACU if it's a non-teaching service. That is to say, an ortho PA is missing out on the essence of ortho.

I’ve seen PAs that worked as dedicated first assist with a specific ortho surgeon all the time. (As a 1:1 pair, multiple teams like this).

 

[IMGASMD]

@LizzyM mentions this obliquely above but I'm surprised it hasn't been the theme of this thread:

Ortho is a surgical subspecialty, and as far as I know, PAs do not commonly perform surgery. They may assist or prep or do wound care, simple lacs etc., but they are not surgeons. So, if you want to do surgery, you will have to become a physician.

I may be completely ignorant about this, as ortho is not my field, but in my experience, when a surgical service has PAs, they do H&Ps, maybe help out with pre-op and prep, and see patients on the floors/PACU if it's a non-teaching service. That is to say, an ortho PA is missing out on the essence of ortho.

There are plenty that will be holding and retracting for ortho. Maybe closing at the end. I am sure if the attending and pa are comfortable, they can do more or do less. Same with gen surgical PAs. I’ve seen PA pretty much does the whole case for older attendings.

But like mentioned above, PA (or any mid level for that matter), may have the the technical know-how and probably “do” as well as physicians, but they will never have the knowledge or the sense of responsibilities for the patient/their craft than physicians.

 

[longhaul3]

I’ve seen PAs that worked as dedicated first assist with a specific ortho surgeon all the time. (As a 1:1 pair, multiple teams like this).

There are plenty that will be holding and retracting for ortho. Maybe closing at the end. I am sure if the attending and pa are comfortable, they can do more or do less. Same with gen surgical PAs. I’ve seen PA pretty much does the whole case for older attendings.

But like mentioned above, PA (or any mid level for that matter), may have the the technical know-how and probably “do” as well as physicians, but they will never have the knowledge or the sense of responsibilities for the patient/their craft than physicians.

Glad to hear a couple other perspectives. Yours are consistent with what I've seen as well. Which is all well and good but basically like being a career med student in the OR.

 

[Matthew9Thirtyfive]

What everyone above said. If you want independence, do med school but be aware that people who want to go into ortho because they got hurt or saw an orthopedist are a dime a dozen. The specialty is very competitive, and most who go into med school wanting to do ortho don’t end up doing it. It is certainly doable with a great step 1, research and dedication. You will have to give up a significant amount of personal time for a while. If having kids early in life is important to you, consider something else. As for being a female in ortho there is no difference other than the kid thing. I have a long running ama thread that addresses this and many other questions; it’s been going for more than a year now.


Sent from my iPhone using SDN mobile

And here it is:

ortho attending AMA