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Discussion in 'Orthopaedic Surgery' started by Fuarky, Sep 4, 2011.
What are the pros and cons of going into/being an orthopedic surgeon?
Interesting pathology, cool surgeries, work with your hands, takes creativity, every case unique, a lot of variety if you want it, work on all parts of the body, make tangible difference in quality of life, usually healthy patients, as of now reimbursement is pretty good, fewer "emergencies" than other surgical subspecialties, little overlap/competition with other fields of medicine, generally laid back colleagues
It is a surgical specialty and you'll have to put in your hours (especially as a resident), you will almost certainly have to take call, you will lose your familiarity and comfort dealing with medical issues, "bone broke me fix" reputation by your peers, diabetes/smoking/5 Ps, dealing with "crazy" patients with unrealistic expectations or no discernable pathology to explain their symptoms (not unique to any given specialty), once you cut 'em you own 'em for life, infections, Low back pain, narcotic abusers
What are the hours generally like post residency after all of the hard work put in???
Too variable. It depends on what you do, and for whom you do it.
I would say the average for an ortho attending across all specialties is around 60 hours per week.
Did you ever have an internal conflict of losing this medical knowledge since you worked so hard to learn it? If so, at what point did you realize it wasn't an issue anymore?
I've been wanting to do ortho since undergrad and I've been going back and forth between not caring about losing this knowledge and hoping to maintain some of it when I do ortho by maybe finding a subspecialty that allows me to use it. I know I don't want to do IM (thought my rotations were very boring) or anything non-surgical. I'm on Ob now and I don't want to do that but it has reaffirmed that I want to do surgery. I haven't done my surgery rotation yet and I know I can change my mind, but I just don't find anything but ortho and the MSK system interesting. As each day of third year passes, I become more apathetic to the idea of losing that knowledge.
As a medical student trying to make the decision between ortho and gensurg, that was an internal conflict. There was a part of me that wanted to be the go to guy when the spit hit the fan (gsurg) who (thought they) knew everything, and there was a part of me that just wanted to make people better and do cool stuff.
Once I realized that I have a skill set and knowledge base that is limited in physicians that don't do orthopaedic care, I was less concerned with upholding some macho image of pretending like I knew everything. I don't. I can't. It is impossible to keep up with the changing recommendations for general medical care (first line/second line treatments, indications and contraindications, diagnostic tests and interpretation, etc...) I felt I would be doing my patients an injustice to pretend like I could manage their complex issues. I will stick to what I know best, and do best.
The knowledge that you learn as a medical student is ultimately superficial, at best. I personally believe you don't truly learn medicine until you are the one 100% responsible for the care of another sick human being. You learn a ton from mistakes and near mistakes but hopefully you don't have too many serious ones. The knowledge gained in medical school is still in there somewhere and comes out in strange ways. I just found out my diagnosis of temporal arteritis on a patient in ortho clinic last week that we referred to vascular came back + on path. Ultimately you'll come to terms with knowing that (no matter what you do) you will do your best helping people within your knowledge base.
This is something I too have struggled with. If you do ortho + fellowship you will have put in 10 years of post-college training...shouldn't you at least be able to remember simple questions about anti-hypertensives from family members?
Now that I'm in my intern year of ortho, two things give me comfort. First, what you learn in med school just gives you a basis for what you learn in residency (regardless of specialty). It doesn't give you the capacity to really take care of your patients (as the poster above mentioned). Ortho applicants are generally pretty smart. That means somewhere in the back of your mind you'll always remember that random crap that got you a good Step 1 score. But, simply knowing about the different kinds of insulin doesn't give you the capacity to prescribe it in a safe/effective way.
Second, yes you forget a lot of the material if you don't use it regularly, but it's still there. Just think - how many ortho residents seem to fail Step 3? A lot of guys don't take it until half way through residency and still do fine. You may not be able to recall that stuff out of context, but sit down with a Kaplan review book and it all comes flooding back.
Bottom line - there are only so many things you can really be good at. Learn all you can about your chosen field and then learn when to consult medicine!