What I define as a good lifestyle in joints is 3 OR days, 2 clinic days and no weekends, except when on call. Joints is nice because you can *usually* predict how long the cases will be, especially if your practice is mostly primary joints. On my rotations with established joints surgeons in their 40's and 50's, they were rarely in the hospital past 5pm. Clinic in joints is a grind tho, because your total patient census grows with each primary joint that you do. So you could have 80-100 patients to see on a clinic day, but it's entirely manageable with some mid level support. Clinic days usually wrap up by 6pm.
If you did a joints fellowship and intend keep a good reputation with your referring physicians, you'll be doing joint revisions which can be less predictable and somewhat painful. Still, the people I rotated with were usually going home before 5pm on OR days, even with 2-3 revision cases per week.
If you're in a large group, which most orthopaedist are these days, then call is also very manageable. You'll probably be on call for 1 weekend a month and have to come in to fix a few fractures during that time. Tired is absolutely correct in his comments about orthopaedists being happy when they can control their schedules. Younger guys usually work much harder, and I know a few who will do 8+ joints per OR day and sometimes operate late into the evening. But those guys choose that life, and enjoy the monetary rewards for their absurd schedules. You definitely don't need to keep up that pace, because your practice is elective by nature.
Contrast this with pedi ortho, where many of your OR cases come from the ED. That's much less predictable. Also in pedi orhto, you need to do a ton a clinic early on to identify operative candidates. Trauma is trauma, and totally unpredictable. Still, those surgeons usually have multiple partners to spread the pain around. A popular trauma practice set up these days is to have a "small" joints practice each week, and add trauma cases on top of your elective practice as they come in through the ED. There's a good amount of variety in that practice set up, and you'll do a little bit of everything (except spine). Trauma has gotten much more lifestyle friendly over the years, and is actually a highly sought-after fellowship now. Starting a few years ago, there have been more trauma applicants than available fellowships. The other nice thing about trauma is that the demand is inelastic--- people will always be driving cars and doing stupid things (often at the same time...) meaning there will always be a strong demand for your services.
