Do any of you FMSM regret not going 2 more years for ortho SM?

[Sthpawslugger]

For those who did FMSM, are you content with your pathway? With fellow salaries being much less than average earned while in practice, how did you make up for loss potential earnings that year? For those who went the ortho SM route, are you content with having spent 2 extra years in training over being in FMSM practice during that time? I'm entering medical school this fall at 37, so I won't enter PP until 45-47. Health, wellness, nutrition, exercise, and MSK injury, treatment and repair, all appeal to me. A side note, I'm very healthy physically and mentally, will have a wife once medical school begins, and likely starting a family. Having significant amount of student loan debt from UG, Grad, premed years, and attending a D.O. school with high costs weighs on my mind a bit. Will 2 years make a big difference in the end? Can I reasonably incorperate my above interests into my practice regardless of FMSM or ortho SM?

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[JonMonkey]

Maybe I am showing my ignorance here but what exactly do you mean by "ortho SM"?

As a family medicine trained fellow all I had to apply to was PCSM or Primary Care Sports Medicine which were all 1 year programs. You offset the missed pay by making more annually with the CAQSM compared to not doing a fellowship. Out of the 13 4-week blocks in my fellowship I spend at least 10 of those working with orthopedists all day both in the clinic and in the OR. You will not learn all of a 5 year ortho residency in 1 year and for that matter 3 years of "ortho SM" but you will have the foundation to practice independently.

I have no regrets. Hope that helps.

 

[Sthpawslugger]

Maybe I am showing my ignorance here but what exactly do you mean by "ortho SM"?

As a family medicine trained fellow all I had to apply to was PCSM or Primary Care Sports Medicine which were all 1 year programs. You offset the missed pay by making more annually with the CAQSM compared to not doing a fellowship. Out of the 13 4-week blocks in my fellowship I spend at least 10 of those working with orthopedists all day both in the clinic and in the OR. You will not learn all of a 5 year ortho residency in 1 year and for that matter 3 years of "ortho SM" but you will have the foundation to practice independently.

I have no regrets. Hope that helps.

Sorry for the confusion...ortho with focus on sports medicine. Was abbreviating rather than typing it out each time.

 

[JonMonkey]

Sorry for the confusion...ortho with focus on sports medicine. Was abbreviating rather than typing it out each time.

So both fellowships are 1 year from what I understand. We have 1 "ortho sports" fellow at my location and he comes and goes the same as we do on the "family sports" side. The difference is the residency. Family = 3 years, Ortho = 5 years. So with fellowship you are looking at 4 years vs 6 years which I believe is the 2 year difference you spoke of.

The question YOU have to ask yourself is what do YOU want to do with your career? Personally I love doing things with my hands and would have loved being a surgeon but like you I was older and wanted to start private practice before I was in my 40s. Also orthopedics is one of the harder residencies to get into so there is the whole being super competitive through medical school in an attempt to get in. The hours suck, being on call sucks so do you want to take time away from your family in order to do a surgical residency? By my 2nd year of family medicine residency I was essentially working M-F 8-5, I had time to eat dinner with my wife every night and still play hockey 2-3 times per week.

At the end of the day I will spend my career working with athletes of all skill levels, will have no call schedule and will not have to be up before 6am for work...so no, I don't have regrets. Good luck.

 

[Sthpawslugger]

So both fellowships are 1 year from what I understand. We have 1 "ortho sports" fellow at my location and he comes and goes the same as we do on the "family sports" side. The difference is the residency. Family = 3 years, Ortho = 5 years. So with fellowship you are looking at 4 years vs 6 years which I believe is the 2 year difference you spoke of.

The question YOU have to ask yourself is what do YOU want to do with your career? Personally I love doing things with my hands and would have loved being a surgeon but like you I was older and wanted to start private practice before I was in my 40s. Also orthopedics is one of the harder residencies to get into so there is the whole being super competitive through medical school in an attempt to get in. The hours suck, being on call sucks so do you want to take time away from your family in order to do a surgical residency? By my 2nd year of family medicine residency I was essentially working M-F 8-5, I had time to eat dinner with my wife every night and still play hockey 2-3 times per week.

At the end of the day I will spend my career working with athletes of all skill levels, will have no call schedule and will not have to be up before 6am for work...so no, I don't have regrets. Good luck.

Thank you, JonMonkey. The last couple of lines is definitely something for me to consider as those will be important. By no means am I choosing a specialty because of money, but due to my school loans past and future (with attending a DO school), I am concerned about how long it will take me to pay off my past and future(unsubsidized) loans as an PC SM fellow once I enter private practice at age 45. My future wife and I are content with not living in the largest home or driving the most expensive cars, yet will it be possible to to pay my loans off before I am eligible for Medicare especially going the PCSM route?

 

[JonMonkey]

Thank you, JonMonkey. The last couple of lines is definitely something for me to consider as those will be important. By no means am I choosing a specialty because of money, but due to my school loans past and future (with attending a DO school), I am concerned about how long it will take me to pay off my past and future(unsubsidized) loans as an PC SM fellow once I enter private practice at age 45. My future wife and I are content with not living in the largest home or driving the most expensive cars, yet will it be possible to to pay my loans off before I am eligible for Medicare especially going the PCSM route?

I too have a tremendous amount of debt but there are programs out there. I am currently in an income based repayment program and as long as I work for a non-profit (this is not as hard to find as it sounds) and pay 10% of my income for 10 years the remaining debt is forgiven. Look into these before residency as all residency based programs work so you are paying 10% of a resident salary ($400-600/month) and not 4-6 years attending money. Yes orthos make more money but can you put a price tag on being able to spend more time at home with your future wife / kids? Not taking call? Not working crazy hours? Having more freedom of where you live or work? You will still be in the top 1% of income earners regardless of specialty but the other things are just as important.

 

[Sthpawslugger]

Thst is true about Income-Based Repayment. I'll have to keep a close watch on the non-profit, with forgiveness after 10 years program as this October will be the 10-year mark for 2007 loan borrowers. Not a guarantee that program will be around but let's hope it will be. Good luck to you as well.

I too have a tremendous amount of debt but there are programs out there. I am currently in an income based repayment program and as long as I work for a non-profit (this is not as hard to find as it sounds) and pay 10% of my income for 10 years the remaining debt is forgiven. Look into these before residency as all residency based programs work so you are paying 10% of a resident salary ($400-600/month) and not 4-6 years attending money. Yes orthos make more money but can you put a price tag on being able to spend more time at home with your future wife / kids? Not taking call? Not working crazy hours? Having more freedom of where you live or work? You will still be in the top 1% of income earners regardless of specialty but the other things are just as important.

 

[septoplasty]

Also, PCSM =/= Ortho SM

Although the common ground is Orthopedics, and logically one is inclined to think that all athletes/sports docs do/need ortho care.. which is not true.

PCSM = Non-OP Ortho + Primary Care (Whether that is neuro, nutrition, psych, rehab, gen med etc.)
Ortho SM = Non-OP/OP Ortho.. that's it.

We PCSM exist because Ortho can't take care of the athlete as a whole, together forming a team for the athlete.

I think shadowing a good academic PCSM and a Ortho Sports doc will give you better insight than reading about it, frankly.

 

[Sthpawslugger]

Also, PCSM =/= Ortho SM

Although the common ground is Orthopedics, and logically one is inclined to think that all athletes/sports docs do/need ortho care.. which is not true.

PCSM = Non-OP Ortho + Primary Care (Whether that is neuro, nutrition, psych, rehab, gen med etc.)
Ortho SM = Non-OP/OP Ortho.. that's it.

We PCSM exist because Ortho can't take care of the athlete as a whole, together forming a team for the athlete.

I think shadowing a good academic PCSM and a Ortho Sports doc will give you better insight than reading about it, frankly.

Thank you for the response. I worked as an Athletic Trainer for several years, and most recently, a couple of years in an outpatient ortho clinic. So, I've been fortunate to get some sports medicine experience. There is a strong presence of ortho and sports medicine in the community where I will go to school, largely through D1 athletics. I will definitely spend time with one of the academic PCSM physicians there to see if that's the better choice for my career path.