Help me decide between Neurosurgery and Ortho

[NotAProgDirector]

Does anyone have any insight on matching nsgy in the US? Does it help to get affiliated with a nsgy program/publish? Or can you match at places you've never worked with/never did a Sub-I there/no affiliations with them?

Neurosurgery is one of (if not the most) competitive fields. Reviewing your prior posts, you're in a state USMD program, have B's in your preclinical years, are "not the best test taker", are on an army HPSP scholarship, and are considering a DIY PhD if possible.

Getting a NS spot usually requires a stellar medical school performance, lots of research, and good connections with a NS department that can advocate for you. If we look at Charting Outcomes for NS, we see that: The average step scores are 250, mean number of pubs is 23, 40% of successful applicants are AOA, and 10% have a PhD. Unlike other specialties where the chance of matching strongly increases at around 5 ranks and peaks at 10, in NS the successful candidates start with 10 interviews and most have 16+.

You would first need to review your HPSP commitments and how that impacts your ability to apply. You would need to get involved with your local NS department and be cranking out research (without starting to fail courses). You'll need the best Step 2 score you can get. You will need multiple NS away rotations in 4th year. And you'll need a good dose of luck.

If Neurology would fit your needs, that's much less competitive and a much easier process.

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[Lawpy]

mean number of pubs is 23

This is why separating out the abstracts from journal articles is so crucial

 

[deleted1132405]

Neurosurgery is one of (if not the most) competitive fields. Reviewing your prior posts, you're in a state USMD program, have B's in your preclinical years, are "not the best test taker", are on an army HPSP scholarship, and are considering a DIY PhD if possible.

Getting a NS spot usually requires a stellar medical school performance, lots of research, and good connections with a NS department that can advocate for you. If we look at Charting Outcomes for NS, we see that: The average step scores are 250, mean number of pubs is 23, 40% of successful applicants are AOA, and 10% have a PhD. Unlike other specialties where the chance of matching strongly increases at around 5 ranks and peaks at 10, in NS the successful candidates start with 10 interviews and most have 16+.

You would first need to review your HPSP commitments and how that impacts your ability to apply. You would need to get involved with your local NS department and be cranking out research (without starting to fail courses). You'll need the best Step 2 score you can get. You will need multiple NS away rotations in 4th year. And you'll need a good dose of luck.

If Neurology would fit your needs, that's much less competitive and a much easier process.

Hey there. Appreciate the feedback, I do not need anyone to try to tell me my chances of matching neurosurgery or try to discourage me from matching neurosurgery. I know myself best, not you.

 

[guytakingboards]

Hey there. Appreciate the feedback, I do not need anyone to try to tell me my chances of matching neurosurgery or try to discourage me from matching neurosurgery. I know myself best, not you.

Lol wut. Pragmatic feedback is bad? Okay guy.

It's like going to a restaurant and ignoring the waiter's advice not to get the fish. Proceed at your own peril.

 

[Lawpy]

Lol wut. Pragmatic feedback is bad? Okay guy.

It's like going to a restaurant and ignoring the waiter's advice not to get the fish. Proceed at your own peril.

I’ll be pretty interested if that person actually matches nsgy and comes back to prove SDN wrong.

 

[WheezyBaby]

I didn't read the whole thread. I'm an outsider. As an outsider, the ortho trainees I've worked with seem to be generally quite a bit happier than their neurosurgeon colleagues. Also, as someone who did not enjoy being in the OR, one of our neurosurgery attendings did a >24 hour case. I mean, my god. I thought my patient had died in the OR when they still weren't on my census the next day. Good for them, good for them, different type of person

 

[Oso]

I didn't read the whole thread. I'm an outsider. As an outsider, the ortho trainees I've worked with seem to be generally quite a bit happier than their neurosurgeon colleagues. Also, as someone who did not enjoy being in the OR, one of our neurosurgery attendings did a >24 hour case. I mean, my god. I thought my patient had died in the OR when they still weren't on my census the next day. Good for them, good for them, different type of person

Lol damn

 

[longhaul3]

I didn't read the whole thread. I'm an outsider. As an outsider, the ortho trainees I've worked with seem to be generally quite a bit happier than their neurosurgeon colleagues. Also, as someone who did not enjoy being in the OR, one of our neurosurgery attendings did a >24 hour case. I mean, my god. I thought my patient had died in the OR when they still weren't on my census the next day. Good for them, good for them, different type of person

Yeah. We did a case last week that was still going when I came in the next morning. Sadly that meant I had to round the whole service by myself.

 

[Babble Heap]

The best piece of advice I received before embarking on sub-specialty surgical training was that surgical residency will **** up your life. It ruins relationships, kills hobbies, and slowly grinds you down, in service of a rewarding career. Six years in, I am not the same person I was when I started. I'm a better doctor and clinician, but I'm probably an inferior neighbor, husband, son, brother, father. Maybe I'll obtain better balance when I'm out, but hard to make reliable predictions about the future. The take-home is that you should only choose surgical training if you cannot imagine doing anything else. I love my job and would choose it again, but it has come at great personal sacrifice.

If quality of life is important to you, the decision between neurosurgery and orthopedic surgery is not the question you should be asking. The difference between 5 (or 6) years of hand and ortho trauma call versus 7 years of NSG trauma call is pretty marginal, at the end of the day. Between clinical and academic responsibilities, anyone in our position is burning the candle at both ends. Take a moment to disconnect from the narrative that to be successful you have to be in a competitive high-level specialty, and consider other procedural specialties where you will be rewarded handsomely for your work, will have time for all of your other interests, and where you can still help people who need it. You may arrive at the same conclusion, but I promise you that choosing to prioritize your quality of life is not a bad decision.

 

[Dr. Anonymouss]

The best piece of advice I received before embarking on sub-specialty surgical training was that surgical residency will **** up your life. It ruins relationships, kills hobbies, and slowly grinds you down, in service of a rewarding career. Six years in, I am not the same person I was when I started. I'm a better doctor and clinician, but I'm probably an inferior neighbor, husband, son, brother, father. Maybe I'll obtain better balance when I'm out, but hard to make reliable predictions about the future. The take-home is that you should only choose surgical training if you cannot imagine doing anything else. I love my job and would choose it again, but it has come at great personal sacrifice.

If quality of life is important to you, the decision between neurosurgery and orthopedic surgery is not the question you should be asking. The difference between 5 (or 6) years of hand and ortho trauma call versus 7 years of NSG trauma call is pretty marginal, at the end of the day. Between clinical and academic responsibilities, anyone in our position is burning the candle at both ends. Take a moment to disconnect from the narrative that to be successful you have to be in a competitive high-level specialty, and consider other procedural specialties where you will be rewarded handsomely for your work, will have time for all of your other interests, and where you can still help people who need it. You may arrive at the same conclusion, but I promise you that choosing to prioritize your quality of life is not a bad decision.

Thank you for this. This is something I am currently struggling with as an M3 and I think I am slowly getting driven further away from the surgical side of medicine because I realized I don't want to be "just" a doctor. Although you say you would have chosen your surgical sub-specialty again, what were some of the other specialties you were considering?

 

[Babble Heap]

Thank you for this. This is something I am currently struggling with as an M3 and I think I am slowly getting driven further away from the surgical side of medicine because I realized I don't want to be "just" a doctor. Although you say you would have chosen your surgical sub-specialty again, what were some of the other specialties you were considering?

I was very open during medical school and tried to consider each clerkship as a potential career. I liked OB, Psychiatry, and Family Med a lot. I wound up choosing the surgical sub in the last week of my third year. I’m super non trad and it was hard to imagine 7 years of additional training, but when I looked back at my life I realized I have always been all in on whatever I’m doing. I’ve never been good at balance.

I think in retrospect I probably should have tried rotating on Anesthesia or IR. They probably would have appealed to me, too, but ruined my life a little less.

 

[Dr. Anonymouss]

I was very open during medical school and tried to consider each clerkship as a potential career. I liked OB, Psychiatry, and Family Med a lot. I wound up choosing the surgical sub in the last week of my third year. I’m super non trad and it was hard to imagine 7 years of additional training, but when I looked back at my life I realized I have always been all in on whatever I’m doing. I’ve never been good at balance.

I think in retrospect I probably should have tried rotating on Anesthesia or IR. They probably would have appealed to me, too, but ruined my life a little less.

Thank you! I am currently leaning heavily towards anesthesiology as I think it will give me balance between procedural medicine and a decent lifestyle. In terms of practicing medicine I think orthopedics appeals to me the most, but there are many draw downs that come with it and I just don't think I can make those sacrifices.

 

[NSxortho]

Thought I would update this post with where I'm at now and share my excitement in moving forward with pursuing ortho!

Being an M3 now, and having gone through most rotations, I am certain that the enjoyment I get in the OR is unparalleled to all of my other experiences. I've gone through 26h call shifts, and while absolutely draining, I can't understate the joy and reward I got in the OR. I've made lots of connection in the ortho community, with residents and some staff and I genuinely feel that it's the right fit for me. I mesh really well with them and find myself just being happy even when I come home after long days. I never felt this way in my easier rotations. I felt miserable in psych and family, even when I ended my days at 2PM - I'd come home feeling tired and drained. I'd feel flustered most of the day thinking this isn't why I went to med school.

I know this doesn't translate to residency and staff life - I can only imagine how difficult my life is going to be doing an ortho residency for 5+ years, but I feel resolute in my passion for it. I'll have a tough road ahead, but there is someone drawn to every specialty and I think ortho is that for me. I'm a Canadian, where ortho doesn't pay as much as some of the other surgical specialties (unlike the US where it is the highest paid), so this decision truly isn't about the income for me. There are still days where I consider doing family and just focus on other parts of my identity which I hold dear to myself, but thinking back to my family/peds/psych rotations and remembering how unmotivated and drained I felt makes me feel that I ought to do what makes me feel most rewarded.

Neurosurgery will always be so fascinating to me and a part of me will be sad to not pursue it, but I don't find myself a good fit among them. I sensed more collegiality, happiness, and brightness in ortho compared to NSx, which was the deciding factor for me between the two specialties. I also like that ortho offers such a diverse field where you can pursue something delicate and plastic-ish like hand surgery, or something just like neurosurgery like spine. Also, there is greater variety in lifestyle considerations in ortho than there is neurosurgery. At this moment, I personally think ortho is the best specialty, and seeing how I was interested in it since day 1 of med school and despite all the experiences I've had in M1,M2, and M3 I am still drawn to it is testament to how strongly I feel about it.

I will continue to stay open-minded through M3, and if anything else gives me a nudge towards a different direction, I'll follow it and update you all. But I'm really happy to have made up my mind. Picking a specialty is a damn hard thing to do.

 

[Miles Gloriosus]

Thought I would update this post with where I'm at now and share my excitement in moving forward with pursuing ortho!

Being an M3 now, and having gone through most rotations, I am certain that the enjoyment I get in the OR is unparalleled to all of my other experiences. I've gone through 26h call shifts, and while absolutely draining, I can't understate the joy and reward I got in the OR. I've made lots of connection in the ortho community, with residents and some staff and I genuinely feel that it's the right fit for me. I mesh really well with them and find myself just being happy even when I come home after long days. I never felt this way in my easier rotations. I felt miserable in psych and family, even when I ended my days at 2PM - I'd come home feeling tired and drained. I'd feel flustered most of the day thinking this isn't why I went to med school.

I know this doesn't translate to residency and staff life - I can only imagine how difficult my life is going to be doing an ortho residency for 5+ years, but I feel resolute in my passion for it. I'll have a tough road ahead, but there is someone drawn to every specialty and I think ortho is that for me. I'm a Canadian, where ortho doesn't pay as much as some of the other surgical specialties (unlike the US where it is the highest paid), so this decision truly isn't about the income for me. There are still days where I consider doing family and just focus on other parts of my identity which I hold dear to myself, but thinking back to my family/peds/psych rotations and remembering how unmotivated and drained I felt makes me feel that I ought to do what makes me feel most rewarded.

Neurosurgery will always be so fascinating to me and a part of me will be sad to not pursue it, but I don't find myself a good fit among them. I sensed more collegiality, happiness, and brightness in ortho compared to NSx, which was the deciding factor for me between the two specialties. I also like that ortho offers such a diverse field where you can pursue something delicate and plastic-ish like hand surgery, or something just like neurosurgery like spine. Also, there is greater variety in lifestyle considerations in ortho than there is neurosurgery. At this moment, I personally think ortho is the best specialty, and seeing how I was interested in it since day 1 of med school and despite all the experiences I've had in M1,M2, and M3 I am still drawn to it is testament to how strongly I feel about it.

I will continue to stay open-minded through M3, and if anything else gives me a nudge towards a different direction, I'll follow it and update you all. But I'm really happy to have made up my mind. Picking a specialty is a damn hard thing to do.

You made the right decision.

Ortho gives you way more options as you mentioned. Most non academic neurosurgeons do spine surgery anyway. Why go through a hard lengthy, intense residency when you could do spine as an ortho instead.

Also, when taking call, what would you rather do, nail a femur or do an emergent crani?