Hey guys... most, if not all, of you are in the allopathic forum post that covers the "MS1 interested in ortho" topic, but I figured that I should repost my response here in this thread, seeing how it's in the ortho forum...
As a graduating MS4 who matched into orthopaedics (sorry, pet peeve, but it's spelled with an "a"), I can put my $0.02 into this discussion.
First and foremost, as said before, enjoy your summer and don't start worrying about the specifics until you have to.
Second, a little background... I became an EMT at 18 and worked as an in-hospital and ambulance EMT for 6 years through undergraduate and my first two years of med school. Can you say "Trauma Junkie," anyone? However, this experience was beneficial in many regards. For example, I knew that I could handle the mangled and gory patient encounters, and could listen to heart, lung, and abdominal sounds in an enclosed room with grenades going off in the background (ambulances are noisy, people). Yes, I am also a former baseball player/outdoor activity activist, so naturally, orthopaedics was a draw to me by virtue of the patients that I would meet and treat (and the colleagues that I would work with).
I entered medical school knowing that I would be either an Emergency Medicine doc or a Trauma Surgeon. Now, there wasn't a rotation that I didn't like or subject that didn't interest me, but I found out two very important things during my third year clinical rotations: 1) I loved being in the OR and operating, and 2) I hated "Butt and gut" (namely, general surgery territory). Trauma suited me just fine, but I couldn't stand the bread and butter of the field. Also, IMO, EM docs are becoming more and more like triage/primary care providers given the current state of our healthcare system and the ways in which patients currently utilize emergency services. Sure, they can intubate and cardiovert patients, but it seems that once stabilized, the specialists take over anyway. I also hated the feeling that you only took care of patients between the ambulance and OR/ward doors... I wanted to go to the OR with them or follow through with their care once they left.
There are also many other things that turned me into a die-hard orthopod... I love MSK (musculoskeletal) anatomy. It was my favorite part of gross anatomy, and I could spend 24-7 in the lab dissecting bodies to expose muscles, vessels, and nerves. I also love radiology, and being an orthopod, I'll know my films better than the majority of radiologists (except fellowship-trained MSK radiologists... and even then, sometimes) who will read and dictate reports on them. I've always worked with my hands and the physical demand of orthopaedic surgery is appealing. Also, orthopaedics is fast-becoming and growing into an increasingly more complex academic field (not to say that it wasn't academic before, but nothing near the level it's at now and will be in the future). There is so much research with regards to basic science in bone/fracture growth/care, and clinical research in areas such as biomechanics, implants/prosthetics, and clinical outcomes. There's also a growing interest in community MSK health that is being pursued by those who have interests and degrees/training in public health (like myself).
Don't get me wrong though... there are downsides. First off, it's a very competitive residency to match into. Applicants are at the top of their classes and come from all walks of life and each brings a unique perspective to the field. The physical demands (not only surgeries, but hours and potential sacrifice of personal lifestyle) can be overwhelming. True, once you're out of residency, you have some degree of flexibility with regard to your own personal employment situation, but this is true of all specialties. You work as much as you want to, and therefore, dictate your own earning potential. Orthopaedics does involve a lot of trauma care (but especially for the general orthopaedist, trauma orthopaedist, and in residency, in general). Call will always be a reality (it's musculoskeletal, the majority of your patients will have pulled, torn, or broken something... and unlike the drunk college frat boy, most people don't plan these things).
As for job opportunities and career outlook... the population is getting older, and that means an increasing need for orthopaedic care... period. Yes, reimbursements may decrease and we may need to work harder to retain our earning potential, but the need will always be there. As the technology gets better and more complex, new treatments will continue to come down the pike, and the overall lifelong learning curve of an orthopaedist will most likely always be a steep one. That's why current programs are looking for those applicants that show a love and dedication to the field, strict work ethic, an eagerness to participate in research and contribute to the growing knowledge base of our speciality, and a determination to strive to be the best that one can be.
Now that I've written that monster of a response, here are my quick suggestions for determining your interest in this specialty:
1) Contact faculty and introduce yourself. Schedule "get to know me" meetings with your home program director and/or chair. I didn't do this (again, I knew I was going into EM or GS), but this would have made things a little easier.
** TALK TO RESIDENTS (and senior students going through the match/electives)!!!
2) Look for ways to get involved in research (especially if you're interested in it... but even if you're not, you'll be doing it during residency, so get involved). Try to find projects that are of interest to you (e.g., basic science vs. clinical), and those that may be potentially lucrative (publish, poster presentations, academic meetings, etc.).
3) Pay attention to the subjects that interest you. If you make it through gross anatomy and feel that you hated MSK and couldn't stand dissecting out the brachial plexus (you'll find out what this is soon enough) or the complex anatomy of the hand, then perhaps orthopaedics isn't for you. If you're in the ED and an open fracture comes in and you get vertigo/tunnel vision and go pale looking at the mangled wound (shredded skin, muscle, dirt, and blood all mixed in one big appetizer) or while helping to pull traction and feeling the bone ends grinding against one another... think about it.
4) Get in on some operations (refer to #1).
5) Can't make it through a meal without dropping your utensils? Family hide the drills and saws from you? These might be small clues.
6) Do you regularly fall asleep in a conference first thing in the morning after being up all night (or can you absolutely not function being awake all night)? Think about a non-surgical career.
Thesea are just a couple of things to think about. And I always try to say this at the end of my posts... please don't hesitate to contact me with any questions. We're all going to be colleagues one day, and the most important thing out there for us is the health and well-being of not only our patients, but ourselves. Pick the field that best suits you, not what you aspire to be, or your parents want you to be, or what you can make the most money doing. This is a career... a long-term deal... try your best to make the right choice for you.
You can PM me here or reach me via
[email protected]. Good luck to all.
