ortho attending AMA

[PingPongMD]

I have questions regarding taking a research year.

As someone with below average step score but above 240, average/below average amount of research (multiple poster and oral presentations, and 1 publication), and at low ranked USMD school, would you recommend taking a research year between 3rd and 4th year to do ortho research to improve my chances of matching?

A few things that I am thinking about:
1. Doing research won't make up for a below average step score.
2. Taking a research year will hopefully help me build connections - but the institutions with formal ortho research programs are competitive programs that I won't be able to match at anyways despite making connections (Penn - Benjamin Fox Orthopaedic Research Scholar Award | Children's Hospital of Philadelphia , Mayo - Mayo Clinic Orthopedic Sports Research Fellowship 2020-2021 | Orthogate , Rush - several positions with various faculty).
3. Getting a good letter from a faculty member during the research year might help in the application process, but once again won't make up for the below average step score.

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[OrthoTraumaMD]

I have questions regarding taking a research year.

As someone with below average step score but above 240, average/below average amount of research (multiple poster and oral presentations, and 1 publication), and at low ranked USMD school, would you recommend taking a research year between 3rd and 4th year to do ortho research to improve my chances of matching?

A few things that I am thinking about:
1. Doing research won't make up for a below average step score.
2. Taking a research year will hopefully help me build connections - but the institutions with formal ortho research programs are competitive programs that I won't be able to match at anyways despite making connections (Penn - Benjamin Fox Orthopaedic Research Scholar Award | Children's Hospital of Philadelphia , Mayo - Mayo Clinic Orthopedic Sports Research Fellowship 2020-2021 | Orthogate , Rush - several positions with various faculty).
3. Getting a good letter from a faculty member during the research year might help in the application process, but once again won't make up for the below average step score.

I don’t chance people as I said in my very first AMA post.
Just as an FYI, if you make connections at a research program that you won’t match into anyway, it doesn’t mean it is useless— ortho is a very small world and your PI may call another program about you.
I always advise middle of the road applicants (step 1 scores below average but decent application otherwise) to have a backup specialty plan.

 

[Rachapkis]

I have two related nature versus nurture questions: Are ortho residents born or made? Would you rather take into your program someone who is truly gifted or someone who has an unbelievable work ethic (all else being equal)?

 

[VincentAdultman]

I have two related nature versus nurture questions: Are ortho residents born or made? Would you rather take into your program someone who is truly gifted or someone who has an unbelievable work ethic (all else being equal)?

I’m not her but...

1. That’s a weird question and I’m not sure what the purpose is. Especially since I would hope being an ortho resident isn’t the long term goal. I guess...made?

2. The latter 100/100.

 

[Rachapkis]

I’m not her but...

1. That’s a weird question and I’m not sure what the purpose is. Especially since I would hope being an ortho resident isn’t the long term goal. I guess...made?

2. The latter 100/100.

I am full of weird questions. In fact, my friends have dubbed me hypothetical boy. This question occurred to me as I was thinking through my own strengths and weaknesses. If I am being honest, my spacial skills and manual dexterity are so-so, and thus I would clearly be anything but a natural in the orthro world. However, I am exceedingly hard working and willing to repeat rote tasks ad infinitum until I master them. Thus, I wanted to get a sense of how I would be perceived as an ortho resident--a necessary step in achieving the long-term goal.

 

[VincentAdultman]

I am full of weird questions. In fact, my friends have dubbed me hypothetical boy. This question occurred to me as I was thinking through my own strengths and weaknesses. If I am being honest, my spacial skills and manual dexterity are so-so, and thus I would clearly be anything but a natural in the orthro world. However, I am exceedingly hard working and willing to repeat rote tasks ad infinitum until I master them. Thus, I wanted to get a sense of how I would be perceived as an ortho resident--a necessary step in achieving the long-term goal.

Being a hard worker trumps all.

 

[OrthoTraumaMD]

I have two related nature versus nurture questions: Are ortho residents born or made? Would you rather take into your program someone who is truly gifted or someone who has an unbelievable work ethic (all else being equal)?

made.
Work ethic and grit are necessary to be a great surgeon. Innate talent helps but is not sufficient on its own.

 

[Windpt21]

I am not going to lie and say that I read all 29 pages, so please forgive me if you answered a similar question.. I’m a 35 yo female, OMS 1 at a pretty competitive DO School and am really concerned I’m too old for ortho. I feel like you would have good insight as to whether I should consider a different speciality at this point in my life. Before med school I worked as a physical therapist for 6 years, so my orthopedics and sports med passion is strong. Everything about ortho is freaking cool. I’m married, no children, don’t plan on them either. I understand you can’t tell me what to do, but I also believe a female finishing fellowship at 44 may be extremely rare.. I feel like when you finish fellowship you need to hit the ground running, be willing to work 80 hours and take call all the time, I’m just not sure if I will be able to keep up with the orthos 10-15 years younger than me.. I guess I just want advice, your thoughts, anything you can give me through this decision process. Thank you.

 

[DarkHorizon]

I am not going to lie and say that I read all 29 pages, so please forgive me if you answered a similar question.. I’m a 35 yo female, OMS 1 at a pretty competitive DO School and am really concerned I’m too old for ortho. I feel like you would have good insight as to whether I should consider a different speciality at this point in my life. Before med school I worked as a physical therapist for 6 years, so my orthopedics and sports med passion is strong. Everything about ortho is freaking cool. I’m married, no children, don’t plan on them either. I understand you can’t tell me what to do, but I also believe a female finishing fellowship at 44 may be extremely rare.. I feel like when you finish fellowship you need to hit the ground running, be willing to work 80 hours and take call all the time, I’m just not sure if I will be able to keep up with the orthos 10-15 years younger than me.. I guess I just want advice, your thoughts, anything you can give me through this decision process. Thank you.

It has been done before and can be done again. It won’t be easy. You’ll really have to find inner motivation as to why you want to do this. I know two guys who started residency at around 40. Both made it through but both were miserable as both had large families. They also had some trouble fitting in with rest of the residents but that was less of an issue. You really have to decide that you want this for the right reasons, or it’s not worth it, IMo.

 

[Windpt21]

It has been done before and can be done again. It won’t be easy. You’ll really have to find inner motivation as to why you want to do this. I know two guys who started residency at around 40. Both made it through but both were miserable as both had large families. They also had some trouble fitting in with rest of the residents but that was less of an issue. You really have to decide that you want this for the right reasons, or it’s not worth it, IMo.

Thank you, I have wanted to be a physician for as long as I remember but I didn’t do it for a number of reasons in my 20’s and became a PT. When I chose to pursue medicine I did it because I love it and felt like I still had time to chase my dream, but now I’m sitting at a crossroads where I may chose something I’m less passionate about because the path is easier. I feel like I could be making the same mistakes all over again.

 

[DarkHorizon]

Thank you, I have wanted to be a physician for as long as I remember but I didn’t do it for a number of reasons in my 20’s and became a PT. When I chose to pursue medicine I did it because I love it and felt like I still had time to chase my dream, but now I’m sitting at a crossroads where I may chose something I’m less passionate about because the path is easier. I feel like I could be making the same mistakes all over again.

There’s no doubt you can do it, but there will be obstacles that’ll test your commitment and make you question if it’s worth it. For one, you have to do well in classes and boards to set you up to just have a shot. Once you get in, it’ll be another battle. You’ll be working a lot of hours with colleagues that are 12 years younger than you, and your bosses, some of which will be younger than you. You’ll work harder than you ever have, you will be tested and question your decision. It’s a long process and requires your full dedication from early on in medical school. I’m not discouraging you, just want to make sure you know what your getting into.

 

[Windpt21]

There’s no doubt you can do it, but there will be obstacles that’ll test your commitment and make you question if it’s worth it. For one, you have to do well in classes and boards to set you up to just have a shot. Once you get in, it’ll be another battle. You’ll be working a lot of hours with colleagues that are 12 years younger than you, and your bosses, some of which will be younger than you. You’ll work harder than you ever have, you will be tested and question your decision. It’s a long process and requires your full dedication from early on in medical school. I’m not discouraging you, just want to make sure you know what your getting into.

Thank you

 

[OrthoTraumaMD]

I am not going to lie and say that I read all 29 pages, so please forgive me if you answered a similar question.. I’m a 35 yo female, OMS 1 at a pretty competitive DO School and am really concerned I’m too old for ortho. I feel like you would have good insight as to whether I should consider a different speciality at this point in my life. Before med school I worked as a physical therapist for 6 years, so my orthopedics and sports med passion is strong. Everything about ortho is freaking cool. I’m married, no children, don’t plan on them either. I understand you can’t tell me what to do, but I also believe a female finishing fellowship at 44 may be extremely rare.. I feel like when you finish fellowship you need to hit the ground running, be willing to work 80 hours and take call all the time, I’m just not sure if I will be able to keep up with the orthos 10-15 years younger than me.. I guess I just want advice, your thoughts, anything you can give me through this decision process. Thank you.

If you don’t plan on kids or a family then it is less of a factor. If you want to do it, go for it, that’s still young.

 

[Windpt21]

If you don’t plan on kids or a family then it is less of a factor. If you want to do it, go for it, that’s still young.

I don’t know 35 doesn’t feel young some days.... ;-)

I’m married, he’s the extent of my family. Thank you. I think the best thing I can do is do well in school and don’t close any doors. I appreciate your input.

 

[slowthai]

I've got several questions now that step 1 will be P/F as of January 2022.

1. How do you think this will affect things when it comes to the orthopaedic match?
Will they now use step 2 as a screen?

2. How will programs screen potential rotators for aways now that there will be a large surplus of applicants that didn't get sorted out by their step 1 score? Will it just be first come first serve?

3. Let's say the NBME retroactively changes the class of 2023's scores into passes. Do you think programs will accept score submission from the applicants directly, or at least from the schools on their behalf?

 

[ceilingfan019]

I've got several questions now that step 1 will be P/F as of January 2022.

1. How do you think this will affect things when it comes to the orthopaedic match?
Will they now use step 2 as a screen?

2. How will programs screen potential rotators for aways now that there will be a large surplus of applicants that didn't get sorted out by their step 1 score? Will it just be first come first serve?

3. Let's say the NBME retroactively changes the class of 2023's scores into passes. Do you think programs will accept score submission from the applicants directly, or at least from the schools on their behalf?

This seems to be a hot topic. It's all speculation right now like using Step 2 as a screening tool now and putting more emphasis on other parts of the application. Programs have more than 2 years to figure this out though, so anything people say now might not end up being true.

No way NBME retroactively does something like that. Medical students would absolutely go nuts.

 

[CherryRedDracul]

I guarantee you that Step 2 CK will the best screening tool to replace Step 1.

 

[OrthoTraumaMD]

I've got several questions now that step 1 will be P/F as of January 2022.

1. How do you think this will affect things when it comes to the orthopaedic match?
Will they now use step 2 as a screen?

2. How will programs screen potential rotators for aways now that there will be a large surplus of applicants that didn't get sorted out by their step 1 score? Will it just be first come first serve?

3. Let's say the NBME retroactively changes the class of 2023's scores into passes. Do you think programs will accept score submission from the applicants directly, or at least from the schools on their behalf?

Aways will be more important. Perhaps step 2 may be a screen.Otherwise, I have no idea what the answers to your questions are. No one does... yet.

 

[OrthoTraumaMD]

Are there any ortho procedures where being a short and petite surgeon (difficult.

I talked about this early on in the thread. generally the answer is no.

 

[Rachapkis]

I just finished reading, "The Butchering Art", which you recommended earlier in the thread. I found it compelling. Dr. Lister was quite a man--a dedicated scientist, surgeon and teacher as well as a compassionate human being. Any other books on medicine, surgery especially, that tickled your fancy?

 

[OrthoTraumaMD]

I just finished reading, "The Butchering Art", which you recommended earlier in the thread. I found it compelling. Dr. Lister was quite a man--a dedicated scientist, surgeon and teacher as well as a compassionate human being. Any other books on medicine, surgery especially, that tickled your fancy?

House of god is required reading. Otherwise I try not to read books about medicine. I get enough of it at work. You will too, eventually.

 

[nimbus]

I just finished reading, "The Butchering Art", which you recommended earlier in the thread. I found it compelling. Dr. Lister was quite a man--a dedicated scientist, surgeon and teacher as well as a compassionate human being. Any other books on medicine, surgery especially, that tickled your fancy?

Along similar lines there are “The Youngest Science: Notes of a Medicine Watcher” and “The Lives of a Cell:Notes of a Biology Watcher” both by Lewis Thomas.

 

[VincentAdultman]

I’ve never read HoG; seems so cliche at this point.

I also actively avoid reading non-medical books for leisure.

 

[Angus Avagadro]

I’ve never read HoG; seems so cliche at this point.

I also actively avoid reading non-medical books for leisure.

Your loss.

 

[VincentAdultman]

Your loss.

I think I’ll be fine.

 

[OrthoTraumaMD]

I think I’ll be fine.

I think it’s like reading any classic novel. You don’t have to... but it helps, to understand what everyone else is talking about. I mean... it gave us words like gomer and turf, and the rule about taking your own pulse. It is also one of the first books to talk about physician burnout and suicide, long before it became ok to talk about it.

 

[VincentAdultman]

I think it’s like reading any classic novel. You don’t have to... but it helps, to understand what everyone else is talking about. I mean... it gave us words like gomer and turf, and the rule about taking your own pulse. It is also one of the first books to talk about physician burnout and suicide, long before it became ok to talk about it.

Oh I definitely get it.

I just think at this point I'm so immersed in medicine as it is I would rather not read medical books for leisure.

 

[CherryRedDracul]

House of god is required reading. Otherwise I try not to read books about medicine. I get enough of it at work. You will too, eventually.

I've read it 3 times so far.

I'm itching for a 4-peat.

 

[OrthoTraumaMD]

I've read it 3 times so far.

I'm itching for a 4-peat.

It’s unfortunate that the sequel sucked.

 

[OrthoTraumaMD]

Oh I definitely get it.

I just think at this point I'm so immersed in medicine as it is I would rather not read medical books for leisure.

It’s more of a novel than it is a true medical book in the sense, say, an atul gawande book. But to each his own. It’s basically the only medical book I recommend. I read mostly nonfiction these days.

 

[Lingering]

If I'm at all hesitant about the lifestyle component of orthopedics does that mean it's not for me?

I'm a 3rd year struggling to decide at this late junction between ortho and a more lifestyle friendly specialty that I like, but definitively do not enjoy as much as orthopedics. However, having a family is important to me and being present for them is also a high priority. The rush from taking call with the residents at my home program and scrubbing cases when I have flexible days during the week with attendings has been one of my favorite parts of medical school. I prefer reading about knee and hip biomechanics and Hoppenfelds vs. my reading for the other specialty, but I feel exhausted thinking about the number of ortho consults my PGY2 friend has already taken this year and worry about my well-being.

My clerkship schedule hasn't permitted me to do a full rotation on orthopedics however, and my only opportunity is to do a sub-I in April, AFTER away rotations have already opened up (the other specialty I'm considering also requires aways).

Any advice/insight would be appreciated. Thanks!

 

[DarkHorizon]

If I'm at all hesitant about the lifestyle component of orthopedics does that mean it's not for me?

I'm a 3rd year struggling to decide at this late junction between ortho and a more lifestyle friendly specialty that I like, but definitively do not enjoy as much as orthopedics. However, having a family is important to me and being present for them is also a high priority. The rush from taking call with the residents at my home program and scrubbing cases when I have flexible days during the week with attendings has been one of my favorite parts of medical school. I prefer reading about knee and hip biomechanics and Hoppenfelds vs. my reading for the other specialty, but I feel exhausted thinking about the number of ortho consults my PGY2 friend has already taken this year and worry about my well-being.

My clerkship schedule hasn't permitted me to do a full rotation on orthopedics however, and my only opportunity is to do a sub-I in April, AFTER away rotations have already opened up (the other specialty I'm considering also requires aways).

Any advice/insight would be appreciated. Thanks!

Sounds like you’re on the fence. Probably better to pick the lifestyle specialty. Things get better as an attending but residency/fellowship is pretty busy.

 

[Summerlax2016]

In terms of applying for residency/away rotations, are there any programs that may stand out that screen for "prestige" in terms of top 10 vs top 20 vs. top 50 and such medical schools? I have heard some programs are selective for more "name brand" applicants.

 

[OrthoTraumaMD]

If I'm at all hesitant about the lifestyle component of orthopedics does that mean it's not for me?

I'm a 3rd year struggling to decide at this late junction between ortho and a more lifestyle friendly specialty that I like, but definitively do not enjoy as much as orthopedics. However, having a family is important to me and being present for them is also a high priority. The rush from taking call with the residents at my home program and scrubbing cases when I have flexible days during the week with attendings has been one of my favorite parts of medical school. I prefer reading about knee and hip biomechanics and Hoppenfelds vs. my reading for the other specialty, but I feel exhausted thinking about the number of ortho consults my PGY2 friend has already taken this year and worry about my well-being.

My clerkship schedule hasn't permitted me to do a full rotation on orthopedics however, and my only opportunity is to do a sub-I in April, AFTER away rotations have already opened up (the other specialty I'm considering also requires aways).

Any advice/insight would be appreciated. Thanks!

the truth is you will not know if you made the right choice until it’s too late and you’re either already in it or in something else. it sounds like you really like to do ortho stuff in your spare time, which is a good sign.
Everyone worries about lifestyle, but if you scrub cases on your flexible days you clearly like the work. Residency is brutal, but it’s only 5 years. everyone survives.
It’s much harder to switch into ortho from another specialty, than vice versa. Based on what I’m hearing I think you should try for ortho, unless 5 years is too long for you.

 

[OrthoTraumaMD]

In terms of applying for residency/away rotations, are there any programs that may stand out that screen for "prestige" in terms of top 10 vs top 20 vs. top 50 and such medical schools? I have heard some programs are selective for more "name brand" applicants.

Not to my knowledge. maybe some of the big ivory tower places but even then I’ve seen rotators from other places. Most places will take local med students and prioritize location rather than prestige.

 

[Dox4lyfe]

Wrote a review paper and burned out from working on it for so long as it was my first paper: options are to continue editing and aim to submit at a top clinical biomechanics type journal 4+ months down the line or submit to a much lower impact journal and move on to the next project. What should I do in your opinion in terms of ortho residency view?

 

[OrthoTraumaMD]

Wrote a review paper and burned out from working on it for so long as it was my first paper: options are to continue editing and aim to submit at a top clinical biomechanics type journal 4+ months down the line or submit to a much lower impact journal and move on to the next project. What should I do in your opinion in terms of ortho residency view?

Depends on where you are at and how many more opportunities you have to publish. If you’re getting close to the end, take the sure publication.

 

[Frogger27]

How do you think the possibility of lack of away rotations/loss of core clinical rotations (many schools are switching P/F due to Covid) will affect this upcoming application cycle?

 

[bonemann]

@OrthoTraumaMD any advice for incoming ortho interns?

 

[OrthoTraumaMD]

How do you think the possibility of lack of away rotations/loss of core clinical rotations (many schools are switching P/F due to Covid) will affect this upcoming application cycle?

no idea. this is a weird new world.

 

[OrthoTraumaMD]

@OrthoTraumaMD any advice for incoming ortho interns?

be nice to everyone, read before work, keep at least 1 personal hobby.

 

[risus_sardonicus]

be nice to everyone, read before work, keep at least 1 personal hobby.

This bro is keeping it real!! Appreciate the advice.


Sent from my iPhone using SDN

 

[Throwaway92]

be nice to everyone, read before work, keep at least 1 personal hobby.

Thank you! I just matched ortho and i am very excited to start. I had a couple questions.
I'm a little nervous coming in as an intern even with my previous 4 aways. Is alot of orthopaedics learning on the job + reading + questions? I felt I had a good grasp on anatomy but still felt like I struggled identifying things during cases.

How do you feel about someone entering the field with tunnel vision on one specific specialty? Ie joints. Etc. Or would it be better to keep an open mind.

What texts do you recommend for interns or residency in general? I have netters ortho anatomy and the hand book for fractures but they seem more like references than actual learning material.

Thank you!

 

[gonavy1234]

As an attending in an academic center, how much do you actually operate versus your other duties and/or letting residents operate?

 

[OrthoTraumaMD]

This bro is keeping it real!! Appreciate the advice.


Sent from my iPhone using SDN

I’m a girl, but yes.

 

[OrthoTraumaMD]

Thank you! I just matched ortho and i am very excited to start. I had a couple questions.
I'm a little nervous coming in as an intern even with my previous 4 aways. Is alot of orthopaedics learning on the job + reading + questions? I felt I had a good grasp on anatomy but still felt like I struggled identifying things during cases.

How do you feel about someone entering the field with tunnel vision on one specific specialty? Ie joints. Etc. Or would it be better to keep an open mind.

What texts do you recommend for interns or residency in general? I have netters ortho anatomy and the hand book for fractures but they seem more like references than actual learning material.

Thank you!

A ton of it is learning on the job. I would say 70%. Particularly the manual things like splints and casts, reductions.

Keep an open mind. Real decisions shouldn’t be made til 3rd year.

I list textbooks and give similar advice in the thread. I know the thread is long, but it’s been running for 2 years now. I try not to answer the same questions over and over as it’s not a good use of time.

 

[OrthoTraumaMD]

As an attending in an academic center, how much do you actually operate versus your other duties and/or letting residents operate?

20% academic duties, 80% clinical. Of the latter, it is 80% OR, 20% clinic.
You allow residents to operate as much or as little as you think they can handle, it is person dependent.

 

[gonavy1234]

20% academic duties, 80% clinical. Of the latter, it is 80% OR, 20% clinic.
You allow residents to operate as much or as little as you think they can handle, it is person dependent.

Do you ever feel like you don’t get to operate enough because you’re having to teach the residents? Or do you do solo surgeries as well

 

[OrthoTraumaMD]

Do you ever feel like you don’t get to operate enough because you’re having to teach the residents? Or do you do solo surgeries as well

You hand off responsibility as you get comfortable. A young attending in their first or second year of practice should not have residents operate at all because they don’t have enough experience to “rescue” them. As you get more experienced, you don’t feel like you’re giving anything up because you’ve done a lot of these cases and you’re now teaching, which is an entirely different job. If it’s a difficult case that requires finesse, no one is doing it except me.

 

[Freshley Snipes]

What is clinic like for orthopedic surgeons? I know in other surgical subspecialties there is some (or a lot) of medical management of some diseases, does that translate over to orthopedics as well? Or is ortho clinic more of screening to see who gets surgery or not? And are there any procedures in clinic that you (as an ortho surgeon) do?

I know this may differ since you're a traumatologist, but could you also speak to other aspects of ortho as well?

Thanks!