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Medical Education
Medical Student Education

Career Information: Orthopaedic Surgery

Specialty: Orthopaedic Surgery
Completed by: Nicole Schroeder and Mohammad Diab
Date completed/updated: April 2014

  1. What can students do in the 1st and 2nd years to explore and/or prepare for this career?
    Orthopaedics 160.01 Introduction to Clinical Orthopædics, winter quarter.
    Musculoskeletal examination practicum, linked to 160.01 in March and given again in September.
    Shadow a surgeon in clinic and in operating room. For more information, contact our residency coordinator, Nicola Sequeira.
    Shadow a resident on call.
    Research project with an attending orthopædic surgeon in the summer between 1st and 2nd years.  Start investigating opportunities at Christmas, so that preparatory work can be completed by the beginning of the summer. Contact Nicola Sequeira.
    Attend the bi-annual medical student meeting with the Chairman of the Orthopaedic Department.
     
  2. What common variations exist in the length/content of residency programs for this career?
    Most orthopædic programs are five years in length: intern year (6 months general surgery, 6 months ortho), 4 years rotating between the 8 principal (trauma, arthroplasty, sports, pædiatrics, hand, foot, spine, oncology) divisions of orthopædic surgery.
    Some programs add a 6th research year.
    Most divisional fellowships are 1 year.
    Some surgeons are taking 2 fellowships, in particular in pædiatrics and sports.
     
  3. What common variations exist in this career after training?
    Private practice and academic medicine. This is a busy surgical field.
    Part time is possible though rare. Most groups require full time call.
     
  4. What is a typical work-day for someone in this field?
    At work before 7:00 am
    Home by 7:00 pm, though varies.
    The days of the week are divided equally between clinic and operating room. 
    Number of call days for an attendting surgeon vary according to institution, but can be as frequently as 10 days per month or as infrequently as 2 weeks per year.
    Residents work the full 80 hours per week and take call 2-3 days per week.
     
  5. What is the culture of this career?
    Extrovert, energetic, up-tempo, technological, innovative, brash, optimistic.
    Higher proportion with a sports background.
    Lower than average non-Caucasian.
    Male-dominated field: < 7% of all practicing orthopædic surgeons are female, however this is changing.  This is an opportunity for impact for women.
    Trauma care is integral to the culture: immediacy, unpredictability.  This is a less controlled field like some other surgical subspecialities such as ophthalmology.
     
  6. How compatible is this career with raising a family? How is this different for men and women?
    Surgeons have families, who are successful. Female surgeons have families, who are successful. Surgery requires a more organized and planned approach to family, including assistants for a female surgeon whose partner also works.
    Women in surgery are more likely to postpone starting a family until residency is finished.   
           
  7. What are the most important qualities or character traits for a person in this field?
    Hard work is the single most consistently valued trait in orthopædic surgery.
    Distinguishing characteristics include: team spirit; physical demand (e.g. of long operations, of handling heavy limbs); absence of pretense to manage ‘the whole patient’.
     
  8. How competitive are the residency programs in this field?
    This is one of the most competitive fields, in the same group as neurosurgery and dermatology and ENT.
     
  9. How competitive is the job market after residency?
    The prized positions are competitive because the quality of student who enters the field is high.
    However, there is an abundance of jobs because the burden of musculoskeletal disease is high in society. The population is ageing, and technology is driving expansion of the field.
     
  10. What programs have been popular among UCSF applicants, or how should applicants go about considering programs?
    Away rotations are critical to the application, but can be a double-edged sword. While they usually improve the chance of matching because they may be regarded as a month-long interview, they occasionally harm if the student does not perform well. It is expected that students complete at lease two away rotations in addition to your home rotation.
    UCSF students are popular at Columbia, Harvard, UC Davis, University of Washington, Duke and Hospital for Special Surgery.
    Several factors influence decision to rotate at an away program:

    Location.  Will you enjoy living there?  Note that surgeons settle a mean of ~ 60 miles from where they train, showing that strong connectxions are formed during residency and fellowship.
    Large or small program?  The former may offer a more diverse experience, while the latter may be more intimate.
    Private or academic?  As general rules with exceptions, private programs tend to be more gentile, more primarily operative (e.g. less fellows), less intellectually rigorous.
    Do you have an early interest?  E.g. a broad county public trauma experience or a highly specialized more private training?
    How is the resident culture?  Are the residents cohesive and happy?
    How is the faculty culture?  Is there turnover?  Is the Chair position stable?
    How is the operative experience?  E.g. do fellows constitute a barrier?
    How is the formal education curriculum?  E.g. conference schedule, funding for academic travel.
    What are there research opportunities?  E.g. research rotation, publications with attending faculty, extra year or other time for research training.
    Where do graduates take fellowships?
     
  11. What resources (eg, websites, books, professional groups) would you recommend for students interested in learning more about this field?
    Start at https://www.aamc.org/cim/.
    Orthopædic Surgery Interest Group (OSIG) at UCSF.
    Reading list on UCSF Department of Orthopædic Surgery wiki, including primary literature and textbooks (e.g. Principles of Pædiatric Orthopædics).
    Orthopædic curriculum on the Department of Orthopædic Surgery website.
     
  12. How important is each the following for admission to a competitive program?

 

 

Very Important

Somewhat Important

Not Important

Comments

Extracurricular/
volunteer work

 

x

 

 

Research/publications

x

 

 

Does not have to be in orthopædics: excellence is most important.  However, in orthopædics is more understandable to potential interviewers and offers an opportunity to discuss and impress.

Honors in third year

x

 

 

These are the best correlates with success in residency; hence importance attached to them.

AOA

 

x

 

 

Subinternship

x

 

 

Essential for recommendation. Hard work. Read for every case. Demonstrate initiative.

Externship

x

 

 

Specific to externship. For example, letter of recommendation from an externship may not be important beyond that program.

Other: USMLE Step 1
 

x

 

 

Many programs screen out applicants < 225.

Other: Longitudinal Clinical Experience x 

A source of second orthopædic letter of recommendation from a varied setting.

An opportunity to learn more about the field.

 

 

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