By Guest on Friday, 16 November 2007
Posted in Match Center
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On a day to day basis, how physically demanding are your cases? How important is fitness to performance? Is fitness part of the criteria used to judge applicants?

Basically all ortho's I see are jacked, so I wanted to know if I needed to get started in the gym.
to get a residency interview at top ten places, you need certified proof that you can bench over 450...seriously
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18 years ago
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oh lordy. this again?

i'm 5'4" and around 125 pounds. i'm a biker and distance runner. and i'm a woman.

i can hold my own. not all stereotypes are true.
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18 years ago
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I'm stoked on all my interviews, I'm 5'9'', 125 lbs, female and a rock climber... so while I'm not buff I do know about body positioning for maximum efficacy. The result is I can hold my own with most guys I've worked with... and thus far no one has asked for proof of what I can bench press (and if they did they would probably laugh).
So basically it's not about the size of your equipment, but how you use it!
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18 years ago
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Agreed. Ive seen plenty of smaller sized individuals do even better than those with larger folk with brute force because they know how to use their weight effectively via positioning and such. This is coming from someone on the other side of the size spectrum
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18 years ago
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its not the size of the equipment its how you use it. I have heard plenty of guys use this line but it never seems to work
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18 years ago
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I'll be controversial. . . . . . . .but truthful. I'm 6'3" and about 270 lbs. Former FB player, can bench over 300lbs. Have I had trouble performing some orthopaedic tasks. . . . .yes. But usually, if I couldn't do it. . . . . .no one else was going to be able to do it either. When I was a junior, if the hip couldn't get reduced by me in the ER, then we'd be booking it for the OR. No questions asked.

I have definitely seen some smaller residents struggle with things that come easily to me. Examples: Doing a Lachman's on a 350lb NFL lineman. Prepping a leg in a 350lb trauma patient with ipsilateral tibia and femur fractures. Hammering home a rasp down a supper tight femoral canal. Water skiing on a huge leg for hours (I could just lean my 270 lbs backwards w/o using much muscle activity) during a tough fracture case. This doesn't mean you should go out and start doing growth hormone. It just means you need to find ways to work with what you have.

In short. Is ortho a physically demanding field. Yes. 10x more so than ANY other medical field. But OVER 95% of what we do actually requires more brain and dexterity then braun. But the reality is I NEVER saw my size as a disadvantage. And if you're on the smaller size of the spectrum and actually believe that you have NO limitations, you're fooling yourself. It's like me thinking I'm gonna go out and win a marathon. Just my humble opinion.
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18 years ago
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is that 270 muscle or chubb? I am kinda in the same boat. My six pack is now a full fledged keg!
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18 years ago
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In the words of one of my former teamates - "I got a six pack, it's just covered up by a bag of chips."

Translation:

Lots of muscle. . . . . . . . .and chub.
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18 years ago
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bone jock - sounds like you get scutted out to skiing the leg precisely because you are huge. i will proudly admit that i'm not strong enough to do some of things you've described. i am, however, smart enough to call for help when i need it, without a single adverse consequence to myself or the patient.

for the undersized out there - do not let this be part of the equation during your application process or career choice. do what you want to do for the hundreds of other good reasons out there.

rocket
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18 years ago
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My partner is the Orthopod, not me.

She's 5 foot exactly and her size hasn't stopped her doing anything so far.

Cheers
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18 years ago
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Young grasshopper. . . . . .never got scutted out because of my size. Every one will spend some time water skiing. . . . . .even attendings. Not exactly scut. Most times it was for the junior to do the case, as was done for me when I was a young jedi. More like being a team player.
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18 years ago
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Honestly, I have never seen a situation in ortho where being huge was a disadvantage, and many situations where being huge was an advantage (this from the perspective of a small guy).

That said, many great orthopods out there are not huge guys. Being huge helps with many of the tasks of daily living in ortho, but not being huge is not a great disadvantage either.
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18 years ago
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Honestly, I have never seen a situation in ortho where being huge was a disadvantage, and many situations where being huge was an advantage (this from the perspective of a small guy).

That said, many great orthopods out there are not huge guys. Being huge helps with many of the tasks of daily living in ortho, but not being huge is not a great disadvantage either.


sounds like a reasonable compromise


big and strong helps with trauma and total joints. on a 250+lb total hip patient, you need to be able to range the hip with one arm, and feel in the joint for impingement/etc. with the other.

small and nimble is probably better for hand surgery, foot and ankle, etc.

either way, the career seems physically demanding when it comes to general stamina. if you're 400+lbs and way out of shape, you better have good help
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18 years ago
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big and strong helps with trauma and total joints.


Just because I like to play devil's advocate, I would like to point out that there are plenty of great trauma/joint surgeons of small or medium stature: Tornetta, Koval, Scott, Harris, etc.

Can't say I can think of too many humongous hand surgeons though. I can certainly think of many great "small and nimble" hand surgeons.
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18 years ago
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yeah, like you would ever see tornetta skiing on a leg. if you are small, you just have to get to a point in your career where you have a band of meatheads following you around to lift legs and what not.
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18 years ago
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yeah, like you would ever see tornetta skiing on a leg. if you are small, you just have to get to a point in your career where you have a band of meatheads following you around to lift legs and what not.


Amen to that
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18 years ago
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You dont have to be jacked to meet the demands of an orthopedic residency, but there are some things to be said about maintaining a healthy lifestyle to get you though the long hours without fatigue. Oftentimes, its more of a stamina game than a strength game.

If you absolutley insist upon hitting the gym, work on your grip and forearm strength. This will help you more during the daily activities of holding stuff, reducing fractures and driving screws in without slowing down.

Mr_M
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18 years ago
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many who are apply to ortho think to much like Cobra Kai

John Kreese: Fear does not exist in this dojo, does it?
Cobra Kai: No, Sensei!
John Kreese: Pain does not exist in this dojo, does it?
Cobra Kai: No, Sensei!
John Kreese: Defeat does not exist in this dojo, does it?
Cobra Kai: No, Sensei!
John Kreese: Prepare! What do we study here?
Cobra Kai: The way of the fist, sir!
John Kreese: And what is that way?
Cobra Kai: Strike first, strike hard, no mercy, sir!
John Kreese: I can't hear you!
Cobra Kai: Strike first, strike hard, no mercy, sir!


and you need to think more like Mr. Miyagi
Mr. Kesuke Miyagi: Fighting always answer to problem.
Daniel LaRusso: No offense, Mr Miyajee, but I don't think you understand my problem...
Mr. Kesuke Miyagi: [interrupting] Mi... ya... gi... understand problem perfect. Your friend, all karate student, eh?
Daniel LaRusso: Friend? Oh, yeah, those guys.
Mr. Kesuke Miyagi: Problem: attitude.
Daniel LaRusso: No the problem is, I'm getting my arse kicked every other day, that's the problem.
Mr. Kesuke Miyagi: Because boys have bad attitude. Karate for defense only.
Daniel LaRusso: That's not what these guys are taught.
Mr. Kesuke Miyagi: Hai - can see. No such thing as bad student, only bad teacher. Teacher say, student do.
Daniel LaRusso: Oh, great, that solves everything for me. I'll just go down to the school and straighten it out with the teacher, no problem.
Mr. Kesuke Miyagi: Now use head for something other than target.
Daniel LaRusso: Hey, I was just kidding about that.
Mr. Kesuke Miyagi: Why kidding?
Daniel LaRusso: Because I'll get killed if I go down there.
Mr. Kesuke Miyagi: Get killed anyway.


having strength is only part of ortho. practicing orthopaedics is not holding a leg for hours. are there things that require some physical strength, sure. can people learn leverage techniques, most definitely. beyond the physical strength, stamina tends to be more beneficial than strength. even more important than physical stamina is mental stamina. most cases will not physically fatigue you, but they will mentally fatigue you. if you are going to train for the demands of surgery, concentrate on your physical stamina, more so than strength. hand and forearm strength is probably helpful as well. you really can't train for mental stamina required in a long case 5+hrs.
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18 years ago
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I agree with several of the various opinions stated so far. having strength cant hurt, especially if you how how to efficiently apply it.

I have only met one surgeon that I thought actually had a noticably harder time of things b/c of his poor strength. He was a great surgeon, things were just alittle harder but he still got the job done and I would allow him to operate on me in a second.

I have met several surgeons/residents who attempt to "muscle" through things rather than using a more proper efficient way of doing things. It usually ends up a big struggle/mess. there is a reason we have things like AO distractors and fracture tables.

In the end, I dont think it really matters that much. Some people may just have a little harder time with certain things but still get the job done
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18 years ago
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I have met several surgeons/residents who attempt to "muscle" through things rather than using a more proper efficient way of doing things. It usually ends up a big struggle/mess. there is a reason we have things like AO distractors and fracture tables.

In the end, I dont think it really matters that much. Some people may just have a little harder time with certain things but still get the job done


what the hell is an AO distractor?? j/k. strength NEVER hurts as long as you know how to use it. period
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18 years ago
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