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Orthogate

  Monday, 10 January 2005
  17 Replies
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Hey---

I've been considering ortho a specialty; I love the acute diseases, all ages of patients, good and quick results, and practice autonomy.

But I have also been turned off by the attitude in ortho. My first day of medical school I vividly remember going to the gym and listening to a pack of third years stand around drinking protein shakes, working on their biceps and other show muscles, talking about how their going into ortho cause the hours are good and you can make serious bank. This same event has recycled every year in that same gym as a new class arises.

A year ago, underwent surgery. At the 2 month follow-up, I said I was still having some pain with eversion. He told me and I quote, "look, you know know the anatomy, so its probably just in your head, you'll get over it." I'm still having problems with it.

I volunteered a few days to learn more about ortho. While working with the residents, twice in one day I saw them falsify the medical record/OR report (in a year on the floors I've never saw that once).

Over the holiday break, I hung out with an old friend MSIII of my wife who has always wanted to do derm because of the serious bank and good lifestyle, now wants to do ortho. This guy calls all fat people pre-ops, does cocaine regularly, and carries a bottle of JD in his glove compartment 'just in case.'

So I've come to your website and gone through most of your posts looking for some consoling. There are lots of unprofessional and crude remarks, and generally lots of concern about lifestyle and cash. Another poster asked about this a few months ago in regards to another seriously unprofessional post about 'body dysmorphic syn.' The response to her was quite positive and reassuring from two of you. But, again a third poster, says "IF you get flustered from comments on an anonymous message board you might be too touchy feely for Ortho....have you ever thought of Family Med???" Too touchy feely? because she stood up against some unethical behaviour, what if that was indeed a real patient? (and I dont think the 'troll poster' theory is all that valid)

In conclusion, as much has I want to go into ortho, I feel very bothered by my impression of orthopods as frat boys who have too little compassion for their patients and great love for their money and lifestyle.

Please tell me I'm wrong (if it indeed am). Please do not deny that many people who go into ortho choose it for money, lifestyle, and the avoidance of the touchy feely, but what percentage of people do you think choose it for those reasons? And, if I chose ortho, will I be ostracized for standing up to unethical behavior?

I know that I have been harse and inflammatory in this post--I'm hoping to incite some response. I think the stereotype of ortho needs serious improvement and the 'just chill' attitude that always counters it just isn't cutting it. So I apologize if I have offended anybody, but hopefully I've made you think (maybe thats just a familt med thing
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21 years ago
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#49325
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I am currently applying for an orthopaedic residency position and couldn't help but respond to this post. I'm sure your experiences were upsetting but I have rotated with a few programs and have never witnessed any of the behavior to which you refer. I agree that some of that is unforgivable but in my experience very rare.
However, I do think that if you have that many misgivings about ortho, it isn't for you. To do well in any aspect of medicine, you must love what you are doing and it sounds like you and ortho may have gotten off on the wrong foot.
21 years ago
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#49326
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I think that it may be easy to be misled by a series of bad experiences like those you've had with people in the field, though I would have to agree with the previous post in that I do not think this a representative sampling. While some will use money and lifestyle to sell the field, most will use it as a tertiary reason -- far behind their interest in the field and in the surgeries, and also far behind their interest in being with those people already in Ortho. It's true that the field is still male-dominated, and that some programs may resemble a fraternity house, but what you describe is something quite different from what I've seen around and what drew me to apply. Maybe you'd be better served by keeping an open mind and doing an elective at a program very different from your home program, to see what it's like there. If you still don't like the people you're with, or Ortho in general, then maybe you'll be better off doing something else. Hey, my girlfriend isn't a good fit for Ortho, but then again, I'm not a great fit for Peds either.
21 years ago
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#49327
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It is unfortunate that you have had so many bad experiences. I am a thrid year resident in Ortho. There will always be jerks in whatever specialty you go into. There will always be people that have questionable motives/ethics. These are the people that give the field of medicine a bad name and put money in the lawyers pockets. thankfully they are the minority but stick out the most and get the most attention.
Do ortho docs make good money? Yes. They also have a lot of training and work very hard to earn that money. Does that mean we are bad people for having high salaries? No. Bottom line is, you would be foolish to draw global assumptions about the whole specialty based on your limited exposure to a few meat-heads. Most orthopods are down to earth, easy going people who enjoy what they do b/c they notice a difference in their patients from when they first met them.
If you have any other questions feel free to ask on here so that the answers can be read by everyone.
21 years ago
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#49328
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"Please tell me I'm wrong (if it indeed am). Please do not deny that many people who go into ortho choose it for money, lifestyle, and the avoidance of the touchy feely, but what percentage of people do you think choose it for those reasons? And, if I chose ortho, will I be ostracized for standing up to unethical behavior? "



It seems that you lack a clear understanding of orthopedic surgery when you site lifestyle and the avoidance of the touchy feely as reasons for going into orthopedic surgery. Maybe you should do an elective in orthopedic surgery and see how "easy" orthopedic trauma is when you get hammered by calls all night. Orthopedic residency is one of the toughtest residencies around and at the places where I have rotated, almost half the cases presenting in the ER happen to be of an orthopedic nature. If you've had that many negative encounters with orthopedic residents/attendings and remain bitter as your last post indicates, then I think you should look elsewhere as far as future medical specialities go since most people going into orthopedic surgery go into it feeling that they get along and admire each other in that field. Your views of orthopedic surgery are vastly skewed since they are representative of a very small minority at most.
21 years ago
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#49329
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I do agree with the initial poster that the jock attitude is relatively common in ortho and can be somewhat obnoxious. It is particularly prevalent in the "sports" world and amongs quite a few general orthopods in the community. Academic orthopaedics tends to be a bit more conservative and "refined" for lack of better term. The stereotype of the sports guys is the roudy jock-type personality, "scopin' for dollars" as they call it. I completed my residency 2 years ago, and without a doubt over the years I have worked with my share of attendings and residents who left a lot to be desired from a social and professional standpoint.

The ethical dilemmas I disagree with. By and large the people I've worked with in this field have been as ethical and upstanding as those in any other specialty. There are bad apples in all areas of life.

Ignore all this bs if ortho is what you love. You don't have to "become" one of those people if you go into ortho!
21 years ago
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#49330
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I'm an MS4 going into ortho and I have had almost all positive experiences, and I've spent time rotating at 5 different programs, East coast and West. The idea that all orthopods are jocks and only want to make lots of cash is an overgeneralization. While there is more of a "locker room" atmosphere in ortho than perhaps in other specialties, sometimes that is what makes it fun (and I'm a GIRL!!!). Most of these people have at least half a brain to not take it too far. Also, I haven't met anyone who didn't go into ortho out of sheer passion for the specialty. The fact that some subspecialties make a ton is merely a bonus.

I have to agree w/ Bonedr about the rotten apples - there are going to be abrasive personalities in any specialty, but if I have to put up with them then I might as well do it in the one that I love.

Echoing some of the sentiments above, getting into and making it through an ortho residency takes serious committment, and if you don't love it 100% the whole process will wear on you and make your life miserable. It could just be your school - I'd suggest rotating at other institutions as early as you can to get a different perspective.

Good luck to ya.
21 years ago
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#49331
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Ortho does tend to attract the jock type joker personality and I have encountered a few of these in my elective months. In my experience this has been just a very superficial thing. The residents like to joke a lot and sometimes take it a bit far but when it came down to business (taking care of patients) they did an excellent job. Ortho residents in general really look out for each other also. Ortho is certainly not the only subspecialty in which residents/attendings joke about patients and make lewd comments. I remember the internal medicine residents joking about the obese, COPDer, sleep apneic patient; the pedi attending insulting a paranoid parent (not in front of the parent/patient of course); and the famiy med resident making lewd comments about an attractive patient, but patient care was very well above par in all cases. I have never witnessed a resident falsify facts but it is a pity that it does happen.
We should not become obsessed with being perfect and polite in every single instance. When dealing directly with patients, we should of course try to be at our best behaviour, but find instances where we can loosen up otherwise.
I have also made jokes about making money in ortho or joking about patients with other med students. I hope someone does not judge my entire personality after evesdropping on just one conversation.
In any medical residency, you will definitely encounter people you do not like but that is absolutely not a reason to reject a particular residency. If you truly like ortho then go for it, but be prepared for what you may encouter. This goes for any other residency program you are considering.
On the interview trail, I have noticed that different programs have different personalities. You can rank the programs that fit your personality high.
I don't believe that money and lifestyle are what drive orthopaedics. The guys who make a lot of money work VERY hard. If patient care were truly lacking it would not be long before these guys run out of business. Most people choose ortho because ortho is FUN and it's nice to make money doing what you think is fun.
Please don't let a few bad apples spoil the bunch.
21 years ago
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#49332
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maybe you should go into psych
21 years ago
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#49333
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I am a total joint surgeon at a university program in Philadelphia. The comments and questions raised by krufne01 are literally ridiculous. Inappropriate behavior occurs on occasion in a number of fields. Choose ortho because you love it. If you do it because of the money, you will ultimately become very frustrated. There are major headaches with the practice of medicine. What field do you have fun, operate with great tools, and make people a whole lot better. Most of us love what we do and we frankly don't care if you like it or not.
21 years ago
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#49334
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With so many misconceptions and misgivings about ortho I suggest you look elsewhere.
21 years ago
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#49335
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Dude, Just chill! Hahaha! I think that the people that go in to ortho are what makes it so cool. Orthopods are almost always the coolest, most down to earth people you will ever meet in a hospital. They are usually at the top of their class but not book nerds and have lots of interests outside of medicine. They work harder than almost any other specialty. Tough to judge someone from a single post, but I'd say that someone like you would not fit-in in ortho. You can care about patients but you don't have to be a pr1ck about it. I'd say go for psych or peds. Plenty of touchy-feely, and no one will think you did it for the money. Lates.
21 years ago
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#49336
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loosen up the sphincter old boy. most ortho people are decent. you've been blinded by the bright lights of being a doc only to find that we're all human beings w/ the normal variation in behavior (or "behaviour" as you put it). with that attitude, you may not be satisfied with any field in med --or outside. you should do like your friend, get your own bottlle of JD and place your bets on winning the lottery instead.
21 years ago
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#49337
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Find the FIELD that you love, because at 3AM, that may be all you have to keep you going.

Once you find the field, find the PROGRAM composed of the PEOPLE you would like to work & associate with professionally and/or personally.

Although Ortho has a male-dominated, Jock STEREOTYPE, there remains some degree of variety and "intensity" of this personality.

For example, I am very happy at my East Coast male dominated, mixed academic/community program. We occasionally get together outside of work (house parties, bars/lounges, drug rep/equipment rep events, etc.) and have a good time. ~50% are married so it's obviously not just frat boyz getting drunk and throwing up on each other, although that has happened once or twice
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However I am very aware that one (of two) of the females is not too happy... then again, she probably wouldn't be any happier at any other Ortho program either.

To summarize: FIND YOUR FIT!!! Gen Surg, Psych, Ortho/ NW, SE, SW/ Male, Mixed / Whatever or wherever this may be.
21 years ago
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#49338
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funny that so many belligerent replies to a legitimate post have only confirmed the authors suspicions. if anyone cares about my 2 cents (which i seriously doubt), i think you have the 3 most important characteristics of any outstanding orthopod - high ethical standards, concern for your patients, and a love of ortho. keep in mind that some of the respones telling you to look elsewhere are quite possibly competing for your spot. you will carve your niche in any specialty, so don't miss out on a chance to do what you really want to do. no great surgeon on the planet disregards bedside manner and patient communication. they will never be better than good, since post-op compliance so heavily influences outcomes.
21 years ago
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#49339
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The original post is the stupidest thing I've ever read or heard. The original post doesn't resemble anything logical or intelligent.

A guy does coke and drinks "JD" is going into ortho? He must be at the top of the food chain and represent the orthopaedic resident/physician! Someone falsified the record and you've never seen that before? Oh my! That must happen all the time! But, only orthopaedic surgeons use records! Hang 'em! Hang 'em! People going into a specialty dealing with sports related injury are former athletes/interested in sports (ie "jocks")? SHOCKING!

Well, I guess if I'm stereotyping from my personal experiences, family medicine doctors are all incompetent, general surgeons are all a-holes, emergency room physicians are all triage nurses (ok, this one may be true), etc. Ridiculous. You're condemning a field while simultaneously you're stereotyping the professionals that comprise it? Didn't momma or dadda tell you that was wrong?

Believe it or not, there are bad doctors and bad people in all fields of medicine just like there are for those in "real life" (unfortunately, it seems, you haven't yet sprung from the pre-med to medical student vacuum) job (ie bankers, lawyers, construction workers, etc.). Those by virtue of their own apathy, stupidity, immorality, or bad luck.

I can't believe I wasted my time on this topic. Best of luck in the future and perhaps try to think before speaking/typing. It's what every good doctor should do.
21 years ago
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#49340
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BoneCivitasDei, that was a great post. Well said.

I was more shocked that people took time to try to get this kid to apply to ortho.
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