Ortho vs. General Surgery

The answer is... it depends on what you are doing and where you are.

If you did a gen surg trauma rotation you probably saw mostly non-surgical management of sick/disaster patients. Private/elective services are generally much more tolerable. Hours depends also, in general, most places the orthopods will work less, but with 80 hour work weeks, it probably isn't too much different if the programs are making an honest effort to follow duty hours. The biggest differences I notice are]
The patient population (trauma excluded), as they are often younger and healthier.

More operating (by far) on ortho trauma vs. GS trauma.

The ortho attendings are generally more laid back than their GS peers.

Many fewer "life and death" decisions.[/b]

Keep in mind that ortho still has it's share if sick, difficult to deal with patients to manage. There is still a lot of non-op management and clinic.

My advice is to learn as much as you can now, it will make you a better physician in the future. Explore ALL options, surgical and non, and you will eventually find the right fit for you. Now matching can be another story...
Good luck.

I'm guessing you're asking this because you thought you wanted to do ortho but hated gen surg. Here's my take:

In general (note that this is in general) people in Gen Surg are miserable. Attendings are mean, residents work hard and typically don't like it - especially in a malignant program like the school I go to. They also do a lot of managing sick patients that don't need to go to the OR. It also seems like they have an arrogance about them that they are the best doctors in the hospital. Example: my buddy who also wants to do ortho is doing a Shock/Trauma gen surg rotation and when he told them he wanted to do ortho they said, and i'm paraphrasing, "why would you want to do that,don't you want to help people?"

that being said, it is different in the world of ortho as compared to gen surg.

Hours: depends on what service in ortho and what kind of inpatients you have. If you're on the hand team, not a lot of inpatients, you show up later and the cases usually finish earlier (compar.) so the hours are better. If youre on joints or trauma with more inpatients then your hours will be longer

Intern year for gen surg and ortho are fairly similar at most places, and they are miserable in both fields usually...

You Operate a lot...and there are very surgery heavy ortho programs out there. That being said, there is a lot to learn from clinic and stuff. You don't usually spend most of your days in ortho dealing with floor issues and managing very ill inpatients.

In the private world, a lot of orthopods consult internal medicine/ICU to help manage vents and all those other ICU/medicine complexities

That's my take. Ortho is awesome and you will 1. be the only person in the hospital who can do what you do, and 2, actually definitely make people better (except spine...)

And to echo fatpad, matching is a different story
--Ortho is pretty tough to match in so i'd plan for ortho (research, etc) and if you fall back to something else it's easier than climbing an uphill battle

a lot of surgery is critical care...but mostly, these days.. only if you do surgery critical care.

I don't think it's fair to say that all GS folks are miserable. I think one of the reasons residents these day are miserable in GS is because they're all going to specialize in something else.. ortho is more off that bat..what you want to do.

Every orthopod, no matter what the speciality is, will pretty much do a combination of 1. their sub-speciality, 2. trauma, 3. joints.. that's like 'general' stuff..which is what you want to do. I think a lot of general surgeons further specialize in colorectal, breast,tumor,trauma,vascular,cardiac,thoracic,head/heck,etc. etc.. that's 5 years of wading through a lot of stuff that you don't want to do or maybe will never do again..

Unless you specialize in gsurg, a lot of what you do is primary care medicine,..but with a surgical/critical twist... In my program, the ortho residents work longer hours more consistantly than the gsurg ones do..why? because there is higher operative volume.. But the ortho folks love it...because it's what they want....and when you're that busy (especially on ortho trauma), ortho folks in big places dump the stuff onto a general medicine team or surgery team.. Imagine how that must feel for the gsurgeon..they're surgeons too, ortho get's to have the fun..and they deal with fluids and diet..

but that's residency.. once you get through that stuff.. it's up to you how you want to practice
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I would agree and have to retract my previous notion in that it is unfair to say all GS people are miserable. There are definitely people who specialize in GS and love it. I think you emphasized more what I was going for in that a lot of people want to further specialize and doing the other stuff isn't that fun for them. This is particularly bad if they ended up falling back on gen surg from another categorical, i.e. urology, ortho, ent, etc.

Either way, every specialty has that one thing that is annoying/their bread and butter - GS has appys and gallbladders, IM has DM and HTN, ortho has back pain etc.