So I'm trying to get my foot in the door of Ortho but I keep getting rejection after rejection. End goal is to work with prosthetics and working towards my ME degree. While I'm doing that I've been trying to get a job in or close to the field. I've looked at getting a Cert as an Ortho Tech but the closest college is an hour away. Any suggestions on how to get through this barrier? I know once I can start gathering experience I'll be good.

Hey everyone- I'm an adult recon fellow and have essentially finished interviewing, likely expecting some contracts to come in (3PP, 1 Academic/Hosp Employed). I'm wondering if anyone has used Resolve, Emily Ast (her husband is an HSS joints attending), or any other contract review lawyer? Any suggestions would be greatly appreciated!

Hello and a good day to everyone.

I am a IMG Ortho on my 2nd of my 3rd ACGME fellowship here in the US. I would really like to become a US board certified Orthopedic surgeon and have worked my ass off to get where I am right now. I finished my USMLEs and am ECFMG certified.

It has not been easy and I often feel unwelcomed by some US orthopods to join in on the pool but I would like to see my dreams come to fruition. I would like to talk shop with my PD and other US fellows like salaries and guidance on how to set up a practice in the US, however I feel out of place and again ( maybe its my fault) unwelcomed in these types of discussions. I know they talk about money matters and practice option when they go out and have a beer or go for golf, but so far, I have not been invited to such events.

Anyway, I am seeking for guidance. From what I know the path is going through 3 ACGME accredited fellowship years then get offered a job in a university for 4-5 years then apply for board certification. Correct? However my assumption has been challenged when I met other IMGs who have finished 3 years of orthopedic fellowship training ( some not even ACGME) and end up with a job from a practice that does not require board certification.

Now my question is, is this legal? Is it acceptable? I don't want a quick buck and get in trouble down the road. I am really concerned on these matters especially with the new administration coming in and I am still on a J-1 visa. Certain states have approached some fellows even after 1 year of training. I would like to do this the right and proper way without getting in to trouble. But the same time I am running out of time, money and options.

I so far get good to acceptable reviews from my peers and seniors but not on par with a US ortho grad fellow. That much I understand and I am willing to work hard to bridge the difference eventually.

Any insight and advice on the matter or if you just like to throw in your 2 cents is welcome.

Any thoughts on how this will affect our specialty? I doubt this will affect employed positions too much due to how much value they provide hospitals, but probably will just further squeeze private practice

Anyone else have a similar dilemma?

Joints pros: Primary hips and knees are extremely gratifying both as case itself, but also outcomes. My favorite cases of residency thus far

Clinic can be very efficient

Predictable for the most part

Cons: Tough, stressful revisions

Less variety than sports

Physically taxing

Sports

Pros: High case variety

I enjoy scoping and cases like ACL, meniscus, cuff repairs

Potentially could supplement practice with primary hips/knees(although I’m at an academic institution and don’t know how feasible it is)

Can satisfy enjoyment of arthroplasty with shoulders

Cons: I dislike hip scopes and would not want them in my practice

While I enjoy scopes, my favorite cases are primary hip and knees

Depending on practice set up, team coverage on the weekends when I’d rather be watching my kids events

Torn between these two specialties. I don’t know if I wanna be the revision guy but I love hips and knees. Don’t know if I would have to give that up to do sports. My primary reason to do sports fellowship would be to add another skill set and do scopes I do enjoy, but hope I could still do some joints. I also don’t know how important hip scopes are when job searching but I really don’t find them enjoyable. On the other hand, doing joints private practice guarantees me the ability to do primaries a large percentage of the time.

MS3 30M interested in both ortho and rads, I really dont wanna make the wrong decision so I once again am back on ole faithful reddit asking for your advice.

Let me break it down for you... and yes i know they are completely different.....but buckle up cuz this is gonna be long.

Ortho Pros: 

I love the nature of the work they do.  My dad is a carpenter and I grew up using hammers, nails, saws, etc .. it just feels right and I think I will be good at it which is a huge attraction for me.  I love the OR and I like the idea of putting music on locking in and working with my hands from muscle memory... no thinking about how staph aureus is a fucking catalase/coagulase + whatever...*retches*.....  I am excited to forget these little nuances in medicine although it was definitely cool to learn them once.  I also am very familiar with the culture of the "ortho bro" and I tend to get along with these types and fit in well so this is a plus for me.  I couldnt care less about the "prestige" that comes with ortho but the money is nice cuz I'll be half a mil in debt. One major thing that attracts me to ortho is the fulfillment you get from making a tangible difference in patient's lives.  You give people the ability to walk again, and on my elective ortho rotation people were so grateful all the time when talking with the ortho team.  I can only imagine how good that feels.  

Ortho Cons: 

Big thing here is lifestyle, as I prioritize my family over everything.  I wanna be there for my (future) children and go to their sports games etc.  I know lifesyle gets better as an attending but does it really get that much better?  You need to bust your ass  to establish yourself after residency, and it will take a few years to find a group and get set up so you can finally have flexibility.  I'm already old so by time that happens ill be 40.  Perhaps the biggest deterrent for me is that trust me there is an extremely low chance I will be able to stay in my hometown, and will likely be in a somewhat bootycheeks neighboring state/city where most people from my school match.  This sucks but i guess ill be living in the hospital for 5 years regardless anyway so whatever.  Another con is taking work home with you, which I am just assuming orthos do here could be wrong, and if I add I'll just pivot to add on cases that fucking suck and just when you think youre going home boom add on case and you gotta stay so now u cancel your dinner plans with bae who's getting more and more frustrated with your absence.  Theres also a much higher risk of not matching than rads even tho both are hard. Moving on..vacation time.  Rads gets a shit ton, ortho doesn't really unless youre private practice and youre taking a financial loss / your partners are getting frustrated with you.  Also you kinda gotta plan ur cases around it leading up cuz u dont want a major complication while ur in Cabo.  I'll put call here but idk shit about call for orthos...q6? idk but its prolly worse than rads.  

Rads pros: 

I always enjoyed reading CTs MRIs Xrays etc.  I would get a lil excited when I was doing Uworld and would see an image. Its like a  puzzle for me to figure out which i like.  Radiologists really seem to like their jobs overall.  They seem happy with their work life balance and a ton of people say it was the best decision theyve ever made because they have so much time for their family and hobbies, this is HUGE to me.  This is perhaps the biggest allure to me.  Being able to work from home are you fucking kidding me? and the money they make ? insanity.  The fact that I am moderately interested already i feel like is big bc i know a lot of people doing it just for the lifestyle and they hate the nature of the work.  Also the hours as a resident are half of what orthos will work.  I know theres a lot of self study that must be done but still.  This will give me time to date, go to the gym, hang with friends, etc.... i know not much but still. Also theres a TON of rads residencies in my hometown and that allows me to be by my family and friends for 6 years (huge).  Its  easier to get into than ortho too, although still hard. VACATION TIME. THIS IS NUTS. 8-12 WEEKS ON AVERAGE.  MORE LIFE! DRIZZY! Big plus! Less call (i think).  Work is done when youre done, you dont bring it home. No add ons. Hours are more predictable, and hours are probably less on average. My pre-medschool extracurriculars all just happen to be rads-esque so I have a great trajectory on paper, this in addition to it being an easier overall match is a pro.  

Rads Cons: 

I like rads day to day work, but I'm not sure i love it... is does anyone? My elective I sat behind a MF talking like Twista into the mic in a dark room and i was ignored.  Thats fine bc its like watching someone play video games i get it.. but i know for a fact I like the day-to day work in ortho better as of now at least. I met a radiologist (only one whos ever said this out of a ton btw) who says he regrets doing rads and wishes he did surgery because the work is inherently isolating and he really underestimated that.  He says he would rather make a more tangible impact on patient's lives. Rads are the unsung heros much like anesthesia.  Theyre saving lives behind the scenes. Ive also heard radsis one of the few residencies where attendinghood is more difficult than residency.  I know ur making real money at that point so whatever but still. I know I like reading imaging studies...but i'm not sure I would like a never ending list of them.  This just forces you to work faster which increases the likelihood of a miss (scary).  I also have no idea if id be good at Rads, whereas i know I will be a good surgeon.  Will i be good at finding one of those super rare diagnoses? Seems like you have to be locked TF in all day long and there are few breaks at all not even to eat.  I might get antsy! I heard its like taking a 9 hour anatomy exam every day and theres few things comparable to the level of mental exhaustion achieved from a single rads shift.  I'm a slow reader! does this translate? idk maybe not..probably not...but idk maybe id be a shitty radiologist.  I think I would miss interacting wth patients but again not a deal breaker.  This is gonna trigger people but also AI!!! I know itll neve4r replace but im worried it will change the landscape and could potentially make rads so efficient that it could drive demand, pay, vacation time etc down.  

Alright this is long enough even tho i can keep going on and on about this bc im currently in crisis mode, but ima end there.  TIA reddit fam any input is appreciated <3

I will be starting M1 this summer. I was wondering how the lifestyle is looking in the current climate for hospital-employed and private practice orthopods.

My main considerations for selecting a specialty are compensation and lifestyle -- I am well aware dermatology is great for this but I enjoy the MSK subject matter a lot more than skin.

Correct me if I am wrong, but from research online, I would have to specialize in Sports Med or Hand to have a great lifestyle?

Any input or reccomendations would be helpful. Thank you!

Title says it all.

Currently R1 at a Top 3 rads program nationally. I scrubbed into some ortho surgeries my intern year and was blown away by how cool it was and it's been eating at me since...

I am now reading scans all day and it...just isn't what I thought. Would love to do IR but feel as if I could be even happier back in the real OR (I loved my surgery rotation).

I was top 2% in my med school, USMLEs > 265, published a LOT (but nothing at all in ortho), AOA. Did very well my intern year and could get some nice letters, etc...

Hey guys, just a lowley PGY2 here.. but for someone in Ortho who wants arthroplasty and as someone who used to ski race competitively I feel my worlds have collided.

Thoughts on Lindsey Vonn returning to competitive skiing with a lateral uni? As someone who used to ski downhill I would absolutely not be skiing on a uni knee to that level.. but maybe that’s just me after seeing some of the complications from periprostehtic fractures.. What are your guys thoughts on this?

https://www.powder.com/news/lindsey-vonn-knee-replacement

I want to make so cal my forever home after training, looking to do private practice, is it really that bad of a deal as my attendings keep saying?

Do you really get payed peanuts relative to the rest of the country, while paying HCoL and high taxes? I find that really hard to believe, but don’t really have proof.

I don’t really care about the political climate and I think that’s what bothers a lot of my attendings.

Hello, Resident struggling to learn Oncology.

I have zero framework on how to even begin to classify these tumors; they all just seem like a mashup of words.

Is there a good resource / other method to help learn how to categorize ortho Onc tumors? Is it just brute force memorization? Everything from how they’re named, benign vs malignant, most common sites of local/met disease, etc

Mnemonics would be great too

Thanks in advance

Medicine just ain't what it used to be. Reimbursements are going down, administrative rates are going up. Administration and management has been the primary driver of increasing healthcare costs over the past 30 years. This job isn't as safe as you think.

Large corporate entities are commanding contracts that reimburse up to 300% medicare rates, but the mom and pop shop ortho down the street will barely be able to get up to 100% after years of grinding.

Meanwhile, if you are working for corporate, you're probably generating 1.5 million, but only getting paid a third of that, effectively paying a 66% overhead to administrators and middle management who are going home with million dollar salaries.

There's gotta be a better way than working your ass off and seeing most of the fruits of your labor going to some un-qualified shyster who makes you sit in on Zoom meetings every fucking month or you don't get your year end bonus.

I'm open to all ideas, cash clinics, PRP clinics, contract work, QME, basically anything to end this rat race down to the bottom that we are all un-knowingly stuck in.

I don't want "well you shouldn't have become a doctor!" to be the only answer I hear, because that fucking sucks for those of us who have been working for 10+ years in the shit to make good money, only to have it squirreled away by the fuckers in c-suite.

I want this to be an open forum for all suggestions on how to increase our reimbursements, increase our compensations, and to stop letting PE and corporate rob us of the money and good we do.

This may fall upon deaf ears, but at least it's something other than just sitting back and just accepting whats going on in not only this field, but all of medicine.

Long term, healthcare is going to go belly up as the smart and driven individuals are driven away from practicing medicine and surgery.

Hi everyone, PGY-1 here!

Had an opportunity to scrub into an internal hemipelvectomy on a young patient with ewings sarcoma. I’ve been leaning towards pursuing a peds fellowship, but this case with its complexity and multidisciplinary approach really drew me in. I know I’m super early in the process and my exposure is limited. Would love feedback from some of you who may have considered an onc fellowship or currently in one.

Thanks!

"Why are there so many Korean spine surgeons?"

There does seem to be a positive correlation between having a last name of Choi, Lee, Yoon, and Kim and ending up doing spine. Or is there not really a correlation at all? Anyone have a good answer?

Hey guys, relatively new resident here.

Been doing a set of nights with lots of casts, usually just have one other person to help with casts.

Even using a wedge and another person I find a really struggle keeping the backslab and stirrups in a good place before the crepe and they all fall down with gravity ending up with heaps of creasing at the ankle.

Any tips?

For cephallomedullary nails, what’s the basis behind loosening the set screw a quarter turn after locking in the lag screw?

What is the best way to study and memorize anatomy? I always forget it and its a bit boring to study. Any tactics!

As the title says. I'm a current PGY5 strongly considering applying to do a trauma fellowship (as a second fellowship following a one year adult reconstruction fellowship). Heres the thing.. I have no interest in, or intention on fixing pelvic and acetabular fractures. It is not something I personally find appealing.

I do however find complex peri-articular trauma/DCO etc to be very interesting and something I would love to become proficient at. I don't think my residency training alone will help be become comfortable at managing smashed pilons/distal humeruses, very nasty plateaus etc.. and I would love to do more than just basic bread and butter trauma.

- Is it reasonable to spend an entire year (trauma fellowship) to become better at managing these (injuries mentioned above) in practice?

- Would it be considered a "waste" (although I don't like using that word because no training/education is truly a waste) of valuable fellowship time if I don't plan on operating on pelvises/tabs?

- Are there certain trauma fellowships with less emphasis on pelvic/acetabular trauma?

PGY3 currently weighing the pros and cons of fellowship choices. Currently between joints and shoulder elbow. I enjoy shoulder arthroplasty, but I'm not sure if I like everything else that comes with a shoulder elbow fellowship. I've also been told by my attendings that it's hard to find a job as a shoulder elbow surgeon and you need to be okay with taking care of a multitude of injuries and conditions. Is that true? I understand that job availability is location dependent, but is the market really that grim? I am in the northeast

The worry with joints is Medicare/Medicaid cuts. There are also a number of residents going into joints in mine and adjacent programs and so again I worry about the job market here if it does get saturated with a ton of joint surgeons.

Or do I do sports and do shoulder and knee replacements?

Am I overthinking this? Maybe. I know I should pick what I enjoy doing the most but any and all advice/people's experiences would be greatly appreciated

TLDR: PGY3 struggling with fellowship choices and worrying about stuff I shouldn't be worried about

I'm writing a book and have a couple of questions about distal radius fractures which I'd be very grateful to have some guidance on. I've researched quite a bit on scholarly databases but have reached a point where an expert's thoughts would be enormously appreciated.

Could a very severe distal radius fracture (perhaps resulting in a nonunion) have the potential to cause chronic pain/nerve damage? What would be the markers of this sort of fracture?

Is there a type of distal radius fracture which (even post distal radius ORIF) could leave the area more vulnerable to further fractures of the distal radius or even the ulna?

Hey all,

In the middle of my first year but have spoke to some of my attendings at an academic program in the Midwest. Some saying with overhead costs etc as a junior attending at a private practice, the gap between academic and private pay is getting less. Others saying more and more people are going private and it’s becoming harder to attract academic physicians. What’s the landscape out there really like for pay and jobs in the academic vs private fields?

Thanks!

Just want to get an idea of what market rate for taking call at a trauma center is. Please list your rate and the level of trauma center. Thank you, hopefully we can use this to negotiate higher pay for those of us who take ED call

Hello everyone

What is the difference between those two techniques? Both include the medialization of the tibial tuberosity, I am at a loss here.

Thank you, a lowly PGY2

Hi all.

Once an orthopedist told me so. Is it true?

I remember learning in school that avascular necrosis often comes with a weight-bearing restriction but so far in my practice (5+ yrs) it seems as though most ortho docs have their patients be WBAT (usually with RW or other assistive device). Is this the case 90% of the time? Just wondering because I’ve held patients before pending ortho recommendations but it seems like there’s usually not any WB’g restriction. Thanks in advance!

EDIT: specifically wondering about AVN of the hips.

Hello! Im 17 who's applying for universities right now, and is planning to be an orthopaedic surgeon in the future, I'm not sure what to major in to be one. On one of my college applications that I’ve submitted, I put my major as nursing because then i would be guaranteed a job right after and it would help me pay for any debts that during university and pay for medical school. Some colleges that I'm applying to rn dont have nursing as an option so i dont really know what to choose i do have a few options i was thinking of majoring in pre- medical, physiology, and public health but im not really sure. What would be best to major in to be an orthopaedic surgeon?

Hey everyone! A couple of weeks back, I had posted the anonymous salary sharing form here, and it’s been great to see the initial response. We have ~30 FT salary contributions already, with all the rich details like shifts, hours, and benefits, and the data is now really starting to take shape - so I put together a quick summary of averages. The good news is the community powered average is holding up ok against other salary benchmarks, but with our data - we can look much deeper into shifts, benefits, etc and into individual contributions.

Community Powered Salary Average - $580k
Other Benchmarks - Doximity - $654k, Medscape - $558k, AMGA - $723k, AMN - $686k

What do you think of the average? Feels like our average is a bit lower than I expected, but we probably just need some more contributions for this to be more solid.

You can share your salary here to see the full data.
Here are the details inside the averages -

https://preview.redd.it/bqbtbgl5qw0e1.png?width=402&format=png&auto=webp&s=4d2affd45866230e5bc08bfc1cb712c494b2e988

If you don’t have access to the full sheet of salary data - add your salary here to unlock all the data.

Nice work all. Let’s do this! 🤝