Session 5 In this week's episode, Ryan talks with an orthopedic hand surgeon in a hybrid setup. He's in a community-based hospital and program but he has residents he interacts with who rotate through the hospital. He has been practicing for almost two years. Here are the highlights of the conversation with Ragu: When he knew he wanted to be an orthopedic hand surgeon: Deciding he wanted to be an orthopedic surgeon towards the end of 2nd year medical school He chose hand surgery towards the middle of his orthopedic residency after doing some rotations and liking the intricate nature of the hand What led him to orthopedics vs. general surgery: Enjoying the aspect that you focus on the extremities It's a specialty with multiple subspecialties - (ex. sports, joint replacements, shoulder, knee, hand, children) so it gave him a lot of options General surgery is like a primary care field with no cross-correlation for orthopedics. Other specialties he was considering: Anesthesia Radiology EENT Traits that lead to being a good orthopedic surgeon: Hardwork Dedication Desire to work with your hands and doing procedures Good motor coordination A typical day for an orthopedic: 3 days of office 1 1/2 days of surgery 1/2 administrative work or extra surgery Office day: 8am - 4pm seeing 20 patients 20 minutes per patient + 5 minutes to do charting Consultations on the floor in between Answering calls from patients One weekend per month of call Surgery day: 7:30 am to 3-4pm doing 3-6 surgeries a day (depending on the type and length of surgery) 75-80% of his surgeries are hand/upper extremity surgeries (hand, wrist, forearm, elbow) *Majority of hand surgeons do only hand surgery (90-95%) *The average orthopedic surgeon takes 5-6 days of call a month (1 weekday a week and 1 weekend for the month) Types of patients and cases an orthopedic sees: Carpal tunnel syndrome Tendonitis Hand fractures/injuries Traumatic injuries (lacerations on the hand) Percentage of patients he sees in the office that he ends up taking in the operating room: 1-2 out of 20 people that he sees Does he have work-life balance? He is married and travel once every 3-4 months for a vacation. He has a number of hobbies outside of work like basketball and golf. Quality time with his wife, friends, and family You have a good chance of having a say on who you want to set up your life because you get to pick and choose what is important to you. What makes a competitive applicant for orthopedics: Showing interest in orthopedics (talking to the orthopedic department in your school and talking to some people) and getting involved such as research or lectures Good board scores Good letters of recommendation Good scores on clinical rotations especially those involving surgical stuff (surgery, OB, medicine) Bias in the orthopedic field towards DO applicants: In the past, DO applicants were not getting proper consideration. But in the recent years, DOs are starting to get more recognition as being just as competent as MD applicants. Generally, there is a slight bias against DO applicants applying to MD orthopedic programs. Residency as an orthopedic surgeon: Tough but every year gets better He enjoyed it a lot. Duration: 1 year general surgery intern year (half doing orthopedics and half doing general surgery with a potential for a month of elective such as radiology) 4 years of orthopedic-only residency What the orthopedic fellowship looks like: 1 year (Others do second year on a different fellowship) Orthopedic fellowships are cyclically competitive (every 4-5 years, there's a new, popular fellowship that everybody wants to get into) Opportunities for females to enter orthopedics: There are many females in orthopedics. Women can be just as good as men in orthopedic surgery and can do any subspecialty they want. It's just a matter of knowledge and training. More and more women are now going into orthopedics and there are now more and more women in orthopedics