Dr. Elaine Joughin chose to go into orthopedics because it's a "doing"
kind of specialty. "I actually am quite mechanically minded. After I went
into medicine, I found this specialty was most to my liking because of that
mechanical aspect.
"When you're fixing broken bones, you're essentially trying to reverse
the mechanism of injury and make sure it stays where it's supposed to until
it's healed. You often put plates and screws and rods into the bone to keep
it there. That's sort of like carpentry skills."
Surgery itself is also a "doing" kind of specialty. "Rather than waiting
for medicine to act, we fix the problem so that you see an instant result.
We rarely prescribe medicines at all except to reduce pain after surgery,"
Joughin says.
Only two to three percent of board-certified orthopedic surgeons are female.
"Part of the reason is the carpentry skills and the mechanics, and the fact
that a certain amount of strength is required in order to do some of the operations.
"Traditionally, women didn't like putting a lot of mechanical effort into
things, so it was stereotyped as one where you sweat and toil. That's changing.
Most of us who go into it don't mind spending some energy to do these kinds
of things, because it does require strength and muscle."
Dr. Mitchell Goldflies chose orthopedic surgery because he couldn't go
into engineering. "Performing surgery is a privilege. It can be very scary.
Stress is always present even if you are confident and relaxed.
"It's like driving your car on an icy road. Things may go OK, but suddenly,
even if you are cautious, you can slip off the road into the ditch. The trick
is knowing how to get out of the ditch by yourself and when to call for help.
"Prepare for all possible alternatives. You can learn from every case because
every case is different. You can never let your guard down and assume that
everything is routine."
Goldflies has this advice to anyone considering the career. "Get great
grades and letters of recommendation. Do research and do community service.
Have a backup career plan."
Dr. Jacob Rozbruch went into orthopedic surgery because it offers so many
options for patient care. "The individual subspecialties include sports medicine,
as well as concentrations on various parts of the skeleton and limbs. Fellowships
are offered to postgraduate residents of one to two years in a particular
subspecialty if desired."
Rozbruch's areas of interest include spine, shoulder and knee arthroscopy,
and joint replacement surgery. His partner prefers fracture care.
"We both will see other problems as needed, however. Most orthopedic surgeons,
regardless of what they call their subspecialty, are seeing and treating multiple
problems unless restricted by their hospital privileges, as determined by
the chief of their orthopedic surgery program."
If you're considering this career, Rozbruch offers some wonderful advice.
"I'd highly recommend this field for those who are interested in surgery.
But a student doesn't have to make up their minds in advance. There's plenty
of time after they have been exposed to the various specialties in medical
school and during their residencies."
Dr. Lisa DeGnore was always the person in her family who fixed things.
"I always put the toys together for Christmas. My dad was hopeless at that!"
So the mechanical nature of orthopedic surgery appealed to her. But she had
another, more personal reason for choosing the career.
"I was also an orthopedic patient all my life -- a congenital hip problem
-- which I know influenced me. Many people, male and female, become interested
in orthopedics through their own bone problems or through sports," says DeGnore.
DeGnore feels it's more difficult to be a woman in the profession because
of male stereotyping. "Only two to three percent are women, and the number
has remained constant.
"People think you must be strong to do it, but you don't have to be. If
you do things right and know how joints work, you can do anything the guys
can do. There are also power tools, making surgery much easier.
"I think another reason is that the hours are long, and many young women
choose lifestyle over surgical choice. It's very true that I
work much harder and longer than my female colleagues in pediatrics or medicine,
and there's little room for working part time as a surgeon. Surgical skills
and referrals drop off if you are only intermittently available."
But would DeGnore consider working in another field? "I wouldn't trade
what I do for anything!"
Dr. Ruth Thomas worked as a physical therapist before entering medical
school. She already felt very comfortable with the musculoskeletal system
and kinesiology.
"During my junior year in medical school, I spent a little time in each
medical specialty, and nothing excited me like orthopedics. I like solid,
predictable results. I love math. I understand and love anatomy. It was natural
that I should go from physical therapy to orthopedics.
"Most orthopedic patients have the potential to improve dramatically based
on my treatment. Most patients aren't sitting on death's door. They're mentally
positive and believe that the treatment rendered will make them better. There's
usually a very direct correlation between the treatment rendered and the result.
It's very positive, rapid feedback."
But what's the worst aspect of being an orthopedic surgeon? "The hours.
Trauma happens on weekends and nights -- and frequently under the influence
of alcohol. Orthopedic surgeons frequently work long hours, even when not
on call. I average 12 hours a day, not counting my call. It can be very demanding
in terms of physical strength as well as mental attitude."