ortho - pros and cons of different schools?

[cod]

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Hey guys

 

I've read the info the schools put out, and ive looked for answers on forums but havent really found much. what are the best ortho programs in canada? what are their pros and cons? im planning on being an academic surgeon, and im mostly interested in trauma,upper limb and lower limb.

 

for example, i heard that toronto residents dont get as much surgical exposure as some of the other schools, and that western has the most. true?

and more specifically, whats the program in ottawa like?

 

thanks

[coastalslacker]

check your mail.

[tb123]

would you mind cc'ing me on that? I'm also interested in ortho, especially spine and trauma.

[arielvslotus]

Same here.

[three6teen]

cc me too please

[JB.]

Me too! 10 char

[F.R.]

me too please!

[coastalslacker]

Here are the two messages I previously sent out to those interested in ortho. Decided there's really no secret info here, may as well put it out there.

 

#1 - slanted towards trauma as inquirer had an interest in this field.

 

"I'm an ortho resident at Queen's. I'm not sure how appropriate it is to talk publically about other programs, that said, everyone talks anyways.

 

Best ortho programs is hard to sort out. Essentially it comes down to which program feels like it has the best fit for you. It's hard (ie impossible) to figure that out in the interview tour, but hopefully you've done some electives and have an rough idea where you want to go. You will be well-trained coming out of any centre in Canada. My own choice several years ago was based on three factors - 1) operative experience; 2) quality of life outside ortho; 3) relationship with staff guys/residents.

 

Toronto has the reputation you allude to, although their residents deny it. People I know who have spent time there (as residents) observed that their operative experience as residents is somewhat curtailed by the heavy fellow presence. I could see that - my residency has had very few fellows, but whenever there is one around, it certainly cuts into knife time, even if they're very good. That said, there are lots of big name orthopods there in various fields (including trauma which you said you were interested in). Sunnybrook has tonnes of trauma. Lots of residents.

 

Western certainly is a well-known program. Excellent operative experience and, given it's size, probably a better known group of attendings than anywhere in Canada. When I applied several years ago alot of people, myself included, had it well down their list despite it's reputation because of the pseudo-military environment which they continuously say they are trying to change. You will operate alot and be very good coming out of this program.

 

Calgary is probably the best known program in the west. Dr. Buckley does trauma there and is one of the most prominent orthopaedic traumatologists in north america. Well-connected to the trauma world; I think 3 of their residents in my year are applying for trauma fellowships.

 

Those would probably be the three with the best reputations. Whether that means they are the best places to do residency would be an entirely different matter. Western's environment and the fellow presence in Toronto would drop them down my list. Calgary seems like a great program and the residents are happy. Lots of people want to go to UBC as well, but that is more because it is in Vancouver, I think.

 

I rotated through Ottawa as a med student and friends have done electives as residents there. The residents in the upper years whom I know seem like really solid guys - lots of fun. They are for the most part happy and the training they are getting seems to be good.

 

Hope that's somewhat helpful. Realistically, the connections are there within any program to set you up for a good fellowship. Go where you think you're going to be happiest for five years.

 

Good luck and enjoy the tour - it's a blast"

 

#2 - in response to "how do you like Queens?"

 

I love Queen's - I did my medical school here and it was my first choice for residency. It's certainly not for everyone, however. Kingston isn't a big town, so if you like big city life, it's not for you. Some areas of orthopedics aren't covered by subspecialists - namely foot and ankle and tumor (although we've started going to Peterborough for a 2 month foot and ankle rotation, and several programs don't have dedicated tumor rotations. We don't have big name staff guys who publish tonnes (with probably two exceptions). There are, however, tonnes of opportunities to work with Engineering Masters students which facilitates research if that's your thing.

 

On the upside, we operate quite a bit. Wherever you go you will spend tonnes of time off-service during your first 1-2 years. Because Queen's doesn't have Plastics, Neurosurg, or Vascular programs, you will be the senior resident on these rotations as a PGY 1 or 2. That's basically 6-7 months of being the primary operator as opposed to being a scut monkey on those rotations at other programs that have trainees in those areas. I ran the vascular service for three months before I was half way through my first year of residency.

 

We don't have many fellows, so operating time isn't diluted once you're back on ortho. We are not preceptor based, which is a weakness for some and others say a strength. In preceptor based programs (Calgary being and example) one resident works with one staff person (and fellow if applicable). This means that whether you're PGY1 or 5, you operate as much as that staff person does (usually twice a week). In our program we're organized by teams (ie arthroplasty) with a couple residents covering a couple of attendings together. There is probably less operating at the junior level on ortho than at preceptor based programs - at least one day on your own where you are the primary/first assist (depending on your prep), and probably another day shared with a senior resident. I think we make this up (and then some) by operating way more than almost every other place during the off-service months I mentioned above (plastics, neurosurg and vascular). At the senior level, we operate more than preceptor based places. I did one day of clinic last week, had three full OR days, and went to the OR after our academic morning on the other day. This isn't always the case, but we generally operate more at the senior levels than preceptor based programs, and rarely have to share with fellows.

 

More important is quality of life. Kingston is cheap to live in and everything is close. I pay less than $1000 per month for my mortgage and have a really nice house a 10-15 minute drive from the hospital. We have a night float system now so aside from Friday or Saturday nights, residents are never on call past 11pm (aside from when you are on night float, during which time you have no daytime duties). I've lived through working 40 hours straight and almost falling asleep while operating and can say without question that this system is so much better. We have an awesome, supportive, group of residents, and most of are staff guys are the same. Compared to most places, we have a great relationship with the staff guys - we want things to change and they actually do it (night float being an example).

 

Anyways, I'm biased, as is everyone you will talk to. You'll get good training almost everywhere you go. Make choices based on where you feel you would fit in, and where you would like to live. The doors to wherever you want to go can be opened from wherever you do your residency. You'd be surprised that "big name" programs don't actually get their residents to better fellowships.

 

good luck!