You still get full salary while doing a fellowship right?

[deeman101]

Yeah ortho can do hands too (with the proper training).

 

Deeman, you think that orthos are only good with a hammer and a reamer? You think that the spine only has 10 non vital structures (shared between orthos and neurosx)?

 

Yes yes I know ortho is not cake walk . I've also spent some time with a spine surgeon I know its l33t stuff.

 

I wasn't aware orthos do hands. The hand surgeries I've seen were all done by plastics.

[rmorelan]

Yes yes I know ortho is not cake walk . I've also spent some time with a spine surgeon I know its l33t stuff.

 

I wasn't aware orthos do hands. The hand surgeries I've seen were all done by plastics.

 

oh yeah - big time actually. Definitely a valid speciality if that is the area you want to work in

[Med0123]

I know a pediatric orthopedic surgeon specialized in hands... now we're talking of oversubspecialization

[aaronjw]

I know a pediatric orthopedic surgeon specialized in hands... now we're talking of oversubspecialization

 

Wow. wonder what his case load is like for that

[rmorelan]

Wow. wonder what his case load is like for that

 

ha probably does a lot more than that. I worked with a cardiac surgeon that specializes in minimal evasive valve replacement but that doesn't mean he doesn't do the bread and butter stuff as well.

[aaronjw]

ha probably does a lot more than that. I worked with a cardiac surgeon that specializes in minimal evasive valve replacement but that doesn't mean he doesn't do the bread and butter stuff as well.

 

Oh I know, just seems like for things like that it would be a pretty small percentage of the population that would need it. Wonder if keeping their skills up would be difficult?

[A-Stark]

It varies - if he's one of only a handful of surgeons doing that particular type of procedure, it probably isn't. My gen surg preceptor from a pre-clerkship elective is a surgical oncologist and one of the few that does Sugarbakers - he has patients who are referred from the GTA for it.

[thebouque]

now we're talking of oversubspecialization

 

How about a nephropathologists subspecialized in kidney transplant pathology

[justletmein]

Btw plastics does hand surgeries. Why? Cause something like the knee has maybe 5 to 10 structures, and things related to the hand start numbering into the 100s. I've seen a few hand surgeries. No way an ortho could do that! Its like some of the most intricate and important (because of how necessary a hand is) stuff you could get into.

 

Both Ortho and Plastics do hand surgeries.

Both have specific fellowships as well in hand surgery.

[coastalslacker]

Btw plastics does hand surgeries. Why? Cause something like the knee has maybe 5 to 10 structures, and things related to the hand start numbering into the 100s. I've seen a few hand surgeries. No way an ortho could do that! Its like some of the most intricate and important (because of how necessary a hand is) stuff you could get into.

 

I can think of 5-10 structures in the posterolateral corner of the knee alone. Your knowledge is about as superficial as that of most physicians not involved in taking care of the MSK system. Anatomy lab and a lecture on the knee and not much else. Hand isn't any more complicated - I find it less so. Small does not equal complicated. The best hand surgeons are those who choose to specialize in it, whether they be ortho or plastics. Plastics is typically at a disadvantage because most of them can't manage problems at the wrist which really should fall under the umbrella of "hand surgery". In my center the best hand surgeon is an orthopod by a mile.

 

Regarding fellowships, there are alot of misconceptions out there. Technology and knowledge has exploded in orthopaedics in the last 20 years. A fellowship is standard not because of jobs, but largely because of the amount you need to know about each subspeciality to own it.

 

Someone compared dermatology and surgery in an earlier post which is ridiculous. Dermatologists don't need fellowships because of their masterful manipulation of supply and demand? Partly true, but it's also dermatology. Think about the proliferation of knowledge in derm in the last couple decades, and the highly technical nature of the speciality which requires countless repetitions to master.....wait never mind.

 

However, as has been mentioned the second fellowship in orthopaedics has largely come about because people couldn't find jobs and then everyone started doing it to be competitive. It's silly because most people aren't going to get enough OR time to maintain expertise in two sub-speciality areas. When a second fellowship allows you to further sub-specialize into an area of interest, however, it's worthwhile. Someone gave the example of pediatric hand surgery, which is a great example of this. There is a need for sub-specialists. You don't need many but you do need them (and they're busy). I'm heading into a sub-specialized branch of ortho- there's probably 20 surgeons in Canada doing the job I want when I'm done. If you're a patient undergoing a highly complicated operation, you want the sub-specialist expert doing the procedure not the guy who does a couple a year. This will limit my job options, but I don't like snow anyways (unless I'm skiing).

[jerkstore]

At mah anatomy class, we was taught there aint nothin but fav fingers and a palm, thats how i sees it and thats hows it is.

 

*spits into bucket*

[deeman101]

Man feeling the heat from the orthopods tonight! I get into heated arguments with uros too.

[1234]

Btw plastics does hand surgeries. Why? Cause something like the knee has maybe 5 to 10 structures, and things related to the hand start numbering into the 100s. I've seen a few hand surgeries. No way an ortho could do that! Its like some of the most intricate and important (because of how necessary a hand is) stuff you could get into.

 

You, sir, are a retard.

[deeman101]

You, sir, are a retard.

 

FFS! How do you read this comment on the last page but not my next comment just a few lines below?

 

Yes yes I know ortho is not cake walk . I've also spent some time with a spine surgeon I know its l33t stuff.

 

I wasn't aware orthos do hands. The hand surgeries I've seen were all done by plastics.

 

^ I have been enlightened, and by a couple people before you (in much more informative ways). But thank you, now go blow off steam with a hammer and some power tools. I guarantee you will be as ignorant to my specialty of interest as well.

[1234]

FFS! How do you read this comment on the last page but not my next comment just a few lines below?

 

 

 

^ I have been enlightened, and by a couple people before you (in much more informative ways). But thank you, now go blow off steam with a hammer and some power tools. I guarantee you will be as ignorant to my specialty of interest as well.

 

I don't pretend to be an expert and make ignorant statements about things I don't understand. You'd do well to change your approach of 'I'll pretend I'm an expert on things I don't understand and will only shut up when someone disproves me'. That is how Type A physicians get patients killed.

[deeman101]

I don't pretend to be an expert and make ignorant statements about things I don't understand. You'd do well to change your approach of 'I'll pretend I'm an expert on things I don't understand and will only shut up when someone disproves me'. That is how Type A physicians get patients killed.

 

You mistake my laziness for prissy qualifiers as Type A personality? I've seen some of your previous posts. Your past arrogance is why I don't particularly care what you think of me. But if you're really concerned about killing patients (often comes up for you) then your time is better spent with this guy. I was shadowing him at his hand clinic last month. I think you two could have great chats.

[thebouque]

I don't pretend to be an expert and make ignorant statements about things I don't understand. You'd do well to change your approach of 'I'll pretend I'm an expert on things I don't understand and will only shut up when someone disproves me'. That is how Type A physicians get patients killed.

 

 

I think deeman is a fine member of the forum. Everyone can be wrong once in a while.

[Real Beef]

Age is a factor I believe

 

Partly age. But other factors are likely more important for me in shying away from a surgical specialty|trauma surgery career path:

 

1) To a greater extent lifestyle ... the lifestyle is much busier with as a general surgeon (70-90 hrs|wk) than as an Emerg. doc (40-55 hrs|wk). Fortunately or unfortunately I have many interests that require time and attention.

 

2) Also there are only 4-5 trauma surgery fellowships in Canada at 3 institutions (UBC, UT, Ottawa). I am realistic and I may not be competitive enough at the end of the day to get one of 4 spots in Canada.

 

3) Trying to maintain a serious relationship which I find strained when I work 60 hrs+wk may not make it with a 70-90 hr work week. Ive already had one marital disintegration ... trying to keep at at one

 

Beef

[NLengr]

Partly age. But other factors are likely more important for me in shying away from a surgical specialty|trauma surgery career path:

 

1) To a greater extent lifestyle ... the lifestyle is much busier with as a general surgeon (70-90 hrs|wk) than as an Emerg. doc (40-55 hrs|wk). Fortunately or unfortunately I have many interests that require time and attention.

 

2) Also there are only 4-5 trauma surgery fellowships in Canada at 3 institutions (UBC, UT, Ottawa). I am realistic and I may not be competitive enough at the end of the day to get one of 4 spots in Canada.

 

3) Trying to maintain a serious relationship which I find strained when I work 60 hrs+wk may not make it with a 70-90 hr work week. Ive already had one marital disintegration ... trying to keep at at one

 

Beef

 

There are lots in the states. With much more penetrating trauma.

[A-Stark]

Partly age. But other factors are likely more important for me in shying away from a surgical specialty|trauma surgery career path:

 

1) To a greater extent lifestyle ... the lifestyle is much busier with as a general surgeon (70-90 hrs|wk) than as an Emerg. doc (40-55 hrs|wk). Fortunately or unfortunately I have many interests that require time and attention.

 

2) Also there are only 4-5 trauma surgery fellowships in Canada at 3 institutions (UBC, UT, Ottawa). I am realistic and I may not be competitive enough at the end of the day to get one of 4 spots in Canada.

 

3) Trying to maintain a serious relationship which I find strained when I work 60 hrs+wk may not make it with a 70-90 hr work week. Ive already had one marital disintegration ... trying to keep at at one

 

Beef

 

But keep in mind that general surgery in particular can be pretty variable - you certainly could work 90 hours per week, but there is such variety in careers and practice settings that you can certainly do better than that.

 

Otherwise, I wouldn't be concerned by the number of trauma fellowships in Canada - just write the USMLEs, which isn't that bad if (1) you only care about passing and (2) you don't wait til long after pre-clerkship to write step 1.

[thebouque]

 

2) Also there are only 4-5 trauma surgery fellowships in Canada at 3 institutions (UBC, UT, Ottawa). I am realistic and I may not be competitive enough at the end of the day to get one of 4 spots in Canada.

 

 

There aren't a lot of fellowships in Canada period, in any discipline. Most people go to the USA or even Europe.

[Helpmemedstudents]

Here is the pay scale for residency by year in each province.

http://www.carms.ca/eng/r1_program_salaries_e.shtml#ON