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because the field is as much about clinical decision making asit is about the technical aspects of the surgery

Opportunities for research is enormous. Lot of work in basicsci and biomechanics.

Orthopedic surgery is a ful lling eld for numerous reasons, Dr.Vander Lugt says. “You get to work with your hands. You get to workwith various instruments. nd you can help people get !etter andget !ack to work," he e#plains.

You get to work with your hands. nd you can help people get !etterand get !ack to work.

$he specialty appeals to results%driven individuals rather than those

who like to pu&&le over diagnoses or provide longitudinal carelasting years.

“$here is an instant grati cation that comes from repairing someonerather than taking care of someone with a chronic condition like high!lood pressure," points out 'oel L. (ush, DO, who directs the O %approved orthopedic surgery residency at )roward *ealth +edical

enter in -ort Lauderdale, -la. “ especially en/oy orthopedics!ecause 0m a tool /unkie. love that get to use really cool nitrogen%powered saws and all manner of drills, chisels and hammers."

$hose who are drawn to orthopedic surgery over other surgicalspecialties often have personal e#perience with orthopedics as apatient.

“1hen was 23, tore the meniscus in my knee while wrestling. could tell that the physician who took care of me loved his /o!," Dr.Drouillard remem!ers.

4otman also !ecame aware of the specialty as a teenage athletewho tore his knee0s anterior cruciate ligament twice. Like many whoare attracted to orthopedics, he has a twin passion for sportsmedicine, which he0d like to su!speciali&e in.

+ost of all, 4otman loves orthopedic surgery0s creative side.“Orthopedic surgery isn0t as algorithmic as other specialties. $hereisn0t one single correct answer for every pro!lem," he e#plains.“)ecause half a do&en surgical techni5ues can !e used to # mostorthopedic pro!lems, the eld is very artistic."

Dr. Elaine Joughin chose to go into orthopedics because it's a "doing" kind ofspecialty. "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."!hen you're fi ing broken bones you're essentially trying to re#erse the mechanismof in$ury and make sure it stays where it's supposed to until it's healed. %ou often put

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plates and screws and rods into the bone to keep it there. &hat's sort of like carpentryskills."

urgery itself is also a "doing" kind of specialty. "(ather than waiting for medicine toact we fi the problem so that you see an instant result. !e rarely prescribemedicines at all e cept to reduce pain after surgery " Joughin says.)nly two to three percent of board*certified orthopedic surgeons are female. "+art ofthe reason is the carpentry skills and the mechanics and the fact that a certainamount of strength is required in order to do some of the operations."&raditionally women didn't like putting a lot of mechanical effort into things so it wasstereotyped as one where you sweat and toil. &hat's changing. ,ost of us who gointo it don't mind spending some energy to do these kinds of things because it doesrequire strength and muscle."Dr. ,itchell -oldflies chose orthopedic surgery because he couldn't go intoengineering. "+erforming surgery is a pri#ilege. It can be #ery scary. tress is alwayspresent e#en if you are confident and rela ed."It's like dri#ing your car on an icy road. &hings may go ) but suddenly e#en if youare cautious you can slip off the road into the ditch. &he trick is knowing how to get

out of the ditch by yourself and when to call for help."+repare for all possible alternati#es. %ou can learn from e#ery case because e#erycase is different. %ou can ne#er let your guard down and assume that e#erything isroutine."-oldflies has this ad#ice to anyone considering the career. "-et great grades andletters of recommendation. Do research and do community ser#ice. /a#e a backupcareer plan."Dr. Jacob (o0bruch went into orthopedic surgery because it offers so many optionsfor patient care. "&he indi#idual subspecialties include sports medicine as well asconcentrations on #arious parts of the skeleton and limbs. 1ellowships are offered topostgraduate residents of one to two years in a particular subspecialty if desired."(o0bruch's areas of interest include spine shoulder and knee arthroscopy and $oint

replacement surgery. /is partner prefers fracture care."!e both will see other problems as needed howe#er. ,ost orthopedic surgeonsregardless of what they call their subspecialty are seeing and treating multipleproblems unless restricted by their hospital pri#ileges as determined by the chief oftheir orthopedic surgery program."If you're considering this career (o0bruch offers some wonderful ad#ice. "I'd highlyrecommend this field for those who are interested in surgery. 2ut a student doesn'tha#e to make up their minds in ad#ance. &here's plenty of time after they ha#e beene posed to the #arious specialties in medical school and during their residencies."Dr. 3isa De-nore was always the person in her family who fi ed things. "I always putthe toys together for 4hristmas. ,y dad was hopeless at that5" o the mechanicalnature of orthopedic surgery appealed to her. 2ut she had another more personalreason for choosing the career."I was also an orthopedic patient all my life ** a congenital hip problem ** which Iknow influenced me. ,any people male and female become interested inorthopedics through their own bone problems or through sports " says De-nore.De-nore feels it's more difficult to be a woman in the profession because of malestereotyping. ")nly two to three percent are women and the number has remainedconstant."+eople think you must be strong to do it but you don't ha#e to be. If you do thingsright and know how $oints work you can do anything the guys can do. &here are alsopower tools making surgery much easier."I think another reason is that the hours are long and many young women chooselifestyle o#er surgical choice. It's #ery true that I work much harder and longer thanmy female colleagues in pediatrics or medicine and there's little room for workingpart time as a surgeon. urgical skills and referrals drop off if you are only

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intermittently a#ailable."2ut would De-nore consider working in another field6 "I wouldn't trade what I do foranything5"Dr. (uth &homas worked as a physical therapist before entering medical school. healready felt #ery comfortable with the musculoskeletal system and kinesiology."During my $unior year in medical school I spent a little time in each medicalspecialty and nothing e cited me like orthopedics. I like solid predictable results. Ilo#e math. I understand and lo#e anatomy. It was natural that I should go fromphysical therapy to orthopedics.",ost orthopedic patients ha#e the potential to impro#e dramatically based on mytreatment. ,ost patients aren't sitting on death's door. &hey're mentally positi#e andbelie#e that the treatment rendered will make them better. &here's usually a #erydirect correlation between the treatment rendered and the result. It's #ery positi#erapid feedback."2ut what's the worst aspect of being an orthopedic surgeon6 "&he hours. &raumahappens on weekends and nights ** and frequently under the influence of alcohol.)rthopedic surgeons frequently work long hours e#en when not on call. I a#erage 78

hours a day not counting my call. It can be #ery demanding in terms of physicalstrength as well as mental attitude."

Typically, as much as 50 percent of the orthopaedic surgeon's practice is devoted tono surgical or medical management of injuries or disease and 50 percent to surgicalmanagement. Surgery may be needed to restore function lost as a result of injury ordisease of bones, joint, muscles, tendons, ligaments, nerves, or skin.