The Road to Orthopaedics

the surgeon's path Feb 14, 2019

Even halfway across the globe, the love story with orthopaedic surgery has common themes. I've had the luck to be acquainted with Dr. Michelle, an amazing mom of young children who is not only a PhD but also an orthopaedic surgery resident in Europe. She is guest blogging for NancyMD today about her road to the specialty. I see echoes of what I found so satisfying about going into this surgical specialty in what she writes. 


Which specialty fits?

As a medical student I thought I wanted to get into plastic surgery. I liked the artistic aspect of shaping body parts. I thought the heavy machinery (and more specifically the drilling into bones) in trauma surgery would make me faint. I dreaded my first fracture fixation. When I was there, I noticed that it was not fear but a weird fascination that got to me so much. I simply loved it. Then I thought if I'd first see a dislocated joint I would need to sit down and breathe into a bag. But a weird thing happened when 'my' first ankle dislocation came in. I felt such a rush relocating the joint and witnessing the relief the patient felt as the cast went on. The anxiety when awaiting the second X ray was enormous. ‘Please, please let the situation not be worse’ I told myself, while trying to look relaxed. We take the whole - do no harm- thing quite seriously of course. When I saw that the ankle was back in position I felt so proud. I did that. (Yes, I am conveniently leaving out the horrific scream that I will also never forget). I felt so light driving home. I was hooked.

Now it actually turns out that relocating dislocated joints and fractures are still one of my favorite things. I take pride in making fast decisions, leading a team in the ER relieving the patients’ first pain, and most importantly securing neurovascular status. And then casting, a very useful life skill. It comes in handy in various practical jokes also*. To read the worst one I know scroll down. Or read on and get there naturally of course... Where was I going with this?


That one encounter that changed everything

I was just saying I was hooked. I had not connected the dots to ortho yet, just knew I wanted to be involved in trauma, maybe emergency medicine? And then this one class happened. I had no idea it would change my life forever. It was about the spine. Topics such as how evolution to standing on two legs led to scoliosis, how fractures of the spine can cause neurological deficits and so on were discussed. The X rays of scoliosis correction surgeries were mesmerizing. At the end of the class I asked the professor what the practical differences between general surgery and orthopedics are. He invited me to join him in clinic and OR for one week, and predicted I wouldn't leave. Also he said that if I wanted to thank him, he "didn't drink flowers". I defended my thesis with him as my promotor 8 years later.

He didn't see a girl. He saw a passionate student. Not all professors are able to look past stereotypes, and I'm so lucky that encounter got me off to a great start. He is still my role model and mentor and we keep in touch often.


How did I get in?

After deciding you want a specific residency the issue of how to get in arises. It kept me occupied for 5 years. I did rotations in two high-profile orthopedic clinics and worked like a maniac. Residents and attending surgeons saw that I went the extra mile and how much I loved the specialty. And that it was a good fit. It is of course pivotal to be able to work with your hands. If you need to call for help to assemble cabinets or hang a painting on your wall then orthopedics might not be for you. I then applied for a fulltime, basic science research PhD position. It was not the easy way, but I knew it would make my resume stand out so much more.


As a woman

When I look in my group of colleagues a mind blowing 100% of the females has a PhD, compared to 25% of the guys. Yes it's definitely harder to get in as a woman. You have to work harder to get noticed. As a woman I can't change how others see me. I get slighted, looked over, and underestimated by co-workers, supervisors, nurses and patients when they first meet me. Prejudice is so widely present. People will bluntly say that I don't look like an orthopedic surgeon. At the end of the consult or shift I very often already have this turned around, but I feel I have to earn it time and again where it comes natural for men. I want to write another blog about that. When I look at it in glass-half-full way, which I usually do, look at what that extra mile got me. The PhD program allowed me to learn a whole new profession, really turning into a scientist. Nerdy statistics and all. It gave me the chance to work with amazing people from different backgrounds, studies, and nationalities. I got to travel around the globe presenting my research and networking. It will help find a position as attending I hope. Yes, I paid my dues culturing cells for 4.5 years but I got residency in return.


Long story short

Don't let anyone tell you what you can or cannot do. Find your tribe of colleagues that have your back. Stay focused. Take the hard road, they say it’s not crowded on the extra mile and that is very true. Keep getting up when you get knocked down. It can be done. I did it and so can you.

Thanks to lovely NancyMD for allowing me to guest blog on your website, your such an amazing role model. If you want to read more about my adventures as a doctor & resident & mom find me on Instagram, @arthroplastyinheels. Please feel free to comment on this blog, NancyMD and I are happy to answer questions.


*Anecdote of why being good with plaster is important. A male ortho resident had a bit to much to drink at one of our office parties and was making a horribly inappropriate move on one of our - very pretty- plaster technicians. She brought him home only to let him wake up in a bilateral thorax abduction cast. Kept me howling with laughter for at least a year on. 


For more on the path to medicine and to orthopaedic surgery, visit NancyMD on YouTube, and don't forget to subscribe. 


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