July 2, 2018
Orthopedic surgery is a medical specialty that deals with the treatment of the musculoskeletal system—-that is to say, problems with your bones, joints, muscles and the tissues that hold it all together.
Given the ever-expanding volume of information, we tend to “sub-specialize” in the medical business. Many orthopedists will refine their expertise to a specific area of the body such as the knee, shoulder, hand or spine, or, specialize in a particular disease condition, such as arthritis or bone tumors.
As important as specialization is not loosing sight of the bigger picture, that is, how do orthopedic conditions integrate with the body as a whole? Your body mechanics affect your activities—your activities affect your diet—your diet affects your muscle output—-your muscle output affects your joint forces—-your joint forces affect your body mechanics—and so on.
The art in orthopedics is sorting through these levels of complexity in order to find a long term solution to the problem, or chain of problems. The body is a wonderful puzzle to solve.
How are they trained and certified?
Orthopedic surgeons, like all physicians toil through 4 years of medical school. An M.D. degree is awarded, but a doctor is not yet permitted to practice independently. In the last year of medical school, one decides upon the specialized area of medicine for which they will train. This could be pathologist, brain surgeon, primary care specialist or any of the many options. After deciding to be a doctor, this is the second most important career choice we encounter. This period of training is called “residency.” The first year of residency is known as “internship.” Internship allows us to work across specialties, but after that, one trains specifically for one’s area of specialization. Residency varies in length; an orthopedic residency is 5 years.
The next option is that of “sub-specialization.” Sub-specialization is a further year (or more) of training, further focusing one’s expertise. This is referred to as “fellowship” training. Sports medicine, total joint surgery, hand and spine surgery are examples of fellowship programs.
Research projects are an important part of fellowship training. Research requires a specialist to become somewhat of a world expert on a particular topic.
Eventually, the unthinkable occurs, and a properly trained physician gets a real job. He or she can work independently. At this point, one can work as an orthopedic surgeon, however not a “board certified” surgeon. This important credentialing occurs about 2 years after one begins working independently. A written and oral test is administered; pass it, and you become board certified.
To remain board certified, continuing medical education credits are necessary and tests are administered on a regular basis. Most hospitals require their physicians to be actively board certified.
Never-ending learning is critical to the life of a physician. If you don’t love to learn, you’re in the wrong profession.