Early operative exposure

Hi,

Can any current ortho residents please give feedback on the amount of "1st operator" experience they're receiving in their current year of their current program. I imagine that programs with a heavy emphasis on research wouldnt have as much operating (only a certain number of hours in a day)? and have also heard that programs with "big names" arent great for operative experience as the "big name" often prefers to do the case him/herself.

I'm not talking about getting time in the OR as an assistant - but rather am specifically interested to know how much operating 'skin-to-skin' you're getting. "eg I'm a PGY2 and my Attendings usually let me do the approach in a knee arthroplasty but then they tend to take over by the time we get to the bone cuts". or "I'm a PGY3 and when we have a comminuted distal radius the Attending usually lets me do the entire case while just watching on and giving a few pointers" etc.

Obviously this will vary depending on the particular attending or on the complexity of the case but overall please try and give me and the other readers on this forum a sense of how much actual 'cutting' you're getting.

why on earth is that a poor question? There are lots of posts on here trying to "rank" residency programs. I would think that a pivotal consideration when trying to evaluate a program is the amount of operating that you're going to get. Why rely on a fellowship for operative experience when some residencies will offer more opportunities than others?

No offense buddy, but I wouold worry less about which program will give you the best training and more about which program will let you in. Regardless of your superior training and skills, orthopaedics is the single most difficult specialty to get into for non-us medical grads. less than 1% of all residents according to the most recent information released by the ACGME. There was only one other program with less than 3%. I think it was Plastics, but I could be wrong on that. If you want to come here, you better apply to 150 programs and hope one accepts you, or get a research spot somewhere and show them how badly you want ortho. Honestly, I think research fellowships is how most non-us grads manage to land ortho spots.

By the way, I agree. THis is not a stupid question. This is a very important question for US grads, but not for you. You just need to find a place that will take you.

Thanks for the response but I'm be most grateful for a response to my original question. I'm not one of the desperate FMGs dying to get to America at any cost but instead am only interested in programs that offer outstanding operative training.
If I cant find anything superior to or equivalent to what I am getting in Australia I'll stay here and rather come across to the US of A at fellow or attending level.

I would say most ortho programs in US are far superior to the training you get in Australia. Specifically I have heard about the fellowship programs in Australia from a couple US residents who went there...their primary motivation was the location and they thought Australia would be a cool place to visit for a year. They were disappointed with the training they got in Australia. The volume you get in the US cannot be matched anywhere other than perhaps Japan...the only place where the surgeons work as hard as US surgeons. So if you want the best training, try to get a spot in US. Majority of US programs give you excellent experience so don't worry about which program. What you do with it is up to you.

OzOrtho: After you get some OR time, skin-to-skin operating is not that attractive. I want to the critical portions of case and scrub out and let the PA or junior resident close. Of course, if you're still learning how to close a wound, "skin-to-skin" is helpful...sounds like that's the level you're at. So what you get to do depends on your level of experience. I agree with previous posts...don't worry about which program: just get in somewhere! You cannot be selective. If you do want to be selective, then stay in Australia...I'm sure you get at least decent training there.