What’s Important: What Constitutes Success in an Orthopaedic Career?

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The March 2017 American Academy of Orthopaedic Surgeons Meeting that took place in San Diego afforded me the spectacular annual opportunity to connect with old friends, listen to fascinating lectures, and participate in stimulating discussion. On the way home, I reflected on my 26 years of postfellowship practice.
Sometimes, such introspection can be disquieting. During the meeting, countless suited physician leaders strolled by me in intellectual cliques, their Academy name badges adorned with multicolored extensions touting distinguished titles such as “Session Speaker,” “Instructional Course Lecturer,” “Poster Exhibitor,” and “ORS (Orthopaedic Research Society) Presenter.” My badge, by comparison, had only my name, my city, and my member status. A small “Orthopaedic PAC (Political Action Committee)” placard did little to compensate for my self-perceived credential inadequacy.
Where did this insecurity come from? In my training, I became conditioned—through inference, intonation, and sometimes blatant declaration—to believe that academic prowess is the pinnacle, or at least the primary measuring stick, of orthopaedic accomplishment. If followed to its natural conclusion, that contention suggests that major orthopaedic procedures should be done exclusively at high-volume tertiary centers by renowned academicians with impressive curriculum vitae, extensive bibliographies, innovative research interests, and expertise in cutting-edge technologies.
Hence, the Academy meeting reminded me of the “aberrant” career path that I have taken compared with my cotrainees. All 8 of my surgical residency colleagues have gone on to high-level prestigious academic positions (mostly department chairs). The same is true for many of my coresidents in orthopaedics, and the other fellow from my year at Johns Hopkins is a prolific author and researcher.
In the meantime, what have I accomplished? I have published a number of articles in peer-reviewed journals. I have presented at the ORS meetings. I have served on the clinical faculty of a medical school and have been a consultant and speaker for 2 orthopaedic implant companies. I have had the privilege to perform >5,000 joint arthroplasties, along with thousands of hip fracture repairs, arthroscopies, and other procedures. The intellectual and physical challenges of those cases, and the concomitant patient care, have been, in almost every instance, wonderfully rewarding experiences. The 2 years of intense preliminary surgical training at Brigham and Women’s Hospital, followed by 3 years of arduous orthopaedic residency at Columbia University and an adult reconstructive fellowship at Johns Hopkins, seem a small price to have paid for this incredible journey in the private practice of orthopaedics.
So, did I “go wrong”? Am I a failure? Is it blasphemy to leave an “academic pedigree” to serve in a private practice in the paradise of western Florida? My father, a retired pediatrician now well into his late eighties, always wanted me to be a department chair somewhere. Have I disappointed him?
I do know that I have had a very fulfilling career and have raised a terrific family. My son is at Yale School of Medicine, my alma mater, and wants to be an orthopaedic surgeon. My daughter is a political reporter and a television anchor. I had 20 years of blissful marriage before my wife was taken at the age of 48 by metastatic renal cancer. That horrible experience taught me the importance of health and happiness, above all else, and I treasure my memories. My kids remind me more and more of my wife every day, and I thank God for that. I had the incredible serendipity to have found another wonderful woman with whom to share my life, and we have blended our 2 families. She too had a spouse taken from her at a young age by cancer.
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