Ortho & OB

It's been awhile since I've been on here. In that time frame, I've finished up neurology, had a friend tie the knot, watched the Rams and Illini win games, done two weeks of orthopedic surgery, and started six weeks of OB/gyne. Clearly only one of those is of any real life significance - congrats buddy. Other than that, not a whole lot of excitement from the clinical front.

Ortho
Orthopedic surgery deals with management of musculoskeletal problems. Some of the more common surgeries are shoulder and knee arthroscopies and some of the more common repairs are bone fractures and ligament/tendon tears (ACL, Tommy John, rotator cuff). And then there's the always popular hemi/total hip or knee replacement.

As for the nuts and bolt of the specialty, that metaphor describes the field pretty well. There's a lot of hardware involved: screws, pins, drills, mallets, metal plates, etc. It reminds me a bit of carpentry, as these tools are used a lot in conjunction with measuring angles, range of motion, and approximating fractures. It's a bit mechanical, maybe too much for my liking. It's a moot point anyway, since ortho is one of more competitive fields to get into.

OB/Gyn
I've been on OB for three weeks and dealing with pretty much anything birth related. By far, my most common patient is the high risk mother in for prenatal care and fetal screening. After that, there's a lot of women who come into triage for rule out pre-term/term labor. There's also some higher risk pregnancies at term coming in for labor induction and/or augmentation. And of course, there are deliveries and C-sections.

Overall, it's actually a better field than I thought. And I'm surprised at the number of people who have no problem answering pretty intimate questions and having a random med student involved in a lot of their care, including deliveries. I consider it a privilege to be involved in families' happiest moments. I'll admit, it legitimately puts a smile on my face - even if it's 330 in the morning. That said, the attendings have a pretty pervasive obsession for perfect prenatal care and deliveries. This mostly comes from the litigious nature of the specialty, which is especially exacerbated by practicing in Illinois (and Chicagoland). That said, I'm pretty grateful for the amount of stuff the attendings and residents let me do.

The next three weeks I'm on the gyn service, which is a lot more surgically oriented - scheduled C-sections, hysterectomies, tubal ligations, D&Cs, fibroidectomies, etc. It'll for sure be interesting and a nice reintroduction to the OR. That said, I'll actually miss OB and L&D, which I never would've thought possible a month ago.

The major downside of this rotation are the hours, at 11-13 hour days. Similar to surgery, but not as intense or busy. Patient volume is definitely site dependent though. The thing that was particularly rough working a week of 13 hour nights, from 6P-7A. It takes a little getting used to and once you finally do, it's back to working days. Overall though, I'm actually liking the rotation. Which is shocking, since I was pretty sure I was going to hate it.