Looking At An Orthopaedic Surgeon's Daily Schedule

Orthopaedics is a specialised surgical discipline that involves the diagnosis and management of conditions concerning the musculoskeletal system. Orthopaedic surgeons use both surgical and conservative measures to treat musculoskeletal trauma, soft tissue injuries and infections, spinal conditions, sports injuries, degenerative diseases as well as congenital disorders, tumours and infections involving the muscles and bones. 

Orthopaedic surgery can require working for long hours and being on one's feet for a long duration of time performing physical labour in the operating room. One's resolve needs to be strong, and keeping physically fit is a big advantage for being able to keep up with the demands of this surgical discipline.

Training

Orthopaedic training involves first completing the 5 to 6 year undergraduate degree, depending on which country you live in, of bachelor of medicine and surgery which qualifies a student in becoming a medical doctor. Thereafter internship training of 1-2 years needs to be completed before a doctor can specialise in orthopaedic surgery.

If an orthopaedic surgery post is available at the academic institution the doctors chooses to specialise at, and if there are consultants available to mentor and train new candidates, then the Aspiring doctor can apply for such position. If the doctor's application is accepted and the interview phase is successful, then the candidate can begin training as a specialist orthopaedic surgeon. If a post is not available yet, then the doctor can take a medical officer position where they can work in the orthopaedic department and gain valuable experience while waiting for a post to become available.

The postgraduate training in this discipline lasts 5 years and when it is completed successfully, the doctor is then a specialist orthopaedic surgeon.

Sub-specialties

Orthopaedic surgeons can then decide to continue in private practice or work in a state run hospital where they diagnose and manage general orthopaedic cases such as simple or complicated fractures, soft tissue infections and trauma cases. These doctors can, however, also decide to sub-specialise further and would therefore need to complete a further 1-2 years of fellowship training in their chosen sub-specialty. Orthopaedic sub-specialties include the following:

• Total joint reconstruction/replacement, known as arthroplasty
• Shoulder and elbow surgery
• Hand surgery
• Orthopaedic trauma
• Spinal surgery
• Foot and ankle surgery
• Pediatric orthopaedics
• Surgical sports medicine
• Musculoskeletal oncology

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Most common orthopaedic procedures

The following list mentions the most commonly performed orthopaedic surgeries in order, starting from the most often performed procedure.

• Knee arthroscopy with meniscectomy
• Arthroscopy and decompression of the shoulder joint
• Knee arthroscopy and chondroplasty
• Carpal tunnel release
• The removal of surgical implants
• Knee replacement
• Knee arthroscopy and anterior cruciate ligament reconstruction
• Repair of femoral neck fracture
• Debridement of skin, muscle, bone or a fracture
• Hip replacement
• Knee arthroscopy repair of both menisci
• Repair of rotator cuff tendon in shoulder
• Shoulder arthroscopy with distal clavicle excision
• Laminectomy of spinal vertebra
• Repair fracture of radius and/or ulna
• Shoulder arthroscopy and debridement
• Repair of bimalleolar ankle fracture 
• Repair of fracture of the distal part of the radius
• Lumbar spine fusion
• Lower back intervertebral disc surgery
• Repair of femoral shaft fracture
• Repair of fibula fracture in ankle
• Repair of femoral trochanteric fracture

The Orthopaedic Surgeon's Weekly Diary

The schedule for an orthopedic surgeon can involve around 50–55 hours of work per week. This time is divided among attending clinics, performing surgery, administrative duties and possibly teaching and/or research if in an academic setting. There are orthopaedic surgeons in private practice who also perform research using their own patients in order to determine what the long-term outcomes are in these patients.

The rest of this article will focus on the daily work done by an orthopaedic surgeon, in general. 

Monday

Mondays are usually reserved to organise the orthopaedic surgeons week. Therefore, this is more of an administrative day in order to go through which patients are booked for procedures for the week, noting when meetings with reps, hospital management, etc. are scheduled and to also make sure that the mornings after being on call (seeing emergency cases after hours) aren't too busy.

On Monday morning, the orthopaedic surgeon will visit patients they have in the hospital in order to follow up with them and give further instructions regarding management to the nursing staff. Afterwards, the doctor will begin consulting patients for the day and either manage them conservatively or medically, or decide if they will need further surgical intervention. These patients will therefore be booked for surgery on the scheduled surgical days.

Tuesday

Tuesdays will usually be reserved as a full surgical day. This means that the entire day is booked out to perform surgical procedures. Depending on the list, this day can be quite long and the specialist can be busy for a substantial time after the work day is done.

The morning may consist of performing joint replacement surgeries as they take longer and require more concentration from the doctor in order to have better outcomes. The afternoon will then consist of starting to perform arthroscopic work which can include rotator cuff repairs of the shoulder, cruciate ligament repairs in the knee and dealing with CAM lesions in the hip. The late afternoon will consist of work that tends to be quicker such as arthroscopy of the knees to deal with meniscus pathologies. At the end of the list, the orthopaedic surgeon may have a septic case that needs debridement. These cases are reserved for this time of the day as the operating theatre will then have to be sterilized and no further procedures may be performed.

Once the list is completed, the orthopaedic surgeon will visit the patients that have been operated on for a post-surgical consultation, as well as any other patients they may have in the hospital.

Wednesday

Wednesday mornings are also reserved for seeing patients in the wards and performing surgery. The specialist will usually perform 1-2 arthroplasties and 1-2 arthroscopies. 

The afternoon will then be reserved for going to meetings and also for training of students, if they are involved with the academic setup of the orthopaedic department of the university. Private orthopaedic surgeons may use this afternoon for seeing further patients, performing further administrative tasks or working on a research article. 

Thursday

Thursdays are very similar to Wednesdays as the morning also involves consulting hospital patients and performing surgeries, and the afternoon is used for the same purpose as mentioned above. The afternoons can be interchanged or used exclusively as one day for seeing patients and the other day for academic purposes or training.

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Friday

Friday mornings can be quieter than the rest of the week, especially if the orthopaedic surgeon was on call for the hospital the night before. The doctor will begin the day by consulting with patients that were operated on the previous night and patients who are still in hospital. The orthopaedic surgeon will then hand over the management of the patients they have to the specialist who will be on call for the weekend, if it's not them.

The afternoon will then be used to finalise any unresolved or pending administrative issues. The doctor will tie up any loose ends that need to be dealt with and then end their work week.

Weekends

Every couple to few weekends, depending on how many other orthopaedic surgeons are available, one of the specialists will be on call for the hospital for the entire weekend.

If needed, the orthopaedic surgeon will be consulted by primary care and emergency doctors during this time. Patients will be seen by the specialist and further management will be initiated where necessary. Emergency cases can include closed and open fractures, dislocations and severe soft tissue infections.