Editor’s Note: A nurturing and inspiring residency experience followed by an employment situation which lacked those attributes.
“I did not start medical school with orthopaedics in mind.” I assumed that I would become a pediatrician. Interestingly, I was miserable doing my pediatrics rotation but loved my surgical one. As I looked around, I realized that orthopaedic surgeons appeared to find joy in their work and overall, were very happy. I was inspired to pursue an orthopaedic career path.
I had a wonderful orthopaedic mentor in medical school and was on his research team. I had a positive experience and decided definitively to pursue orthopaedics. If you like what you do, you want to spread the word. While doing so, I encountered women who were interested in orthopaedics but who were afraid to enter an orthopaedic training program. This saddened me.
I sought out orthopaedic surgery residency programs where there were female residents. I was admitted to one where 25% of the residents chosen each year were women. Although rare at the time, we had an extraordinary female attending who was a pioneer in many ways. She mentored the residents and was a great role model. I feel that because of her positive influence, the program welcomed more women into the residency ranks. The only sexism I encountered as a resident was from attendings in other specialties.
My eventual job as an employed surgeon in a multispecialty group was initially positive. I felt I had chosen a good place to work. I had two male partners who focused their practices on the lucrative and high-profile sides of orthopaedics. I was very happy to care for patients outside of these categories. In many ways, I allowed my colleagues to be more productive by taking on patients they did not care to see. I found joy in the work I did both for myself and for the department.
Later, as monetary issues had more of an influence on our ability to practice orthopaedics as we saw fit, things changed. My work generated fewer RVU’s than my colleagues and that became problematic. The administration was “tone deaf” when I tried to explain the positive nature of my work and how it enhanced the production of the department as a whole.
In the midst of this, I tried unsuccessfully to begin a family. Eventually, it became necessary to begin infertility treatments. These were unsuccessful. I went on to adopt a wonderful daughter. Interestingly, there was no parental leave for the process of adopting a child and no institutional support for me during this life-changing period. I just “shut up and worked.” I’d like to add that my daughter has turned into a wonderful adult!
In another life-altering event, I went through a divorce. I was able to discuss the situation with the nurses I worked with, but no colleagues or administrators reached out to me to lend support.
Eventually, my salary was reduced. In the same timeframe I was given a pen by the institution that had an inscription stating, “You are awesome!”
As you might guess, these events led to compassion fatigue and burnout. This time was also accompanied by the realization that THREE of my close female friends had died of suicide over three years. One was a medical school classmate and two were my fellow interns. One of them was retired and two were still in practice.
Around this same time, I sought out a physician coach whose input proved incredibly valuable. Her input led me to take some concrete steps and to explore options I might not have considered otherwise.
Eventually, under financial stress, my institution cut back on staff. I was laid off. Initially, I was unsure about my future path because I was at an age where many employers are reluctant to hire surgeons.
As is sometimes said, “when one door closes, another opens.” The imposed change proved to be good for me. I began to teach and found a pleasing non-operative clinical role with a schedule that allows me to pursue other interests.
As a result of this time of change and reflection, here is what I have learned:
• Orthopaedic surgery was the best career choice for me, and I would do it all over again.
• It is critically important to have mentors and support during both training and career. You must actively seek them out. The Ruth Jackson Orthopaedic Society provided a wonderful source for me.
• It is important to have “people who have your back and you, in turn, have their backs.”
• If you find that your first job is not supportive or fulfilling, make a change. You will not do your best work under negative circumstances. A bad job is a direct path to burnout.
• Physician coaches or neutral parties can be invaluable. Seek out their counsel.
• Change is not a bad thing. Some of the benefits will reveal themselves later.
• Take an interest in medical students and residents. Give them the mentoring and support you needed when you were in their positions. It can be gratifying to all parties.
• Women have not yet reached a critical mass in orthopaedic surgery. More change will come when they do.