How to Thrive on an Orthopaedic Surgery Sub-I
Written by Krishna V. Suresh
At this time of the year, many 4th year medical students are busy applying for acting internships at other institutions to demonstrate their work ethic, build relationships, and understand the “culture” of the specific program they will be rotating through. Acting internships, whether at home or at another institution, are essential components to a student’s residency application, as they are the primary means through which students secure strong letters of recommendations and build connections at a variety of programs. For ultra-competitive specialties, strong letters of recommendation and connections can determine whether an applicant matches or not.
Particularly for surgical specialties like orthopaedic surgery, strong performance on an acting internship has been repeatedly cited by program directors as one of the most important factors when determining which applicants receive an interview invite and their relative position on the final rank list. But what constitutes “strong” performance? Are you expected to answer all the questions asked during an operative case correctly? Are you expected to suture like a plastic surgeon? Are you not allowed to make any mistakes during this important month?
These were the questions that were racing through my mind when I began my first acting internship in orthopaedic surgery last year. After talking to one of my closest friends—who was an orthopaedic chief resident at the time—I quickly realized the following. Success during an acting internship is not knowing all the nuances of the specialty or all the questions asked of you, but rather the opportunity for you to demonstrate your effectiveness as a team member, your ability to demonstrate growth in your learning and performance, and your resilience in the face of failures or mistakes. As my chief resident said, “It’s not really about how much orthopaedic surgery you know when you show up on your first day. We can teach you how to be an orthopaedic surgeon, but we can’t transform your personality into a proactive team member or a disciplined worker.”
Ultimately, success on an orthopaedic surgery acting internship comes down to the following five points:
1) Identify your goals. Do you want a letter of recommendation from a particular faculty member on the rotation? Do you want to become better at a specific, fundamental skill, such as suturing or splinting? Speaking to the residents on your team and being clear about your goals and learning objectives can help them tailor their teaching to you and help you on subsequent rotations.
2) Identify what your strengths are and how to market yourself without showing off. It is essential to demonstrate your work ethic and your ability to work in a team environment, without being overbearing. Often, students conflate being eager and aggressive with showing interest and being proactive. This is not the right approach to success. Demonstrate your skills and talents through silent and purposeful action, not excessive speech.
3) Become a reliable team member that the residents can depend on, not someone that the residents must worry about. Residents are your biggest advocates. Work hard to become a helpful team member to make their lives easier. This can be as easy as showing up early to help the on-call resident with the patient list or even offering to stay late and help the intern with any remaining floor work. Never try to one-up a resident or fellow team member. It does not make you look better, but rather makes you seem arrogant.
4) Ask residents how to prepare for specific cases. Residents have inside knowledge on the types of questions attendings will ask medical students. In fact, many of my residents even provided me with resources to study from. Pay close attention to the information residents tell you, as it is typically extremely valuable information.
5) Finally, always maintain proper etiquette. Treat everyone you meet (mid-levels, nurses, fellow medical students) with absolute respect and kindness. They can often offer you help when you need it. In the operating room, offer to help the nurses set up and clean the room. Many of them have worked with the same faculty for long periods of time, and their opinion of you is important. More importantly, being a kind and pleasant person always precedes becoming an orthopaedic surgeon.
