Orthopedic vs plastic surgery – Comparison of Work, Lifestyle, Salary

Orthopedic vs plastic surgery. The battle of the giants in surgery. Ortho and plastics are the major fields that most surgeons decide between at the start of their residency training. While Neurosurgery always seems to sit at the top of the pyramid of surgical specialties due to its prestige and glamour, most surgical residents are now competing for either ortho or plastics. The reason is that neurosurgery training is getting longer and longer. With seven years of mandatory training plus one to two years of fellowship, the training time keeps on increasing. This accompanied by the fact that surgical training is already as hard as it gets, most students want to skip neurosurgery entirely. Similarly, cardiothoracic surgery is also losing residents to the same conundrum as well. So, the most competitive fields currently in surgery are orthopedic and plastic surgery.

Both fields are very different from each other in fact. Let’s look at them one by one.

man people woman roomphoto of medical professionals wearing personal protective equipment

Orthopedic surgery walkthrough

Orthopedic surgery ( full name of ortho) deals with bone illness and trauma related to the bones. They also deal with bone tumors and pediatric bone problems. Ortho is a very well-known field among med students as well as among patients. Everyone respects and appreciates the ortho bros. No ER day is spent without trauma and ortho is always on call 24/7 (which can be a good or bad thing depending on what kind of lifestyle you want in life). So every med student comes to know the ortho bros and all med students have a very good understanding of the field. Ortho is also one of the mandatory rotations at least in my area, but it differs from place to place.

That aside ortho is not just trauma and the cases dealt with by ortho range from sports injuries all the way up to elderly osteoporosis and joint diseases. Ortho also deals with the muscular ligament and tendon problems as well as the spine. They see patients all the way from neonates with pes cavus up to the elderly with stress fractures. If anything has a bone (not a boner 🙂 ) ortho is involved. Learn more about it at the AMERICAN ACADEMY OF ORTHOPEDIC SURGEONS.

Plastic surgery walkthrough

Plastic surgery is derived from the Greek word plasticos which means to mold. It is not related to plastic at all. Plastic surgery deals with molding of the human body to return function or form to the tissue that may get deformed due to either illness or trauma. They also perform a lot of reconstructive operations to restore essential form to the tissues. They also do cosmetic surgeries which is probably the one thing they are known for the most.

So, in essence, plastic surgery is a very big and wide subject. Even most med students who don’t rotate in plastic surgery are unaware of the scope of the field and they also believe it to be just cosmetic. Plastic surgery is one of those fields which is not available in most hospitals and teaching institutions so med students don’t get exposed to it that much. Furthermore, all of the cases dealt with by plastics are so complex that they are usually not taught at the med school level. For e.g. doing a bicep head repair or fixing a laparotomy wound that won’t close or doing a nose job.

While plastic surgery is a lot more than cosmetic most surgeons do tend to do set up their private practices and work independently. This is probably why there are so few plastic surgery programs in the US. Learn more about plastic surgery at the AMERICAN SOCIETY OF PLASTIC SURGEONS.

Orthopedic vs plastic surgery breakdown

Ortho is for the ratchets and plastics is for the bougies, or so the stereotype goes. 🙂

To get into ortho your bench score plus your step 1 score should be over 500. All jokes aside ortho is one of those specialties which has the highest competition and not just among the fields in surgery. Ortho demands scores well above 250, with higher 240s being the bottom standard for the field even in far-flung areas. So your step 1 game needs to be on point before you consider the field.

For plastic surgery, the residency slots are even lower when compared to ortho so the competition is through the roof. Higher to lower 260s are the norm in the field on both steps 1 and 2. So you need to be a massive nerd to live the plastic surgeon lifestyle.

If you are deciding between the two fields, don’t worry about lifestyle. Both fields can be as tough or as relaxing as want them to be. For ortho if you want to make it tough you can just take trauma call, similarly with plastics as well. If you want to make ortho chill you can just run a private practice focused on arthroplasty or sports medicine. If you want to make plastics chill just go for a cosmetic surgery practice.

Remuneration in both fields is almost the same. That is if you are working as an attending at a hospital. If you are working in private practice then the numbers can vary greatly and no data is available for me to comment on that.

Both fields have a ton of burden. Ortho being the bigger contender here as trauma never stops. Plastic surgery also has a ton of burden not only because of the very few specialists. But also because burn and reconstructive cases fall under plastics. So, a lack of patients even in private practice should not be a concern in both fields.

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