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Orthopedic Surgery vs. Nephrology: Which Specialty is Right for You?

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by Yousmle Staff in Career

Orthopedic surgery vs. nephrology is one of the biggest debates among medical students interested in physiology. Both specialties allow you to explore the complex workings of the human body and use your skills to improve patient outcomes. However, they also have significant differences, such as the scope of practice, the work environment, and the training requirements.

How do you decide which one is right for you? In this article, we will provide helpful information and tips to help you make an intelligent decision on orthopedic surgery vs. nephrology and find a fulfilling career that matches your interests and abilities. We will also help you evaluate practical factors such as job availability, salary, and training duration.

Orthopedic Surgery vs. Nephrology: Salary and Job Security

Orthopedic surgery might be your specialty if you want to earn a lot of money and have a steady demand for your services. But be prepared for a competitive job market, even if you graduate from a prestigious program.

Nephrology, meanwhile, offers more job openings. You can easily find a hospital that needs nephrologists, and the career outlook is positive, even if the salary is not as high as orthopedic surgery. But nephrology also comes with some challenges, such as less job security, which we will discuss later.

According to recent data, orthopedists earn an average annual salary of $573,000, while nephrologists have a lower average salary of $312,000. Of all medical specialties, only plastic surgeons have higher average annual salaries than orthopedists, with plastic surgeons earning $619,000

Estimated Physician Average Yearly Salary by Medical Specialty in the US

Orthopedists earn $573,000 per year on average, while nephrologists earn less with $312,000 annually

Orthopedic Surgery vs. Nephrology: Competitiveness

Here we can assess the competitiveness of a specialty by looking at the unmatched rate – the % of people who apply and do not match into their preferred specialty Orthopedic surgery was the 2nd most competitive residency in the 2022 Match, with a 34.2% unmatched rate among US Seniors. Only plastic surgery had a higher percentage of 37.3%.

Orthopedic Surgery vs. Hematology and Oncology

Orthopedic surgery had a 34.2% unmatched rate, while internal medicine had a 2% unmatched rate among US seniors

To pursue a career in nephrology, you must first match into an internal medicine residency. Among US Seniors, the unmatched percentage for internal medicine residency was only 2%, making it less competitive than other residencies. However, this does not mean that nephrology is less competitive. After completing your internal medicine residency, you will still need to match into a fellowship, which is generally more competitive than matching into a residency. 

Below is the unmatched percentage among non-pediatric fellowships with >100 applicants. The unmatched percentage of US Seniors applying to the nephrology fellowship was 1.9%, making it less competitive compared to most fellowships with >100 applicants.

Plastic Surgery vs Nephrology

Training Path: Residency

The training pathways for orthopedic surgery vs. nephrology are not the same. Nephrology involves three years of internal medicine followed by two more years in a nephrology fellowship with an optional third year. Orthopedic surgery involves a five-year orthopedic residency

Nephrology fellowships are typically less competitive than orthopedic surgery residencies. Your USMLE scores, med school, and research are the main things for residency applications. Research is also a big thing for fellowship applications, and your residency program counts more, but your USMLE scores matter much less.

Orthopedic Surgery vs. Nephrology: Work-Life Balance

Work-life balance is a crucial factor for many medical professionals. Orthopedic surgeons and nephrologists have to deal with demanding schedules and on-call duties. However, due to the nature of their work, nephrologists may have a slightly better balance between work and personal life.

In comparison, orthopedic surgeons often have demanding surgical schedules and may work long hours in the operating room. They may also be on-call for emergencies such as trauma or accidents.

On average, orthopedic surgeons work 52.9 hours per week, which is above the middle of all medical specialties. In comparison, nephrology averages 54.9 weekly working hours, ranking near the upper end of all medical specialties.

Estimated Physician Weekly Working Hours by Medical Specialty in the US

Orthopedists work an average of 52.9 hours per week, while nephrologists work slightly more hours, at 54.9 per week.

Orthopedists need less documentation, such as referral letters and diagnostic tests, which means they spend approximately 14 hours per week on administrative work and paperwork. In comparison, nephrologists require more documentation due to the extensive diagnostic tests involved, which results in an estimated 18 hours of admin/paperwork per week.

Estimated Physician Admin/Paperwork Hours by Medical Specialty in the US

Orthopedists work on admin/paperwork an average of 14 hours per week, while nephrologists work more hours, at 18 per week.

Training Duration and Subspecialties

The training duration is a key aspect to consider when choosing between orthopedic surgery vs. nephrology. Nephrology has three years of internal medicine and a two-year training period, while orthopedic surgery has a minimum of five years of orthopedic residency.

After completing an orthopedic surgery residency program, some surgeons may choose to pursue additional fellowships to further specialize in a particular aspect of orthopedic surgery. This can increase the length of your orthopedic surgery training.

Orthopedic Surgery vs. Nephrology: Job Satisfaction and Burnout Rates

Job satisfaction plays a significant role in career fulfillment. According to various studies, orthopedic surgery tends to have higher job satisfaction rates than nephrology. Many orthopedists express contentment with their career choice and would choose it again if given the chance. Additionally, orthopedic surgery has slightly higher reported burnout rates than nephrology.

According to recent data, orthopedic surgery ranked near the upper end of all medical specialties with 95% of orthopedists stating that they would choose the same specialty again, while nephrology ranked lower with 72% of nephrologists feeling the same way.

Job Satisfaction Rate By Medical Specialty in the US

Orthopedists reported a 95% job satisfaction rate, while nephrologists reported lower satisfaction with 72%

That being said, nephrology and orthopedic surgery both have burnout rates of 44% and 45%, respectively, placing them near the lower end among medical specialties.

Burnout Rate By Medical Specialty in the US

Orthopedists and nephrologists have similar burnout rates of 45% and 44% respectively.

Orthopedic Surgery vs. Nephrology Comparison

To provide a visual overview, here’s a table comparing orthopedic surgery and nephrology:

AspectOrthopedic SurgeryNephrology
Average SalaryHigh, especially those focusing on high-demand joint/spine proceduresCompetitive salary, with potential for high earnings in subspecialties like retinal surgery
Job SecurityHigh demand field as population ages. Injuries and sports will ensure job stability.High demand due to increasing rates of chronic kidney disease and kidney-related conditions
Training PathTypically involves 5 years of orthopedic surgery residencyTypically involves 3 years of internal medicine residency, and 2-3 years of nephrology fellowship
LifestylePredictable work schedule and increased opportunities for time off, but involve on-call responsibilities for trauma or accident casesMore predictable schedules but higher administrative burden. Call duties mainly for inpatient consults.
Administrative PaperworkModerate documentation requirements for surgery notes, consults, and orders.Higher administrative requirements.
Job SatisfactionGenerally high, satisfaction tied to successful surgeries and patient outcomesLower
Burnout RatesLow to Moderate, depending on the workload and stress associated with surgical proceduresLow to Moderate
PersonalityDetail-oriented, mechanically inclined. Enjoy operative procedures.Strong problem-solving and critical thinking skills, ability to handle complex and challenging cases

Please note that this table serves as a general comparison. To determine the most suitable career for you, consider your personal and career priorities and goals.

Concluding Thoughts

Choosing the right specialty between orthopedic surgery vs. nephrology depends heavily on your priorities. To determine this, try reverse engineering your ideal life and identify your top priority. A helpful exercise is to write down the top five things you want to achieve in your career and personal life. Knowing these priorities will make finding a career that aligns with them easier. Often, the biggest obstacle is not a lack of knowledge about different fields but a lack of self-awareness about our own preferences.

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Cardiology is key for impressive USMLE scores. Master cardiology from a Harvard-trained anesthesiologist who scored USMLE 270 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.