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

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by Yousmle Staff in Career

Orthopedic surgery vs. rheumatology 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. rheumatology 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. Rheumatology: 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.

Rheumatology, meanwhile, offers more job openings and the career outlook is positive, even if the salary is not as high as orthopedic surgery. But rheumatology also comes with some challenges, such as higher burnout and less job security, which we will discuss later.

According to recent data, orthopedists earn an average annual salary of $573,000, while rheumatologists have a lower average salary of $281,000. 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 rheumatologists earn less with $281,000 annually

Orthopedic Surgery vs. Rheumatology: 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 had a 34.2% unmatched rate, while internal medicine had a 2% unmatched rate among US seniors

To pursue a career in rheumatology, 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 rheumatology 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 rheumatology fellowship was 8.2%, making it moderately competitive compared to most fellowships with >100 applicants.

Training Path: Residency

The training pathways for orthopedic surgery vs. rheumatology are not the same. To become a rheumatologist, you must complete a two-year fellowship in rheumatology after completing an internal medicine residency. Orthopedic surgery involves a five-year orthopedic residency

Rheumatology 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. Rheumatology: Work-Life Balance

Work-life balance is a crucial factor for many medical professionals.  Rheumatologists often enjoy a better work-life balance due to the nature of their work. They usually have predetermined working hours, leading to more predictable schedules.

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. Rheumatologists work an average of 47.2 hours, ranking near the lower 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 rheumatologists work fewer hours, at 47.2 per week.

Orthopedists require documentation, such as referral letters and diagnostic tests, resulting in an estimated 14 hours of admin/paperwork per week. The estimated physician admin/paperwork hours were not provided for rheumatology, but you can see estimated paperwork hours for other specialties below.

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

Orthopedists work on admin/paperwork an average of 14 hours per week

Training Duration and Subspecialties

The training duration is a key aspect to consider when choosing between orthopedic surgery vs. rheumatology. Rheumatology requires a minimum five-year training period, including three years of internal medicine residency, 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. Rheumatology: 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 rheumatology. Many orthopedists express contentment with their career choice and would choose it again if given the chance. Additionally, orthopedic surgery has lower reported burnout rates than Rheumatology.

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 rheumatology ranked lower with 81% of rheumatologists feeling the same way.

Job Satisfaction Rate By Medical Specialty in the US

Orthopedists reported a 95% job satisfaction rate, while rheumatologists reported lower satisfaction with 81%

That being said, the burnout rate for orthopedic surgery was 45% which was near the lower end of all medical specialties. In comparison, rheumatology had a burnout rate of 50% ranking in the middle of all medical specialties.

Burnout Rate By Medical Specialty in the US

Orthopedists have a burnout rate of 45%, while rheumatologists have a higher burnout rate of 50%.

Orthopedic Surgery vs. Rheumatology Comparison

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

AspectOrthopedic SurgeryRheumatology
Average SalaryHigh, especially those focusing on high-demand joint/spine proceduresGenerally high income but lower than orthopedic surgery
Job SecurityHigh demand field as population ages. Injuries and sports will ensure job stability.High demand due to an increase in autoimmune and musculoskeletal disorders
Training PathTypically involves 5 years of orthopedic surgery residencyTypically involves 3 years of internal medicine residency, followed by 2 years of rheumatology fellowship
LifestylePredictable work schedule and increased opportunities for time off, but involve on-call responsibilities for trauma or accident casesGenerally more predictable hours with less frequent emergencies; outpatient clinic-based practice
Administrative PaperworkModerate documentation requirements for surgery notes, consults, and orders.Moderate documentation requirements, focusing on rheumatologic assessments, imaging, and treatment plans
Job SatisfactionGenerally high, satisfaction tied to successful surgeries and patient outcomesLower
Burnout RatesLow to Moderate, depending on the workload and stress associated with surgical proceduresHigher
PersonalityDetail-oriented, mechanically inclined. Enjoy operative procedures.Strong analytical skills, empathy, and good communication skills to understand and address patients' complex musculoskeletal and autoimmune concerns

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. rheumatology 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.