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ORTHOPEDIC SURGERY PROFILE

Orthopedic surgery focuses on the diagnosis, treatment, rehabilitation and prevention of diseases of the bones, joints, ligament, muscles, tendons and

ORTHOPEDIC SURGERY PROFILE

p , j , g , ,nerves. These specialists employ medical, physical, rehabilitation and surgery to restore normal function. It is estimated that approximately half of an orthopedic surgeon’s practice is devoted to non‐surgical or medical p g p gmanagement of injuries and disease, and half to surgical treatments.

Originally dedicated to the care of children with spine and limb deformities, O g a y ded cated to t e ca e o c d e t sp e a d b de o t es,orthopedic surgery now cares for patients of all ages, from newborns who have clubfeet to young athletes requiring arthroscopic surgery to older people suffering with arthritis.suffering with arthritis.

Orthopedic surgeons treat diseases and conditions, such as:‐ fractures and dislocations‐ fractures and dislocations‐ torn ligaments, sprains and strains‐ tendon injuries, pulled muscles and bursitis

‐ ruptured disks, sciatica, lower back pain and scoliosis‐ abnormalities of the fingers and toes and growth abnormalities‐ surgical management of degenerative joint diseaseg g g j‐ knock knees, bow legs, bunions and hammer toes‐ arthritis and osteoporosis‐ bone tumors, muscular dystrophy and cerebral palsy‐ club feet and unequal leg length

Orthopedic surgeons may engage in a broad practice or may focus on a narrower area of special interest, such as the spine, hip, foot, hand or sports medicine. It is a dynamic field that has witnessed much advancement in techniques and equipment, such as microsurgery and j i ljoint replacements.

Upon completion of medical school, to become certified in orthopedic s rger req ires an additional 5 years of Royal College approvedsurgery requires an additional 5 years of Royal College‐approved residency training.

This training includes: 24 months of foundational surgery training as a junior resident This must‐ 24 months of foundational surgery training as a junior resident. This must include a minimum of 6 months but no more than 12 months as a junior resident in orthopedic surgery. This must include a minimum of 1 month in ICU general surgery internal medicine or its relevant sub specialties;ICU, general surgery, internal medicine or its relevant sub‐specialties;

‐ 36 months of further residency training that includes: at least 6 months in pediatric orthopedic surgery;

‐ at least three 3 months in each of the following rotations: trauma sportsat least three 3 months in each of the following rotations: trauma, sports medicine, community orthopedic surgery, spine surgery, oncologic orthopedic surgery; and at least three months of adult reconstruction/arthroplasty in each of the following: upper limb, foot and ankle.each of the following: upper limb, foot and ankle.

For more detailed training requirements for orthopedic surgery go to:http://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route

For The Canadian Orthopedic Association:http://www.coa‐aco.org/

Number of physicians and physicians/100,000 population for Orthopedic S rgerfor Orthopedic Surgery

Province/Territory Physicians Phys/100K pop’n

Newfoundland/Labrador 22 4.3

Prince Edward Island 6 4.1

Nova Scotia 48 5 1Nova Scotia 48 5.1

New Brunswick 35 4.6

Quebec 361 4.5

Ontario 567 4.2

Manitoba 54 4.3

Saskatchewan 37 3.4

Alberta 151 3.9

B iti h C l bi 226 4 9British Columbia 226 4.9

Territories 2 1.8

CANADA 1509 4.3

Source: 2013 CMA Masterfile

Physicians/100,000 population for Orthopedic SurgeryC d 1995 t 2013Canada, 1995 to 2013

4.5

4.0

n

3.5

0,00

0 p

op’n

2 5

3.0

Phy

s/10

0

2.0

2.5

1995 1997 1999 2001 2003 2005 2007 2009 2011 2013


Orthopedic Surgeons by gender and year C d 1995 t 2013Canada, 1995 to 2013

1600

1200

1400

800

1000

400

600

800

200

400

01995 1997 1999 2001 2003 2005 2007 2009 2011 2013

Total Males Females


Orthopedic Surgeons by age and genderp g y g gCanada, 2013

Age groupG d Age groupGender

< 35 35 to 4445 to 54 55 to 6465 + Unknown Age

Males Females


Orthopedic Surgeons by age and genderCanada 2013Canada, 2013

54 27<35

367

54

54

27

35 to 44

<35

296

339

12

40

55 to 64

45 to 54

274 2

Unknown

65+

41 3

0 100 200 300 400 500

Unknownage

Male Female


Main Work Setting of Orthopedic SurgeonsCanada 2013Canada, 2013

2 %C it h

24%

25%

Acad H Sc Centre

Community hosp

10%

21%

Non‐AHSC teach hosp

Private office/clinic

2%

3%

Admin office

Community clinic

6%

2%

Other

Admin office

0% 5% 10% 15% 20% 25% 30%

Source: 2013 National Physician Survey. CFPC, CMA, Royal College

Practice Organization of Orthopedic SurgeonsPractice Organization of Orthopedic SurgeonsCanada, 2013

SoloGroupInterprofessionalNo response

Source: 2013 National Physician Survey CFPC CMA Royal CollegeSource: 2013 National Physician Survey. CFPC, CMA, Royal College

Hours worked per week (excluding on‐call) by Orthopedic Surgeons

Activity Hours worked per weekper week

Direct patient care without teaching component 26.72

Direct patient care with teaching component 11p g p

Teaching without patient care 1.6

Indirect patient care 5.0

Health facility committees 1.0

Administration 2.4

R h 1 8Research 1.8

Managing practice 1.9

Continued professional development 3.2Co t ued p o ess o a de e op e t 3.

Other 2.4

TOTAL HOURS PER WEEK 57.0


On‐Call Duty Hours per Month for Orthopedic SurgeryCanada, 2013

U t 120 h / th 121 t 180 h / thUp to 120 hrs/month 121 to 180 hrs/month181 to 240 hrs/month > 240 hrs/monthNo response

Time spent on call spent in direct patient care = 54 hrs/month


Remuneration for Orthopedic SurgeryRemuneration for Orthopedic Surgery

P i h d1Primary payment method1

Average gross clinical earnings i 2011/12 ( h iin 2011/12 (those earning at least $60,000) = $389,2682

Average percent overheadAverage percent overhead reported by all surgeons in 2010 = 28.4%3

90% + fee‐for‐service 90% + salary

90% + other* Blended

NR

* Other includes capitation, sessional, contract and other methods

1 National Physician Survey, 2013, CFPC, CMA, Royal College 2 National Physician Database, 2010/11, CIHI3 National Physician Survey, 2010, CFPC, CMA, Royal College

Satisfaction among Orthopedic SurgeryCanada, 2013

6% 20% 20% 40% 14%Balance of personal &

professional commitments1%

p o ess o a co t e ts

6% 3% 8% 12% 50% 21%Current professional life

0% 20% 40% 60% 80% 100%0% 20% 40% 60% 80% 100%

NR Very dissatisfied DissatisfiedNeutral Satisfied Very satisfiedy


Total and Ministry funded postgraduate MD trainees in 2012/13 ‐ Orthopedic Surgery

Faculty of Medicine

Ministry funded

Total Faculty of Medicine

Ministry funded

Total

MUN 14 14 McMaster U 33 45MUN 14 14 McMaster U 33 45

Dalhousie U 15 22 UWO 28 49

U Laval 27 27 NOSM 4 4

U Sherbrooke 22 22 U Manitoba 19 23

U Montréal 35 40 U Sask 17 17

Gill 2 8 lb 2McGill U 27 48 U Alberta 17 24

U Ottawa 30 41 U Calgary 31 44

Queens U 18 24 UBC 26 50Queens U 18 24 UBC 26 50

U Toronto 62 137 Canada 425 630

Source: 2012/13 Annual Census of Post‐MD Trainees, CAPER

First year and exiting postgraduate‐MD trainees in

90 90

2012/13 – Orthopedic Surgery

2216

70

80 1170

80

90

16

50

60 17

50

60

62 5620

30

40 FemaleMale 73

5530

40 IMGGCMS

0

10

20

0

10

20

0First year Exits from

postgrad

0First year Postgrad

exits


Postgraduate‐MD trainees in 2012/13 –Orthopedic Surgery

• Total of 84 first year Orthopedic Surgery trainees representing 20% of all Orthopedic Surgery trainees.

• Total of 425 Orthopedic Surgery trainees representing 4% of all Ministry funded trainees.

• Total of 114 visa trainees in Orthopedic Surgery.• Total of 72 Orthopedic Surgery trainees completed

postgraduate training in 2012.


Location of 2011 Postgraduate‐MD exits in 2013

2730

Orthopedic Surgery

20

25

912

7 710

15

1 0 1 1 2 1

74

7

0

5

10

0

Of the 72 exits in 2011, 61 (85%) were known to be practising in Canada


Stress associated with finding employment at end of residencyg p y y

7% 43% 42% 8%FM resident

6% 20% 50% 25%Other spec res

0% 20% 40% 60% 80% 100%

NR/NA Not stressful Somewhat stressful Very stressful

Source: 2012 National Physician Survey of residents. CFPC, CMA, Royal College

Number of Orthopedic Surgeons who retired during THREE year period of 2010 to 2012during THREE year period of 2010 to 2012

20

141618

19 1981012

1 21 2246

1 21 202

< 35 35 to 44 45 to 54 55 to 64 65 +

M l F l T t lMales Females Total

Source: CMA Masterfile – year over year comparisonsNote: “Retired” is based on giving up licence and is therefore excludes those who have retiredNote: Retired is based on giving up licence and is therefore excludes those who have retired from clinical practice but are still licensed; it includes physicians who have temporarily given up their licence but may return to practice at a later date.

Percentage of Orthopedic Surgeons who are g p gRoyal College, CFPC or CMQ certified

95%100%

70%80%90%

50%60%70%

22%20%30%40%

3% 7%

0%10%20%

R l C ll CFPC CMQ O t id C dRoyal College CFPC CMQ Outside Canada

Note: Subset of those who reported a certification. Physicians could indicate more than one certification body.


Links to the organizations supplying information for this document

National Physician Surveyhttp://www.nationalphysiciansurvey.cap p y y

Canadian Medical Associationhttp://www.cma.ca/c3pr

Association of Faculties of Medicine of Canadahttp://www.caper.ca/

Royal College of Physicians and Surgeons of Canadahttp://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route

College of Family Physicians of Canadahttp://www.cfpc.ca

Canadian Institute for Health Informationhttp://www.cihi.ca

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