Colleen Nesbitt

Hello everyone! As stated in my welcome post, this blog is an opportunity for students and young adults to get in-depth information about various medical jobs that they may be interested to pursue in the future. I have interviewed some lovely people about their careers and am very excited to start sharing! So let's get started…

My first interviewee is Colleen Nesbitt, she is in the third year (of five) of her orthopedic surgical residency at the University of Saskatchewan. Colleen is originally from Calgary but currently resides in Saskatoon, Saskatchewan. Outside of the hospital she enjoys staying active, which is especially important to her since she was a competitive athlete before residency. Since the pandemic she has started baking as well, which acts as a de-stressor while working in residency! 

Question: Can you give us a brief summary/overview of what your job is?

Colleen: The field of orthopedics consists of fixing broken bones. This can be as simple as bone fractures or as big as a hip replacement. They also fix soft tissue injuries like ACL ligament repairs, rotator cuff repairs and shoulders. They also deal with pediatric injuries as well, so broken bones in children. Orthopedic surgeons also work with children who are born with deformities that prevent them from leading full active lives. This field also consists of non-surgical interventions, such as taking care of people with diabetes or other soft tissue problems that don’t necessarily require surgery. I am currently completing residency, so I have already completed med school. After medical school, you get to train in your specialty of choice and do your residency in that field. My job varies a lot because I am learning all of the different sub-specialties in orthopedics. Every month, I will move to a new sub-specialty and have to learn the operations that those groups of surgeons do. For example, this month I'm having foot and ankle surgery. Next month I am on upper extremity surgery, like wrists, elbows and shoulders. So my job right now consists of the full range of orthopedics. My days are quite long, they usually start at 7am and our operating rooms run until 4pm. Sometimes as a resident we also have classes that go into the evenings. I also do call, which is part of residency and staff duties, meaning I am working at the hospital for shifts as long as 24 hours. My staff are also on call, so I am calling them at all hours of the night to discuss patients. Depending on which sub-specialty surgeons focus on for their career, their days will all look very different. In general, orthopedics is a lot of working with your hands and moving around. I meet tons of patients everyday and talk to new people all the time. One of the things that drew me to this career was being busy and the constantly moving aspect. 

Question: After your residency do you get to choose your specialty?

Colleen: During your residency, you think about which sub-specialty appeals to you the most, and after your 5 years in residency you have to do an extra training year in fellowship for that. Sometimes the fellowship is 2 years because the job market is getting more competitive, so then you will have a way to stand out. Then you can find a job in your area of interest. 

Questions: Has any of the sub-specialties peaked your interest yet?

Colleen: I am currently in the self-discovery phase! Some of my colleagues have picked and are really enthusiastic about one thing in particular, but I do like a lot of the things that I have seen so I am struggling to narrow it down to one specialty. I do like working with the pediatrics population, they are very unique and they heal very well, so good outcomes happen more often. I also like doing hip and knee replacements because you give lots of people back their mobility and quality of life. 

Question: Do you find the one month intervals of sub-specialties overwhelming, or do you find that it's a good amount of time for each? 

Colleen: I think it has its pluses and minuses. Obviously, we have to learn the scope at the end of our residency. We have our licensing exam for orthopedics after, so you have to know everything about everything to pass it, to be a comprehensive surgeon. You have to be okay with being uncomfortable in scenarios when you don’t understand as much as you would like, especially in your earlier years of residency when there is lots of new stuff. It is impossible to know everything before so you just have to make sure you read up on what you're learning about so you comprehend the stuff you see in residency. 

Question: What programs of course did you take prior to your residency?

Colleen: First you complete your undergrad. It is now less important on your choice of study in undergrad because the medical field is trying to diversify the candidate getting into medical school, which I think is really important. So not always does your undergrad degree help or hurt your chances. But I knew going into my undergrad degree that I liked science, but I wasn't sold on being a doctor. I thought that there must be something else equally as exciting because I knew that the amount of time it takes to become a doctor is long. There are so many options out there that I was unaware of. One of the obvious choices is doctor because it's often heard of, just like lawyers. I did my undergrad in science at UBC and minored in kinesiology because I like human body movement. Then, after undergrad, I realized that I did want to go to medical school but had not made enough academic connections to create an appealing application. Unfortunately, we are still in the time where you have to make an application that fits what is expected. I did a masters at the University of Calgary in kinesiology that was thesis based, which is how I made my academic connections for my application to meet criteria. Then, I applied to medical school five times to try and get in. I started applying during undergraduate years, but took me some time to figure out what they were looking for, hence completing my masters. I ended up being waitlisted and got in on the last day of applications. It was a process, which I was very excited about in this next chapter. 

Question: How long did your undergrad and masters take you?

Colleen: Undergraduate took five years because I did a reduced course load since I was competing on the UBC varsity swim team. Then my masters took 2 years. So 7 years before medical school, which took me three years to complete. 

Question: How did you decide which university to go to?

Colleen: For undergraduate I chose UBC because they had a good swim team which was a priority for me at the time. They also had a great science and kinesiology program which was a bonus. I don't think you can go wrong with what university you chose to attend in Canada in terms of education level. I also chose it because I wanted to live outside of my hometown and fortunately had the means to do so. I had gotten a scholarship to swim on that team as well. For my masters, I also chose to go UCalgary because I had connections there, I had to move home after undergrad and was still deciding what I wanted to do. For medical school, I applied to schools in the west because I knew I had a better chance in my home provinces. Calgary made more sense for me because they allow more personalization of your application and my story was not the typical academic story so I was able to talk more about that which I think was why I was more successful. 

Question: Is there anything that you wish you knew before going into orthopedics or that you want somebody going into it to know?

Colleen: In particular, is it a physical and demanding specialty, so you have to be prepared for the workload. It's hard to go into shifts that can be over 24 hours, unfortunately that is the reality of residency right now. And it is a specialty that you move a lot so it takes a certain amount of energy for sure. There are a lot of misconceptions about orthopedics as well. It is a male dominated specialty only 12% of orthopedic surgeons are females, which had not budged for the last 8-10 years despite trying to recruit more women. I am the only female resident in my program right now. Fortunately, for me, being in a sports environment growing up I have seen how great men can be. But there is a difference between a male dominated OR and a female dominated OR, the vibes are different. I think it's definitely a disservice to say that this dominance has changed, because it hasn't changed much. So you should know you are entering a male dominated space when going into this field. It hasn't influenced me negatively in my program because there has been a precious history of female residents and the staff is awesome but that's not always the case for every program. I would say as a female, that is important to know. Plus, it's important to know that your job will be awesome! You get to work with cool tools, nice patients, restore peoples lives and its wild. It's a huge responsibility to people and you get to do very powerful things every day. 

Question: When did you know that you were interested in orthopedics? 

Colleen: So I was extremely lucky, because my mom was an orthopedic surgeon so she was obviously a huge influence for me. And she was an orthopedic surgeon when it was “uncool” for a woman to be an orthopedic surgeon. So she broke a lot of ground that way. But I saw her job growing up and I saw the struggle and way she was balancing things with us, so that was one of the reasons that I was like there has to be another career than this out there! But I was able to shadow orthopedics in high school, and I saw operations for the first time and was like “oh my god this is the coolest thing I have ever seen!” I couldn't believe this was a job that people got to do. I could never see myself with a job where I sit at a desk all day and I could definitely see myself doing a job like this. I think that when you’re going through med school and you are trying to make the decision of career choice, it is a very difficult decision. It's not only what you like, even though that's a huge driver in your interest, but it is also looking at lifestyle and even timeline. You have to be able to see yourself in these environments and see what “fits” best for you. Every time that I was on an ortho rotation, I felt like I fit in and these were my people, which was very affirming and made me comfortable with my decision. 

Question: What do other people with your degree work with which is different from your work?

Colleen: When I was in undergrad I did a lot of volunteer work with rehabilitation programs and physio therapy. I think if med school didn't work for me, those options were very legitimate career choices for me because they have the same undergrad degree that I do. Many people that I met during my masters were going into things like lab coordinators, project coordinators, academic researchers, statisticians, healthcare administrators, and fitness trainers. And of course, anything in medicine!

Question: Can you describe a day in your life in residency?

Colleen: Ooh, what day should I pick? Well today was a pretty standard day, on a more elective service. Today was a day of operating with the foot and ankle department. Like I mentioned, I was an athlete for a long time and physical activity is a large part of how I process and function as an individual, so my schedule won’t look like most peoples. Today I woke up at 4:50am this morning and I worked out. Then I got back to my house around 6:30am, I ate and then went across to the hospital around 7:00am and set up the doctors part of the OR for the morning. I brought up x-rays, made sure the patients charts were available and just made sure the general things in the room were there for what we will need for the first case. By then, my boss had arrived and we talked about what we were gonna do. We met the first patient of the day around 7:35am. We got working on our first operation around 8:00am, we did a total ankle replacement, which was very cool, I had never seen that before. This took about 90 minutes. Then it's basically a rinse and repeat cycle for the rest of the day. Get the patient out of the room, clean it, set up, meet the new patient and do the next procedure. I did a first total fusion for arthritis, overall we did 4 cases today. In between each one I am writing notes, trying to learn, my boss is relaxing! We eat in between each case and just do the little things. We wrapped up at 4:00pm today, and then I got to go home because we didn’t have classes today. I did some house chores, ate supper and then did this interview! Normally, after eating I would spend my evening studying and preparing for the next day. 

Question: Is the hospital that you're doing residency at, do you hope to work there after? 

Colleen: We’ll see how things go. My partner is not in Saskatchewan because his job is elsewhere and after my residency I have to do a fellowship and potentially another one. Both of those will be in different locations, and at the end you see where things are at. Surgical specialties are more resource limited so you don't always get to work where you want to work. So I will have to see in a few years where I end up. 

Question: What does a fellowship look like?

Colleen: What it means is that you are a full-fledged orthopedic surgeon, you have passed your exam, but you are now getting extra training in a specific specialty. You are doing procedures but you're still under the supervision of a staff surgeon. Their name is still on the patient but you get a lot more freedom and treat it as your case. But they are still available as a resource when you need help because you are still learning. 

Question: What traits do you think would be essential to be successful in this job?

Colleen: I think we need people with a lot of different traits, we can't stereotype. A lot of the older staff say things like you have to be big and strong to do ortho, which is not the case! I do think that you have to be tenacious. I think being athletic can be helpful, because you're used to getting feedback from a coach or you'll fail and have to learn from that and build from it, and that happens everyday as a surgical resident. You are faced with failures and not being good at stuff, so you have to be comfortable with that. You're not going to be good at things the first, second or even third time that you do it. You're watching people who have had this career for 10+ years and they are really good, you need to understand that they have way more practice then you and it's okay to not be good in the beginning. I think if you don't have that mindset, you won't progress in this specialty, so you have to be able to take those hits and learn to take feedback. If you can do that, you can learn anything. You can't practice this job outside of it, so you will learn it if you accept you're bad at something and go from there. 

Question: Over the summer between school years, where would you recommend that students get a job/volunteer to help improve chances of getting a position in this job in the future?

Colleen: That's tough one to answer because I don't have a lot of personal experience there, I was swimming for a varsity team which took place for 50 weeks in a year so I didn’t have a summer job, I took classes over the summer to be able to finish my degree in a reasonable amount of time, which I was super privileged to be able to do. When I did some minimal work, it was at a medical office scanning patients files to transfer them from paper to online. I didn't have a typical job, so I don't know if I can answer that with any personal experience. There are lots of volunteer opportunities for students at the hospital. Lots of people do greetings, do tours of the hospital, play entertainment for the patients and greet long term patients to keep them company. I would encourage people to look for volunteer positions that are more hands-on that can get you closer to the action and specialties. 

Question: What are some common misconceptions that people have about your work/industry?

Colleen: There are a lot of “ortho bros” in ortho. Many residents in ortho do have an athletic background, so conversations can be filled with gym talk, but this is not always the case because you do not need that background to be successful in this career. I have many staff and fellow residents who are super intellectual and into research about medicine, there is a big diversity of people besides the stereotypical athletic residents that social media often portray the specialty as. We aren't people that get super jazzed by electrolytes and blood pressure, so that is also a big misconception. You do not have to be a big strong dude to be in orthopedics, but that is what most patients expect. I do think that the updated application process is trying to bring down these misconceptions and I think the more voices in the room from different backgrounds, the better. 

Question: How do you think your industry/field of work will progress in the future?

Colleen: I think that some of it's already happening, like I said we need to diversify more which is already starting, it will help our field and patient care. AI is already happening, we use it to help with our clinic notes which saves lots of time. It's starting to be used on the administrative side and that part can take us away from our patients, so the use of AI is helpful there. We have a lot of robotic advancements, they use robots to do hip and knee surgery a lot in the states, not as much here because it is quite expensive. At this point it hasn't been proven to be better than humans but I think that will change. So probably robots and AI planning of surgeries will be the next step forward. Fortunately, for this specialty I think we are a while away from robotics taking our jobs because putting legs back together is a complex job! 

Thank you Colleen for letting me interview you, it was super fascinating and eye-opening! I hope these answers help other students get a better look into a career like yours and see if it's something they would want to pursue! I wish you the best luck in your career and I hope we can talk again! For the students reading this, let me know if you have any further questions!