http://thestar.com.my/news/story.asp...;sec=education

Goriest type of surgery

BY ZECH PHARAMOND

DR ZANARIAH: Orthopaedic surgery is the goriest type with lots of blood and protruding bones.
AT the back of her mind, she had only one ambition – to be a doctor. Although tempted to be a dancer, actress or model along the way, Dr Zanariah Othman stayed the path based on the simple logic that even in wartime, doctors would always be able to continue using their skills and knowledge.

The Universiti Putra Malaysia (UPM) lecturer decided to be an orthopaedic surgeon in her second year in medical school. One contributing factor was the people involved in this area of specialisation.

Right from the start, the lecturers and seniors (who were studying to specialise in orthopaedic surgery) were extremely approachable. Their friendly and helpful demeanour encouraged her even more to pursue her chosen field.

She attributes that to the fact that unlike other types of surgery, orthopaedic surgery is very rarely life threatening. Another reason is the fact that it is a“straightforward science” which is a little like engineering – one and one always makes two, says Dr Zanariah who is clearly passionate about her work.

The Greek root of orthopedics is from ortho (straight) and pais (child). Much of the early work in orthopedics involved treating children who had spine or limb deformities. Although orthopedists continue to treat children, they also treat diseases prevalent in the elderly.

While some orthopedists confine their practice to specific areas of the musculoskeletal system, such as the spine, hip, foot or hand, many generalists have a special interest in a specific area, but still treat most injuries or diseases of the musculoskeletal system.

What does an orthopaedic surgeon do?

My medical specialty focuses on the diagnosis, care and treatment of patients with disorders of the bones, joints, muscles, ligaments, tendons, nerves and skin which are the elements of our musculoskeletal system. I commonly encounter fractures or dislocations, torn ligaments, sprains and strains as well as arthritis and osteoporosis which my older patients suffer from. Depending on their conditions, I might use medical, physical and rehabilitative methods as well as surgery.

Describe a typical day at work.

There are nine doctors from UPM and 20 from government service. We all have our own designated clinic days and operation days. But I also have my specialised clinic day when I conduct operations such as joint replacements or deal with sports injuries. I also remedy ankle and foot problems. So in all I have about three days to which I devote to the clinical aspect of things. On those days, my rounds in the wards start at 8am. I spend the other days teaching at UPM and conducting research as well as working in collaboration with drug companies.

What qualifications do you need?

After the basic medical degree, I spent another four years specialising. Then I commenced my compulsory three years in the civil service upon finishing my housemanship. I was an undergraduate at USM (Universiti Sains Malaysia) and enrolled at UKM (Universiti Kebangsaan Malaysia) for my Master’s.

The Government has made it harder to become a surgeon by raising the standard so even clinical specialists graduating from foreign universities need to complete two to three years under an established surgeon before receiving their call-up to the post. I had to complete about six months of tutorship before my postgraduate qualification was recognised fully.

Also, the syllabus itself is tough with students getting only a two-week break a year. There is no such thing as spoon-feeding students with notes; they have to come in prepared to handle the workload on their own.

What type of personality best suits this job?

To be honest, a girl that thinks like a guy. Orthopaedic surgery is the goriest type of surgery with lots of blood and often times, protruding bones. For example, I’ve had a fellow orthopaedic surgeon in Ipoh who had to deal with a loaded bus that crashed into a ravine. Can you imagine the injuries sustained by the passengers? Literally broken bodies that he had to repair! You also have to be able to handle the criticism that this male-dominated field throws at you. You have to be strong mentally as boys will be boys and speak the first things that come to their minds without much thought for female sensitivities. So no, definitely not for the faint hearted. In fact, many girls opt for fields like plastic surgery and internal medicine.

What are the career prospects?

That depends on what you want or how far you’re willing to go. There are only a handful of female orthopaedic surgeons around and I haven’t come across any glass ceilings yet. Most surgeons spend between seven to eight years in public hospitals before branching out into the private sector. That’s where we lose our best talents actually.

What is the best part of your job?

I love my patients, all of them, from the Ah Pohs to the Ah Chees. They mean very much to me and though I have to give them a telling off from time to time, they know I care with all my heart for their wellbeing. That's probably the best part of my job, the satisfaction of being able to help others. This explains why after nine years wholly devoted to orthopaedic work, I’m still here. Sometimes they don’t understand, but I do and it is enough for me to know that I’ve given something to them that will enhance their lives for years to come.

What is the worst part of your job?

There is nothing to dislike about what I do. I love the research, some of which even included building better crash helmets. I also love the people I work with, from the students to the patients. There have been absolutely no disappointments, never from my job at least.

The most difficult times though, come when I face shallow people who cannot seem to understand what it is I’m trying to do. There is a lot of red tape to be negotiated before any requested aid can come through. Funds for spinal implants for example – it takes time from getting the message across to finally seeing things being put in motion.

What is the salary range?

Did you know that orthopaedics are the best paid surgeons around? Heart surgeons come in second because while they are considerably fewer in number, there are also fewer cases that they attend to. Malaysia has over 300 orthopaedic surgeons and they are making lots of money.

Fresh surgeons in their first year can expect between RM2,000 to RM3,000 excluding their allowances. That goes up to about RM6,000 to RM7,000 as they progress. In the private sector, orthopaedic surgeons easily make RM60,000 to RM70,000 a month so it’s normal to hear of surgeons breaking the RM100,000 mark. In a group practice, which is seven to eight surgeons within one private hospital, they also tend to make between RM60,000 to RM70,000.

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