Last week we heard residents give their impressions on the logistics and educational programs of the 2009 AAOS Conference. We continue this week with their thoughts on the buzz and breadth of the exhibit floor, and on their contact with senior surgeons. They also had a few suggestions for next year’s meeting, as well as for future resident attendees.
Industry Exhibits
There are several high-wire acts in Las Vegas, one of which took place on the floor of the Sands Expo this past February. Balancing the need to work with industry with the need to be free of even the hint of impropriety is a professional performance that residents are just beginning to learn. And this year, say some residents, the industry folks were displaying not just new products, but a new attitude.
Dr. Waldron explains, “I had been told that during past meetings it was customary for sales reps to take residents out at the end of the day. Things were very different in 2009, however; I even got an email from a rep saying that his company had instituted a new rule that they couldn’t even speak to doctors after 5PM. When I did interact with the industry people at the booths they were quite nice and helpful. There were a number of companies I had never heard of, so it was a good chance to expand my knowledge in this area. Generally speaking, I think the onus is on the surgeon to not get sucked into something just because you like the sales rep. The bottom line is that we must choose a product based on its merit.”
One resident thought that the only thing missing was a Tilt-A-Whirl. Dr. Labson: “It was such an amusement park atmosphere with all of the glitz and noise. You could tell who had the most money to spend. I interacted with people from the large companies, but what struck me was that there were so many smaller companies I had never heard of. It was nice to learn about them.”
One resident said there was a bit of cloak and dagger amidst the screws and fixators. Dr. Upasani: “The reps were less aggressive this year, even waiting to be approached by doctors. I actually heard that there were undercover agents in the exhibit hall monitoring reps and their interactions with surgeons.”
Dr. Van Sice noted, “The industry presence surpassed my expectations and was a bit overwhelming. Unfortunately, where I work we are contractually limited to two companies, so it’s a bit frustrating to see all that’s available, but not be able to use it. As for mixing with the industry folks, my resident colleagues and I were well aware of the fine line that must be walked and did not socialize with the sales reps. But the fact is that industry is a big part of the meeting and the field, so that must be taken into account. I’m still trying to determine where I stand on this issue.”
“I didn’t feel that anyone was inappropriately pushing anything, ” said Dr. Strebe. “The company representatives were helpful and took the time to explain their products. And I never felt treated differently because I am a woman.”
On the other hand, Dr. Siemionow’s experience was not as positive.
There were times when company representatives were not as welcoming as they could have been. I look very young, so perhaps this affected their decision about whether or not to interact with me. It was a bit like going to an expensive boutique and being ignored by the salesperson.
And here’s that “O” word again. Dr. Ali: “The expo booths were overwhelming. Also, it wasn’t obvious to me how things were organized. I spent a fair amount of time wandering around and would have preferred it if things were more clearly laid out.”
Generally speaking, the industry exhibits did not occupy much of the residents’ time while at the 2009 meeting. Perhaps this is because, as Dr. Harris said, “The exhibit area is not very helpful because I am not in practice yet. Aside from the fact that it’s so overwhelming, many of the products featured there don’t relate to what I do on an everyday basis.”
Contact With Senior Surgeons
Residents perusing the program not only focused on the topics available, but on who was delivering the information. While they were pleased to see so many orthopedic dignitaries on hand, some residents had difficulty getting access to the surgeons. Some just wanted to ask questions of the orthopedic veterans, while others sought to explore the possibility of a fellowship. In the end, most residents relied on friends and colleagues to help them make new connections.
Dr. Kuntz sums up the process by which many residents met seasoned surgeons: “Most of my contact with surgeons was because one of my faculty members introduced me around. Overall, I felt like I had enough time to speak to surgeons at the meeting.”
Dr. Labson felt the hint of a pecking order at play. “My colleagues and I traveled around the meeting with a gaggle from UC Davis, so I met surgeons through these people. In general, I was not able to interact with the presenters because they were inundated by other people. We residents were essentially beat out by the attendings.”
The folks from Ohio also moved en masse. Dr. Siemionow: “I traveled around with a large pack from the Cleveland Clinic and was basically able to meet new surgeons because someone I was with bumped into someone they knew.”
Drs. Upasani and Harris found little difficulty interacting with surgeons after the educational sessions. Dr. Upasani adds: “I met surgeons after the lectures, as well as at our UCSD reunion party.”
For Dr. Shanti, however, things could have been better. “I didn’t have enough interaction with surgeons because I felt like I couldn’t stay after the lectures…I had to run to catch the next presentation. A couple of my resident colleagues told me that they attended seminars where the speakers didn’t even remain for Q&A.”
Advice for Future Resident Attendees
Most of the residents interviewed acknowledged that being prepared is the best way to approach the AAOS annual meeting. They had other suggestions as well for those who will attend these meetings in the future. The bottom line, however, is that there is no one entity telling you how to prepare. You must do your own due diligence and strategic planning.
Dr. Kuntz recommends,
Have a game plan! When you get the final program at registration, sit down and look at each day’s offerings and strategize.
On the focus issue, Dr. Waldron concurs with many residents: “Before you arrive, or soon after, decide why you are there. It is easy to get distracted by any number of things, including the location of the meeting. Have a plan.”
Sounding a similar note, Dr. Strebe says, “Residents should attend the day-long symposium that is designed for us, especially the fourth and fifth years who need to devote time to issues in our careers that we don’t normally consider.”
In addition to this, says Dr. Labson, reach out to others who have gone before. “Ask attendings about what to expect at the meeting and how you should navigate through all the various activities.”
With so many concurrent sessions, says Dr. Upasani, trying to do too much is the kiss of death to a good meeting experience. “As a second year it was particularly hard to focus. This early in my residency I felt like I wanted to attend a bunch of different sessions in a variety of different subspecialities and it was difficult to organize my days to make it all work out. I really should have spent more time before the meeting selecting the sessions that were most important to me.”
Dr. Ali adds, “Go over the schedule thoroughly and only attend those things that will be most relevant to your practice. I would also recommend that you try to interact with as many people as possible in your area of interest.”
Dr. Shanti not only learned lessons about pre-registration, but decided that it was face time with surgeons that is the most beneficial. “I found the AAOS website to be a little difficult to navigate. I tried signing up for courses online prior to the meeting, but gave up because it was so confusing. Later I realized that you don’t have to sign up on the site. Also, based on my experience this year, I would recommend that residents focus on getting to know surgeons instead of attending as many talks as possible.”
If You Were in Charge…
The good news is that when asked if they were given the responsibility for improving the AAOS meeting experience for all residents, most folks interviewed felt that there was not a lot of room for improvement. The other good news is that they had some interesting ideas.
A popular cry from the residents was, “more residents.” Dr. Kuntz: “I’d like to see more of my fellow residents in attendance. I think the issue is home hospital coverage; there are no barriers from the Academy.”
Dr. Van Sice agreed about coverage issues, adding, “I want more residents there, but I know that the programs are sometimes limited by the amount of funding.”
With regard to getting and staying involved in the Academy, Dr. Van Sice noted, “AAOS has a resident liaison program whereby each orthopedic department designates one resident to be the point of contact for their program. The liaison meeting at AAOS was basically a slideshow lecture to indicate what the Academy can do for residents, a la, ‘Welcome, these are your contacts, stay in touch.’ It is easy for residents to attend and say they’re going to be involved. I think it would be helpful if at the end of this session each resident wrote down goals for their program. For example, have a resident in their program apply for a committee position, or arrange for a guest lecturer to visit their program.”
Practicality was the order of the day for Dr. Waldron, who said he would like to see more presentations geared toward helping residents prepare for their careers. “I also think it would be useful to learn about any programs that the Academy offers to residents to help them find the right job. Additionally, any specialty-specific presentations about career planning would be particularly helpful, since the types of jobs available differ greatly amongst specialties.”
If in charge, Drs. Ali and Strebe would plan social events that would enable residents to interact in a relaxed atmosphere. Dr. Ali:
I would hold one or two resident cocktail receptions or coffee hours at times that don’t conflict with anything else.” Dr. Strebe added, “A residents-only reception would go a long way toward making us feel welcome and included in the meeting.
Dr. Ali also indicated that he would like to have a business education/practice management seminar that doesn’t conflict with anything else, adding, “I found the instructional course lectures to be a bit too expensive. Perhaps the Academy could arrange it so that residents attend one or two at no charge.”
If given the chance, Dr. Harris is ready to roll up his sleeves. “I’d like to see more resident specific courses during the week, especially those that involve hands-on activities. We could work with sawbones, other equipment, and do hands-on demonstrations with new implants. Labs and didactic sessions would also be great learning opportunities.”
A bit of on-site mentoring would enhance the meeting experience, said Dr. Labson. “It would be great if it could be arranged for senior residents to attend different events with attending level surgeons. For the junior residents perhaps there could be one or two sessions directed more toward basic orthopedic topics.”
Drs. Upasani and Siemionow would like to see more pre-meeting coordination. Dr. Siemionow specifies, “The resident-specific events should be better advertised. I’m definitely part of the AAOS email chain and I don’t recall too many notifications, if any, about resident events. It also wasn’t clear if these activities were things the program coordinators were supposed to know about/help us with.”
He continues, “Last year the North American Spine Society held a fellows dinner which was led by a surgeon who had just completed his program. He gave an informative presentation about his first year in practice. On hand were a number of fellowship program directors from across the U.S.; it was a super opportunity to get to know them. There’s no reason why we couldn’t have a residents dinner at AAOS with a similar program/agenda.”
Dr. Upasani adds, “I really enjoyed the residents forum organized by Clinical Orthopaedics and Related Research and feel that more sessions to allow informal interactions between the residents and senior surgeons would be useful.”
Wrap Up
On the whole, those residents interviewed felt welcome and generally well-integrated into the 2009 meeting of the American Academy of Orthopaedic Surgeons. Because the majority of the residents had scheduling/organizational challenges, however, perhaps a more formalized system could be instituted to address these issues. (For example, enhanced communication between AAOS and residency coordinators.) Additionally, it may be worth exploring the extent to which residents benefit from the industry exhibits. There may be a lack of clarity as far as how this part of the conference impacts residents, especially at this point in their careers. Lastly, as it is now, the process of resident/surgeon interaction seems somewhat random and at times, harried. Thus, it is likely that residents would gain from having specific time set aside to meet with senior surgeons.
Congratulations to the Academy for its continued efforts to meet the needs of future orthopedists. After all, now a resident…later, a President.
