Finding One’s Legacy: How to Approach the Question of Retirement from Orthopaedics

Editor's note: The Final Cut is a recurring editorial series written by a member of the AAOS Now Editorial Board.

As I write this, my grandmother passed away about 6 weeks ago. She was 94 years old and suffering from severe dementia before she fractured her hip. She was my last remaining grandparent, and her passing caused me to reflect a great deal on the purpose of life. The feelings that surfaced have become familiar from times when I’ve previously lost a loved one: What did that person mean to me? What is their legacy? What will be my legacy?

In preparing for my grandmother’s funeral, I came across the following quote from Ralph Waldo Emerson: “The purpose of life is not to be happy. It is to be useful, to be honorable, to be compassionate, to have it make some difference that you have lived and lived well.” I first found this quote 3 years ago when my grandfather—her husband—passed away, and it has really stuck with me. The purpose of life in Emerson’s view is to be useful, honorable, and compassionate and to make a difference. I stopped to think: Was I making a difference in the lives of others? Was I living and living well?

My mother passed away unexpectedly a few weeks after my residency graduation, and it made me question everything. I’d been chasing degree after degree since I was 18 years old, but how happy was I really? I started pursuing new hobbies, traveling more, and doing things that enriched my non-medical life. Today, I have probably too many activities, and one could argue that no one really needs to go to that many concerts, but I’m determined to live as fully as I can. Life is busy, and it can be a juggling act, but I wouldn’t have it any other way.

I do wonder, though, what my second chapter will look like. Will I know when it is time to move on to the retirement chapter, and what will that chapter even look like? Orthopaedic surgery allows me to make a difference, which I want to do long as I can—but I cannot continue forever, nor do I want to. Luckily, I’m still (somewhat) young and (depending on the day) energetic, so I have plenty of time to figure this out. But at some point, I want to more fully enjoy the fruits of my labor and spend time doing the things I enjoy with the people I love. How does a surgeon grapple with this decision?

Many surgeons may get caught up in the grind of medical training, obtaining degrees and certifications, building a practice, and chasing research or academic pursuits. It’s easy to be swept up in chasing salaries, accolades, or that next accomplishment, perhaps losing sight of why we chose this field to begin with. How often do we stop and reflect on the quality of our lives?

The measure of a life well lived, the definition of career success, and the decision whether or when to retire are all highly personal issues. No one path is correct for every surgeon, and deciding how this process will look requires each individual to take an honest look at their priorities and values. I believe that work/life balance, job satisfaction, and stress/burnout management are extremely important in modern-day medical practice. For surgeons to be able to live well within today’s healthcare system, maintaining happy, healthy lives while providing high-quality medical care, they should practice as long as they are able and willing. For some, this may mean working into their 70s and 80s. The Association of American Medical Colleges 2022 Physician Specialty Data Report found that in 2021, 46.7 percent of active physicians in the United States were aged 55 years or older. Furthermore, 60.6 percent of active orthopaedic surgeons were older than 55 years.

For some orthopaedic surgeons, earlier cessation of surgical practice but continued contribution to medicine through education, consulting, writing, or other non-clinical roles may feel more authentic. Many physicians continue to remain active in non-clinical activities such as administration or education, resulting in a median retirement age of around 66 years from any professional activity.

Some surgeons may find that living well means a total 180: touring the country to see all the national parks, taking up gardening, moving off the grid, or opening a coffee shop. Retirement from medicine may mean spending time with children and grandchildren, or it could mean a return to school for the MBA they always wanted to get. The next chapter of one’s life after medicine looks different for everyone, but I want to echo Emerson in that I want to know I’ve made a difference and lived well.

Leslie Schwindel, MD, FAAOS, is a general orthopaedic surgeon at Lake Cumberland Regional Hospital in Somerset, Kentucky, and a member of the AAOS Now Editorial Board.