Orthopedic Surgery vs Emergency Medicine

[Dyerseve30]

I am very interested in both of these fields. I would be happy if I landed a residency in either one, however, I really want ortho. I am writing this thread because I am confused on how the residency match works and how I should approach applying. I know ortho is super competitive and emergency is becoming a very competitive field as well.

If I shoot for ortho and apply to all residency programs, will this hurt my application to emergency medicine programs? - For example, if my top 15 rankings are ortho programs, and my 16 rank is emergency medicine, and that emergency medicine program ranks me 1 on their list, will I get matched there if my first 15 ortho programs do not rank me? Or because I have them ranked 16, another student who has them higher on their ranking list will get it? Or is this not even how it works?

Would applying DO ortho and ACGME emergency medicine be viable? Or is this no longer viable under the merger?

I have hundred's of hours of volunteer work, completed a research paper and looking to get it published, 669 COMLEX score, and I attended emergency medicine conferences and workshops.

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[NontradCA]

I have thought about this. Wouldn't it make the most sense to apply AOA for a competitive surgical specialty, since this is the most realistic situation for matching one and then having a less competitive ACGME for backup? The match has not been consolidated to my knowledge, and I don't foresee it being so even when I graduate (2018), so you'd have two separate rank lists. From my limited understanding you need at least 2 SLOEs and at least USMLE Step 2 for ACGME EM. I'm sure someone else will chime in as well. @Petypet @sylvanthus

 

[FrkyBgStok]

I would say you go with either field full bore, but i don't know how feasible it would be do go at both and be successful. First off, I assume you are a 3rd year as you have step 1 but nothing else mentioned. EM requires 2 SLOEs usually, which are usually gotten in the first few months of 4th year. I have a good friend applying ortho and basically, DO ortho puts 98% of the application weight in the audition rotation. So basically if you don't rotate there, you won't match there. If you want to increase your chances in ortho, you need to have as many auditions early in the year as your school allows. Because the DO application opens July 15th, many of the deadlines are October and early November. So you have to load up in the beginning of 4th year or it will be too late to audition. Wasting 2 months getting SLOEs takes away 2/4 or 2/5 of your possible ortho chances. So in my mind, you either choose ortho or EM, or you half-ass, and likely fail, both. Maybe someone along the way matched DO ortho without a rotation, but i've never heard of it. At least not in the past couple years.

 

[racerwad]

I think @FrkyBgStok has hit the nail on the head: choose one or the other and if you need a backup, don't choose one that is so resource intense (or choose something more similar to ortho, like another surgical specialty).

The more important thing to consider is, while both fields have their positives and negatives, they aren't very similar. You should choose the field whose bull**** you can put up with best on a day-to-day basis. All fields in medicine have their high points. I think in order to be happy in the long term, you need to be satisfied with the more mundane aspects of the job, whatever they may be. Try and compare the two fields on those terms and it may be easier to decide which one to focus on, although by your first post it sounds like ortho. Good luck.

 

[TwinsFan]

Backing up ortho with a surgical sub specialty is not really a backup and a bad idea (other than gen surg). Also surgical sub specialties have very few spots in the aoa match and acgme is pretty much impossible for plastics/ent/neurosurgery. These are all fields where connections and research are pretty much a prerequisite.

 

[OrthoDO25]

I think your first step should be understanding how the match works

 

[gyngyn]

If I shoot for ortho and apply to all residency programs, will this hurt my application to emergency medicine programs?

For the NRMP programs the short answer is no.
No matter how many programs you rank, you do not diminish chances for a match at a subsequent program.
http://www.nrmp.org/match-a-to-z/video-tutorials/about-the-matching-algorithm-tutorial/

 

[Captain DO]

my understanding is that you could rank all ortho places first, and EM second...and it will not hurt your chances at all.


but... can program see your rank list? meaning if they ask you "why ortho?" and you say "fell in love with the procedures and love helping improve peoples lives" (aka "I love the salary") will a program be able to see that you're considering EM too and question you about that?

that would be the only thing I could think of that would hurt your chances.

 

[racerwad]

my understanding is that you could rank all ortho places first, and EM second...and it will not hurt your chances at all.


but... can program see your rank list? meaning if they ask you "why ortho?" and you say "fell in love with the procedures and love helping improve peoples lives" (aka "I love the salary") will a program be able to see that you're considering EM too and question you about that?

that would be the only thing I could think of that would hurt your chances.

No!

 

[IslandStyle808]

my understanding is that you could rank all ortho places first, and EM second...and it will not hurt your chances at all.


but... can program see your rank list? meaning if they ask you "why ortho?" and you say "fell in love with the procedures and love helping improve peoples lives" (aka "I love the salary") will a program be able to see that you're considering EM too and question you about that?

that would be the only thing I could think of that would hurt your chances.

I'll stem off this thought.

What about doing only ortho research? I believe that would be the one thing they could see if it were to be put on the ERAS. Not sure how students handle this scenario of having research in one specialty and then explaining about that research when on the interview trail of a completely different speciality.

 

[FrkyBgStok]

Easy. You just say your original interest was X research and even though it shifted, the research was great and you wanted to stay involved. People change their minds all the time.

 

[Elevencents]

I would say you go with either field full bore, but i don't know how feasible it would be do go at both and be successful. First off, I assume you are a 3rd year as you have step 1 but nothing else mentioned. EM requires 2 SLOEs usually, which are usually gotten in the first few months of 4th year. I have a good friend applying ortho and basically, DO ortho puts 98% of the application weight in the audition rotation. So basically if you don't rotate there, you won't match there. If you want to increase your chances in ortho, you need to have as many auditions early in the year as your school allows. Because the DO application opens July 15th, many of the deadlines are October and early November. So you have to load up in the beginning of 4th year or it will be too late to audition. Wasting 2 months getting SLOEs takes away 2/4 or 2/5 of your possible ortho chances. So in my mind, you either choose ortho or EM, or you half-ass, and likely fail, both. Maybe someone along the way matched DO ortho without a rotation, but i've never heard of it. At least not in the past couple years.

This is the #1 problem you face. Ortho, at least in the DO world, is huge on auditions. Huge. Just as much as EM relies on SLOEs. So to be able to do both sounds like a juggling act destined for failure. I would pick one and go all in.

 

[Seth Joo]

Emergency Medicine is very reachable as a DO, many DOs match into both ACGME and AOA, Orthopedic Surgery at least MD Ortho is very hard for DOs, but AOA Orthopedics is an option.

 

[Dyerseve30]

Thank you for all the replies! This has been very helpful, especially the nrmp match video link.

Couple questions... Are emergency medicine SLOE's that hard to get? Can't I just try to get them during my required emergency medicine rotation?

What do other orthopedic surgery students normally do? Ortho first and general surgery second?

Just curious, based on my stats for the original post, am I competitive to at least get an interview? (Assuming I get a couple audition rotations 4th year)

Are there special requirements specific for ortho I should be focused on getting now? For example, do they also require SLOE's specifically from an orthopedic surgeon or like x amount of hours in something?

Thanks again for all of the help!!!!

 

[racerwad]

Thank you for all the replies! This has been very helpful, especially the nrmp match video link.

Couple questions... Are emergency medicine SLOE's that hard to get? Can't I just try to get them during my required emergency medicine rotation?

What do other orthopedic surgery students normally do? Ortho first and general surgery second?

Just curious, based on my stats for the original post, am I competitive to at least get an interview? (Assuming I get a couple audition rotations 4th year)

Are there special requirements specific for ortho I should be focused on getting now? For example, do they also require SLOE's specifically from an orthopedic surgeon or like x amount of hours in something?

Thanks again for all of the help!!!!

SLOEs are only an EM thing.

They aren't "hard" to get, but you can only get them from hospitals that have a residency program. Non-residency faculty attendings can't write one for you (I mean, obviously, they could, but they will not receive the same consideration). If your required EM rotation occurs at a place w/ an EM residency, you're fine.

I think the more important question is still to figure out which specialty. These two are really not that similar and it seems a waste to put in this effort without first knowing what you want to do.

 

[FrkyBgStok]

Like racerwad mentioned, SLOEs come from residency programs. If you take a look a SLOE template available online (here is one: http://www.cordem.org/files/DOCUMENTLIBRARY/SLOR/SLOE Standard Letter of Evaluation 2015.pdf) you will see that there is a spot on how you compare and where they would rank you. So a program director usually fills this out. So technically speaking you could get one in your third year if you happen to get a site that allows 3rd years and has an EM program, however being that you are going to be compared to 4th years, you aren't going to look like a baller and are probably going to get a lackluster SLOE. Maybe if you set it up into the end of your 3rd year, you might be ok to get one.

From the people I know who are applying ortho, they are going full bore and if they fail, hoping to scramble into a preliminary year and try again the following year. Not an ideal situation, but ortho is competitive.

 

[Makati2008]

I am very interested in both of these fields. I would be happy if I landed a residency in either one, however, I really want ortho. I am writing this thread because I am confused on how the residency match works and how I should approach applying. I know ortho is super competitive and emergency is becoming a very competitive field as well.

If I shoot for ortho and apply to all residency programs, will this hurt my application to emergency medicine programs? - For example, if my top 15 rankings are ortho programs, and my 16 rank is emergency medicine, and that emergency medicine program ranks me 1 on their list, will I get matched there if my first 15 ortho programs do not rank me? Or because I have them ranked 16, another student who has them higher on their ranking list will get it? Or is this not even how it works?

Would applying DO ortho and ACGME emergency medicine be viable? Or is this no longer viable under the merger?

I have hundred's of hours of volunteer work, completed a research paper and looking to get it published, 669 COMLEX score, and I attended emergency medicine conferences and workshops.

Good luck going on 31 interviews.....jk