Orthopedic Surgery

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Curlyfriez12

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Hi,

I just started medical school last month at UTSW and found out I was a little below average in terms of grades, as compared to my peers. But I want to do Orthopedic Surgery.

I tried research... I don't care for it, but will do it if I need to.

Is there anything I need to start to doing now to be able to secure an Orthopedic residency later?

Thanks for your help.

Curly

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The first two years, when it comes to competitive specialties, these are all you need to focus on:
1.) Get to know the department. Shadow/scrub/hang around clinic when you got the time. Work with different attendings. You want to be a familiar face when it comes time to rotate through/get LORs/apply. And you may come across an attending who you have a great rapport with who would be a good mentor. It also pays off with stronger LORs later on where your writers can talk about a long-standing relationship instead of one based on a 1 month sub-i.

2.) Research. Ask to sit down and chat with the program director at your school. He'll tell you how important it is (or isn't) for the given field. And probably have some contacts in regards to who is working on what and who needs free labor, I mean, medical students to "assist." If it's important, you have to decide whether you want to be a lab monkey in a basic science study, or want to be a chart cruncher in clinical study. Regardless of what SDN woudl have your believe, getting a good study completed and published in the limited time of medical school is very difficult. So is being first author. Don't set your sights too high in that regard unless you're a MudPhud or plan on doing a research year. Instead, commit yourself to projects fully so that when it comes time to talk about them on interviews, you come across as someone invested, intelligent, and interested.

3.) Grades. Clinical grades are whats "important" to residencies and on your MSPE, but the preclinical years are where the AOAs/non-AOAs tend to shake out, since everyone busts their butt during third year. You don't have to be AOA (hell in ortho last year 28% were AOA, which means 72% weren't!). If AOA isn't in the cards (like the OP suspects), at very least stay in the top half of the class. That may mean you need to work harder than your peers, but if its the field you want to do, it's worth it.

4.) Step 1. Whatever your opinion is on the matter, you can close doors before they are ever open if you don't hit the minimum cutoff for Step 1. Your PD can give you a sense of where that lies for your chosen field. But in general, you're shooting for above 230. Have people matched into competitive fields with board scores below that? Of course. But cross that bridge when it comes.

5.) Fluff. Yes, it's probably good to get involved in some "volunteer experiences" your first two years. Don't get sucked into anything too time consuming unless you truly enjoy it. But join an interest group or two. Volunteer at a free clinic a couple times. It'll make you a better medical student in the process.

That's it. That's all you need to focus on your first two years. Don't worry about things like surgical skills, clinical skills, etc. I knooooow you really want to learn how to do a one handed tie and spend all night sewing pigs feet as a first year. That's more fun that studying biochem. But that will come in time. Focus you energies where it can help you.
 
Hi,

I just started medical school last month at UTSW and found out I was a little below average in terms of grades, as compared to my peers. But I want to do Orthopedic Surgery.

I tried research... I don't care for it, but will do it if I need to.

Is there anything I need to start to doing now to be able to secure an Orthopedic residency later?

Thanks for your help.

Curly

Wait until you get to third year. You may not find Ortho that wonderful and may want to do something else. Most people change specialties several times. Do the best that you can do but don't obsess about anything at this point. Your biggest hurdle is to make the medical school adjustment which is a process and not an event. Chill out and take each hurdle as it comes.
 
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honestly i find it pretty annoying that there are so many dudes in my medical school class who come in and wanna do ortho. Wait until you actually see what it is like. You may actually realize the field is not for you as the majority of these bros
 
Ortho and EM are the two most popular in my class. Truth be told just crush boards. That separates the people going into ortho from the people who want to go into ortho.
 
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While it is important to keep an open mind (esp during 3rd year) since you may change your mind about what you want to do later - ortho is extremely competitive and as previous posters have pointed out there are some things you can do to make yourself a potential player come this time during 4th year. You need to get a killer Step 1 score. This is single-handedly the most important thing that will come out of your first two years of medical school unless you have some ridiculously significant research under your belt (but you've already said that wasn't for you). The best way to do this - as cliché as it sounds - is to learn the material well during the first two years. You'll kill two birds with one stone by getting good grades hopefully during the pre-clinical years as well (which may be important for AOA). Most of the rest of the "important stuff" comes in the clinical years. Third year grades are extremely important and I'm not just talking about your surgery clerkship and your ortho elective. I was asked by an ortho PD "Well what did you get in your internal medicine rotation?" Who cares about IM if I wanna do ortho? --> THEY MIGHT, because doing well in other speccialties shows that you're probably a well-rounded medical student and that you can excel in fields that you're not necessarily interested in. Then during third year or usually fourth year you probably wanna do a home sub-I and a couple away rotations. Its a little early to start thinking about this, but as far as the home sub-i goes... As someone pointed out earlier the more ppl you know in the department the easier it will be to get good, personal LORs when it comes time to ask for them and these are important! Get to know people early - residents, attendings, the PD/chair. Go to the ortho interest group meetings (or start one if there isn't one maybe). This is clearly not an all-inclusive "must do" list, so you need to gauge where you'll get the biggest bang for your buck in terms of what you focus your time on. The following documents can help because they show you what the "average" applicant looks like (for all fields, not just ortho), and also what the program directors look at as being the most important part of your application (again for all fields).

http://www.nrmp.org/data/chartingoutcomes2009v3.pdf

http://www.nrmp.org/data/programresultsbyspecialty2010v3.pdf
 
While it is important to keep an open mind (esp during 3rd year) since you may change your mind about what you want to do later - ortho is extremely competitive and as previous posters have pointed out there are some things you can do to make yourself a potential player come this time during 4th year. You need to get a killer Step 1 score. This is single-handedly the most important thing that will come out of your first two years of medical school unless you have some ridiculously significant research under your belt (but you've already said that wasn't for you). The best way to do this - as cliché as it sounds - is to learn the material well during the first two years. You'll kill two birds with one stone by getting good grades hopefully during the pre-clinical years as well (which may be important for AOA). Most of the rest of the "important stuff" comes in the clinical years. Third year grades are extremely important and I'm not just talking about your surgery clerkship and your ortho elective. I was asked by an ortho PD "Well what did you get in your internal medicine rotation?" Who cares about IM if I wanna do ortho? --> THEY MIGHT, because doing well in other speccialties shows that you're probably a well-rounded medical student and that you can excel in fields that you're not necessarily interested in. Then during third year or usually fourth year you probably wanna do a home sub-I and a couple away rotations. Its a little early to start thinking about this, but as far as the home sub-i goes... As someone pointed out earlier the more ppl you know in the department the easier it will be to get good, personal LORs when it comes time to ask for them and these are important! Get to know people early - residents, attendings, the PD/chair. Go to the ortho interest group meetings (or start one if there isn't one maybe). This is clearly not an all-inclusive "must do" list, so you need to gauge where you'll get the biggest bang for your buck in terms of what you focus your time on. The following documents can help because they show you what the "average" applicant looks like (for all fields, not just ortho), and also what the program directors look at as being the most important part of your application (again for all fields).

http://www.nrmp.org/data/chartingoutcomes2009v3.pdf

http://www.nrmp.org/data/programresultsbyspecialty2010v3.pdf

what exactly is a killer step 1 score (in your opinion)?

according to your second link, a 236+ will almost always get you the interview. I think the average for the match is around 235 or so as well if i remember correctly. I've personally heard from some interns that some programs have a 230 cut off and after that it's not really an issue.

just wanted to see what others have heard... I had the idea in my head for a long time that you needed to get 250+ to match ortho, but with the exception of maybe derm, a 240 or even a 230 is not going to make or break your application....that having research, getting good clinical grades, and getting solid LORs are equally important. Just what I've heard though.
 
what exactly is a killer step 1 score (in your opinion)?

according to your second link, a 236+ will almost always get you the interview. I think the average for the match is around 235 or so as well if i remember correctly. I've personally heard from some interns that some programs have a 230 cut off and after that it's not really an issue.

just wanted to see what others have heard... I had the idea in my head for a long time that you needed to get 250+ to match ortho, but with the exception of maybe derm, a 240 or even a 230 is not going to make or break your application....that having research, getting good clinical grades, and getting solid LORs are equally important. Just what I've heard though.

Average is around 220 (think it was 222 last year?), so 235 is "above average".

There's a difference between making the cutoff and having a "good" step score. When it comes to the more coveted residencies which employ cutoff scores, all a 235 means is that your application doesn't automatically get screened before it even gets looked at. It doesn't mean an automatic interview. Once you make the cutoff then the things like LORs, clinical grades, and research come into play. If you have a "good" step score (245+) then that works towards you favor in getting interviews... programs are more likely to extend an interview even if the rest of your application isn't perfect.

That being said, I think the Step 1 score gets too highly emphasized amongst medical students (and especially on SDN). When it comes to competitive fields, it really is important to have a well-rounded application. I don't think there is a score the "guarantees" you interviews or "guarantees" you'll match. I know of students with 270 scores who didn't match. The step score is more about doing well enough to not close doors before they're open rather than guaranteeing you a residency spot.
 
Ortho is not as competitive as a lot of people think, at least nothing to the extent of derm, optho, ENT, urology. There's like more ortho spots than all four of the latter combined.

It's just a lot of jocks who had wanted to do ortho since they were 14 have trouble getting a 240+. With ortho, there's less self-selection at play than say ENT.
 
what exactly is a killer step 1 score (in your opinion)?

according to your second link, a 236+ will almost always get you the interview. I think the average for the match is around 235 or so as well if i remember correctly. I've personally heard from some interns that some programs have a 230 cut off and after that it's not really an issue.

just wanted to see what others have heard... I had the idea in my head for a long time that you needed to get 250+ to match ortho, but with the exception of maybe derm, a 240 or even a 230 is not going to make or break your application....that having research, getting good clinical grades, and getting solid LORs are equally important. Just what I've heard though.

Well I guess maybe "killer" is a strong word, but you still have to do pretty well. The average for matched applicants in the last publication of 'charting outcomes' is 238 - right up there with every other competitive specialty. So if you get somewhere around there clearly you've got a shot since half of the people who matched scored BELOW 238. However, everything else being equal, the guy (or gal) with a higher step 1 score will probably have a better shot at getting an interview. I think the point I was getting at in my post was that getting a good Step 1 score is probably one of the most important things you can do during your basic science years in medical school (in addition to research since this may be the time during medical school when you have time to dedicate to it). Having good clinical grades and LORs is very important as well but those come later and you might as well work on getting as much of your foot in the door as possible at this stage in the game (i.e. getting that "killer" Step 1 score).
 
Ortho is not as competitive as a lot of people think, at least nothing to the extent of derm, optho, ENT, urology. There's like more ortho spots than all four of the latter combined.

It's just a lot of jocks who had wanted to do ortho since they were 14 have trouble getting a 240+. With ortho, there's less self-selection at play than say ENT.

Regardless of how many spots there are, with the exception of Derm you're at least 10% more likely to match in any of those other fields. So, yes, ortho is as competitive as a lot of people think.
 
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While we're here... Did you match into Ortho, OP?
 
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Hi,

I just started medical school last month at UTSW and found out I was a little below average in terms of grades, as compared to my peers. But I want to do Orthopedic Surgery.

I tried research... I don't care for it, but will do it if I need to.

Is there anything I need to start to doing now to be able to secure an Orthopedic residency later?

Thanks for your help.

Curly
Grades are dumb. Crush Step 1, get pubs, and you'll get in

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what exactly is a killer step 1 score (in your opinion)?

according to your second link, a 236+ will almost always get you the interview. I think the average for the match is around 235 or so as well if i remember correctly. I've personally heard from some interns that some programs have a 230 cut off and after that it's not really an issue.

just wanted to see what others have heard... I had the idea in my head for a long time that you needed to get 250+ to match ortho, but with the exception of maybe derm, a 240 or even a 230 is not going to make or break your application....that having research, getting good clinical grades, and getting solid LORs are equally important. Just what I've heard though.
Cutoff at my institution, and I was told this by an ortho attending, is a 250

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