Canadian Applying Ortho - Need Advice asap

[tolietpaper123]

Hi! Any advice please share!!! This is on behalf of my friend, we're trying to figure out what's going on. They are an M4 at a mid-tier MD school applying to match orthopedic surgery, did both undergrad and med school in the US, but they're Canadian.
Offer Day was Tuesday (ortho has 30 signals), since then they received around nine rejections from signals, three waitlists, and only one interview from a school they didn't even signal.
In total only has four interviews (1 from home school, 2 from aways, 1 non-signal school). Still waiting to hear back from around 15 of the schools they signaled and 20 from those they didn't. Applied to around 50 programs overall.

Is this mostly because of them needing a Visa? We did not expect this at all, they couldn't have really done anything more... Should we assume schools that participate in offer day that we haven't heard from are going to rejections? Is there a second wave? Do waitlists ever actually move?

Stats

• Step 1: Pass
• Step 2: Over 268
• AOA: Yes
• Clinical Rotation grades: Honors on every rotation, including aways
• Publications/Abstracts/Presentations: Over 20 (9 pubs, 14 abtracts/presentations)
• Good letters
• Community Service: good amount, volunteer tennis coach for children w/ autism, uninsured clinic, etc.
• D1 athlete in undergrad
• Overall, very normal and likeable not socially awkward, reserved, incredibly hard-working

(reposting b/c I think i put in the wrong thread initially)

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[NotAProgDirector]

What type of visa did they indicate they were looking for?

Might have nothing to do with a visa, and something else in their app.

 

[tolietpaper123]

What type of visa did they indicate they were looking for?

Might have nothing to do with a visa, and something else in their app.

Either J1 or H1B, application was reviewed by their PD and mentors all told them it was great and that they should safely get enough interviews to match.

 

[CJhooper123]

I wish I could tell you this is uncommon, but it's not in ortho. I don't think people really understand that the ortho match is less about getting perfect grades and getting 10+ publications. In fact, I know more people with 260+ on-board scores who never ended up matching than those who had <240 board scores. It has more to do with your letter writers, mentors, and family in medicine.

Personally, I would consider withdrawing from the match and finding a research-year position. Preferably at a place with a well-connected mentor who can make phone calls and vouch for you. Tell your friend congrats on putting together such an amazing application and that the ortho process is TRUELY not a reflection on the quality of the person/student they may be.

 

[DOVinciRobot]

I wish I could tell you this is uncommon, but it's not in ortho. I don't think people really understand that the ortho match is less about getting perfect grades and getting 10+ publications. In fact, I know more people with 260+ on-board scores who never ended up matching than those who had <240 board scores. It has more to do with your letter writers, mentors, and family in medicine.

Personally, I would consider withdrawing from the match and finding a research-year position. Preferably at a place with a well-connected mentor who can make phone calls and vouch for you. Tell your friend congrats on putting together such an amazing application and that the ortho process is TRUELY not a reflection on the quality of the person/student they may be.

I mean… they have 4 interviews and 3 of those are from aways and their home program… most ortho applicants match somewhere they rotated, which means their chances aren’t 0.

If they withdraw they will absolutely not match. I might not be ortho but seems like a really terrible idea

 

[CJhooper123]

I mean… they have 4 interviews and 3 of those are from aways and their home program… most ortho applicants match somewhere they rotated, which means their chances aren’t 0.

If they withdraw they will absolutely not match. I might not be ortho but seems like a really terrible idea

The odds of matching as an MD student with 4 interviews are low. In fact, according to NRMP data (which has flaws), chance of matching is ~37% (21/57 matched). If you feel comfortable taking that risk... then full send. Doing a sub-I somewhere can help but it by no means is it a shoe in. Most programs have ~25+ rotators each year and don't fall in their ranks.

The next question - what happens if you don't match?
-While reapplicants are being viewed more favorably in recent years, there's no doubt still a bias towards reapps in a negative way in ortho. Your odds are MUCH lower as a reapp compared to a first time app. If you withdraw from the match (before ranking), you can still maintain your status as a first-time applicant (I believe).

I know people who were actually in a similar position to OP's friend who withdrew with 3-4 interviews prior to ranking, did a RY, and reapplied with 15+ interviews and matched at their #1 with their research mentor helping out.

It's crappy but that's what it's like in the ortho match right now. Strategy is important. Almost a quarter of incoming ortho interns have completed a RY at some point.

 

[DOVinciRobot]

The odds of matching as an MD student with 4 interviews are low. In fact, according to NRMP data (which has flaws), chance of matching is ~37% (21/57 matched). If you feel comfortable taking that risk... then full send. Doing a sub-I somewhere can help but it by no means is it a shoe in. Most programs have ~25+ rotators each year and don't fall in their ranks.

The next question - what happens if you don't match?
-While reapplicants are being viewed more favorably in recent years, there's no doubt still a bias towards reapps in a negative way in ortho. Your odds are MUCH lower as a reapp compared to a first time app. If you withdraw from the match (before ranking), you can still maintain your status as a first-time applicant (I believe).

I know people who were actually in a similar position to OP's friend who withdrew with 3-4 interviews prior to ranking, did a RY, and reapplied with 15+ interviews and matched at their #1 with their research mentor helping out.

It's crappy but that's what it's like in the ortho match right now. Strategy is important. Almost a quarter of incoming ortho interns have completed a RY at some point.

I simply disagree with the advice. I personally know many ortho residents who would as well. 37% is > 0%…

It’s a self fulfilling prophecy, you can’t know how many of those people would have matched the first time since they literally turned their chances to 0 by withdrawing from the match. How many research labs are there with a mentor well known enough to make a difference? What are the odds this person can get into one of those this late in the game? How many people have done that and then failed to match after the year? There is a very real chance the match percentage of people who do what you’re suggesting is less than 37% when you factor in everyone who does it….

What happens if they get that spot, and the same visa issues come up next year and they still have 4-5 invites but haven’t been able to do away rotations and their home program now has a fresh batch of qualified home students to pick from?

What happens if they withdraw and their home program says, “WTH, we were planning on taking you.”

This person already has 9 publications, and how do you know they don’t already have strong letter writers who are going to bat for them?

Pulling from the match when you have interviews, and a home program that clearly likes you is reactionary and short-sighted

 

[CJhooper123]

I simply disagree with the advice. I personally know many ortho residents who would as well. 37% is > 0%…

It’s a self fulfilling prophecy, you can’t know how many of those people would have matched the first time since they literally turned their chances to 0 by withdrawing from the match. How many research labs are there with a mentor well known enough to make a difference? What are the odds this person can get into one of those this late in the game? How many people have done that and then failed to match after the year? There is a very real chance the match percentage of people who do what you’re suggesting is less than 37% when you factor in everyone who does it….

What happens if they get that spot, and the same visa issues come up next year and they still have 4-5 invites but haven’t been able to do away rotations and their home program now has a fresh batch of qualified home students to pick from?

What happens if they withdraw and their home program says, “WTH, we were planning on taking you.”

This person already has 9 publications, and how do you know they don’t already have strong letter writers who are going to bat for them?

Pulling from the match when you have interviews, and a home program that clearly likes you is reactionary and short-sighted

I'm sorry, but a 63% chance of going unmatched is not short-sighted and reactionary - and I'd actually argue that OP's odds are much lower than that given the NRMP data shortcomings. OP's friend is most likely not going to match - I personally wouldn't continue down that path when there are options you can take to improve your chances next cycle.

Unless OP's friend is content with another specialty, they need a backup plan or a better plan to get into ortho.

It's tough seeing 265+, AOA, well-published, and all honors candidates come up short in the ortho match (barring other red flags).

 

[NotAProgDirector]

There is no "right" answer.

In this case, the student is on a visa. That makes getting a research year very complicated. They would need to have their medical school extend their training for the research year to maintain their F visa. Otherwise, they will need a work visa of some sort for the research year -- which might be possible on an OPT extension of the F but that would seriously limit their visa options going forward.

Students needing visas in competitive fields get less interviews than those who do not. I completely agree that getting less interviews tends to indicate a lower chance of matching -- but most candidates like that will just be "weaker" candidates, and may not be comparable to the OP.

The whole issue of "reapplicants" comes up here on SDN all the time. You are correct that re-applicants have a lower match rate. But that's because something in their application made it less competitive. It's possible that very competitive programs screen to only current grads -- but there's also plenty of stories of people failing to match, doing a research year, and then matching.

The OP's need for a visa to stay in the US is the driving issue here. If they don't match, they will either need to SOAP into something, extend school, get another degree, or return to Canada. Hence even if the chances are low, they probably just need to stay in the match, but absolutely come up with a Plan B.

 

[CJhooper123]

There is no "right" answer.

In this case, the student is on a visa. That makes getting a research year very complicated. They would need to have their medical school extend their training for the research year to maintain their F visa. Otherwise, they will need a work visa of some sort for the research year -- which might be possible on an OPT extension of the F but that would seriously limit their visa options going forward.

Students needing visas in competitive fields get less interviews than those who do not. I completely agree that getting less interviews tends to indicate a lower chance of matching -- but most candidates like that will just be "weaker" candidates, and may not be comparable to the OP.

The whole issue of "reapplicants" comes up here on SDN all the time. You are correct that re-applicants have a lower match rate. But that's because something in their application made it less competitive. It's possible that very competitive programs screen to only current grads -- but there's also plenty of stories of people failing to match, doing a research year, and then matching.

The OP's need for a visa to stay in the US is the driving issue here. If they don't match, they will either need to SOAP into something, extend school, get another degree, or return to Canada. Hence even if the chances are low, they probably just need to stay in the match, but absolutely come up with a Plan B.

Agree - there's no right answer. That being said, I do think there's quite a bit of benefit in withdrawing from the match if OP is 100% all-in on ortho. If OP is OK with going into GS or another specialty, then staying in the match would make sense. Staying in the match is almost accepting the fact that OP will never do ortho (statistically).

With regard to the OP's visa status; I'm not familiar with the data in orthopedics. Yes, it's possible that OP may be considered a "weaker applicant" (despite being perfect on paper), but that makes it all more important to have connections and meaningful mentorship in this process. Furthermore, just about everyone who completes a research year "delays graduation" and is still considered a medical student.

Reapplying in ortho is a near-death sentence - although this bias is improving. Approximately 64 (I think) /900 matched spots last year were from US MD graduate students which is marginal compared to the ~700 students who didn't match the year before. Are there students who did RY who applied as US MD seniors and matched as reapps - yes, and the NRMP does not allow you to extract this data, but I'm almost certain that's a very small piece of the pie.

Doing a RY between M3/M4 year is becoming more and more normal for orthopedic applicants. The crazy part is that getting research done and demonstrating productivity is not even the most important part of doing a research year.

 

[tolietpaper123]

I'm sorry, but a 63% chance of going unmatched is not short-sighted and reactionary - and I'd actually argue that OP's odds are much lower than that given the NRMP data shortcomings. OP's friend is most likely not going to match - I personally wouldn't continue down that path when there are options you can take to improve your chances next cycle.

Unless OP's friend is content with another specialty, they need a backup plan or a better plan to get into ortho.

It's tough seeing 265+, AOA, well-published, and all honors candidates come up short in the ortho match (barring other red flags).

My thoughts on the match data you're referencing for probability of matching based on # of interviews is that you can't really take that at face value....those with better applications would see more interviews, top applicants = more interviews = higher chance of matching not the mere fact that they received many interviews you essentially can't pull that stat out without context of how they would have received them in the first place because interview chances increase based on step, aoa, research, etc all of which are very strong for my friend.

They recently sent an email to a PD at a top 5 program about his app, and in his response he said that "based on your application I'm certain you have plenty of interviews" when in reality they don't lol. Hence why I think this person becomes an outlier is the fact that they do in fact have a very strong application, landing to the point that the Visa seems to be issue that I don't think is solved by doing a research year.

 

[akwho]

I would put this persons chance of matching at 50/50 at this point given the response to his app. Something isn't right with those stats to have that few of interviews. Two away and 1 home interview is 75% of his interview offers and those are often given almost automatically.

I would have a conversation with someone in the home department who is in charge of helping students match and get their honest advice about where the shortcoming in the app is. No one on SDN is going to be able to tell you exactly what the issue is without reviewing the app. The person in the home department can also start making some much needed phone calls or texts.

Option A: barrel ahead and hope to get lucky and match. Not a terrible option if he is personable and a good interviewer.
Option B: back out of the match. Do a research year at a big name residency program and make some connections and correct any identified weaknesses in the app.
Option C: Research year and reapp next year.

Assuming he is all in on ortho those are the only options above and 2/3 involve finding somewhere to do a research year.

 

[CJhooper123]

I would put this persons chance of matching at 50/50 at this point given the response to his app. Something isn't right with those stats to have that few of interviews. Two away and 1 home interview is 75% of his interview offers and those are often given almost automatically.

I would have a conversation with someone in the home department who is in charge of helping students match and get their honest advice about where the shortcoming in the app is. No one on SDN is going to be able to tell you exactly what the issue is without reviewing the app. The person in the home department can also start making some much needed phone calls or texts.

Option A: barrel ahead and hope to get lucky and match. Not a terrible option if he is personable and a good interviewer.
Option B: back out of the match. Do a research year at a big name residency program and make some connections and correct any identified weaknesses in the app.
Option C: Research year and reapp next year.

Assuming he is all in on ortho those are the only options above and 2/3 involve finding somewhere to do a research year.

Unfortunately, ortho is a crapshoot in 2023. It really doesn't matter if you are personable or good at interviewing (in most cases). It's whether you have connections. The top 20% of ortho applicants are going to match b/c they are on a different planet. The next 80% is a toss-up. Nobody cares in ortho if your step scores are somewhere b/w 245-265.

OP, your friend's chances are slim unless he/she has connections that will be vouching for you at one of the places they interviewed. Or if he/she absolutely crushed an away and the faculty are trying hard to bring them back. Literally, every ortho program in the country has ~20/25 rotators per year. Some have more. Small programs save positions for their research year positions. Pretty sure this is not allowed in the match, but it's a trend in ortho.

The real question is whether you'd like to have a research year under your belt as considered a "first-time applicant" or a "reapplicant". The former is probably better. I would also highly refrain from doing a RY at a big-name residency/ortho program. More people do Rush RY's, Harvard's or Brown and fail to match. I know many people with better credentials than above who failed to match. Do a RY at a small, mid-tier or community program. These programs offer a higher chance of matching into their programs.

 

[NotAProgDirector]

It's not a match violation to decide to rank people who have done a research year with you highly.

As I mentioned before, the OP is going to have some fdifficulty with a research year, as they are on a visa. They may be able to do a RY at their home institution on their F visa. Maybe. If they want to do it anywhere else they will need a new visa to do that. It will also prevent them from being funded off of an R01 or most other NIH grants. So it's probably not going to happen without a good deal of luck.

 

[Medstart108]

The odds of matching as an MD student with 4 interviews are low. In fact, according to NRMP data (which has flaws), chance of matching is ~37% (21/57 matched). If you feel comfortable taking that risk... then full send. Doing a sub-I somewhere can help but it by no means is it a shoe in. Most programs have ~25+ rotators each year and don't fall in their ranks.

The next question - what happens if you don't match?
-While reapplicants are being viewed more favorably in recent years, there's no doubt still a bias towards reapps in a negative way in ortho. Your odds are MUCH lower as a reapp compared to a first time app. If you withdraw from the match (before ranking), you can still maintain your status as a first-time applicant (I believe).

I know people who were actually in a similar position to OP's friend who withdrew with 3-4 interviews prior to ranking, did a RY, and reapplied with 15+ interviews and matched at their #1 with their research mentor helping out.

It's crappy but that's what it's like in the ortho match right now. Strategy is important. Almost a quarter of incoming ortho interns have completed a RY at some point.

Stop using odds to discuss an individual case. Clearly, this is not your run of the mill applicant, this is a unique situation with a need for visa. This kind of use of overall stats is just simply mistaken.

There is nothing wrong with being a reapplicant, the reason reapplicants don't match well overall is because there was a reason they didn't match first time around.

If you take an excellent applicant with mentors to vouch for them, no red flags, and put the reapplicant label on them, it wouldn't impact their chances of matching much. You just never see this kind of a situation because excellent applicants with mentors to vouch for them only need to apply once.

 

[Medstart108]

Unfortunately, ortho is a crapshoot in 2023. It really doesn't matter if you are personable or good at interviewing (in most cases). It's whether you have connections. The top 20% of ortho applicants are going to match b/c they are on a different planet. The next 80% is a toss-up. Nobody cares in ortho if your step scores are somewhere b/w 245-265.

OP, your friend's chances are slim unless he/she has connections that will be vouching for you at one of the places they interviewed. Or if he/she absolutely crushed an away and the faculty are trying hard to bring them back. Literally, every ortho program in the country has ~20/25 rotators per year. Some have more. Small programs save positions for their research year positions. Pretty sure this is not allowed in the match, but it's a trend in ortho.

The real question is whether you'd like to have a research year under your belt as considered a "first-time applicant" or a "reapplicant". The former is probably better. I would also highly refrain from doing a RY at a big-name residency/ortho program. More people do Rush RY's, Harvard's or Brown and fail to match. I know many people with better credentials than above who failed to match. Do a RY at a small, mid-tier or community program. These programs offer a higher chance of matching into their programs.

Do a research year with a PI who is well known within the field regardless of the program. A lot of these small mid-tier programs may not even have great research productivity, you don't want to end up with nothing to show for your research year.

At the same time, clamoring for the Harvard name only to end up calling patients for 10th author on a trial because you are one of 15 research fellows is also going to end up poorly when your PI doesn't vouch hard enough for you at the end of the year.

My advice is choose the right PI based on their rep and their rep with students, its like any research based grad school decision.

 

[CJhooper123]

Stop using odds to discuss an individual case. Clearly, this is not your run of the mill applicant, this is a unique situation with a need for visa. This kind of use of overall stats is just simply mistaken.

There is nothing wrong with being a reapplicant, the reason reapplicants don't match well overall is because there was a reason they didn't match first time around.

If you take an excellent applicant with mentors to vouch for them, no red flags, and put the reapplicant label on them, it wouldn't impact their chances of matching much. You just never see this kind of a situation because excellent applicants with mentors to vouch for them only need to apply once.

I don't think you are familiar with the ortho match. Being a reapplicant is a red flag. In fact, several programs have screens preventing reapps from getting interviews. I have plenty of friends who went from 16 interviews first cycle to 3 interviews in the next cycle after doing a research year.

The visa situation can affect OP's friend, and you're right - maybe the data isn't entirely generalizable. But OP's friend should at least be aware of what it looks like for more generalized applicants for their own perspective.

Do a research year with a PI who is well known within the field regardless of the program. A lot of these small mid-tier programs may not even have great research productivity, you don't want to end up with nothing to show for your research year.

At the same time, clamoring for the Harvard name only to end up calling patients for 10th author on a trial because you are one of 15 research fellows is also going to end up poorly when your PI doesn't vouch hard enough for you at the end of the year.

My advice is choose the right PI based on their rep and their rep with students, its like any research based grad school decision.

If you can get a RY with a well-known person in your field, that would be great. But RY positions are actually very competitive and several "successful programs" often have over 100 applicants for 1 spot. The purpose of doing a RY is to match ortho. You are greatly disadvantaged in applying as a reapplicant.

The small/mid-tier programs most certainly DO NOT have equivalent research productivity to a Rush or Harvard situation. But, they will dramatically increase your chances of matching into their program if show up. Rush and Harvard will rarely take a RY applicant if you went unmatched the year before. While these small programs don't have written contracts stating that you will match if you do a RY (which has to be a match violation), they near verbal promises that you will match if you don't have a terrible year.

 

[MDMechEngr]

… most ortho applicants match somewhere they rotated, which means their chances aren’t 0.

I think this is true for DOs, but not so much for MDs.

 

[DOVinciRobot]

I think this is true for DOs, but not so much for MDs.

Nope, that is incorrect. COVID changed that significantly. There has been zero indication or newer data saying the below findings have changed in the post 2021 cycles. 60% of applicants matched their home program or a program they had done an in person rotation at.

I’m at a traditional academic center, doing a rotation with them has become an expectation for the ortho program. The idea of an audition rotation has become a significant part of the ortho application process for MDs and I don’t really see that cat being put back in the bag although this is an N of 1. Obviously for DOs the audition is king.

The Effects of the COVID-19 Pandemic on Orthopaedic Surgery Residency Match Results, a Cohort Study | Published in Journal of Orthopaedic Experience & Innovation

By Andrew A Furman, Alexander A Linton & 2 more. This study sought to investigate the effects the pandemic had on the outcomes of the 2021 Orthopaedic Surgery Match compared to the preceding four cycles 2017-2020.

journaloei.scholasticahq.com

Of note, even pre-pandemic 60% of ortho matchees matched “same region programs” as their medical schools.

 

[CJhooper123]

Nope, that is incorrect. COVID changed that significantly. There has been zero indication or newer data saying the below findings have changed in the post 2021 cycles. 60% of applicants matched their home program or a program they had done an in person rotation at.

I’m at a traditional academic center, doing a rotation with them has become an expectation for the ortho program. The idea of an audition rotation has become a significant part of the ortho application process for MDs and I don’t really see that cat being put back in the bag although this is an N of 1. Obviously for DOs the audition is king.

The Effects of the COVID-19 Pandemic on Orthopaedic Surgery Residency Match Results, a Cohort Study | Published in Journal of Orthopaedic Experience & Innovation

By Andrew A Furman, Alexander A Linton & 2 more. This study sought to investigate the effects the pandemic had on the outcomes of the 2021 Orthopaedic Surgery Match compared to the preceding four cycles 2017-2020.

journaloei.scholasticahq.com

Of note, even pre-pandemic 60% of ortho matchees matched “same region programs” as their medical schools.

Thanks for sharing - it states that, of matched applicants, 60% matched at either their home program or at an institution where they had completed an away rotation (Camp et al. 2016). Not 60% of applicants matching at these spots. The NRMP data is flawed, but the true ortho match rate is likely ~55%-60%. It wouldn't make sense for 60% of applicants to match at their home institution or away rotation.

You're right that the away rotation is huge, though.

In general, what MDMechEngr said was true. While I don't have data to support it (I'm sure it exists), DO programs tend to match their away rotators at higher rates than MD programs.

 

[tolietpaper123]

I would put this persons chance of matching at 50/50 at this point given the response to his app. Something isn't right with those stats to have that few of interviews. Two away and 1 home interview is 75% of his interview offers and those are often given almost automatically.

I would have a conversation with someone in the home department who is in charge of helping students match and get their honest advice about where the shortcoming in the app is. No one on SDN is going to be able to tell you exactly what the issue is without reviewing the app. The person in the home department can also start making some much needed phone calls or texts.

Option A: barrel ahead and hope to get lucky and match. Not a terrible option if he is personable and a good interviewer.
Option B: back out of the match. Do a research year at a big name residency program and make some connections and correct any identified weaknesses in the app.
Option C: Research year and reapp next year.

Assuming he is all in on ortho those are the only options above and 2/3 involve finding somewhere to do a research year.

Yeah, their home PD reviewed their application and said it must be a result of visas because they should have many interviews. Both the programs they did aways at don't give interviews to all rotators if that matters. Definitely going to see if the home PD can make some calls

 

[tolietpaper123]

Stop using odds to discuss an individual case. Clearly, this is not your run of the mill applicant, this is a unique situation with a need for visa. This kind of use of overall stats is just simply mistaken.

There is nothing wrong with being a reapplicant, the reason reapplicants don't match well overall is because there was a reason they didn't match first time around.

If you take an excellent applicant with mentors to vouch for them, no red flags, and put the reapplicant label on them, it wouldn't impact their chances of matching much. You just never see this kind of a situation because excellent applicants with mentors to vouch for them only need to apply once.

Yes, i think the mentor piece is huge and in hindsight should have been more top of mind for them.

 

[DOVinciRobot]

it states that, of matched applicants, 60% matched at either their home program or at an institution where they had completed an away rotation (Camp et al. 2016). Not 60% of applicants matching at these spots. The NRMP data is flawed, but the true ortho match rate is likely ~55%-60%. It wouldn't make sense for 60% of applicants to match at their home institution or away rotation.

Correct, which is why I didn’t specify matchees from applicants. People who match are matching home programs and places they rotate, that’s my point. This also is the basis of my comments above as to why this applicant should not withdraw from the match…

The ortho match rate for MD seniors is 73%. NRMP data isn’t so flawed the actual match rate to ortho for MD seniors is somehow 55%.

 

[MDMechEngr]

Nope, that is incorrect. COVID changed that significantly. There has been zero indication or newer data saying the below findings have changed in the post 2021 cycles. 60% of applicants matched their home program or a program they had done an in person rotation at.

I’m at a traditional academic center, doing a rotation with them has become an expectation for the ortho program. The idea of an audition rotation has become a significant part of the ortho application process for MDs and I don’t really see that cat being put back in the bag although this is an N of 1. Obviously for DOs the audition is king.

The Effects of the COVID-19 Pandemic on Orthopaedic Surgery Residency Match Results, a Cohort Study | Published in Journal of Orthopaedic Experience & Innovation

By Andrew A Furman, Alexander A Linton & 2 more. This study sought to investigate the effects the pandemic had on the outcomes of the 2021 Orthopaedic Surgery Match compared to the preceding four cycles 2017-2020.

journaloei.scholasticahq.com

Of note, even pre-pandemic 60% of ortho matchees matched “same region programs” as their medical schools.

Thanks for sharing. Yes, I was aware how COVID changed this. Vast majority of MD programs matched their home team regularly including mine. I know aways are important for ortho, especially if you need to make up for a weakness somewhere in your application. BTW, I have an upcoming interview with the academic center that you are at, but I did not rotate there. I hope that will not sink me. LOL.

 

[DOVinciRobot]

BTW, I have an upcoming interview with the academic center that you are at, but I did not rotate there. I hope that will not sink me. LOL.

Hey you got the invite, that’s far from sunk.

Good group of peeps. We work with them pretty closely for trauma. We keep their trauma team busy lol

 

[CJhooper123]

Correct, which is why I didn’t specify matchees from applicants. People who match are matching home programs and places they rotate, that’s my point. This also is the basis of my comments above as to why this applicant should not withdraw from the match…

The ortho match rate for MD seniors is 73%. NRMP data isn’t so flawed the actual match rate to ortho for MD seniors is somehow 55%.

People dual apply and I'm not entirely sure how the NRMP accounts for this.

In 2023, I think ~1430 applied. 899 matched. About 37% didn’t match into ortho.
According to ERAS, 1673 applied ortho. That indicates that ~235 matched into specialties other than ortho - that's around 45% of students doing something that wasn't ortho when they initially intended to go for ortho.

 

[DOVinciRobot]

People dual apply and I'm not entirely sure how the NRMP accounts for this.

In 2023, I think ~1430 applied. 899 matched. About 37% didn’t match into ortho.
According to ERAS, 1673 applied ortho. That indicates that ~235 matched into specialties other than ortho - that's around 45% of students doing something that wasn't ortho when they initially intended to go for ortho.

The NRMP match data specifically accounts for this and only includes those who rank that specialty at the top of their rank list.

People who applied ortho but where it was not at the top of their rank list would not be included as the assumption is whatever specialty someone ranks first is their specialty of choice. ERAS data is just purely boxes clicked in their system. Someone throws a few Hail Mary ortho apps for fun? They get rolled into the ERAS data for ortho and whatever else they applied to as well.

The NRMP data also based off of those who submit rank lists… I.e those who get interviews. People who apply through eras and then don’t get any interviews would not show up in the NRMP data.

 

[CJhooper123]

Would you mind sharing where you found that rule?

The NRMP match data specifically accounts for this and only includes those who rank that specialty at the top of their rank list.

People who applied ortho but where it was not at the top of their rank list would not be included as the assumption is whatever specialty someone ranks first is their specialty of choice. ERAS data is just purely boxes clicked in their system. Someone throws a few Hail Mary ortho apps for fun? They get rolled into the ERAS data for ortho and whatever else they applied to as well.

The NRMP data also based off of those who submit rank lists… I.e those who get interviews. People who apply through eras and then don’t get any interviews would not show up in the NRMP data.

Thanks for the follow-up, Vinci. I think the NRMP data is valuable and can help guide decisions but it's not perfect.

I found this on page 2022.
"U.S. MD Seniors who match to a specialty not ranked first on the rank order list or who do not match are not included in analyses. No distinction was made based on whether applicants matched to the first, second, third, or lower choice program."

Also, the fact NRMP wouldn't include people who didn't get an interview skews the data; it's common to not get interviews in competitive specialities. Also also - I didn't realize that 17% of people didn't even report to the NRMP.

 

[GoSpursGo]

it's common to not get interviews in competitive specialities.

Even in competitive specialties, it is not common to get literal zero interviews. You'll usually get an invite from your home program. And besides, if someone gets literal zero interviews, then that's someone who really did a poor job of evaluating their competitiveness for a specialty, and so it is not useful to include them in the analysis because they never had a shot.

I really would not do a deep dive on the NRMP data, which as others have said have little to no meaning when applied to a single applicant and particularly when you add in the need for a visa which likely accounts for a good deal of the variance related to this specific applicant. The takeaway should be "ortho is really competitive, and basically no matter what you do you're taking a real chance at not matching." Rather than setting benchmarks for things like numbers of interviews where someone can feel "safe" the data really should be used to help people have a general sense of whether or not they are in the ballpark in terms of competitiveness, and if the answer is yes then you cross your fingers and hope your connections are good enough to help you match.