Matched Ortho this year, ask away

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Bonebro

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Hey guys,

I have a paper to write I've been slacking on all semester so to keep my procrastination on the computer instead of leaving my house to do something I thought I'd start this thread. I matched this March into an ortho residency, feel free to ask some questions and I'll reply as I hammer out this paper.
 
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nalcodr said:
When did you decide on ortho and how did you know it was the right choice ?
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I went into med school knowing I wanted to do ortho or at least that I had to find something I liked better. I had extensive shadowing experience with some sports med and trauma sub specialists before I matriculated. I definitely kept an open mind, considered neurosurg until I took neuroanatomy my second semester, considered ER until I realized I needed to do a surgical specialty. I enjoyed a lot of my rotations 3rd year, which made made me doubt ortho until I went out of my way to make it into some ortho OR's after a few months break and remembered why I liked it, the surgeries, the patient population, and the personalities of the orthopods just all fit my style.
 
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Shjanzey said:
I keep flipflopping between surgery and medicine (ER in the mix too). What is it about surgery that takes the cake for you?
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I like the hands on part of surgery. I'm too ADD to sit around and think and talk for hours on rounds and put in orders when not rounding forthe rest of my life like I would in IM, a year of it as an intern is going to be long enough. I like the environment of the OR as well. I like that in surgery especially ortho your treatment is typically definitive and there is something to structurally fix, unlike BUN or sodium, whatever those are.....
 
Noob question, but is ortho an advanced (PGY-2) position like ophtho?
 
Roughly what quartile/%'lie were you in during preclinical years? How many hours/day of work did you work to get that rank?
 
clonoGnic said:
Roughly what quartile/%'lie were you in during preclinical years? How many hours/day of work did you work to get that rank?
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I was in the 4th quartile my preclincal years. I didn't do particularly bad just didn't do particularly well either. I worked my butt off and ranged between 82-89% (So B range since our school was ABCF grading) I just couldn't really get over the hurdle to get A's. Looking back I didn't have great test taking skills which I greatly improved on 3rd year. I was definitely a late bloomer in medical school. With that being said no one ever mentioned my preclinical grades in any single one of my interviews.
 
Bancrofti said:
how many papers/research activities did you have?
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I had one peer reviewed retrospective study published and a poster presentation at a major national conference all off one project. I also had another project I was involved with starting but didn't publish anything with this one by the time ERAS was submitted, all both ortho projects. I didn't have a home ortho program and did all this with private physicians.
 
How many programs did you apply/interview/rank?
 
Can't believe nobody asked this yet, what are your Step 1/2 scores? You don't have to give exact number, just a rough estimate.

How do you deal with long surgery hours? What was your backup plan if you didn't match into Ortho?

Bonebro said:
I had one peer reviewed retrospective study published and a poster presentation at a major national conference all off one project. I also had another project I was involved with starting but didn't publish anything with this one by the time ERAS was submitted, all both ortho projects. I didn't have a home ortho program and did all this with private physicians.
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When did you start your research? Did you have a research experience prior to those?
 
kenjixshadow said:
Can't believe nobody asked this yet, what are your Step 1/2 scores? You don't have to give exact number, just a rough estimate.

How do you deal with long surgery hours? What was your backup plan if you didn't match into Ortho?
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Step 1: 225-235 Step 2: 250-260

Not sure if you mean a single long surgery or long days with multiple surgeries, but I can address both from my perspective as a med student on my ortho aways. If I knew it was going to be a long case I would make sure I ate and got some caffeine in me and used the restroom, which was always encouraged by the residents at all the programs I rotated. If it's a long surgery day with multiple cases the same applied just more meals and caffeine spaced throughout the day. Trying to focus in surgery was the most difficult after your first away because you're exhausted, may be post call, and most of the time are just retracting. I made sure I studied for every case and knew the anatomy and fracture classification for the case and would try to identify everything in my head as we would go through cases even if I wasn't being pimped. This was the only thing that stopped me from falling asleep standing up while holding retractors. On the services where I got to do more in the OR the feeling tired thing was a non-issue

Back-up plan was prelim gen-surg year and reapply. I did a few prelim interviews so I could have a choice of where to do one instead of hoping to get a good one in the SOAP.


I started my research the summer between MS1/2 and it finally ended up published a month before ERAS was submitted, so I was working on it continually throughout medical school. I had built a relationship with the physician I did the project with prior to starting medical school so we had an idea for a project ahead of that it was just when I had time to really get started and make a lot of head way.
 
TheRobin said:
Noob question, but is ortho an advanced (PGY-2) position like ophtho?
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Missed this one. No its a 5 year categorical position. So you wouldn't apply to a separate intern year, in fact as of 2 years ago you only do 6 months of off service rotations your intern year.
 
Shjanzey said:
I keep flipflopping between surgery and medicine (ER in the mix too). What is it about surgery that takes the cake for you?
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If you truly like medicine in addition to the technical aspect, you might consider other surgical disciplines with general surgery giving you the most general medical knowledge base. Doing a year of critical care fellowship makes you fairly comfortable with medicine issues, and this can be completed after any surgical specialty residency (I think).
 
Have you thought about if you might do a fellowship like in sports med etc? How did you decide to apply to 100 programs. I could be a noob, but are those all the programs out there? Do you feel like your Step 1 score held you back?
 
What has been your favorite or most memorable surgery to be a part in?
 
C@lidoc said:
Have you thought about if you might do a fellowship like in sports med etc? How did you decide to apply to 100 programs. I could be a noob, but are those all the programs out there? Do you feel like your Step 1 score held you back?
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I'll do a fellowship >90% of ortho residents go on to do a fellowship. I'm not sure at this point what I'll do it in though as I really enjoy most sub specialties within ortho.
I didn't have a home program so not too much advice on where to apply so I essentially started with all the programs and went through FREIDA, any program that posted a step 1 score cutoff I didn't meet or if they didn't ones I knew I wouldn't get an interview at I didn't apply to. There were 157 programs to apply to last year and I think 152 of those were civilian. I do feel like I was prescreened out of having a shot at an interview at a lot of programs but at the same time it didn't stop me from matching.
 
Fellow ortho brah here, also matched this year. Congrats mang.

Just curious --- how do you feel about the classic advice that you need to go to a trauma heavy program if you ever want to be a good orthopaedist? I'm skeptical of this old school wisdom, and I'm curious if my ortho bretheren are still buying into this advice. For what its worth, I matched into a program that will crush me on trauma and take years off my life, but I'm currently not convinced this will make me any more skilled in the long run... Honestly its seems more like a badge of pride/machismo more than anything, as there are plenty of excellent surgeons coming out of the "white collar" programs. Just curious what your impression is now that you've made it through the machine.
 
What advice would you have for someone looking to go into ortho? Where do you see the field headed?
 
KinasePro said:
Fellow ortho brah here, also matched this year. Congrats mang.

Just curious --- how do you feel about the classic advice that you need to go to a trauma heavy program if you ever want to be a good orthopaedist? I'm skeptical of this old school wisdom, and I'm curious if my ortho bretheren are still buying into this advice. For what its worth, I matched into a program that will crush me on trauma and take years off my life, but I'm currently not convinced this will make me any more skilled in the long run... Honestly its seems more like a badge of pride/machismo more than anything, as there are plenty of excellent surgeons coming out of the "white collar" programs. Just curious what your impression is now that you've made it through the machine.
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I was actually wondering about this as well. I also matched into a very trauma-heavy program and everyone keeps telling me "oh you're gonna get such great training and you'll be a way better surgeon for it." But throughout the process the basic mantra was always that you will get solid, if not great training almost anywhere you go.
 
TOcho118 said:
I was actually wondering about this as well. I also matched into a very trauma-heavy program and everyone keeps telling me "oh you're gonna get such great training and you'll be a way better surgeon for it." But throughout the process the basic mantra was always that you will get solid, if not great training almost anywhere you go.
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Same here. I matched at a high trauma program. I did all my away rotations in trauma and I am pumped to be at a high volume trauma spot. I love that you have to deal with every part of the body on any given day and know what you're doing. As long as all the subspecialties are well represented, I think being at a place with a solid trauma foundation is important.
 
KinasePro said:
Fellow ortho brah here, also matched this year. Congrats mang.

Just curious --- how do you feel about the classic advice that you need to go to a trauma heavy program if you ever want to be a good orthopaedist? I'm skeptical of this old school wisdom, and I'm curious if my ortho bretheren are still buying into this advice. For what its worth, I matched into a program that will crush me on trauma and take years off my life, but I'm currently not convinced this will make me any more skilled in the long run... Honestly its seems more like a badge of pride/machismo more than anything, as there are plenty of excellent surgeons coming out of the "white collar" programs. Just curious what your impression is now that you've made it through the machine.
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I'll chime in on this too. I bought into this idea to some degree. I, like you guys here, matched at a program with a busy trauma service and was looking for this. But more importantly I focused on autonomy within the trauma service. I figured this out after my first away that I rotated on a trauma service where the operative experience was SUPER top down. The 5 and the trauma fellow were the only ones that touched anything in one room and in the other the trauma attendings barely let the 3 close on a TFN. Oh and the 2's on the trauma service never saw the OR.

This was opposed to my second away where on the trauma service the attendings floated between rooms and only scrubed if the resident was struggling. At this program the 5 would teach the 2 in one room and the 4 had their own room, where on one day he walked me through a TFN cut to close. I felt consistently on my aways that the culture and autonomy on the trauma service tended to radiate to the subs. Basically the 2's at this program were doing more than the 5's at the previous program despite having equally busy services.
 
Bonebro said:
This was opposed to my second away where on the trauma service the attendings floated between rooms and only scrubed if the resident was struggling. At this program the 5 would teach the 2 in one room and the 4 had their own room, where on one day he walked me through a TFN cut to close. I felt consistently on my aways that the culture and autonomy on the trauma service tended to radiate to the subs. Basically the 2's at this program were doing more than the 5's at the previous program despite having equally busy services.
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Holy mackerel!! I wish I rotated at this program. The most I ever got to do on any rotation outside of routine skin closure was place a locking screw during a proximal humerus fracture ORIF. And this was only as a "reward" since it was my last day and I gave a good presentation earlier in the day, as the attending put it. Otherwise it was just retract this, or here, play around with the scope for a minute.
 
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Tired said:
Hopefully as you put that screw down you said, "**** this, we should be doing a hemi."
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Actually, I straight up questioned the integrity of the cuff and then suggested we go reverse.
 
This one goes for all the matched ortho brahs, what did your interview trail look like? In terms of location. I'm interested in going to a region I'm not originally from. I'm always heard there's a bias but is this true or just overblown
 
What was the name of that ortho guy who keeps complaining that podiatrists are taking over LEX and that plastics are taking over Uex
 
TheBunkMD said:
This one goes for all the matched ortho brahs, what did your interview trail look like? In terms of location. I'm interested in going to a region I'm not originally from. I'm always heard there's a bias but is this true or just overblown
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Do aways at places you think you really want to go.

Dream spot? Makes sure your step scores are up to snuff so you don't waste your time at a place that won't interview you even after a rotation. Put youe dream spot second or third in your ortho electives; the first rotation you'll be dumb, by the fourth you'll burn out.

I interviwed all over the midwest, but only rotated in two states.
 
Did you match where you interviewed? Did you do research? Is it MD/DO residency?
 
Bonebro said:
I'll chime in on this too. I bought into this idea to some degree. I, like you guys here, matched at a program with a busy trauma service and was looking for this. But more importantly I focused on autonomy within the trauma service. ... This was opposed to my second away where on the trauma service the attendings floated between rooms and only scrubed if the resident was struggling. At this program the 5 would teach the 2 in one room and the 4 had their own room, where on one day he walked me through a TFN cut to close. I felt consistently on my aways that the culture and autonomy on the trauma service tended to radiate to the subs. Basically the 2's at this program were doing more than the 5's at the previous program despite having equally busy services.
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Pretty much same for me. All of my rotations had very strong operative autonomy (although some arguably TOO much autonomy...) I also was graced with the opportunity to nail a femur on one away rotation. Felt pretty damn cool.

I dunno. Part of me is glad I'll be in the trauma club and the white haired guys will respect my training, but I don't think it will make me a better joints/hand/spine/sports surgeon to have nailed 200 femurs and put on 1000 splints.
 
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