First of all let me say that I'm probably being extremly anal asking about these things this early in my medical education (I start med school in August) but here goes. I am interested in the field of orthopaedic surgery and I have read that to match into a particular program it's almost an unwritten rule that you must have done an orthopaedic rotation there during your 4th year. Is this really the case or just for the very top programs? Would AOA, USMLE scores, research, and LOR be enough to get one a spot in a program or is an "audition" rotation an absolute must? How would one determine which programs to take a 4th year rotation at, since one will be limited to only a few specialty rotations? Should one apply to do a rotation at top notch dream programs (ie Johns Hopkins, MGH, or HSS) or only at programs they think they have a shot at based on other criteria? I ask these questions because this notion of an "audition" rotation seems to severely limit the number of programs that an orthopedic hopeful could apply to with much hope of getting a spot. Thanks for any feedback, I will really appreciate it. I know for now though that my first priority should be to enjoy myself this summer and then ace the basic science years and the USMLE.