Here goes nothing, I have the day off grab a cold one lol. This is directed at OP and just general info I have told multiple students in conversations so I might as well post it. Yes, I had nothing better to do today than to write this.
*There are certainly more people knowledgable than me*, but I will give my 2 cents as a dumb 4th year in the grind currently. My opinions are from what I have noticed on the trail this year, and from going to fracture conference and didactics with my home program since very early in my first year and watching and networking with different applicants over the last 4 years.
So basically the best odds to get an ortho spot as a DO isn't scores, or research it is networking and being likable. However, this applies mostly to your odds at 1 program in which you can expound your efforts before 4th year.
If you have a program and bust your balls going to fracture conference and such it will be noticed, and eventually they will want to get to know you. Once they do, if you keep those relationships going you will not only have a pretty good chance of matching there but will also have amazing mentorship and knowledge that will help you on all your other auditions. However, the caveat is you have to be likeable or this doesn't apply as much. As said above, showing up consistently, shutting up, listening, and showing growth is VERY important and can make you highly desirable by a program before 4th year and auditions even start.
The next best way is to have a killer app (duh) but what does this mean? In my experience over talking to people the last few years and then now in the application cycle it seems people with 250+ or 700+ and good letters/ ortho stuff on their CV get the cheese. What I mean is, overall your best odds of getting interviews and matching are at the places you rotate, but people with the above get a good amount of other opportunities as well because of their app.
In regards to both showing up and getting a killer app, none of that matters if you aren't a likeable person and a hard worker. You would be surprised at how many students on the audition trail are rude to fellow students / junior residents / nursing and who noticeably work less hard than those around them. Its noticed by students, and residents, and everyone in between. I had multiple rotations where the residents would put the rude/lazy dude on blast in front of everyone. Don't be that guy. I can't believe this is advice that needs to be given, but I saw first hand that it does.
I have noticed the applicants over the last few years (I know a lot of people through my services on national ortho boards and through mad networking) can be broken into 4 categories:
1. People who only get 1-2 interviews, despite rotating at 5 or so programs. (Usually due to a weaker app + possibly not fitting in as well with ortho)
2. People who get interviews at most of the places they rotate but no non-rotator interviews (usually average scores, but still a good rotator)
3. People who get interviews at most of the places they rotate and 1-2 non rotator interviews (usually above average scores to really high scores but no other *sauce* on the CV, good rotator)
4. People who get interviews at most of the places they rotate and 3+ non-rotator interviews (usually the people with very high scores, or something highly unique on their app that is very impressive)
Obviously more interviews = better chance of matching. I think the stat used to be 5 interviews for DO in DO ortho = match. This is certainly changing and will trend higher is my guess. Because most people can only do 4-5 auditions, that means you HAVE to get an interview at all of your auditions and a couple of non-rotator interviews to feel "cozy" (not that anyone applying ortho feels cozy)
Getting into category 4 is really tough, and you need to be very well rounded. I know people with 260's and 800's still in category 3 because thats all they had. No good ortho letters or extra ortho sauce on the CV. Then there are other people with low board scores for ortho who are in category 4 because their app is basically all sauce and no scores lol. So, boards are very important but not everything and an extremely strong or unusual app can make up for board score deficiencies. From my experience, it seems the people in group 4 gobble up most of the non-rotator interviews and you see the same group of people at all of the interviews as non-rotators.
Because of the above, choosing your auditions is very important. If you have 5 interviews, but they are all at places that rotate 50+ people and invite non-rotators the odds aren't great. If you have 2-3 interviews at places that rotate 15 people for 2 spots your odds are pretty good at those places. So, you need to pick auditions carefully. I would recommend 1 reach, and the rest safe picks (places that don't rotate a lot of people and require a rotation to interview). If you are dead set on ortho the goal should be to match, because any ortho match is prestigious imo despite what SDN says.
As far as MD ortho goes, you need to have great letters and research etc. to even get a look and even then is not going to go great. I know plenty of people in the 250's who applied to 100+ programs and got 1-2 MD interviews at community places that aren't any different from DO. I know of one person with around 10 MD interviews, but they skipped rotating at DO places and did 6 MD auditions at places that give interviews to all rotators in addition to a ridiculous app + diversity. The other thing is the "DO friendly" places that have taken DOs in the past got FLOODED with DOs this year. 8+ people rotating at mayo, 5 at LSU etc. So, we may have a DO match there this year, but I think the DO flood at these places will hurt all DOs. So if you rotate MD, think outside the box.
I would only plan on DO for ortho though if you wanna maximize chances unless you have a killer app. Even then, risky.
As far as research goes, it can be a really big boost to your app and if you can get good research you need to do it. Problem is, most DO schools do not have this opportunity. I HIGHLY recommend a research year for ortho in the coming years. With DO school expansion, DO ortho is going to be an absolute blood bath. Even more so than it is now. The other underrated aspect about research is that if you do a good job, you create lasting relationships which will result in good letters and people to make calls for you and help you match. With so many more DOs graduating (which means a lot more people with high board scores) research will allow you to set yourself apart in regards to CV, letters, and calls in an increasingly competitive field. Also, doing a research year means you can focus on boards and crush them, and then focus on research without responsibilities at school.
Summary: Score as high as you can, put as much sauce on your CV as you can, get as good of letters as you can, and rotate at high yield places is the recipe for matching DO ortho.
Also: Bold prediction, this year we will have double digit DOs matching to "MD" residencies. You heard it here first. I know of enough DOs with a couple MD interview invites that we are bound to have a handful them match at those places (one place I interviewed at had like 5 DOs interviewing that day), if we don't have more this year than in the past take it as a sign that MD ortho is completely off limits not just a huge reach like it is considered now.
