Ortho Competitiveness (Step 2)

[OldBenKenobi]

Hey all,

New to posting (not browsing) here. I am an M4 at a mid-level school who just received my Step 2 score of a 255 last week. I just don't know how to gauge my competitiveness for orthopedics in this upcoming cycle. So I'm hoping for some honest feedback.

For context, I have had my sights set on ortho since early M1. I will finish in the top MSPE percentile bracket possible for my class after honoring all of M1 and M2 with 4/8 Honors in clinicals including surgery (the rest were HP with one Pass in Family). I was also fortunate to recently receive AOA. My research experience is decent with around 20 total publications (4-5 manuscripts with the rest being presentations and posters). I also have several extracurriculars that I am passionate.

Currently, I am in the middle of my away rotation season featuring three ortho rotations at good programs. I felt really solid about my application prior to Step 2 and while I underperformed by a fair margin from my practice tests, I am proud of the work I put in. Nevertheless, at slightly below the average matched score of 256 from last year and with the change to Step 1 P/F shifting all the focus to this exam I am very worried this year might be a whole new ball game. (It certainly seems like everyone I am hearing from interested in ortho got a 260+ but hopefully this is just reporting bias.)

Any input regarding my competitiveness or anticipated changes in scores this year would be greatly appreciated as I am now contemplating also applying to general surgery prelim years/research years (but obviously ERAS is drawing near so these options would require a lot of immediate effort).

TLDR: Got a 255, applying ortho (last year's average was 256). How concerned should I be about my score this cycle? And should it impact my signaling strategy (+/- dual applying)?

Thanks everyone 🙂

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[medschoolaspirant]

1. Go full fledge apply Ortho.
2. apply widely. Apply everywhere.
3. Dual apply general surgery, if you feel happy doing it For living.
4. step 2 is just one part of equation. Not whole picture. You will most likely get in to mid tier program. You have great credential.
5. god forbid, if not, then you will be glad you applied gen surg. Hedge the bet.

good Luck.

 

[LunaOri]

Looks like you are a competitive applicant despite the 255. Talk to your advisor about how others from your school have matched (or not matched) into ortho to better assess your chances.

 

[deleted1139416]

Looks like you are a competitive applicant despite the 255. Talk to your advisor about how others from your school have matched (or not matched) into ortho to better assess your chances.

Not sure why that is a bad score. The average step 2 MD ortho score is 255.

 

[MDMechEngr]

The median S2 that matched is 256 for 2023. Your S2 is slightly below that, but I would anticipate the mean to be higher b/c the focus is solely on S2 starting this year. Your S2 will hurt slightly, but you have AOA, which is significant for Ortho and will be the equalizer. Your clinical grades isn't excellent, but you honored surgery and IM, which are good things. Your pubs and research are good also. Apply broadly as you have a very good shot at academic programs is my take. GL.

 

[deleted1139416]

The median S2 that matched is 256 for 2023. Your S2 is slightly below that, but I would anticipate the mean to be higher b/c the focus is solely on S2 starting this year. Your S2 will hurt slightly, but you have AOA, which is significant for Ortho and will be the equalizer. Your clinical grades isn't excellent, but you honored surgery and IM, which are good things. Your pubs and research are good also. Apply broadly as you have a very good shot at academic programs is my take. GL.

Where did you get average scores for 2023? Do you know what the neuro average is?

 

[operaman]

You likely have a decent shot but obviously no guarantee given how competitive it is.

It will take a cycle or two to learn how the new S2 benchmarks will shake out. It’s simply impossible compare old averages when so many strong applicants with a high S1 didn’t even take S2 before applying. My gut says the averages for top fields will shake out around 260-265 ish (on par with S1 of 250ish), but hard to say for sure.

I doubt your score will close many doors and should at least keep you in the running. The rest of your app will hopefully secure some interviews. Dual applying is unlikely to be a great option for you as your app is pretty solid and doing so might slightly weaken your Ortho chances. You’d be a good candidate for a research year if you don’t match since you’ve only got 4-5 pubs, so that might be a good backup plan especially if you have any connections to a funded position.

 

[MDMechEngr]

Where did you get average scores for 2023? Do you know what the neuro average is?

I was reading the 2023 S2 score and percentile. The median is for 2022 by specialty however. Ortho median overall per this chart is 257.

 

[MDMechEngr]

You likely have a decent shot but obviously no guarantee given how competitive it is.

It will take a cycle or two to learn how the new S2 benchmarks will shake out. It’s simply impossible compare old averages when so many strong applicants with a high S1 didn’t even take S2 before applying. My gut says the averages for top fields will shake out around 260-265 ish (on par with S1 of 250ish), but hard to say for sure.

I doubt your score will close many doors and should at least keep you in the running. The rest of your app will hopefully secure some interviews. Dual applying is unlikely to be a great option for you as your app is pretty solid and doing so might slightly weaken your Ortho chances. You’d be a good candidate for a research year if you don’t match since you’ve only got 4-5 pubs, so that might be a good backup plan especially if you have any connections to a funded position.

2022 median S1 ortho match was 248 (77 percentile). Equating the same percentile to S2, assuming that the median S2 percentile for ortho match would be similar to S1, the median S2 match score would be 259 (rounding up). Most score 11 to 12 points higher on S2 than S1 so this is a pretty good interpolation. So the predicted median S2 match for ortho would be around 260. However, because of the S2 focus, this could be slightly higher.

 

[lacrossegirl420]

when did a 255 become a weakness? lmao

 

[AnonymousDoctorGuyPerson]

2022 median S1 ortho match was 248 (77 percentile). Equating the same percentile to S2, assuming that the median S2 percentile for ortho match would be similar to S1, the median S2 match score would be 259 (rounding up). Most score 11 to 12 points higher on S2 than S1 so this is a pretty good interpolation. So the predicted median S2 match for ortho would be around 260. However, because of the S2 focus, this could be slightly higher.

This is basically what I've been telling people. It's conjecture, of course, but most programs historically have looked and focused hardest on step 1 (perhaps last year maybe programs experimented in anticipation who knows), but for competiveness it seems safest to take your step 2 score, translate it into a rough percentile, and translate that back into a step 1 score and see how people faired the last few cycles with that score - which as you stated comes out to about what you'd get if you subtract 10-12 from your current Step 2 score.



Certainly could be a jump in step 2 scores as well this year since it matters more, and I've certainly noticed more people take longer dedicated periods. Remember, some people last year took step 2 post-eras and half-assed it. However personally I didn't see Step 2 as an exam that people score that much better on by studying more but I guess we shall see.

 

[RonaldinhoisKing]

I was reading the 2023 S2 score and percentile. The median is for 2022 by specialty however. Ortho median overall per this chart is 257.

Im kinda confused about this chart. Does this mean that the bottom number listed is the floor of every matched applicant score?

 

[AnonymousDoctorGuyPerson]

Im kinda confused about this chart. Does this mean that the bottom number listed is the floor of every matched applicant score?

It's the 25th percentile

 

[RonaldinhoisKing]

It's the 25th percentile

Right so there were scores lower than that in the matched pool correct.

 

[Esmolol]

Right so there were scores lower than that in the matched pool correct.

Bones, bro... bones... there were bones lower than that in the matched pool...

 

[Dr. Anonymouss]

2022 median S1 ortho match was 248 (77 percentile). Equating the same percentile to S2, assuming that the median S2 percentile for ortho match would be similar to S1, the median S2 match score would be 259 (rounding up). Most score 11 to 12 points higher on S2 than S1 so this is a pretty good interpolation. So the predicted median S2 match for ortho would be around 260. However, because of the S2 focus, this could be slightly higher.

I’m very curious to see how the average plays out this year. It sure seems like everyone at my school has a 260+…. But I mean even if that’s true why would they get rid of the average being 247. I mean theoretically they could still keep the average at 247 even if students overall performed better but who knows. We won’t know for sure until more data comes out

 

[Esmolol]

I’m very curious to see how the average plays out this year. It sure seems like everyone at my school has a 260+…. But I mean even if that’s true why would they get rid of the average being 247. I mean theoretically they could still keep the average at 247 even if students overall performed better but who knows. We won’t know for sure until more data comes out

How do you keep the average 247 with lots and lots of people having 260+? It's like saying that the average is 5 and here are the students scores 7, 7, 7, 7, 7, 7, and 6.

 

[deleted1139416]

I’m very curious to see how the average plays out this year. It sure seems like everyone at my school has a 260+…. But I mean even if that’s true why would they get rid of the average being 247. I mean theoretically they could still keep the average at 247 even if students overall performed better but who knows. We won’t know for sure until more data comes out

How do you keep the average 247 with lots and lots of people having 260+? It's like saying that the average is 5 and here are the students scores 7, 7, 7, 7, 7, 7, and 6.

All anecdotal. The most recent score report shows the average at 248.

 

[Esmolol]

Only in a parallel universe my friend.🤣

260 average... till underverse come!

 

[CJhooper123]

255 is a great score and will not prevent you from doing ortho

Ortho is sooo much more than your step 1/2 scores. In fact, I'd argue it's not nearly as important as people make it out to be.. I know plenty of people with higher scores who didn't match and plenty with lower who did match.

To answer your question about your competitiveness...
Do you have research?
Did you perform well M3 year?
Are you AOA? GHHS?
Were you involved in leadership in med school?
Do you have good letter writers?
Do you have realistic sub-I's set up?
Do you have a home ortho program affiliated with your med school?
Do you have an original story?

Most importantly... who do you know that can make phone calls for you?

I used to think step 1 and 2 mattered, but they really aren't that important IMO. They can sink you, but they can't match you.

 

[MilesDavisTheDoctor]

What exactly does a "call" look like? Is this your mentor literally calling up another PD and saying "you should rank CJhooper123 highly on your rank list" a few weeks before match day?

 

[CJhooper123]

What exactly does a "call" look like? Is this your mentor literally calling up another PD and saying "you should rank CJhooper123 highly on your rank list" a few weeks before match day?

Yes - it's your mentor reaching out to PD's or the chairman saying... "Hey, I just wanted to tell you about MilesDavisTheDoctor, he/she is a great candidate and would do well at your program". Preferably your mentor has connections like this and can vouch for you. If not, having someone call on your behalf is still helpful. This is actually a huge part of the ortho application that people benefit from or fail to benefit from.

 

[MilesDavisTheDoctor]

How do you identify people who have the power to do this? Would it be safe that if your mentor is the PD at a top ortho program they have the power to make these types of calls?

 

[MDMechEngr]

How do you identify people who have the power to do this? Would it be safe that if your mentor is the PD at a top ortho program they have the power to make these types of calls?

Yes more than likely have the ability to do this, but they will not just vouch for any protege. They must be convinced that you are an outstanding candidate worth a shout out to others and that you will represent their program very well. These individuals are usually functioning at nearly the PGY1 level as an M4 are the remarks that I have seen/heard from my home program PD/Chair.

 

[CJhooper123]

Yes more than likely have the ability to do this, but they will not just vouch for any protege. They must be convinced that you are an outstanding candidate worth a shout out to others and that you will represent their program very well. These individuals are usually functioning at nearly the PGY1 level as an M4 are the remarks that I have seen/heard from my home program PD/Chair.

Not necessarily true. I have co-residents who received phone calls from mentors who are functioning at the MS3 level. Some of the brightest and most personable med students I know who applied ortho are currently in FM or IM due to not matching. I know plenty of very poor candidates who had connections and/or family members at institutions that landed PGY1 positions.

It's all about who you know and who you get along with; letter writers, PDs, chairmen, research PI's... ortho is a small community and connections trump everything. It shouldn't be like this IMO, but it is. It's harsh but the reality of ortho.

 

[medschoolaspirant]

Not necessarily true. I have co-residents who received phone calls from mentors who are functioning at the MS3 level. Some of the brightest and most personable med students I know who applied ortho are currently in FM or IM due to not matching. I know plenty of very poor candidates who had connections and/or family members at institutions that landed PGY1 positions.

It's all about who you know and who you get along with; letter writers, PDs, chairmen, research PI's... ortho is a small community and connections trump everything. It shouldn't be like this IMO, but it is. It's harsh but the reality of ortho.

This is true for all surgery and all competitive residency with small community. its all about who you know in which program and how much they like you. All competitive speciality has very small handful number of spots to fill. They rather go with known people who they will get along with and come recommended vs. unknown highly desirable people on paper. I know people with 15 interviews not matching in our school with very highly desirable credentials on paper and we have one resident with just 1 interview at home program with not much to show on paper and not desirable match As PD really wanted known people With very small number of spot to fill. I am at an away rotation right now. Met PD. PD in clear words told me, each and every resident on program are known ones. Either thru home program rotation or away rotation. We only take people whom we know and have worked with, as we have very few spots to fill.

 

[MilesDavisTheDoctor]

How do you know who are the people who make these kinds of calls?

 

[Esmolol]

How do you know who are the people who make these kinds of calls?

In the ortho world - they all have this secret tattoo of crossed crutches on their right deltoid. It's easy to identify them while they're on the bench pressing 300. It really shows...

 

[CJhooper123]

This is true for all surgery and all competitive residency with small community. its all about who you know in which program and how much they like you. All competitive speciality has very small handful number of spots to fill. They rather go with known people who they will get along with and come recommended vs. unknown highly desirable people on paper. I know people with 15 interviews not matching in our school with very highly desirable credentials on paper and we have one resident with just 1 interview at home program with not much to show on paper and not desirable match As PD really wanted known people With very small number of spot to fill. I am at an away rotation right now. Met PD. PD in clear words told me, each and every resident on program are known ones. Either thru home program rotation or away rotation. We only take people whom we know and have worked with, as we have very few spots to fill.

This times 1000.
People get so locked into step 1/2 scores, number of publications, etc. Hitting the "averages" for matched applicants is much less important than people might think. Connections and aways >>

 

[DarkHorizon]

This times 1000.
People get so locked into step 1/2 scores, number of publications, etc. Hitting the "averages" for matched applicants is much less important than people might think. Connections and aways >>

Agree, but most people don’t make a call for you unless they think you’d be a good resident. Connections are def at play but you still have a to be a good candidate with at least averagish numbers for Ortho. Occasionally you’ll see someone with really subpar numbers, but most attendings would only put their name behind you if you were a solid candidate. My anecdotal experience.

 

[operaman]

How do you know who are the people who make these kinds of calls?

Typically associate prof and above, strong national/international reputation. Chairmen are almost always at this level. Programs director in some cases as well. Other students and faculty would know more.

I found out by scheduling a meeting with my ent chair and asking his advice about applying and who would be the best letter writers. He very quickly listed some names and in retrospect he was spot on. So don’t be afraid to ask.

The calls are most helpful at the pre interview stage. I knew a friend on the trail who did not get an interview at one top program, reached out to their mentor who called that program’s PD and got an interview invite the next day. And then matched there in the end.

Calls post-interview are common but often the lists are set by that point. Once a program meets you, they will form their own opinions and then they care less about what some other bigwig thinks of you.