Hey
I can give you a little glimse of the Orthopedics application process. I agree with what njbmd posted. It is a very good general overview of the residency process. The Orthopedics application differs a little from a lot of the other specialities in terms of what the PD (Program Director) looks for. (It is probably similar to the ENT, Derm, Plastics, Optho, or the more competitve specalities). First, your personal statement is bearly look at. It can hurt you but not help you that much. Most PD don't even look at the PS. Almost all of the programs that I went for interviews last year had a USMLE and/or AOA cut off. From talking to people on the interview trail, the magic cut off for ortho at a lot of programs is somewhere between 220-230, I know alot of programs will trash your app if you are not above a 230 on the step 1, unless you were a rotator or home school applicant. (230 is pretty hard to get on step 1, it is probably in the 65-70th percentile of all MED STUDENTS taking the exam). AOA is also something Ortho PD likes. Being AOA can help alot, but not required. Research is also huge with Ortho, Most of the PD like the applicant to have some kind of research background and or publications. Where you went to medical school is very important, as the top tier med school tend to have more famous orthopods that can write LOR for you. Your EC are somewhat looked at, depends on the PD, but I know have played varsity college sports can help you, since almost half of the people in my program was ex college athletes.
Most Ortho applicant will apply to 40-60 programs, people will tell you that they applied to 10 or 20, these people either is lying or they are a "superstar" applicant = jr AOA, >260 step I, tons of ORTHO research and pubs, Tier I med school, with strong LOR from very famous professors, etc. To give you an example, one of my best friend this yr applied to 60+ programs with a 245 step I, all As in clinical and 1st 2 years except for 2 classes and 1 rotation, research, very very strong LOR, and received only 14 interviews from that, he was not AOA, but was in the top 1/4 of our school (Top 25). So it is very competitive. Another guy that I rotated with at a Chicago program, went to U of Chicago, had 250 step I, missed AOA by a few spots, great LOR, and research, also tossed in 50 or so apps and received about 15 interviews.
Now, assume that you have made the cutoff and your app actually made on to the PD's desk, which is pretty good since most programs get between 100-150 apps per spot, my home program received about 600 this year for 5 spots. Whether you get an interview or not depend on alot of things, but now the LOR comes into play, who wrote them matters as much as how good they are. Because Ortho is a small field and alot of the Program directors know each other and other attendings in your school. If they see one of their close friends wrote you a strong letter and you had a strong app, the PD might pick up the phone and call... this happens alot in Ortho, where on attending call the PD of another program to push for his student. From what I have seen, most of the programs will interview 8-10 people per spot = about 40-50 interviews given for 4-5 spots.
Now you have got all of the interviews lined up, well in Ortho, alot of programs offer interviews on the same day, weekends, etc, so if you are a strong applicant, and get mult interviews, you will have interviews that land on the same day and you will have to cancel one, which is something very hard to do. And if you call the secretary to re schedule, alot of times, they will say tough luck, you either come on that day or we will invite someone else to come. Our school gived us 2 months of vacation/interview/USMLE step II time in 4th year.
So now you have arrived at the interview... well, in ortho, you have to do some ridiculous things at interveiws. Nothing like peds or IM, where people will just be like "how can I convince you to come to our program... do you have any question for me... is there anything I can do for you...etc" I have had programs where the attending threw up X rays that I had to interpret, id what kind of fracture, my management plans, etc. One of the PD was faking an traumatic injury, where I had to exam him, ask him questions, and then I had to present the case to the PD with my management plans, all in the interview. I have been asked travia questions, what kind of animal would you like to be and why, one program/the residents took it's applicants to the gym just to see how much they can bench, another program in the midwest have touch football games after the interview for the applicants (that was kinda fun and the only 2 girls that was there on the interview also play football), at a program in florida, after the interview, the residents took the applicants to a strip club. Another place had the applicants go into a room to assemble a drill and asked the people to drill 45 degrees into a PVC piping (so this is kinda hard, you need to drill at a 90 degrees first and then dril in the 45, otherwise the drill head will slide off), one of my friends told me one of the attendings gived him a nut and bolt and asked him to screw the nut on with his non dominant hand, but the trick is that the nut did not fit the bolt and the attending just wanted to see how long it took the applicant to figure it out (this was done while the interview was taking place). But these are some extreme examples, but alot of the interviews was very benign. It is kinda fun to go to these interviews.
Ok, say now the program have finished interviewing all of the applicants for the season, it is time to make the rank order list. This is when all the attendings come together to rank the people they have interviewed. Most programs will not go past 15 for 4 spots, in fact most places will fill the 4 with their top ten. Another words, if you interviewed at 15 places and was ranked in the 20s to 40s at all places, you will not match with 15 interviews. And this have happened over and over again to very good applicants. This happened to a good friend of mine this year. Anyways, I am glad I have gone through this process, and I would not have repeated it again if you paid for my medical school expenses. I think in this process, it takes a lot of hard work in med school, who you know, and a bit of luck to get a spot.
