I am a 4th year US medical student. I applied for orthopaedic surgery this year and didn't match. At first I was devastated and then eventually felt somewhat relieved. Don't get me wrong, I like orthopaedics but it is a tuff road and I am a young family guy. I scrambled into a general surgery preliminary spot, first to get a job, and second to leave several options open to me, including PM&R. I scrambled into CMC because I really liked their ortho program, know their surgery program and I know they have a PM&R program. I have always had interest in PM&R but didn't pursue it because of many pressures towards orthopaedic surgery. If I had to choose something outside of surgery it would definately be PM&R. I am most interested in disability and would enjoy the opportunity to help treat disability even from a non-surgical standpoint. I have a little exposure to PM&R here at my home school and really enjoyed a 1 week rotation in peds PM&R. I am pretty sure I want to get to know the specialty better and try to match next year. I am new at this and would appreciate any advice to help me increase my chances of matching. Boards are HUGE in ortho and probably what kept me from matching despite 12 interviews. Step 1 220, Step 2 (embarrassing) 195. I understand I obviously need to somehow get some good LORs from PM&R attendings for the upcoming match application. Any suggestions? It will be hard to get much exposure while in a gen surg preliminary year. Any other advice for the upcoming application year? Best scenario would be to find a PGY2 year spot open, but I figure those chances are pretty slim to none. Thanks for your time.