Switching to ortho late

[niku9]

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Hey everyone MS3 here,
Always thought that I wanted to do IM followed by cards but was somewhat underwhelmed during my IM clerkship and cards electives. I wanted to do cards mostly since I found heart physiology interesting and I always wanted to do something hands on. However I didnt find the procedures in cards all that interesting, at the end of the day its all just wires and catheters... Looking back I really enjoyed my surgery rotations and the more extensive procedural component to it. In particular I liked ortho when I had my surgical elective month. My main problem though is that it is almost 4th year in a couple months and I have absolutely no ortho related stuff for my app right now.

Grades wise Step 1 266, high pass in all core rotations (no honors...), research 2 papers in IM related stuff (not first author or anything though). How realistic is it for me to pursue ortho at this point? Any advice from people also made last minute switches to a competitive field?

 

[Donald Juan]

Sorry, you're not competitive enough for ortho, you need at least a 267 on step 1.

[pause for laughter]

Okay, joking aside of course you are competitive enough for anything. I don't think MS3 can be considered a "last minute switch" (changing in September would be last minute). You should get hooked into your ortho department now. Competitive surgical subspecialties almost all expect you to have done a home sub-I and 1-2 away rotations, and this is the time people apply to their aways and are planning their MS4 schedule. The spots won't all be filled up like some neurotic SDNer might tell you, but some of them might be, no big deal. This is when you get your LORs. Research looks good from anything, the idea that it has to be in your field is completely overblown, program directors will be happy to see you have experienced the research process and have some understanding about how to bring a project to publication. Your grades are fine. Would all honors be a little better? Yes. Are you going to have trouble matching into ortho with "just high passes" and a 266 step? Not if you have a halfway decent personality and know how to act interested and like a hard worker on your sub-Is and interviews.

 

[Moose A Moose]

Why ortho? I mean, at the end of the day it’s all just bones and hammers.

 

[OrthoTraumaMD]

Research looks good from anything, the idea that it has to be in your field is completely overblown, program directors will be happy to see you have experienced the research process and have some understanding about how to bring a project to publication.

Not correct in orthopaedics. Research in our field is absolutely essential. The average orthopaedic applicant has 6 to 7 publications. Most of them will be in ortho. You do not want to torpedo an otherwise excellent application with that. Everything must be in good shape to show that you are committed to the specialty. There are routinely about 900 applicants for five spots in any particular program. Research is one way we weed people out.




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[bonemann]

Not correct in orthopaedics. Research in our field is absolutely essential. The average orthopaedic applicant has 6 to 7 publications. Most of them will be in ortho. You do not want to torpedo an otherwise excellent application with that. Everything must be in good shape to show that you are committed to the specialty. There are routinely about 900 applicants for five spots in any particular program. Research is one way we weed people out.




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Do you mean 6 to 7 research experiences, or bona fide publications?
My home ortho program is a top-tier academic ortho program and I was told by a resident who participated in reviewing applications that the actual number of publications is on average 1-2, but with 7-8ish research experiences that include abstracts, poster, presentations, etc

 

[Oso]

Do you mean 6 to 7 research experiences, or bona fide publications?
My home ortho program is a top-tier academic ortho program and I was told by a resident who participated in reviewing applications that the actual number of publications is on average 1-2, but with 7-8ish research experiences that include abstracts, poster, presentations, etc

I don't know anything about orthopaedics. Except that, if you are going into ortho, please make sure your last name is Boneman.

 

[Cyphix]

Do you mean 6 to 7 research experiences, or bona fide publications?
My home ortho program is a top-tier academic ortho program and I was told by a resident who participated in reviewing applications that the actual number of publications is on average 1-2, but with 7-8ish research experiences that include abstracts, poster, presentations, etc

Research is certainly important, but it’s not nearly that high of a # of publications. AAMC data for first year Ortho residents in 2017 (so numbers will be even higher than applying medical students) show an average of 9.2 abstracts, presentations, and publications. I’d wager from that the average number of publications per person is probably 2-3.

 

[W19]

Research is certainly important, but it’s not nearly that high of a # of publications. AAMC data for first year Ortho residents in 2017 (so numbers will be even higher than applying medical students) show an average of 9.2 abstracts, presentations, and publications. I’d wager from that the average number of publications per person is probably 2-3. View attachment 231344

Why is MCAT score included here? Are programs able to see your MCAT score?

 

[Cyphix]

Why is MCAT score included here? Are programs able to see your MCAT score?

Good question. Not sure but it’s possible - it’s sometimes on official med school transcripts. MCAT may be self reported.

 

[OrthoTraumaMD]

Do you mean 6 to 7 research experiences, or bona fide publications?
My home ortho program is a top-tier academic ortho program and I was told by a resident who participated in reviewing applications that the actual number of publications is on average 1-2, but with 7-8ish research experiences that include abstracts, poster, presentations, etc

Experiences. Most of what I see is 4 actual pubs.


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[Donald Juan]

Not correct in orthopaedics. Research in our field is absolutely essential. The average orthopaedic applicant has 6 to 7 publications. Most of them will be in ortho. You do not want to torpedo an otherwise excellent application with that. Everything must be in good shape to show that you are committed to the specialty. There are routinely about 900 applicants for five spots in any particular program. Research is one way we weed people out.




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So, just to be clear, if you saw an applicant with two pubs in medicine, possibly a pub or 2 from undergrad, likely 7-8 "posters/pubs/abstracts," a step 1 of 266 you would weed this person out? Are you suggesting that the OP take a research year to get an ortho pub or 2?

 

[ParallelLines]

Research is certainly important, but it’s not nearly that high of a # of publications. AAMC data for first year Ortho residents in 2017 (so numbers will be even higher than applying medical students) show an average of 9.2 abstracts, presentations, and publications. I’d wager from that the average number of publications per person is probably 2-3. View attachment 231344

What's the difference between research experiences vs. abstracts/posters/etc. here?

 

[Donald Juan]

What's the difference between research experiences vs. abstracts/posters/etc. here?

One research experience would be a project you were working on. If that project was fruitful and ultimately resulted in a publication, it may have also been presented as a poster at a local university presentation and a regional or national conference. This means that one research experience might actually be 3-4 "poster, pubs, etc."

 

[OrthoTraumaMD]

So, just to be clear, if you saw an applicant with two pubs in medicine, possibly a pub or 2 from undergrad, likely 7-8 "posters/pubs/abstracts," a step 1 of 266 you would weed this person out? Are you suggesting that the OP take a research year to get an ortho pub or 2?

If that applicant came head to head with an applicant who had a stated commitment to ortho through research, yes. Our applicant pool is full of such people; it’s not actually as impressive of an application as you seem to think. And yes, that’s exactly what I am suggesting. If the applicant has zero experience in ortho and hasn’t made any effort to do something in it, why would I take them over someone with the same grades who has those things?


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[VincentAdultman]

Just do some research in ortho. Talk to someone in the department. It's not that hard to get involved in something, and not having ANY research (doesn't have to be a pub) is going to be a red flag.

 

[Donald Juan]

If that applicant came head to head with an applicant who had a stated commitment to ortho through research, yes. Our applicant pool is full of such people; it’s not actually as impressive of an application as you seem to think. And yes, that’s exactly what I am suggesting. If the applicant has zero experience in ortho and hasn’t made any effort to do something in it, why would I take them over someone with the same grades who has those things?


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It sounds like you are at a program that can take the cream of the crop. Of course in the scenario of "all other things equal" you would take the better candidate. Not everyone getting into ortho has as much research as the OP or near as high of a board score, and those 900 applicants all apply to 100 programs, and not every program gets to weed out everyone who has one thing that is slightly below average. I'm not saying he will get into hopkins or harvard, but yes, I think assuming he has a decent personality, gets involved in his program and does decently on his aways, and applies broadly he would safely match somewhere with his application.

 

[OrthoTraumaMD]

It sounds like you are at a program that can take the cream of the crop. Of course in the scenario of "all other things equal" you would take the better candidate. Not everyone getting into ortho has as much research as the OP or near as high of a board score, and those 900 applicants all apply to 100 programs, and not every program gets to weed out everyone who has one thing that is slightly below average. I'm not saying he will get into hopkins or harvard, but yes, I think assuming he has a decent personality, gets involved in his program and does decently on his aways, and applies broadly he would safely match somewhere with his application.

Not sure where you’re getting your information from. Do you interview ortho residents regularly? Because I do, and have done so, both as an attending and resident, at multiple places, not just cream of the crop type of places. Zero ortho research is a big red flag and an application killer. It wasn’t that way some years ago; it is that way now. Can someone match without it, sure. But exceptions only prove the rule. Also, just as an FYI, the average applicant applies to about 70 programs, not 100. The data is out there in JAAOS.


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[Donald Juan]

Not sure where you’re getting your information from. Do you interview ortho residents regularly? Because I do, and have done so, both as an attending and resident, at multiple places, not just cream of the crop type of places. Zero ortho research is a big red flag and an application killer. It wasn’t that way some years ago; it is that way now. Can someone match without it, sure. But exceptions only prove the rule. Also, just as an FYI, the average applicant applies to about 70 programs, not 100. The data is out there in JAAOS.


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Well, there is also only about 800 USMD applicants applying to ortho total in 2017, and they are applying to 70 programs each out of 150, so when you said you get 900 applications I figured hyperbole was expected. I guess you could be getting 900 applications if 500 of them are from IMGs and DOs....but if you consider only having pubs in other fields a "major red flag" I can only imagine what you're doing with those applications.

 

[Redpancreas]

I feel that the people who realize they want to do something really late are screwed and that’s unfair. It’s not like you can just take a gap year last minute with all these loans lingering.

 

[tymont12]

FWIW, people in my class who switched late to ortho all did research years. Those who didn't, didn't match. We also don't have a home department and those would be the first people I'd talk to in your shoes.

 

[Redpancreas]

Well, there is also only about 800 USMD applicants applying to ortho total in 2017, and they are applying to 70 programs each out of 150, so when you said you get 900 applications I figured hyperbole was expected. I guess you could be getting 900 applications if 500 of them are from IMGs and DOs....but if you consider only having pubs in other fields a "major red flag" I can only imagine what you're doing with those applications.

Hey now that you’ve gotten in, how many applications per spot are there? My PD tells me his hospital (less desirable area, lower tier) received 200 applications per one fellowship spot.

 

[OrthoTraumaMD]

Well, there is also only about 800 USMD applicants applying to ortho total in 2017, and they are applying to 70 programs each out of 150, so when you said you get 900 applications I figured hyperbole was expected. I guess you could be getting 900 applications if 500 of them are from IMGs and DOs....but if you consider only having pubs in other fields a "major red flag" I can only imagine what you're doing with those applications.

We literally have gotten that many in the past. The numbers lurk around 600-700 generally. If you have hundreds of stellar candidates, the only way to weed them out is by comparing them with everyone else. And in case I wasn’t clear, I’m not the only one who considers no ortho research experience as a major red flag. Nearly every program in the country does. Which is why I gave the advice I did. I don’t mince words. if OP is serious about matching they will have to make their application more competitive in that regard. Just because YOU want their research to count, doesn’t mean it will.


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[OrthoTraumaMD]

I feel that the people who realize they want to do something really late are screwed and that’s unfair. It’s not like you can just take a gap year last minute with all these loans lingering.

Tough luck. Then don’t go into a competitive specialty last minute. It may indeed be unfair, and I don’t disagree, but it’s how things are and given the amount of competition, it isn’t likely to change. OP needs to deal with things as they currently stand. Lamenting about how they ought to be will not help.


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[jw3600]

Dude orthomd is alway very upfront and genuine with her posts. What agenda could she possibly have other than trying to give honest application advice?

 

[Gilakend]

Why ortho? I mean, at the end of the day it’s all just bones and hammers.

 

[Donald Juan]

Dude orthomd is alway very upfront and genuine with her posts. What agenda could she possibly have other than trying to give honest application advice?

There's not always an agenda. I've known candidates going for surgical subspecialties who's PDs tell them they have no chance because they made a 239 on step and that every program will weed them out because they are under 240. And then I've seen candidates with lower step scores get 20+ interviews in the same field. Regardless, I will concede because no, I have not reviewed as many apps for ortho in particular. OP has no shot without ortho research. Obviously a research year is required for ortho if you go into the field late.

 

[ka0]

@OrthoTraumaMD This is only tangentially related but when looking at applications - how much does 255 vs 260 vs 265 on Step 1 matter? As in are you looking at Step 1 scores more on a point by point basis where every single point is better or more of a cutoff to divide applicants into good scores vs great scores? Thanks

 

[DubbiDoctor]

I feel that the people who realize they want to do something really late are screwed and that’s unfair. It’s not like you can just take a gap year last minute with all these loans lingering.

Is it possible to get paid during a research year, like the resistant assistant gap jobs some applicants do before before medical school?

 

[OrthoTraumaMD]

@OrthoTraumaMD This is only tangentially related but when looking at applications - how much does 255 vs 260 vs 265 on Step 1 matter? As in are you looking at Step 1 scores more on a point by point basis where every single point is better or more of a cutoff to divide applicants into good scores vs great scores? Thanks

Not point by point, no.


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