Out of curiousity, the person with 250s that had to scramble. What did they eventually match into
One got plastics one got derm, after doing surgery and medicine prelims that they scrambled into. Ochsner doesn't have a dermatology program either but some LSU or Tulane residents (I never bothered to learn to tell them apart) rotate through. Why the ortho person didn't get ortho here nobody who wasn't in that room when they made that rank list will ever know. Maybe the ortho program wanted to assert their independence and show to UQ-Ochsner that they will make their own decisions and ranked the student, but not to match just to see what happens when the dust settles. Maybe there were better candidates that the program liked better. Maybe they didn't like the color tie that student wore to the interview that day. There is no way of knowing how these decisions are arrived at as they all happen behind closed doors with nobody outside of those doors ever knowing what happened.
It sounds like you're looking for guarantees that you will get a job in a competitive field because of this program. That is not and will never be the case at any medical school US based or not. There is no easy way into these specialties
even for US graduates. You are going to be at some degree of disadvantage as a foreign trained physician if you go into these programs. It is going to be even harder, maybe even impossible, if you have visa issues or don't have a green card. The fields we're talking about can pick and choose who they want based on whatever criteria they want - there are far more applicants than available positions. Throw a rock into a room of applicants for any of these fields and it'll bounce off of a dozen people with a 260 on step 1, good research and top whatever percentile you care to choose of their class.
Enter into this room the foreign trained medical graduate who has the numbers, but so does everyone else. They have good letters, but so does everyone else. They might have a proven track record, but so does everyone else. They're in the top 5-10% of their class but so is everyone else. Some programs will overlook being an FMG, some may consider it to be a dealbreaker and feed their application right into the shredder if it ever gets as far as being actually printed out. They are in a position where if they refuse to even consider FMGs
they lose absolutely nothing. They're going to fill their positions with very highly qualified candidates which are literally lined up around the block no matter what.
You can get into competitive fields through this program - that is demonstrated in the matches of years past. Just being an Ochsner student is no guarantee that you're going to get any kind of special treatment or official leg-up over other candidates even for in house programs and this is especially true of competitive fields where the programs have the luxury of picking and choosing from among the best applicants out there.
These fields are not out of reach of UQ-Ochsner grads. You'll still need to have phenomenal board scores. You'll still need research. The UQ-Ochsner program will facilitate these goals but it is on your own shoulders to do the work to meet the requirements to be a competitive candidate, you will need to be willing to sweat bleed and suffer. Even then you will still have the burden of being an FMG which some places will overlook, some places won't. Even then there is always a chance that things just don't work out and this is true even of US medical graduates.
If you are hardcore set on doing something competitive I would give some consideration towards trying again for a US based medical school as you will have one less disadvantage to have to overcome. You will still need to have incredible board scores and perform exceptionally well throughout your time there.