What's the Plan for Unmatched Ortho Applicant?

[TheBoneDoctah]

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First off, thanks for taking the time to help me. My school literally has zero idea of how this stuff works past the basics and it's really hard for me to find info that can guide me since none of my colleagues are in this situation. Here's my question:

I am going to be applying to orthopedic surgery in 2020 to both ACGME and all previously-AOA programs. As a D.O. student, I know the odds are stacked against me even though I have a decent app, 250+, 660+, few publications, research fellowship via my med school. I will be doing 6 audition rotations in D.O. ortho programs from July-December.

The specialties I can see myself being happy (in order) doing are orthopedics>>>>DR>anesthesia>>general surgery (if I did a fellowship).

I think (maybe not the best thinking) it would be wise for me to throw all my eggs in the orthopedic basket and apply extremely broad (50-70 ACGME programs and all the DO programs).

My question is in the "if I don't match into orthopedics" realm. The whole preliminary and transitional year thing is really confusing for me. If I did not match orthopedics this time around, I think what I would want to do is a preliminary or transitional year (whichever is correct) in surgery (I think, need your insight), and then dual apply to orthopedics and one of the other specialties I listed above (DR, anesthesia, general surgery).

Is my thinking correct in doing it this way? Do I apply for transitional or preliminary surgery? Do you know if it's common to match after doing this?

Again, thank you for your insight!

 

[enalli]

If you're this worried about it, why not just double apply to radiology from the get-got and minimize your odds of SOAPing?

 

[TheBoneDoctah]

If you're this worried about it, why not just double apply to radiology from the get-got and minimize your odds of SOAPing?

I have not done any radiology or anesthesia rotations and don't have LOR from either specialty. Also, trying to schedule interviews for 2 specialties + transitional year for rads is going to be a nightmare.

 

[enalli]

I have not done any radiology or anesthesia rotations and don't have LOR from either specialty. Also, trying to schedule interviews for 2 specialties + transitional year for rads is going to be a nightmare.

How likely is it that you can obtain either of those things as a surgery prelim, or would you plan to get them at the very end of 4th year?

 

[TheBoneDoctah]

How likely is it that you can obtain either of those things as a surgery prelim, or would you plan to get them at the very end of 4th year?

I can schedule anesthesia and rads rotations at university programs at end of 4th year.

 

[mvenus929]

I can schedule anesthesia and rads rotations at university programs at end of 4th year.

I think the issue more is that you won’t have time to go on interviews for two specialties during a prelim year.

 

[Gen3ricDO]

I put all my eggs and ortho and got incredibly close but still missed it and am now left on the didn’t match side. I SOAPed a TY but holy s**t I don’t recommend bankin on the SOAP.

If you really want ortho then dual apply ortho and prelims. You’d have to be comfortable applying again.

Looking back I wish I would’ve applied cat gen surg too. It’s feasible because DOs applyin ortho get 10 interviews max. You get your auditions and maybe a couple more.

So my best advice is to apply ortho and something else. Get 10 interviews in both then boom have no regrets.

Dual applying the second time around will be hard as you will have a job now.

 

[Gen3ricDO]

Applying again will be a rough sell btw. DO programs rarely interview non auditioners and MD programs rarely interview DOs, so your best shot will be your first shot.

 

[scarletgirl777]

I have not done any radiology or anesthesia rotations and don't have LOR from either specialty. Also, trying to schedule interviews for 2 specialties + transitional year for rads is going to be a nightmare.

I agree that's a lot. To cut down on interviews, you could try applying orthopedics and acgme radiology and plan to SOAP into a prelim surgery if you match as a backup to radiology. ACGME surgery prelims are not hard to get and are even available after the SOAP. But I also don't think you can choose a backup specialty without doing a rotation in it.

 

[scarletgirl777]

I put all my eggs and ortho and got incredibly close but still missed it and am now left on the didn’t match side. I SOAPed a TY but holy s**t I don’t recommend bankin on the SOAP.

If you really want ortho then dual apply ortho and prelims. You’d have to be comfortable applying again.

Looking back I wish I would’ve applied cat gen surg too. It’s feasible because DOs applyin ortho get 10 interviews max. You get your auditions and maybe a couple more.

So my best advice is to apply ortho and something else. Get 10 interviews in both then boom have no regrets.

Dual applying the second time around will be hard as you will have a job now.

If you're really only going to have 10 interviews then you could schedule a rads or anesthesia rotation a bit earlier in 4th year to help get letters if necessary and use the end of fourth year for auditions.

 

[Gen3ricDO]

If you're really only going to have 10 interviews then you could schedule a rads or anesthesia rotation a bit earlier in 4th year to help get letters if necessary and use the end of fourth year for auditions.

I agree OP should do a 2 week rotation in one of those to get the appropriate letters.

End of 4th year doesn’t matter however, audition season is July-November.

 

[scarletgirl777]

I agree OP should do a 2 week rotation in one of those to get the appropriate letters.

End of 4th year doesn’t matter however, audition season is July-November.

He would only need to go on auditions if he doesn't match though...for MD residencies it is okay to do your aways in the April or May before you apply. Also it's expensive but another option if your school allows is to delay graduation for a year and do research in the new specialty you are trying for while you reapply.

 

[Gen3ricDO]

He would only need to go on auditions if he doesn't match though...for MD residencies it is okay to do your aways in the April or May before you apply. Also it's expensive but another option if your school allows is to delay graduation for a year and do research in the new specialty you are trying for while you reapply.

I see what you’re saying. I was talking about dual applying. You’re talking about not matching. Got it

 

[TheBoneDoctah]

I agree OP should do a 2 week rotation in one of those to get the appropriate letters.

End of 4th year doesn’t matter however, audition season is July-November.

I really dont want to sacrifice a ortho audition for anesthesia or rads. I can only get a few ortho auditions as it is.

 

[GoSpursGo]

Honestly, if you really want ortho, I think you have to be all-in this year and be willing to reapply if it doesn't work out for you. Go all-out for ortho, maximize your auditions, and hope for the best.

Then if you don't match, I think you have your answer on ortho and should just apply straight GS or DR the second time around. As you said, it would be a nightmare to get letters and apply to multiple specialties in a prelim year, so just take the L on ortho at that point and move on.

 

[deleted950463]

4617 DOs applied in the ACGME match in 2018 and a grand total of FIVE DOs matched ortho in 2018.

Wonder if this and next year we’ll get more

 

[rokshana]

4617 DOs applied in the ACGME match in 2018 and a grand total of FIVE DOs matched ortho in 2018.

Wonder if this and next year we’ll get more

4617 DOs applied for ortho?
I get your point however
The real comparison would be how many DOs applied for ortho and how many matched...number is still gonna be small but your comparison is a bit hyperbolic

 

[TheBoneDoctah]

4617 DOs applied in the ACGME match in 2018 and a grand total of FIVE DOs matched ortho in 2018.

Wonder if this and next year we’ll get more

I bet less than 10 actually applied ACGME and actually stayed the course and didn’t bail out for AOA.

 

[Raryn]

I bet less than 10 actually applied ACGME and actually stayed the course and didn’t bail out for AOA.

In the 2018 match, of those that consented for their data to go into charting outcomes, 4 matched out of 17 applicants. That includes every DO who stayed the course and participated in the ACGME match AND ranked an Ortho program #1. Of course, 10 of those 13 unmatched folks ranked a single Ortho program. The other 3 ranked two. That data doesn't include the people who got zero Ortho interviews.

Of course, the scary thing is that if you look at the ERAS data at least 109 DO students applied to one or more ACGME-accedited ortho programs, and 280 total applied to AOA accredited ortho programs. There were 116 spots in the AOA match.

My bet is the majority of those DOs who failed to match Ortho in the ACGME match first went entirely unmatched in the AOA one, but that's a guess.

(Note: The actual data tables say *five* matched, not four, but presumably one person didn't consent for their data to go into charting outcomes).

 

[TheBoneDoctah]

In the 2018 match, of those that consented for their data to go into charting outcomes, 4 matched out of 17 applicants. That includes every DO who stayed the course and participated in the ACGME match AND ranked an Ortho program #1. Of course, 10 of those 13 unmatched folks ranked a single Ortho program. The other 3 ranked two. That data doesn't include the people who got zero Ortho interviews.

Of course, the scary thing is that if you look at the ERAS data at least 109 DO students applied to one or more ACGME-accedited ortho programs, and 280 total applied to AOA accredited ortho programs. There were 116 spots in the AOA match.

My bet is the majority of those DOs who failed to match Ortho in the ACGME match first went entirely unmatched in the AOA one, but that's a guess.

(Note: The actual data tables say *five* matched, not four, but presumably one person didn't consent for their data to go into charting outcomes).

Cool data to finally see, but in reality it really means nothing with such a small sample, ya know? Like it shows most people applying with Step 1 between 230-240. I mean, as an MD you would have a tough time matching with these scores. I feel like the people applying for ACGME programs before 2020 are either A. Stellar applicants with crazy huge you know whats. B. Ill informed folk. C. People with crazy connections that thought they had it in the bag with a 230.

Even with 4 of 17 matching, I think you will definitely a rise in overall acceptances (not saying it is gonna get easier by any means) just based on sheer numbers applying.

 

[Gen3ricDO]

I put all my eggs and ortho and got incredibly close but still missed it and am now left on the didn’t match side. I SOAPed a TY but holy s**t I don’t recommend bankin on the SOAP.

If you really want ortho then dual apply ortho and prelims. You’d have to be comfortable applying again.

Looking back I wish I would’ve applied cat gen surg too. It’s feasible because DOs applyin ortho get 10 interviews max. You get your auditions and maybe a couple more.

So my best advice is to apply ortho and something else. Get 10 interviews in both then boom have no regrets.

Dual applying the second time around will be hard as you will have a job now.

Applying again will be a rough sell btw. DO programs rarely interview non auditioners and MD programs rarely interview DOs, so your best shot will be your first shot.

Don’t listen to me from a year ago. Apply Ortho with a couple TYs and apply again, this time with a back up specialty. It worked for myself and a friend of mine.

I’m so glad I didn’t dual apply categorical surgery the first time, because I would be stuck as a general surgeon right now, but I matched ortho this year. Gen surg and vascular gave me a ton of interviews even being a PGY-1.