depends on the rest of the application ... and not all schools give us a GPA or school rank

Situation is just too vague to say who's more competitive... Too many questions unanswered, such as: 1) Reputation of med school (e.g., a 3.25 at a top 25 med school is probably a lot different than at a less respected med school) 2) When were the lower grades earned to average a 3.25 (i.e., did the student struggle more with the basic sciences, or clerkship grades...I think most would argue that clerkship grades are more important, especially surgery, IM, completed ortho electives, etc.) You may have indirectly been asking about the whole Step 1 cutoff issue as well. You can refer to the multiple posts about this to try to answer that.

theres actually a fair amount of published work that has been done about evaluating applicants in orthopaedics... pubmed 'orthopaedic residency' if interested. in general, clinical grades are a bigger factor than USMLE I. pre-clinical grades fall further down the list, so GPA and class rank probably aren't as meaningful as 3rd year grades alone.

i think you guys get a little too caught up in the USMLE score ... it really is only one factor ... yes it may be used ... but it has to be kept in perspective with everything else ... 1. clinical grades 2. AOA (which in some schools is political and others is based on clinical grades) 3. research 4. recommendations 5. medical school 6. location (of med school and HOME) all of these things come into play to some extend, each residency is different in there criteria ... and each reviewer is different see http://orthopaedic-residency.blogspot.com/ it may help some ... and sometimes is just full of hot air ....

what about leadership and service? i think those speak much more to a person's character than people concentrating on ortho for their whole med school careers? to me that shows much more versatility and is probably a better judgment of personal character and aspiration than sucking up to get ahead...

leadership is also an important factor (in my mind) ... it is very hard to pull out of some applications ... it comes up morte during the interview process ... things you can pull out of the application are like president of X etc. ... some volunteering stuff as well ... the problem with this information is to sift through the Fluff to get the real leadership stuff ... for ME ... i do look at leadership stuff ... i classify it in the "other" category ... i will tell you the things i look at when selecting applicant to interview ... i give a 10 point scale 2 points to each category (0 to 2) 1. clinical grades 2. medical school 3. Honors (sugery/ortho) 4. AOA/research/recommendations/elected leadership positions (the other category) 5. USMLE (based on what the national average is for the year) so those are the things that I look at in an application ... everybody has there own way ... can't speak for anyone else again, see http://orthopaedic-residency.blogspot.com/ it may help some ... and sometimes it's just full of hot air .... i'll try to write about leadership characteristics in the next few days Staff

i think you guys get a little too caught up in the USMLE score ... it really is only one factor ... yes it may be used ... but it has to be kept in perspective with everything else ... 1. clinical grades 2. AOA (which in some schools is political and others is based on clinical grades) 3. research 4. recommendations 5. medical school 6. location (of med school and HOME) all of these things come into play to some extend, each residency is different in there criteria ... and each reviewer is different

Great points... And to add a little weight to the argument for the importance of clinical grades, I think there are now 2 or 3 studies that, based on outcomes of faculty and peer evaluations of a resident's technical and interpersonal abilities, third year clerkship grades are the most significant single indicator of performance... Not that I subscribe in any way to the idea of creating evidence-based residency selection algorithms (in fact, I think that would discount a lot of unmeasurable variables, such as "fit"), but for those that exist third year clerkships are THE major factor with statistical significance.

Does good clinical grade only mean A or honors or High Pass? or Is getting a B or Pass the equivalent of not being a good clinical grade.

Dear DrHibbert - Out of curiousity, do you by chance know where I might find those articles. In particular, I am curious how they measured the variables you mentioned (outcomes of faculty and peer evaluations of a resident's technical and interpersonal abilities). Thanks in advance. md007

clinical grade importance really depends on the grade distribution ..... some schools have a 50%honors rate in some subject and others only a 20% .... so which honors is more important? .... also depends on the school you attend ... a top 25 or 30 school has better competition (based on undergraduate success) so the honor may be a stronger honor ... so although clinical grades are great and you need to do the best you can ... there are more variables ... it is not in a vacuum ... as with many other factors .... that is why so many programs look at the USMLE ... now i agree with most that it is not the best way of evaluating all the factors that make a good physician/surgeon, but it is the only thing that everyone has in common ...

Here's a good article in JBJS (2002) looking at resident selection criteria. http://www.ejbjs.org/cgi/content/full/84/11/2090 or on pubmed http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12429773&query_hl=12&itool=pubmed_docsum Hope this helps

thanks ... i forgot about that paper ... for your convenience i have add it as a link on my blog links section ...

Sorry for the delay, but it took me a couple of days to find these again... These are the papers which seem to indicate the significance of third year clerkship grades. Turner et al. A quantitative composite scoring tool for orthopaedic residency screening and selection. Clin Orthop Relat Res 2006; 449: 50-55. (out of Mayo) PMID: 16735881 also Dirschl et al. Correlating selection criteria with subsequent performance as residents. CLin Orthop Relat Res 2002; 399: 265-71. (out of UNC/Wake) PMID: 12011720 not to mention some others listed in the references sections of each...

hey i have placed those articles on the my blog page to make them easier for you to get .... remember even with all the justification in the world with literature, you still need to execute it well ... “Nothing in this world is a gift. Whatever must be learned must be learned the hard way.” ~ Carlos Castaneda not too hard though got to go do my long run ... i wish it would get warmer outside ... dag on ice