UNMATCHED.....What to do.

I went unmatched last year, but everything has worked out great for me. The biggest error that an ortho applicant can make (in my opinion) is to scramble into a general surgery spot. The only thing I would try to scramble into would be an orthopaedic spot that didn't fill. The chances of that are slim, but it happened last year. I went after it and was told that I was their 2nd choice out of 100+ that applied for the spot after the match.

Instead of scrambling into a gen surg, I would talk to the head of your general surgery residency and tell them your concernes about not matching into ortho. My school was willing to hold a gen surg prelim spot for me in case I didn't get the unfilled ortho spot or in case I could not find a good ortho research year. Because my school's gen surg department was flexible, I didn't have to worry about being stuck with nothing. That allowed me to look for a great ortho research year.

I found that at UPenn with Dr. Lackman. I have posted details about my research year (post-doctorate orthopaedic oncology clinical research fellowship) in orthogate before. As an update, I have ranked 11 programs, and I am confident that I will match at my No. 1 or #2 choice. I have gained so much orthopaedic knowledge it's amazing. I have also been exposed to more orthopaedic oncology than any ortho resident will get during their 5 years. Some residency programs have NO orthopaedic oncology. I also have the confidence to write papers/chapters on any subject. Coming into this year with little research experience and 3 months (3 months of 4th year electives) ortho experience, I was able to write two spine chapters (about 9,000 words each) and co-author multiple papers in the first several months. Because I had no experience in spine, I took no knowledge for granted and wrote comprehensive chapters. I have been told by one of the editors that these two chapters are excellent and the most comprehensive of their kind. My CV has grown significantly in this year.

I'm not writing to toot my own horn. I just want to make it clear that YOU CAN GO UNMATCHED AND STILL BE HAPPY AND SUCCESSFUL. I have no doubt that I will be able to accomplish all my goals in the future. I am more confident after this year. I feel like I have something to prove to all those programs that didn't think I was good enough to be in their program last year. I have talked to residents that went unmatched and all of them have done very well in the program where they ended up.

If you are a realistic applicant and do not match, don't give up. My suggestions are:
1) Arrange a tentative gen surg spot for yourself ahead of time, so you don't feel forced to scramble into gen surg.
2) Call Dr. Lackman if you are interested in doing paid clinical research and improving your chances of matching next year (215-662-3350 or [url=mailto]rilack@pahosp.com[/url]).
3) If there is a open ortho spot in the scramble, go after it.

Thanks and let me know if you have any questions,
Jesse Torbert
[url=mailto]torbertj@pahosp.com[/url]
215-829-5143

Not sure I know anyone who thinks doing more ortho onc in a year than any resident does during residency is a good thing....

In all seriousness, I think you make a great point though, and I'm happy for ya.

Good luck to everyone today. If you find that you didn't match, you can call Dr. Lackman about his orthopaedic research position at his outpatient clinic office (215-829-5078) or page him (215-308-1009).

In response to Ortho2Be10's comment, orthopaedic oncology was my least favorite orthopaedic subspecialty, and I didn't understand much of it. After this year of research, I have a much better understanding and have grown to love the field. The great things about orthopaedic oncology are: you work all over the body and not just around one or two joints, everyday you see something amazing (it never gets boring), you get to put in amazing implants (total scapula replacement or replacing the entire femur with a total femur prosthesis), you are saving lives everyday, and patients really need your help. I imagine orthopaedic oncology has the potential to be a depressing line of work. This office (3 full-time ortho onc surgeons) is quite upbeat. The vast majority of people come in scared and leave either happy they don't have cancer or leave with options that will save their life and keep them functioning normally.

Even if you don't go into ortho oncology, there are still advantages to doing research in the field. You will probably have no problems on OITE oncology questions (which are often hard for residents). Even more important, as an orthopaedic surgeon, you are going to see quite a few musculoskeletal tumors in your career. Hopefully you will know enough about the clinical characteristics and imaging to diagnose these, decide which ones are bad and which are harmless, and get the appropriate patients to an ortho onc specialist with the appropriate work-up. I think this year has given me a great ortho oncology background as well as improving my overall ortho knowledge. It has also made me a much more sought after applicant. I would encourage anyone who doesn't match to give it serious consideration.

Thanks and good luck,
Jesse Torbert