I read the post, and as I didn't match first time around but did the second I had to chime in. I think some great points are made above.
First, the whole where else did you interview and where did you rotate question. Programs don't invite people to interview unless they are comfortable with them as a potential resident at that program on paper. After that cut has been made they look for reasons (any reasons) to rank the applicants. They definately want someone at their program who wants to be at their program (they've had both in the past and someone who does not want to be there is a huge drag on the other residents and the attendings not to mention the mess it makes when a resident leaves a program). These questions are a way for them to start to guage your interest in them. Unfortunately, it's a game. Those who play it well will match. You don't need to be dishonest, but don't fool yourself by thinking they are being totally upfront with you. If they tell you things like "you are an exceptional applicant, and I think you would do very well at this program" (heard this and varriations at several interviews right before not matching at all), understand that they are simply trying to get you to bump them up on your rank list. If you rotated only in the midwest and you're interviewing at a California program, they want to know so they can bump you down the list. Applicants start looking very similar once you get to those you invite to interview, and the little things start becoming big things. It is in their best interest to ideally have every applicant rank their program number one so they would have their pick of whomever. They will do whatever it takes to acheive or come close to that (do a little search on the ask the attending forum and see some telling confessions by attendings).
Second, contacting your top programs. If nobody did this it wouldn't matter. However, many applicants do this so it does matter. If you are that applicant who is higher on the rank list but does not call, you will be bumped in favor of the applicant who showed interest. Again, programs want applicants who will be happy at their program. Case in point -- three applicants in my class interviewed at a certain midwestern program. Only two of us actually were initially invited to interview. The third had rotated there, made several phone calls to residents and attendings after being rejected for an interview and eventually actually was given an interview. Guess which one of the three matched at that program. Not the two who made the initial list, but the one who didn't make the cut initially but showed the most interest. Don't discount this. It is truly a big deal. However, don't lie. That's also a big deal. Ortho is a small world, and you can get caught in telling multiple programs they are your number one pretty easily.
Third, the outside the match thing. I turned down an offer outside the match too, but thankfully matched. It's a long story, but needless to say an extremely difficult and personal decision. It had mostly to do with family (ergo the where did you rotate and where have you interviewed question from interviewers). I felt strongly that I should turn the offer down, and I'm glad I did. However, that didn't prevent me from feeling sick for a couple days and second guessing myself for a couple months afterward. I had received one of those "you're in our top whatever" emails that helped me (though, again, the email could have just been part of playing the game).
To both Iliz and Calvin the best of luck this time around. It's very difficult to do this twice. Matching is worth it all, however, so stick with it. I got sick of the why ortho and why didn't you match the first time questions too. However, I don't answer them anymore. I just go to work and am thankful I'm an ortho resident. You'll get there. I have a friend who went through it three times and failed only to get a last minute spot outside the match. You can bet he was on cloud nine when that call came. Hang in there. Your dedication will get you through anything residency can throw at you, and you'll appreciate being an ortho resident more than most residents really can.
