give up on ortho

Seeking some advice from others regarding a personal situation: I have a friend who has been trying to land an ortho spot since we graduated medical school together (I just graduated from my residency this year). So it's been 5 years now. I have tried several times to convince him to go for another specialty but his heart is set on ortho. He has done ortho research, published a few papers, done prelim surgery years but to no avail. He's a hard worker but his problem is that his grades from medical school are not very good and neither is step 1 score. So it's not a personality issue. The problem is his academic performance in med school which just doesn't cut it for ortho, and which he cannot do anything about now. Anyone with any ideas about how I should approach this? Has anyone heard of an applicant matching after 5 unsuccessful attempts? He's doing research now at a 3rd institution and is reapplying again. I feel that he is wasting his life to pursue something that is apparently unattainable for him. Any advice would be appreciated.

Micky, that sounds like a very frustrating and heartbreaking situation. I do not believe there is anything you can do or say to dissuade someone who obviously has such an intense single minded focus. It takes a very special person to be willing to put their life on hold for five years without knowing there is a light at the end of the tunnel. Like you, I have difficulty identifying with this type of dedication which arguably has morphed into a self-destructive obsession. At some point I think you have to accept the cards you are dealt and move on. There is nothing magical about what we do in orthopaedics and I think it is naive to think that there is nothing else in medicine or in the world that can be rewarding both financially and personally. Honestly, I bet you have said all a friend can say. To me the questions are simply how long he is willing to put his life on hold (a decade, a half century?) knowing full well he may never match and is it really worth it? We probably know that in the big grand scheme of things it is not, but he seems to lack the ability to recognize this. Good luck. I cant offer any real advice but reassurance that there is nothing that you can probably do and that you should not feel guilty for not being able to help him move on. Maybe he is actually dysfunctionally happy with this situation and just scared of actually joining the real world.

I have never heard of anyone being successful after that many attempts. In fact, I don't know anyone who has attempted it 5 times. It's a form of insanity. I have no advice to offer either, unfortunately.

What about doing g-surg. Then, try to score a plastics fellowship in order to go into hand surgery. That's probably a reach as well.

This is a very difficult situation. I know a guy who is in a similar situation. He did 2 prelim surgery years and 6 years as an unaccredited house officer in the dept of orthopaedics and still was not granted the position. He finally resigned from his position this year in hopes to move onto a different specialty. What he finds most challenging is that even family medicine programs are reluctanct to accept him due to such a longstanding commitment to orthopaedics and not being accepted. You really cannot talk sense to someone whose passion has become a destructive obsession. As difficult as it is, leave him be. He must make peace with his situation and figure it out for himself. Good luck with your friend.

Has this guy done his step 3? If he has not, he may still have a chance.