This was helpful for me last year, so I thought I'd chip into the discussion. I won't post my stats for anonymity, but as a whole (and this can be seen in that stats spreadsheet in another thread), lots and lots of ppl have step 1 of 260+, AOA, and multiple pubs, and it's so hard to distinguish yourself especially during interviews at certain places like HSS, NYU, WashU, Rush, etc. This process is a crapshoot, and choosing your aways wisely may be the most important thing you can do. I'll shed light on my personal "Tier 1" as these are programs I either rotated at or know the most about through talking to other interviewees, attendings, and just researching them just because they ended up being in my top 5.
Iowa:
Extremely well balanced program, with 6 residents (told us on interview day usually 3 of them are away rotators that end up matching). This really is the place to go if you're unsure if you want to go into private practice vs. academics, since the opportunities for both are excellent. The faculty are very down to earth, very committed to resident education (no fellows), and seem extremely approachable. Seems like the residents have a lot of operative autonomy and for the most part the residents seemed very happy. Research is also abundant, but it seems like most people there do administrative database work--for example, two of the residents there have mined NSQIP like crazy and each have like 20-30 pubs. Not so sure about the research opportunities otherwise since that's really all I kept hearing about in terms of publications, but it's Iowa, and I'm sure there's plenty of things to put your name on it if you choose to. A lot of people of course complain about the location, but some of the upsides are that Chicago is only a 3 hours drive, it's a good college down, and it's extremely cheap (a lot of residents bought in 3-4 BR houses and seem to be living very comfortably). A knock on it may be diversity, though, and a lot of the residents just seem extremely extremely similar. One thing to note also is that they did lose a lot of their spine faculty if you're interested, but I'm sure they'll get people to replace those lost.
NYU HJD:
Drs Egol (PD) and Zuckerman (chair) did not fail to impress during interview day. From what I've heard and saw, this is probably the most resident focused program in the Northeast, and one of the most in the entire country. The residents seemed to operate frequently and early, and I think the key really is the huge amount of volume they get here, spread amongst HJD (ortho hospital), Bellevue (VA), Tisch (main NYU hospital), and Jamaica (community hospital in Queens). Seemed to be extremely trauma heavy, but the resident class seemed to be pretty diverse in interests--6 out of 12 matched into Hand for example, all at their 1st choice. The location cannot be beat (lower east side of manhattan), but this does come at a very hefty price--although I heard NYU residents are the highest paid in the city. Another plus, if you're into it, are research opportunities, as numerous residents get thrown research projects and many come out with 40+ pubs if they want to. A potential knock on the program is that with a 100+ attendings, and 12 residents, it's very easy to get lost and attendings may not even know who you are, and hence you really have to be pro active and a self starter to make things happen here, otherwise it's easy to slip through the cracks. But then again, there's a very specific personality here that is very apparent in interview day that they seem to take (also very rotator heavy--11/12 last year), so it probably ends up working out in the end.
Vanderbilt:
In my opinion, the best program in the southeast, although I'm sure others would argue for Duke and/or Ortho Carolina. In terms of operating experience, I'm not sure what other program in the country is better than them. Attendings that I've talked to specifically rave about how well trained the guys that come out of Vandy are, and it's mostly because of the autonomy they get in the OR along with their insanely hard work ethic. During my interview day, you can tell that the residents here really really pride themselves on hard work--my interviewer for example just finished up 36 hour call (as a chief), and still decided to come in on Saturday straight from the hospital to interview me. The facilities were amazing (honestly the nicest gym I've ever seen in a hospital), and the attendings seemed very approachable. Research opportunities do exist here, of course, but it seemed like it wasn't as academic as other places I saw on the trail. Be wary that very very few rotators get an interview here--I heard only about 9 or so do every year. Nashville is a plus or a minus, depending on just how big of a city you want to live in, but at least it isn't too expensive and the weather is nice. All in all, an excellent program, and definitely one of the more underrated ones.
WashU:
What hasn't been said about this program? One of the best and really prides itself on its residency program--even talking about its doximity ranking on its residency website. Dr. Gelberman (previous chair) and Dr. Wright (PD) have done an amazing job in resurrecting this program from the 90s to the powerhouse it is now. If you're looking for a big time academic career, I can't think of a better place to go. The research opportunities here are probably the best, with residents partaking in anatomical/basic science studies and really high impact research (not just the database stuff). In addition, the operating experience IMO was top notch as well, not to mention the fellowship placement. My only concern, however, is that the program may have peaked and now may be at the risk of declining--a new chair, and HUGE names that just left for Columbia, including Lenke and Riew. I also heard rumors about the PD and others (including Dr. Yamaguchi) leaving as well for potential chairmanship, but these of course are just rumors. Other weaknesses may be the large amount of floorwork that juniors as well as seniors had to do, paper charting and over 4 EMR systems throughout the enormous hospital which seems like a pain, and the fact that St. Louis isn't one of the beautiful cities in America. Regardless of these factors, I think this is still an amazing place to end up and will continue to be in the future as well.
UCLA:
Probably the happiest residents I saw in any of the places I visited. It really is amazing to live here, great lifestyle, amazing city, perfect weather, seriously the best way to live as an ortho resident compared to anywhere else. That alone honestly made this my "top tier" program. The big knock on this program, however, is the operative experience here, as the case load seems lax and there's no way residents can live this well and still do 8-10 cases a day. After talking to residents, it is true, they don't operate as much as other places, but to their justification, doing 500 tibial nails doesn't necessarily make u better than the guy who did 250 if all it takes is say 150 to be proficient at them. Honestly, as a med student, I don't know what "good" operative experience really is, and I think we all base it off volume. I think these guys probably come out great surgeons regardless and their fellowship match is simply amazing. In addition, 2 residents do an additional year of research, which is a plus or minus depending on the person, but having a year off in downtown LA isn't a bad gig, plus can only boost ur resume. All in all, an excellent program IMO.
