MS3 Ortho Chances and Aways

I apologize for another "MS3 ortho chances" post, but I have some unique questions that I have not seen on here yet that I've been wondering and Id like to just ask them finally.

MS3 at a non-top 40 US MD school without a home program

Stats so far:

Step 1: 267

Preclinicals: All honors except two HP in our Standardized Patient class each semester of MS1

Clerkships: Medicine, Surgery, and Family med all honors

Research: No pubs at the moment but have first author case report and another case series.... both about to be submitted to FAI. Also have 3 different osteoporosis projects that are submitted for poster presentations at national conferences in endocrinology and at ACP. Also currently working on clinical outcomes project for TKA. Have some basic science research from undergrad.

Im sure I am over thinking things and creating a lot of unneeded stress for myself, so Id love to get some thoughts and advice from others....

Im concerned that being from a non-top 40 school without a home program is going to hinder me. Ive spent as much time as possible with local surgeons learning the last 3 years, but I was curious as to how much where you are from plays a role in the match at the top programs we see talked about on here constantly.

Also, I am currently trying to figure out my away schedule for next year and I was curious as to how I should go about picking where I rotate. I was hoping someone who has gone through this process could give me some advice. I want to rotate at programs that are realistic for me... do you think I need not rotate top programs or are they within my realm of reason and it would be beneficial for me to prove myself there? Would it serve me to rotate at the programs I am truly most interested in or better to go to "safer" schools where I might get a better grade/review on sub-i and hope my credentials get me an interview at these other top programs? Any thoughts and strategies would be very welcomed.

Thanks in advance for any help with answering my questions.

With your performance on step 1 and grades I wouldn't waste time rotating anywhere you don't want to go. You should get plenty of interviews so use your aways for the places you'd truly like to go the most. Just this weekend in an interview a chairman asked me "if you really want to come here why didn't you rotate?"

I applied from a lower-tier medical school, although we did have a home program. I had research, but was concerned that some of the prestigious research institutions wouldn't interview me. The biggest thing you can do to help yourself if you want to go to these places (ie Harvard, Rush, HSS, Jefferson, Penn, UCSF, UCLA, etc) is rotate there. A strong away rotation followed by a good letter from a famous orthopaedic surgeon at one of these places can also go a long way towards securing you interviews at that program as well as at other well-known programs. I will say that without a home program, you should spread your away rotations across different program sizes (ie 3 vs 6 vs 12 residents per year) and types (ie community vs academic, trauma-heavy vs subspecialty-heavy) to see what fits you best. Location also is a big factor in getting interviews, so I would recommend at least 1 rotation at a program nearby so your letter would come from a surgeon people in your region know. Good luck.

I agree with butterfingerbbs above. Your stats are incredible. I however believe that being at a lower tier school without a home ortho program will limit you from the top tier of academic programs (HSS, Harvard, UCSF). Look at the resident list from those schools and ask yourself when was the last time they took a resident from a no-name medical school. It may seem harsh, but you don't want to waste an away rotation. Those programs can and will choose just 260+'s, and AOA's from top-10 medical schools.

Do one big name rotation and try to get a letter from a well known surgeon, which will help the fact you don't have a home program. Otherwise you should spread your rotations around middle tier programs in your area. You're a lock on matching, unless you're weird. So target places you're likely to match! Good luck.

Thanks to everyone who has responded so far. I greatly appreciate all the input and would always like to hear more experiences if people are able to comment.

Agree with the general comments mentioned. You've put yourself in a good position with scores, and at least have some research. I have a few suggestions, perhaps a bit different than what you have heard.

Coming from a medical school without an orthopaedics program, several questions are going to be raised. How did you come to love orthopaedics? How do you know you like it, or fit in? How much do you really know about orthopaedics, or orthopaedics residency? Did you only start learning about it, for real, when you started away rotations just a few months ago? I would ask you these questions, so think you should anticipate them, and work to eliminate even the idea that you don't really know what you are getting yourself into.

I've posted elsewhere about this, but think you in particular need to be knowledgeable about the history of the field - there are a few books, one I like that is a cheap ebook I mentioned in the section on 'what books to read' but there are a few out there. If you get asked what orthopaedics means or how the field got started and you don't have a clue, especially from your position, it'll look bad.

Assuming the local surgeons you've been working with are orthopaedists, or at least some of them are, I'd ask where they did their training. If they trained at places you might be interested with, and if they still have a connection to the program, that could be a HUGE advantage for you. A person could vouch for you, you do an away there and crush it - you'd be set. I've seen this work for people before, in not dissimilar situations.

In your position I'd say do at least 3 away rotations, ideally at places you've researched enough to know you'd really like to go. Don't expect to get a ton of interviews outside your geographic area except at places you rotated. And most importantly, be super prepared to absolutely crush your away rotations - there are several posts out there on this.