I used this feed as well last year, and I had a pretty unique story this year, so i figured that I would share to hopefully help out the future applicants.
Med School: Texas school, not a top 50 and not an Ortho powerhouse,
Boards: Step 1: 250 Step 2: 259 (took in July, was available to programs)
Rank: Top 5%
AOA: Senior
Preclinicals: P on P/F scale
Clinicals: Honors in all clerkships
Ortho: Honors on all 3 aways, we do home rotations as a 3rd year and contributes towards our Surgery clerkship grade
Aways: 3, all of my advice was to stay in the South, and so I did. Two well known and reputable schools in the south with a work-hard mentality but some academic flair, and one smaller program.
Research: 2 published ortho papers in smaller journals, one as first author. A third paper submitted by the time applications went out
Extracurriculars: Collegiate rugby, lots of volunteering and medical mission stuff, Gold Humanism, etc.
What I was looking for in a Program: I really just wanted a program that was well-rounded and would offer me the opportunity to pursue whatever fellowship I wanted. I wanted to leave residency with enough connections that I wouldn't be limited in my fellowship search. I wanted strong didactics and stronger operative experience, research wasn't as important to me, though I am happy to participate as a means to an end. I prefer a family-friendly environment and really enjoy a strong sense of camaraderie in a program. I plan on pursing private orthopaedics in the end, so operative skill was placed at a premium.
How many Programs:
Applied to: 72
Offered Interviews: 24
Attended: 13 (Caveat: I attempted to make every night-before social as an opportunity to truly get to know the program and to see how the fit was. There were plenty of scheduling conflicts, but I also didn't do any back-to-backs if they prevented me from missing a night before social).
In random order:
UT Southwestern (6 residents per year): take 6-10 rotators per month during high season. Very hands on rotation, spend a lot of time in the OR/on consults. Program is run so that 2nd and 4th years are partnered up on each service, and the 2 runs most of the service. Pay your dues as a 2 with very heavy hours, so that you can have a little better lifestyle as a senior resident. Definitely trauma heavy at Parkland Hospital, but all subspecialties represented well. New Chair Dr Wukich hired from UPMC last year and has made it his mission to beef up the academics, requiring certain percentile scores on the OITE to moonlight, etc. Residents are very close with one another, especially within each residency class. Very camaraderie-based program, residents have a big say in who gets interviewed. Take back probably 75% of rotators for interviews, and PD Dr. Gill mentioned that they favor Texas applicants, but especially rotators from Texas. Night float system for call. 3rd year rotation lasting 6 months at Texas Scottish Rite Hospital for Peds, meant to be “mini fellowship.” Research is definitely not a focus of the program overall, but more of a push that way since the new Chair arrived. Option to spend 3 months of 4th year in England acting as a “junior attending,” with housing paid for by the program. Most recent graduates obtaining their 1st or 2nd fellowship choice. One trauma fellow, as well as many fellows on Peds while at TSRH, but very little fellow interference, as this is definitely a resident-first program. Current weaknesses: probably Sports and Hand, with recent turnover in both, but at the interview day, mentioned 2 upcoming hires this year in each subspecialty, so that remains to be seen. BOTTOM LINE: great Texas program with a definite emphasis on operative skill, with Trauma being the big selling point. Probably not the place to choose if you want to churn out research projects, though the opportunities are available if you’re willing to put the work in.
Vanderbilt (5 residents per year): take approximately 10-12 rotators per month during high season. Hard working rotation, be prepared to come early and stay late, especially if you rotate on trauma (the most hands-on for a med student rotator). Changed their away interviewing this past year, now interview all rotators at the end of their away rotation. Pros to this: don’t need to pay to fly back for an interview, program also won’t learn much about you in one day that they couldn’t over the course of a month, and vice versa. Cons: won’t have full CV or Letters of Rec when they interview you, and they also mention that they will not have any contact with you after the away, prior to rank list being finalized, so you will never know exactly where you stand with them. As for the program, very hard-working with a definite academic flair. Didactics for 1 hour every morning, always attending-led, definitely very strong. They pride themselves on their ability to think through complex problems and list of the classifications of everything, as well as their strong basis in basic science. Another benefit of these didactics is the camaraderie built by having the entire residency together 5x/week for an hour. Call is pretty brutal here. One 2nd or 3rd year is in-house with a senior back-up at home, and the resident on call covers the main hospital, Children’s Hospital and VA every night. Even though all three are on the same “campus,” it’s a solid 10 minute jog from one to the next, and often times consults are building up in one while you take care of the other. As a resident, you won’t sleep at all, but will get a post call day. As a rotator, you won’t sleep at all, and you will also be expected to work the whole next day, which can be exhausting, but make sure not to complain or show that you are tired (if possible). Every resident seemed truly excellent, both operatively and academically, and the residents come from all over the country and are not just from Ivy League-type schools. Fellowships of choice seem fairly easy to obtain here because the Vanderbilt name has been well developed, and their graduates perform elsewhere. 2 Fellows on trauma, 1 on hand, one on oncology, not completely sure about other subspecialties, though interference is minimal and many fellows were very helpful to both residents and students with their teaching. Limitations: very few, however work/life balance definitely suffers here secondary to the pride they take in working hard and killing themselves, and the schedule doesn’t get much easier as a senior resident. BOTTOM LINE: excellent program in a hard-working environment with the resources to allow you to obtain whatever you want in the future. Definitely must be willing to work extremely hard to fit in here.
Tulane (3 residents per year): 2-3 rotators per month, with 1-2 home students during high season. Rotation consists of 1 week on 4 different services. The benefits of this being that you get to meet most people in the program, and work with most of the faculty in some capacity. Call is split in the major hospital (UMC) with LSU New Orleans with each program taking every other night of call. Technically every night is home call, though you spend more time at home on nights when you are on call at Tulane vs. nights at UMC which are much busier. The program itself is a bit in flux at this time, moving from 4 residents/year before Katrina, and then went down to 2 before accepting 3/year again. The Chair, Dr Savoie, a big name in the Sports world, particularly with Shoulder and Elbow, is pushing to bring the residency back to 4/year and to stabilize it. He has improved the program greatly since taking over, improving didactics and expects a lot of his residents. Didactics are once a week on Tuesday nights for 4 hours, and are usually split between resident-led vs. attending-led, with some case based presentations from each service. The Trauma service is probably the most hands-on of all of the services, and the PD, Dr. Gladden is well known in the South and mostly only scrubs the complex trauma cases. There is 1 Sports fellow who rotates through from the program at University of Mississippi, but the program does not otherwise have any interference from fellows. Most residents are former Tulane med school graduates, but I was told that they have plans to veer away from that path and are encouraging more rotators each year. With Dr. Savoie’s investment in his residents, and the weight that he holds (particularly in the sports world), recent residents have obtained great fellowships, though it may be harder to obtain them outside of Sports. Weaknesses: the program is still very much in flux, and is still trying to get their rotation schedule optimized. Hand also seems to be a weakness here, with most operative experience being done with private practice surgeons in the city, though they have plans to hire a full time hand faculty member soon. BOTTOM LINE: strong program in the South that is on the rise, with may opportunities available, but still in flux and should improve vastly over the next few years.
Mayo Clinic (12 residents per year): Not a very rotator-heavy program, especially for being one of the biggest names in orthopaedics. Amount of residents who were former rotators varies from class to class, with the most being 6/12 in one current class, while another class has 0/12. They do 1 interview day, invite about 75-80 people with a mix of rotators and non-rotators. Rochester, MN is a small town, with the bulk of the population involved somehow in the Mayo clinic. The program definitely highlights its family-friendly nature with most residents being married, and many with kids. Probably not the program for someone single or preferring a big city, though Minneapolis/St. Paul are only approximately 45 minutes away and have all of the big city amenities. Rochester is also very cold, though there is an elaborate “subway” system which can take you basically anywhere around the Mayo clinic without needing to ever step outside. Beyond the obvious prestige of the Mayo name, this program offers some of the best opportunities available in orthopaedics. The program completely follows a mentorship model, where at every level, the resident is one-on-one with one of the biggest names in each subspecialty. The faculty obviously expects different things from junior vs. senior residents, but you remain one-on-one throughout. This opportunity is unique, and obviously has its benefits. The drawback to this would probably be the lack of uniformity in each resident’s experience, as not every resident will work with every faculty member during their residency. The program is VERY resident-first, with the opportunity to tailor your experience from day one. For example, there are 3 opportunities for 3 month rotations away from Rochester (Shock Trauma in Baltimore, a Sports rotation at Mayo Jacksonville and a Peds Rotation in FL as well). The rotations are all paid for by the program, with housing, transportation, etc. included. There are advisory meetings early on to discuss your future goals, and the PD Dr Turner is very flexible and helpful in tailoring your experience. Fellows are present in virtually every subspecialty, as is the norm at any “big name” program, but with the mentorship model, your only interaction with them is if you want to learn something from them. Many will take you through approaches and dissections on cadavers which are available pretty much on-demand, which is a unique experience. The facilities themselves are world-class, and there are limitless opportunities here. Research, operative experience and academics are about as good as you can get anywhere. The opportunities for research in anything are available, but I didn’t get the sense that it was really forced upon anyone. They also seem to be just as fine with one of their residents going private practice as they are with those going into academics. Weaknesses: not many from what I saw, outside of the obvious: Rochester. If you are single, want a very trauma heavy experience (though the Shock Trauma rotation takes care of that), or want a big-city experience, Mayo may not be for you. BOTTOM LINE: A program considered one of the best in the country for a reason, very strong in every facet with hands-on experience offered because of the true mentorship model.
Wash U (8 residents per year): Kind of an irregular rotator experience with rotators being able to come and go as they please, with rotations anywhere from 1-4 weeks long, and no official curriculum. Because of this, they usually get approximately 45 rotators, who they interview at the end of their rotation, and then another 90 or so on 3 interview dates for their 8 spots. This program is another prestigious one with limitless opportunities and a good combination of operative experience alongside academics and research. I got the feeling that research was a little bit more “encouraged” than other places, and it seemed like everyone here was churning out papers throughout their time. The operative experience is a mix between a mentorship model and a team based environment on some services like trauma, but from what I have seen from graduates of the program, they leave the program with excellent operative skills. You rotate through each service as both a junior resident and a senior, in an effort to perfect your skills in each subspecialty. One draw to the academic side of the program is the “Essential Readings” chosen by Dr. Wright (former PD) and continued by current PD (Dr Klein) which choose a set of important chapters and articles for each level while on their service. This tailors the education portion of the program, allowing for guidance while ensuring academic excellence. The residents seemed close, but not as close as I have seen at other programs, but all seemed happy. There are fellows in most subspecialties, though there isn’t much interaction between residents and fellows. Because of the prestige of the program, the graduates are able to obtain just about any fellowship that they want. There aren’t many weaknesses of the program itself, though some people aren’t thrilled with the prospect of living in St. Louis. The city offers many big city amenities without being too big or spread out, with most places easily reachable within 15 minutes driving. BOTTOM LINE: extremely well regarded program offering a complete academic, operative and research experience with an emphasis on the research side and the opportunity to catapult your career in whatever direction you would like.
NYU Hospital for Joint Diseases (14 residents per year): The biggest residency program in the country now, since adding 2 spots, however, 1-2 of those go directly to an NYU student(s) who graduates early with direct admission into the ortho program. Another 1-2 spots go to research residents, so it is mainly a competition for the other 11 spots. This program is VERY rotator heavy, and I was under the impression during the interview date that all non-rotators were competing for 2-3 spots out of the 11 remaining spots. Most classes are made up of all rotators and home students +/- 1 or 2 residents. The program itself is another one of the powerhouse programs in the country with virtually limitless opportunities for whatever you could want. They are more blue collar/hard working than many of the other “big name” ortho programs, and they seem to enjoy their reputation as a program that will work you to the bone. They definitely push research here, but with the resources available (and the fact that their PD Dr. Egol and Chair Dr Zuckerman wrote the Handbook of Fractures), research is a well-oiled machine and it doesn’t take too much effort to publish. Most of the operative experience is team-based, and there is a lot of resident-resident teaching. The program itself is also very hierarchical, where junior residents have little contact with the attendings, and presentations get passed up the line via seniority. Most of the 1st year consists of floor work, with a lot of the second year consisting of consult coverage, and then most of the operating takes place over the last 3 years, though there are opportunities for some operative experience during the first 2 years. NYU covers the busiest trauma hospitals in NYC and is continuing to expand, so there is plenty of opportunities and uncovered cases that residents can jump in on. One new change (and big plus for the program) is the new institution of moonlighting. Basically, every Saturday that residents work (even if they were already scheduled to be on call that day), they make 75 dollars/hour to operate. Basically you make extra money just for doing what you would do at any other residency program. They also have an orthopaedic urgent care clinic called ICare which can provide senior residents with more moonlighting opportunities, as they can act as covering attendings while the junior residents do all of the work. NYC is expensive, but the salary is about 10 thousand more than most other programs in the country to try to defray the cost. Out-of-towners also get priority for subsidized housing in apartments close to the hospitals for about half the price of an apartment in that area (still about 2000-2500/month for a 1 BR/BA). The residents seem to get along very well and seem to fit the work hard/play hard model, which is something they are definitely looking for in their future residents. BOTTOM LINE: big program with a great reputation and limitless opportunities as long as you like the big city life, like a hierarchical model and are willing to put in a lot of hard work.
University of South Florida/Florida Orthopaedic Institute (4 residents per year): They seem to be a program with a good mix of rotators/non-rotators, with about 4-6 rotators per month during high season. The program is fairly new, ~10 years old, and has a very strong reputation around the country, particularly for their Trauma experience. Their Chair is Dr. Roy Sanders, one of the biggest names in F/A and Trauma, and their PD is Dr. Mir, who was a former Trauma attending at Vanderbilt. They have 3 Trauma fellows/year, but the program is very resident-central and the fellows don’t disturb the overall experience. There is a strong partnership between the academic side of the program and “the industry,” since Dr Sanders is one of the big pioneers in the creation of various prosthesis/biomechanical technology advancement. This allows for a lot of biomechanic research opportunities, as well as some opportunities to learn the business side of orthopaedics. The program seems to offer operative experience early and often and all of the residents seemed more than competent in the OR and from an academics standpoint. The name recognition of the higher-ups in the program allow residents to obtain virtually any fellowship that they desire, particularly in F/A and Trauma. Good mix of married/single residents, and all residents get along very well. Tampa is a great city, expanding quickly, and offers many big city amenities and close proximity to the beach. There is also a budding craft beer scene in Tampa/St Pete, if that is your sort of thing. BOTTOM LINE: strong operative program with research opportunities alongside big names and a good reputation, particularly in the south.
Greenville Health System/University of South Carolina (4 residents per year): One of the best kept secrets in orthopaedics. They take a mix of rotators and non-rotators, and probably have 3-4 rotators each month during the high season. They are affiliated with the Steadman Hawkins clinic, which is one of the most highly regarded Sports Medicine fellowships in the country. They send out a specific survey prior to offering interviews, and choose to offer interviews only to people who have shown some hand-eye coordination abilities in the past, i.e. college sports, instruments, etc. Their PD, Dr. Porter says that he places a preference on hand-eye coordination and personality over test scores because he “is here to make good surgeons, and you can’t teach someone hand-eye coordination.” He also enjoys the fact that his program is largely a secret outside the southeast, as he would rather attract a “certain type of resident.” The interview day is one of the most unique in the country, with 7-8 unstructured interviews with various faculty members, all completely untimed and lasting anywhere from 20 minutes to over an hour. They really want a certain type of person here, and they want to take the time to have their best fit residents. For this reason, they offer about 5 interview dates, with each date consisting of 7-9 interviewees. They match very well into fellowships, and have a great reputation at their fellowships due to very strong operative skill. This is probably not the place for you if you want to churn out research or become a big academic physician, but they do offer research opportunities like any other program. They easily surpass the case-log average for the country and place a great emphasis on operative experience and skill. Great experience in both Sports (Steadman Hawkins and Blue Ridge (Clemson sports)) and Peds (Shriner’s). They are one of the few programs that I have never heard anyone talk bad about, and their reputation is very strong across the southeast. Greenville as a city is another well-kept secret with close proximity to Asheville, NC (big craft beer mecca) and not far from Charleston. It is a young city with a fun downtown area and semi-pro sports teams, and is very affordable. BOTTOM LINE: lesser known program with a great reputation among those who know about it, (i.e. fellowship programs), offering a great operative residency experience in an up-and-coming city.
JPS (4 residents per year): A program with a good mix of rotators and non-rotators, with a slight lean towards rotators (like most programs). Mostly Texans with a few out of state residents. Definitely an moperative-heavy program, with less of an emphasis on research. The strengths of the program at this time are probably Joints and Trauma. PD Dr. Wagner is a big resident advocate, and has continued to drive the program forward and emphasize the academic side to compliment the strong operative experience. Dr. Wagner also has a strong reputation in the Ortho world, and has helped his residents obtain very high quality fellowships. The residents are all very close to one another, and there is a good mix of married and single residents. The program has a reputation for being a bit of a cowboy residency, where residents are in the OR with little guidance, but I was told by most interviewers and residents that the cowboy perception is a bit outdated and doesn’t reflect the current situation of the program. Fort Worth is a great city, combining some big city amenities with affordability, as well as close proximity to Dallas. BOTTOM LINE: strong operative program in DFW with an emphasis on camaraderie and operative skill.
10. Baylor Scott & White/Texas A&M (4 residents per year): Relatively rotator heavy residency program, mostly Texans. Heavy emphasis on operative skill over research/academics, though there have been some recent hires to increase research output. Strong Joints program, as well as strong Peds with young attending turning down a job at Rady Children’s to stay in Temple. Very nice facilities with a separate building for Ortho stuff, complete with outpatient surgical center and clinic. Residents are all close with one another, many are married with kids. Temple is a very small town, but close to Austin and not far from Waco, about 3ish hours south of Dallas. Temple is extremely affordable and most residents own their own house, and all houses are within 15 minutes of the hospital. Via conversations with rotators, residents are very skilled operatively. Definitely a team-first mentality, and like most places, front loads the bulk of the work with a very tough 2nd year. BOTTOM LINE: operative-heavy program in a small town Texas environment.
Others: Baylor Dallas, UNM, Boston University
Unable to interview due to scheduling conflicts: UC Irvine, Loma Linda, Texas Tech (Lubbock and El Paso), Baylor Houston, Allegheny, Oklahoma, UT Austin, UTMB, LSU New Orleans
NOT RANKED
None. Would have been happy at any of them.
Matched at: Here's where the crazy story comes in: NONE (at first).
I was absolutely floored to find out that I did not match on Monday of match week. I had received good feedback on all of my aways, and interview season had gone well, I certainly did not expect to be in that position. That being said, I was all set to start applying for research vs. prelim vs. extending my 4th year. By the grace of God, there was one ortho spot in the SOAP this year, and I managed to scramble into that, and I'm absolutely pumped to start.
Advice for future applicants:
I have a few regrets in how I approached the process:
First, I didn't play the game and tried to let the match work itself out. By that, I mean that I that I did the typical thank you notes and made sure to express great interest during my interviews, but did not tell any program that they were my number one. My actual number one didn't want post interview contact, and I thought that it would be disingenuous to tell even my 2 or 3 that they were my number one, in case I matched at my one. I neglected to tell them anything like, "I'm ranking them very highly" because I thought that they would see through that. My goal was not to burn future bridges, which I completely regret. My advice: Really pinpoint a few programs that are high on your list and absolutely inundate them with your interest. Of course don't annoy them, but really make sure that they know that you want to be there and there more than anywhere else. After getting some feedback from some residents that I became close with during aways, most mentioned that the guys that matched at their program went that route, and they told me that while I was very much in the ballpark of their ranked to match spots, that they felt like not telling the PD that they were my number 1 may have affected my chances. Whether or not that is true, I'm not sure, but that was the feedback that I received. When the one Ortho spot became available in the SOAP, I played the game harder than I ever thought I could. As soon as the PD had contacted me to tell me I was in the running for the spot, I emailed him, I emailed my chair to email him, I texted my dean to email him, I called his secretary multiple times to express interest, and that finally got me the spot. So I say play the game, and play it hard.
Secondly, I skipped some interviews due to scheduling conflicts with the night before dinners, and while I think that is a great idea in theory, it didn't work for me. It allowed me to get to know the program and see how the residents interact, but I just don't think it has all that much bearing on rank lists. I had a great time with many of the residents during those socials, ended up in some deep conversations with some attendings, and still found out that Monday that I didn't match. Maybe the better advice is just to play the statistics.
Third, HAVE SOMEONE GO TO BAT FOR YOU. I am unfortunate that I come from a little known program and we don't have a lot of support from our Ortho department. Nobody knew my chair when asked during interviews, and even though some of our applicants had good relationships with him, I don't think that he went out of his way to help us during interview season, and wrote everyone generic LOR because he is so busy. I think that it is imperative to have someone who can put in a call for you and vouch for you as there are so many good ortho applicants and I know of quite a few this year that didn't match with similar stats to me. I genuinely think that the name of your school matters, and while I was able to obtain quite a few "Big Name" interviews, I'm sure on paper and even in the interview I looked similar to a few "Ivy League-type" applicants, so why would they choose a guy from a small school over that?
4th, Be prepared for absolutely anything to happen. I got ample interviews, interviews in all "tiers" of prestige, and still got nothing. Again, I can't say for sure what happened, just that I got feedback from some residents and attendings from my aways and interviews, and they were as surprised as I was to find me in my position last week. I got the typical, "you were definitely in the running for our spots, we really liked having you, and you must have just been the unlucky person who fell through the cracks this year. Must have just been the person who was one spot too low on everyone's rank list." For me, I think it was a fantastic group of applicants this year, and there was a ton of competition. I met some amazing people on the trail this year during aways and interviews, and I think all will make great Orthopods. I think that you can check every single box out there, have no red flags, be a normal guy that gets along with almost everyone and still not match. I know that to be true because I know of a few instances of it. All I can offer to future applicants is: check all of those boxes, work your absolute hardest, and hope for the best. If you genuinely want to be an orthopaedic surgeon, you can make it happen.
I hope this helps anyone who is applying next year or in the future, and I am definitely available for more info if anyone wants to PM me.
