1. Applying For Orthopaedics

2. Summary Statistics

3. Number of Contiguous Ranks

4. USMLE

5. Research, pubs, work, volunteer experiences

6. AOA, etc.

7. 2011 NRMP Program Director Survey

8. MS1 and MS2 Focus on grades, grades, and grades
The better you learn it now the easier your Step 1 review will be
MS1, MS2 grades count toward AOA
Make some connections in the department, attend the OIG meetings, find a mentor
Volunteer/service work and anything to spice up your CV, help you stand out for app’s later
Especially if you are involved long-term

9. MS1 and MS2 cont.… Do some research b/t MS1 and MS2
Either in Buffalo or where you may want to go
Continue with any long-standing projects throughout the rest of medical school
Supplement studying with coursework-specific Step 1 review if you have time, but DO NOT blow off class to study for your boards (you can’t review something you never learned)
Very possible to achieve high score studying only after MS2 classes end.

10. MS1 and MS2 cont.… USMLE Step 1
Most important “product” of preclinical years
Pick resources that work for YOU and make a reasonable study schedule that YOU can follow
Start as early as you feel you need to
Don’t let everyone else freak you out if they use different resources and schedules/timelines
No matter what method you choose to study, make sure to do plenty of practice Q’s
Do your best – some programs have cutoffs

11. MS3
Surgery rotation is the most important (besides ortho Sub-I), but be well-rounded
Most heavily weighted year for AOA (at UB)
Be a team player, don’t step on toes (residents or students), don’t be annoying, try to act like a junior resident within your scope of duties
Studying hard for each shelf makes review for Step 2 CK easier

12. When to take Step 2?! Step 2 CS – whenever you want to
Step 2 CK – three schools of thought
Didn’t do as well as you want to on Step 1 – take CK early (probably before October) so your IMPROVED score is available to programs for interview invitation decision-making
Did very well on Step 1 and not confident that you’ll improve – take CK closer to the deadline (2/1) so that your score comes out after interviews. Unsure of how a bad/failing score will affect your rank assuming you’re already ranked when score is out???
Did well on Step 1, but confident you can improve – take CK early
You can choose on ERAS application whether or not to automatically release future USMLE scores or to do it manually (programs can’t see what option you chose)
More programs are requiring Step 2 scores to rank you and some programs (i.e. Orlando) even require it before they’ll invite you for interviews. This is apparently a new trend.

13. UB Rotations General Surgery – Trauma service at ECMC
Ortho dept. is based here, so shake some hands!
Scrub ortho cases if trauma service is slow
Can use gen-surg LORs for ortho application
Ortho sub-I – At least one rotation at ECMC
ECMC rotation required to get department LOR from Dr. Mutty/Bone
Potential to get LOR from Dr. Krackow (big name in joints) if you also rotate at BGH

14. UB Rotations Surgical subspecialties
Orthopaedics elective at ECMC - Predominantly clinic-based, with exposure to a majority of the UB ortho faculty and many of the residents. Good practice doing ortho physical exams and casting/splinting.
Neurosurgery elective at Gates – Show up and leave when the attendings do, scrub spine cases all day long and learn a lot about spine, residents may let you do a lot in the OR, all without the pressure of having to impress everyone.

15. Away rotations Start researching potential programs now!!!!
Some programs have required documents that take time to get (i.e. titers for immunizations, N95 respirator mask fitting, physical exam, etc., etc.)
Try to do 2 to 3 away rotations – Many people say do at least one at a “reach” program and one “safety”
Regional bias – Rotate early and get LORs from [big-name] surgeons in regions where you’d like to end up
Contact program/clerkship coordinators for specifics
“is the rotation 1 month on a single service or 4 one-week mini-rotations?”; “Can you accommodate my school’s schedule?”
VSAS application vs. independent applications

16. Away rotations These are essentially month-long interviews
“Can we work with this guy/gal for 5 years?”
Be a good team-player
Don’t complain
Be on time!
Yes sir, yes ma’am
Study in your “free time”- esp. anatomy and cases you have scrubbed or will scrub
If you’re working with other rotators → work well with them! DO NOT ACT LIKE A GUNNER!
Try to meet the faculty that will eventually be influential in you becoming a resident at the program you’re rotating at (PD, chair, resident selection committee members, etc.)

17. Letters of recommendation
Get a LOR from ANYONE who offers to write one for you (even on your IM rotation)!!!
Ensure they’d be willing to write a “strong, positive LOR” or say thanks and move on
In general you need 3 LORs for ortho: some programs have specific requirements so read the “information for applicants” section on EVERY programs website you’re applying to (this sounds daunting, but it is essential)
Some say “orthopod and gen-surg LORs ONLY!”
Hopkins requires 4 LORs
Some programs have weird requirements like a supplemental evaluation form from each LOR writer (i.e. Yale)
Some programs have historically asked for a chief resident or internal medicine letter

18. Letters of recommendation
Strategize where you send LORs:
Have a LOR from an influential orthopod in a specific region?
LORs from a residency/fellowship graduate at a program of interest?
If they say “No more than 3 LORs” don’t send 4
Apparently Dr. Nielsen used to offer to read LORs and tell you which ones were “strongest” since we waive our right to see them. Maybe Dr. Milling would do this as well?

19. Letters of recommendation
Via ok, in person is better
Prepare a LOR packet
Cover page??? CV
Personal Statement – can ask for advice/suggestions on your personal statement at the same time!
USMLE Step I Score (and Step 2 CK/CS if available)
Unofficial Transcript
MSIII evaluations to date
Include the ERAS Letter of Recommendation Cover Sheet which provides the writer instructions on how to submit the letter
Include an addressed and stamped envelope to the OME (where the letters will be sent)

20. Personal Statement Keep it to one page OR LESS
Set up: so 1 page in Word = 1 page on ERAS
Left and Right Margins: 0.3”
Top and Bottom Margins: 0.8”
Font: Courier New
Font Size: 10
Keep it conservative and consider your audience.
Its much harder to write a unique PS that gets remembered for good reasons than it is to try to be unique and get your app thrown directly in the trash
Cover the basics: Why ortho? What makes you a good candidate (in a sea of good candidates)? Career aspirations? Yadda yadda yadda
Try not to use cliché statements or themes (“ever since I heard my ACL pop I wanted to be an orthopaedic surgeon”)

21. ERAS Application Apply broadly and apply to a lot of programs
Application cost is a drop in the bucket compared to your investment in medical education thus far
Lots of people applied to 70+ programs last year!!!!
Apply to all “tiers” of programs whether you think you’re a shoe-in or if you think you’re a weak applicant
ERAS opens September 1 and most deadlines are between mid-October and November 1
Apply right away even if not all LORs are in
Most ortho programs don’t offer interviews until after the MSPE (“Dean’s Letter”) comes out on Nov 1, so don’t freak out if you’re not getting interviews even when your friends applying to psych have already flown back and forth from California five times

22. ERAS Application
Include any “experiences” that you think you can spin into something that shows you will be a good resident and orthopaedic surgeon
Make sure you have some sort of research listed because many interviews have a dedicated “research room” and its hard to ask questions about research if you haven’t done any
“Hobbies & Interests” section – People want to know if you’ve got a life outside of work. I was asked about my outside interests on EVERY SINGLE INTERVIEW
My application verbatim: “Spending time and vacationing with my family. Snowboarding. Playing golf. Classic rock music. Fishing, hunting and camping. Running and lifting weights. Watching football and hockey. Learning how to cook. Boating and wakeboarding.”

23. Scheduling interviews
Have a phone with access and check regularly because interview offers are first-come, first-serve in most cases when you have options for several dates (some even offer more invitations than interview spots and you could end up without an interview if you reply too late – ROCHESTER!)
Check program websites and orthogate.com for dates that programs will be interviewing
Keep a calendar with all possible dates you may be offered an interview so that you can minimize scheduling conflicts if possible
Some programs have only one interview date!
Many program interview on the same exact dates!
If the only available date is one you have a conflict with then accept it and try to switch with someone else or be put on a waitlist for a more preferred date at the same time.
Most interviews will be in January so try to take at least that one month off. Some interviews may be as early as mid-November and a handful will be in December. Take two months off if you have that luxury, or schedule an accommodating rotation during Nov/Dec (EM, rads, etc.) if possible

25. Interviews
The only excuse to miss the night-before social events and dinners is if you’re traveling from another interview
This is where you can get candid answers to your questions
Residents may have a say in who gets in
Find out if you actually like the residents and the program!!!
Be yourself – don’t fake it
Be ready to talk about and be enthusiastic about anything on your application otherwise don’t put it in there
Be prepared to talk about research in detail
Have legit answers for: Why our program? Why this city?
Have some questions for your interviewers

26. Interview day surprises
HSS – mold a boat out of clay
Mt. Sinai – sew a hot dog or warm cheese, play operation, read x-rays
Minnesota – perform H&P on a chief resident who is acting as standardized patient and present to attending, order/read the x-rays
LIJ – read x-rays in a room with several attendings and tell them what you would do
CC – thread nuts onto screws with dominant and non-dominant hands, scope simulation

27. Interview travel
Southwest airlines – allows you to change your flights last-minute without penalty
Megabus – cheap city-to-city travel (as low as $2.50 round trip!!!!)
Don’t always book the hotels at the “discounted rates” provided by program coordinators
Priceline/Hotwire may get a way better deal
Carry your suit and any necessary items as a CARRY-ON, don’t check because it might get lost

28. Post-interview contact
Most people wrote some thank you notes ( or hardcopy) – don’t expect a response
Consensus – unlikely to change your place on the rank-list (usually made the evening of interviews)
“Love notes” – Many people apparently send “you’re my #1 program” letters to their #1 after interviews are done. Don’t have more than one #1 – people talk…
Don’t misinterpret what program directors say as “you are ranked to match here.” Even if they actually say that I would still be skeptical

29. Rank-lists, match
Rank programs in the order in which you’d like to end up there. People will try to tell you to “play the game,” but the match algorithm works in the applicants favor
Rank EVERY PROGRAM you interview at unless you would rather go unmatched than end up at a program
Again, take “love notes” from programs with a grain of salt (how much a program wants you shouldn’t alter how much you want a program anyways, right?)
Submit your list at least a couple days early to avoid possible technical problems
Cross you fingers!!!!!!!!!!!!

30. Final Comments
Despite what you read on orthogate, the average applicant is NOT junior AOA, 260 Step1, former Heisman winner with 37 JBJS pubs.

31. Thank you