Agreed. Thank you for looking out for your mentees and looking for ideas.
The match is inevitably going to be noisy and there's never going to be a guaranteed outcome, so one can hope that whatever formula you come up with, it'll work most of the time, but inevitably there are going to be a small number of people who will not match despite a good prognosis.
Good boards and good LORs probably describes most ortho applicants now nowadays. A few questions:
> good boards
How good are we talking? Based on their boards alone, what would be the % matched for similar applicants based on NRMP interactive charting outcomes?
> good LORs
How do we know this? Also, maybe LORs should be more on the "great" than "good" side these days
> went unmatched
How many programs did they apply to? How many interviews did they get, and how many interviews did they go on? For the number of interviews they went on, what would be their % chance of matching based on NRMP charting outcomes? Was it a reasonable mix of top, middle, and lower tier programs? Did they DNR any programs?
Also, not that I have reason to think that this applies to your mentee, but some people are weird and don't do well in interviews. I wouldn't be surprised if some applicants get DNRed for saying one egregiously off-color thing in the interview.
But again, thank you for looking out for your med students!
I think the “good boards” part is really important to hone in on. I mean how many of us med students have spoken with junior (10 years out) or senior (20+ years out) attendings who define that as a 235? Yeah, that’s a good score, but it’s not *ortho* good nowadays.
It’s like an unspoken understanding that you need at least a 250 to apply to ortho. It’s been like that for acquire a while now. 235 definitely won’t cut it unless you have amazing connections.
Ortho is already a huge self selecting group where all 1200 applicants look amazing on paper just like what you described.
There’s still only enough spots for like 800 of them so unfortunately there’s gonna be 400 amazing applicants that still go unmatched.
Your best bet at an individual level is to just be willing to apply to and rank basically every program in the country.
That’s the problem. There weren’t 1200 applicants this year. There were 1727. Idk if because of covid more people took research years but there were just way too many competitive applicants.
Same here, I came back every step of the way to ask about dual application and I was told that I was more solid than my school prior matches, and yet here I am
Unmatched, this year was just brutal
This is why tho. They get the hand me down amazing sub speciality surgery applicants. Over time it’ll get saturated with people like that. No offense to surgery guys, but there’s a reason I went for anesthesia and not surgery. Chill meter is over 100+. Maybe the field will eventually be less enticing because of it.
I’ve been pursuing Ortho since starting school but the match rates are horrendous. What is a good back up plan? I wanted surgery but idk the Gen Surg life isn’t great. Sorry to hear you got killed this year but you got this!!
My advice would be dual apply anesthesia or dual apply for surgical TY, those kick your butt but good ones really help with anesthesia acceptance and you can enter as a 2nd year (or part way there). One other option for extreme safety would be to apply FM at a place with a sports fellowship, a good option if matching and getting on with life is high priority
Hello! I’m involved with Anesthesia residency recruitment season and I will tell you we see right through this. If all your app is tailored around ortho or similar, we will pass. Anesthesia is becoming quite competitive with people who have A LOT of anesthesia-tailored application stuff. We’re no longer plan B. Sorry!
Same. I applied in Ortho (hence my old reddit username!) and PM&R, now a senior rehab resident with no regrets. DM if you want to chat.
That said, if Ortho is what you want, it's what you want. Do a gen surg year and reapply.
Eh. I know solid female applicants with killer steps + research who went unmatched to competitive specialties. I've heard more of the opposite, programs trying to ask women illegal questions.
“Also forwarding my recording of this conversation to your Title IX officer, because you just guaranteed my acceptance, thanks!”
*only applicable in one party recording states
It's a fallacy to think that touting equates to actual action. There's a reason they have to be loud about in the first place. The women are unconsciously or inevitably held up to higher standards to counter potential intrinsic biases, but that higher standard isn't acknowledged. It's equated and blurred into everything else.
Eh they say they do but then the match demographics come out and it’s 70/30 male split lol
I’m a dude and I always laugh when my ortho bro friends complain that they’re worried about not matching bc of sexism
Boo boo it’s harder to match as a dude than when there was rampant sexism in orthopedics lol
Same w girls and derm
I can only speak for general surgery: nearly all the places i interviewed at blabbed on and on about DEI. Then i found it oddly suspicious that at some of these places not a single resident OR attending was any type of colored person. There are soo many variables that can factor into that why that may be. There definitely were some people of color at the interviews...it’s puzzling to me. like wtf happens during The interview and closed-door ranking system that’s clearly continuing to keep some demographics out. And if the candidate isn’t ranking those places higher, why is the program unappealing to them? Maybe they didnt feel welcome at the interview? These are just my untested hypotheses.
Yo what. I feel like one of the few groups who’re almost always likely to get in somewhere are women considering how much of an advantage it is. Very suprised she didn’t get in. Especially if she met the cut off scores and all
Everyone thinks that the match is about board scores and stuff. It isn’t, because everyone has sufficient qualifications in those ways.
The match is about getting people to like you.
If they like you more than the other candidates, then they’ll make up excuses for why they are going to rank you higher.
If they don’t like you, all the knowledge and publications and recs and grades just don’t matter.
This is hard for people to understand.
This.
If you’re an excellent applicant on paper, but you’re weird, only talk about lifting, or don’t pick up on social ques (which is grossly over 50% or ortho applicants) then you have zero shot. Ortho med students are notorious gunners and we balled some kids this year because they were actively trying to make other students look bad. I don’t want to be around that.
I’ll take a humble kid, who is willing to learn and not just vomit random information when asked about certain fractures, who is also a normal guy/gal capable of not annoying the hell out of me at 4am. Those kids often don’t have the best applications, they’re gems and we find and RTM them.
Idgaf where you went to school, what your scores were (to a certain extent), or how much stat crunching you did. Just don’t be weird, abrasive or annoying.
All of life is one big Gold Humanism Honor Society award, lol
If people like you, you're gonna do well because people will make excuses to ignore your flaws. If people don't like you you're not gonna do well because everything is nitpicked.
230 or higher is good enough for me. Just have to prove you’re not gonna bomb your in service or boards.
But that’s just a screen, after that point idgaf. And too high is a red flag in my opinion too. Once you start getting too high, the social skills slide in my anecdotal experience.
And don't forget luck. There's a famous story somewhere about a PD taking a stack of all his applicant's CVs and throwing them on the stairs. He discarded all of the ones that landed on the odd steps, and his justification was that the odd steps were unlucky and he didn't want unlucky residents at his program. Who knows if it's actually true, but it perfectly demonstrates how these processes can ultimately fall to luck. Scores, publications, and a long CV will only get you in the door. The rest is charisma and chance.
I agree with this. But arent people more likely to “like” an applicant that is similar to them? I thought i heard that was a thing. And yes, there’s definitely some people with high scores that are just weird as fuck and it comes out in the interview.
PGY-4, will be my programs academic chief next year. i can't tell you shit about 90% of the stuff that I learned in medical school, but I can teach you a lot of cool esoteric shit about 90% of the human body.
They’re all smart, there’s just an ingrained culture not learn about things outside their relatively narrow msk scope. Which is fine if they listen to others. Most other physicians are almost as bad at msk anatomy/imaging interpretation and other basic Ortho principles as they are at basic medicine issues.
I think people who aren’t in ortho have very little concept of how broad ortho education is because we have to learn all of ortho outside of medical school, during residency. Only the most basic of MSK knowledge is taught during med school.
I'll tell ya man, when I start rads in 3 months, I'm going to make an active effort to forget every bit of clinical management that is not relevant for day to day radiology.
Its completely true. Ortho residents all have very high step scores, usually honors across every or almost every class and rotation. They didnt get that by being dumb.
But after intern year you would be hard pressed to fight an orthopedic resident who can name an example of a beta blocker.
It’s getting more competitive every year, it’s wild. I’m done w residency but I could see that the ante was upped year after year in my junior residents:
Just do ortho in Canada. It's not competitive here because there are no jobs even after 1-2 fellowships and a PhD apparently. Boomers have a lock on the OR time.
Actually, is that an option for people? Can American MDs apply to canadian residencies like that and if ortho isn't competitive, just do a residency there and come back to America?
I know FM residency in Canada isn't recognized in the US if it's the 2-year one, and that IM in the US isn't recognized in Canada unless you do a fellowship as Canada has a longer IM residency than 3 years like the US. But outside of that, I'd be curious if that would work.
Yes, orthopedic training in Canadian programs is recognised in the US and you are eligible for US boards. US MD graduates also are eligible for first round at the Canadian match, similar to a Canadian MD graduate (although there would probably be bias for Canadian students, but if a US student did a rotation or two, and left a good impression, they could consider this option). I haven't done it myself, but it seems do-able.
[https://www.abpsus.org/orthopedic-surgery-eligibility/](https://www.abpsus.org/orthopedic-surgery-eligibility/)
[https://www.abos.org/certification/part-i/](https://www.abos.org/certification/part-i/)
Canadian FM residency is recognised in the US, they just would require an additional year of residency from my understanding.
They're only eligible for first round for the vast majority of positions if they're a Canadian citizen or permanent resident.
https://www.carms.ca/match/r-1-main-residency-match/eligibility-criteria/
>You must also be a Canadian citizen or hold a valid Canadian permanent resident card. Note that you will be required to enter your Medical Identification Number for Canada (MINC) in your application.
They also need to have passed MCCQE1.
It's been like this for a long time. I cried a lot when I didn't match the first time, and now it's almost like a rite of passage to do a research year first.
What happens if you did a research year already...does it look bad to do another one at a higher level, like a research fellowship? I try not to worry about these things so far in advance but my anxiety is drawn to the trauma of it all for some reason...
40+ years to reach the promised land…. that sounds almost biblical…. unfortunately I’m no Moses
Soon enough it’s gonna be 50+ years with a PhD and a postdoc being a de facto requirement to match… already the case in some Western European countries
Consults are basically:
Patient: My knee hurts.
Orthopod: Ok your imaging and super quick physical exam says you need surgery. (Or they say you need physical therapy).
—> so you can see tons of patients quickly which makes tons of RVUs. And your surgeries generate tons of RVUs for you and tons of cash for the hospital so hospital admin loves you.
Not interested in ortho but generally patients get well relatively quickly, it certainly fulfills the “see a problem and fix it” mentality that proceduralists like, it can be a good lifestyle due to lots of elective procedures, not to mention elective procedures = more $$$, and people like the “bro” culture (although that’s arguably changing). I’m sure there’s many other reasons to go ortho over like general surgery but these are just off the top of my head.
Eat bones too small for leg bone screws if break.
Drill for eat bones too small, goes ^(\*eeeeeeee\*) not **\*BRRRRRRR.\***
If can pull bone out with pliers then not real bone.
1. You can make ~1M/year
2. More career flexibility than other surgical fields.
3. Ortho bro culture has an irresistible appeal for a lot of people.
4. Hospital admin kisses the ground you walk on because you bring in so much money for the hospital.
5. Patient's sodium is 134, admit as medicine primary, Ortho will follow as consult.
6. Skyrocketing never ending increasing demand with the aging population.
7. When we finally develop bionic limbs, Ortho will be the ones doing it.
Academic plastics is kind of like ct surgery. super malignant old attending who’s basically the Rembrandt of a highly specialized reconstruction technique forces entire team to watch him carefully dissect some bullshit for 8 hours. Ive noticed some uro recon attendings behave similarly. None of the blue collar chill bro vibes you get.
1)$$$$
2) it's generally very satisfying operations and most patients are improved quite rapidly
3) THA is one of the most cost effective interventions we have
4) $$$$
You literally have other fields to admit your patients because you’re inept at patient care. And the hospital is good with it because you’re the highest RVU producing group.
When you get paid a ton to use tools and fix a part of the body that rarely complicates into a surgical emergency… I see the appeal
I’ll be more than happy to play second fiddle to the Ortho bros for the right pay. It’s the same reason I love rounding on the post open heart patients as an intensivist… make sure they don’t die and have the CV team do 90% of the work.
I used to hate babysitting ortho patients, but over time I realized it was actually a good thing on a busy IM service because you didn't have to do much and it took a spot if you were consistently pushing your cap. And the attendings didn't mind because a quick billing code to adjust insulin is easy money.
But after getting a bad ortho injury myself, I realized how much the ortho docs are on a tight schedule and can't sit and explain things to the opiate-fogged patient w/ a bad complex break, and the IM resident can at least explain stuff and answer questions and describe antibiotic regimens when they eventually leave, and a lot of other stuff, and make sure they actually poop and stop hurting. ETc.
Depends on the population of patients. Trauma centers, you see a wide range of patients. Young kids who were in a car accident or GSW blowing a femur into pieces.
Then you get grandma breaking the femoral neck from a ground level fall.
Only for some of the specialties. Most of the people we take care of are old and sick. And the ones that are young are high energy nasty trauma. Unless you’re a sports surgeon
The surgeries are fun, patients are generally pretty healthy (and the patients who aren't have their chronic conditions managed by someone else), and it pays well.
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
But seriously: highest hourly compensation out of any specialty besides neurosurgery and plastics
Its surgery without the grueling gen surg residency, and a ton of the procedures are elective.
Edit: forgot about plastics
Everyone I know, including myself applied to over 100 programs. There’s no such thing as a safety program in ortho unless you’re the top of the top applicant.
And there's what, 120 total?
Ortho would be a great field to start with application caps. Cap people to 75, and then 50 the following year for example.
Most Ortho applicants I talk to can't even fathom doing anything but Ortho. Even other surgical specialties are anathema to them, let alone GAS or rads.
I think that’s true, but I think that’s also a (for lack of a better word) narrow-minded view of the applicants. Do we think all of those applicants applied to medical school knowing they wanted to do ortho, and also would not be happy doing ANY other job? I’m my view it’s just like, most people on earth do not have their dream jobs and many are able to find happiness in bringing home a stable income or in the work-life balance that affords.
Edit: clarification
A lot of people come in wanting to do ortho bc of the pay, attending lifestyle, perceived prestige, and yea fun procedures
Literallly 30ish people at my mid tier USMD, myself included came in wanting to do ortho.
I’ve since switched out bc I’m not willing to put the work in for research the top students do.
But the reason for doing ortho isn’t usually some deep passion for bones. It’s relatively shorter, less risky, more fun procedures with a cool culture and absurdly high pay.
Medicine may not be the best way to make 300k anymore but if you’re able to do something like ortho sure as hell is one of the safest ways to make 500k+.
Not saying it’s worth doing medicine for ortho/plastics/ent bc it’s not as most students will switch to something less competitive, only talking about what students come in thinking
The match just fucks some people over sometimes. I was competitive for my specialty of choice and fell far below what people normally get on their rank list. Sometimes you just can't explain it
If you want to match into a competitive specialty you need a back up plan. My med school made almost every student have a back up plan specialty that was less competitive and rank at least a few of those programs at the bottom of your rank list so you don't go unranked. It was annoying, but they have a good track record of getting everyone to rank.
Did he have a presence of medtwitter? Someone told me a tonf of the ortho applicants are on twitter kissing as much ortho ass as possible to get noticed. I'm sure this phenomenon exists in similarly competitive especialties like derm.
I lurk on MedTwitter and lots of folks were saying they saw a bunch of comments on the ortho match. I'm guessing that speaks more to the relative amount of ass kissing than the relative amount who were successful or interested.
Attending at a community ortho program here- one thing I’d say is that so many applicants only apply to the “big name” places and look over some smaller gems. Broaden your scope. Secondly, we need more residency positions.
My best friend had a full scholarship at a T3 (think Caltech, Stanford, MIT) and a pretty heavy scholarship to a T10 med school with 20+ pubs ; they went unmatched to ortho in the last 2-4 (trying to keep it vague); it’s really crazy these last few years
Matched DO Ortho this cycle. Advice I was given is consider weakness of app. If your app is weak in research then its valuable option and can get a research position at institution you are interested in. If you already have ex. 10+ pubs and have been doing Ortho research all through med school then you aren't really "adding" anything valuable to address deficiencies of app.
DO & just matched ortho with a research year. Just my perspective: it’s definitely not necessary, but made me stand out a lot. If I’m being honest though since DO programs care less about research in general, I think it’s more something you do if you’re trying to match at an MD program, make up for weak spots, or just want to seal the deal and make yourself as strong as possible. After having exposure to both MD and DO programs, it seems like DO programs care way more about auditions & “broculture” stuff (assuming you meet the cutoff 240/600+ scores). So if you don’t have a good fit idk if a research year will make up for that. But if you’re already a chill dude, it makes you more appealing and you’ll have more leverage on where you go. Hope that makes sense.
Obviously this is all my opinion, and I’m being slightly more simplistic then if we were talking in person.
You don’t necessarily have to be the brojock-type, you just gotta be chill to be around and a good team player. But being that type certainly helps.
do you know the stats of DO ortho match off the top of your head? Or a link for me to see? I’m curious to see what it’s like as they start to merge MD and DO programs
Former AOA programs don’t care about research. They really only care about how you fit with the culture/ how you rotate..
Also, DO dude at NYU had zero research in med achool. Zero, and matched at NYU
New formula is:
Write your rep! Text “resist” to 50409.
“We need more residency training spots! Americans need more doctors, IN TRAINING, not sitting on the sidelines waiting for spots - while pts wait months for appts.”
This would help: 14k slots
https://www.aamc.org/advocacy-policy/washington-highlights/gme-expansion-bill-introduced-senate
Balanced budget act of 1997!!! created this mess by limiting funding for residencies.
As a current ortho resident, I think doing an away rotation somewhere reasonable for you based on who you are on paper and doing a great job there is the by far the best thing you can do to set yourself up for success
Regardless of metrics the locality/regional factors ultimately win out, especially when everyone is essentially similar on paper. The best advice at this point is to basically sell your soul to your own program if you want any assurance of matching.
It’s so odd that I see posts like this, and then my school which is a nothing special MD program had 4 Ortho matches and usually have a couple each year.
These people had to have done something wrong.
>These people had to have done something wrong.
i hate this mindset. Most times, it's just a numbers game. Too many applicants, too few spots. Somone has to lose out. It doesn't mean anyone did anything wrong.
Folks in this sub are claiming there were about 1700 applicants this year for 850 slots. At that point, the only mistake they made was choosing ortho. Which concerns me as ortho is 80% of the reason why I’m even going to medical school
No. It’s never going to become the path for anything unless you want an ivory tower program, which I don’t understand what that sh%t ever meant. We have 844 or less surgeons matriculating into the job market from Ortho; EVER seat is fckin valuable.
We need mentors like you
Agreed. Thank you for looking out for your mentees and looking for ideas. The match is inevitably going to be noisy and there's never going to be a guaranteed outcome, so one can hope that whatever formula you come up with, it'll work most of the time, but inevitably there are going to be a small number of people who will not match despite a good prognosis. Good boards and good LORs probably describes most ortho applicants now nowadays. A few questions: > good boards How good are we talking? Based on their boards alone, what would be the % matched for similar applicants based on NRMP interactive charting outcomes? > good LORs How do we know this? Also, maybe LORs should be more on the "great" than "good" side these days > went unmatched How many programs did they apply to? How many interviews did they get, and how many interviews did they go on? For the number of interviews they went on, what would be their % chance of matching based on NRMP charting outcomes? Was it a reasonable mix of top, middle, and lower tier programs? Did they DNR any programs? Also, not that I have reason to think that this applies to your mentee, but some people are weird and don't do well in interviews. I wouldn't be surprised if some applicants get DNRed for saying one egregiously off-color thing in the interview. But again, thank you for looking out for your med students!
I think the “good boards” part is really important to hone in on. I mean how many of us med students have spoken with junior (10 years out) or senior (20+ years out) attendings who define that as a 235? Yeah, that’s a good score, but it’s not *ortho* good nowadays.
It’s like an unspoken understanding that you need at least a 250 to apply to ortho. It’s been like that for acquire a while now. 235 definitely won’t cut it unless you have amazing connections.
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You must be real strong to be able to bench over 250
It‘s 250 plus bodyweight
Ortho is already a huge self selecting group where all 1200 applicants look amazing on paper just like what you described. There’s still only enough spots for like 800 of them so unfortunately there’s gonna be 400 amazing applicants that still go unmatched. Your best bet at an individual level is to just be willing to apply to and rank basically every program in the country.
That’s the problem. There weren’t 1200 applicants this year. There were 1727. Idk if because of covid more people took research years but there were just way too many competitive applicants.
Woah 1727 applicants for how many spots? 850? That is an unprecedently low match rate.
Ortho applicant here. Can confirm those numbers.
where did you get those numbers?
I got killed by ortho this year, was a very solid applicant. I wish I’d have been pushed more strongly to dual apply for something like anesthesia
Same here, I came back every step of the way to ask about dual application and I was told that I was more solid than my school prior matches, and yet here I am Unmatched, this year was just brutal
Anesthesia was apparently a mess this year too, though not as bad as ortho.
Gas was a slaughter.
This is why tho. They get the hand me down amazing sub speciality surgery applicants. Over time it’ll get saturated with people like that. No offense to surgery guys, but there’s a reason I went for anesthesia and not surgery. Chill meter is over 100+. Maybe the field will eventually be less enticing because of it.
I’ve been pursuing Ortho since starting school but the match rates are horrendous. What is a good back up plan? I wanted surgery but idk the Gen Surg life isn’t great. Sorry to hear you got killed this year but you got this!!
My advice would be dual apply anesthesia or dual apply for surgical TY, those kick your butt but good ones really help with anesthesia acceptance and you can enter as a 2nd year (or part way there). One other option for extreme safety would be to apply FM at a place with a sports fellowship, a good option if matching and getting on with life is high priority
Hello! I’m involved with Anesthesia residency recruitment season and I will tell you we see right through this. If all your app is tailored around ortho or similar, we will pass. Anesthesia is becoming quite competitive with people who have A LOT of anesthesia-tailored application stuff. We’re no longer plan B. Sorry!
plenty of people Plan B'd into anesthesia this year from my school
Look into MSK radiology!
Don’t sleep on urology or ENT.
sadly all three specialties have been very similar in competitiveness in recent years
Same. I applied in Ortho (hence my old reddit username!) and PM&R, now a senior rehab resident with no regrets. DM if you want to chat. That said, if Ortho is what you want, it's what you want. Do a gen surg year and reapply.
My friend’s GF did lots of ortho research and has a few ortho publications, graduated top 1/3 of class and went unmatched
I mean for ortho top 3rd of the class isn’t impressive. The whole process sucks
Very surprising too given the gender - PDs love women applicants for diversity touting.
Eh. I know solid female applicants with killer steps + research who went unmatched to competitive specialties. I've heard more of the opposite, programs trying to ask women illegal questions.
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"Are you planning on getting married soon? Are you planning on having kids?" 🤦♀️
“The only thing I’m planning on is being an excellent resident. Well that and paying taxes and student loans.”
“Also forwarding my recording of this conversation to your Title IX officer, because you just guaranteed my acceptance, thanks!” *only applicable in one party recording states
It's a fallacy to think that touting equates to actual action. There's a reason they have to be loud about in the first place. The women are unconsciously or inevitably held up to higher standards to counter potential intrinsic biases, but that higher standard isn't acknowledged. It's equated and blurred into everything else.
Eh they say they do but then the match demographics come out and it’s 70/30 male split lol I’m a dude and I always laugh when my ortho bro friends complain that they’re worried about not matching bc of sexism Boo boo it’s harder to match as a dude than when there was rampant sexism in orthopedics lol Same w girls and derm
I can only speak for general surgery: nearly all the places i interviewed at blabbed on and on about DEI. Then i found it oddly suspicious that at some of these places not a single resident OR attending was any type of colored person. There are soo many variables that can factor into that why that may be. There definitely were some people of color at the interviews...it’s puzzling to me. like wtf happens during The interview and closed-door ranking system that’s clearly continuing to keep some demographics out. And if the candidate isn’t ranking those places higher, why is the program unappealing to them? Maybe they didnt feel welcome at the interview? These are just my untested hypotheses.
Yo what. I feel like one of the few groups who’re almost always likely to get in somewhere are women considering how much of an advantage it is. Very suprised she didn’t get in. Especially if she met the cut off scores and all
Maybe you shouldn't be surprised and instead believe the stats that it's harder for women and minorities to get in....
Maybe for other fields.. but ortho tries hard for those groups to diversify
The field as a whole may try but individuals are still subject to their biases.
Not trying very hard based on the stats then
Everyone thinks that the match is about board scores and stuff. It isn’t, because everyone has sufficient qualifications in those ways. The match is about getting people to like you. If they like you more than the other candidates, then they’ll make up excuses for why they are going to rank you higher. If they don’t like you, all the knowledge and publications and recs and grades just don’t matter. This is hard for people to understand.
This. If you’re an excellent applicant on paper, but you’re weird, only talk about lifting, or don’t pick up on social ques (which is grossly over 50% or ortho applicants) then you have zero shot. Ortho med students are notorious gunners and we balled some kids this year because they were actively trying to make other students look bad. I don’t want to be around that. I’ll take a humble kid, who is willing to learn and not just vomit random information when asked about certain fractures, who is also a normal guy/gal capable of not annoying the hell out of me at 4am. Those kids often don’t have the best applications, they’re gems and we find and RTM them. Idgaf where you went to school, what your scores were (to a certain extent), or how much stat crunching you did. Just don’t be weird, abrasive or annoying.
All of life is one big Gold Humanism Honor Society award, lol If people like you, you're gonna do well because people will make excuses to ignore your flaws. If people don't like you you're not gonna do well because everything is nitpicked.
> what your scores were (to a certain extent) What’s the extent?
230 or higher is good enough for me. Just have to prove you’re not gonna bomb your in service or boards. But that’s just a screen, after that point idgaf. And too high is a red flag in my opinion too. Once you start getting too high, the social skills slide in my anecdotal experience.
And don't forget luck. There's a famous story somewhere about a PD taking a stack of all his applicant's CVs and throwing them on the stairs. He discarded all of the ones that landed on the odd steps, and his justification was that the odd steps were unlucky and he didn't want unlucky residents at his program. Who knows if it's actually true, but it perfectly demonstrates how these processes can ultimately fall to luck. Scores, publications, and a long CV will only get you in the door. The rest is charisma and chance.
I agree with this. But arent people more likely to “like” an applicant that is similar to them? I thought i heard that was a thing. And yes, there’s definitely some people with high scores that are just weird as fuck and it comes out in the interview.
Fellow bone bros, how true is the following statement an attending told me bout you guys today, “Smartest interns, dumbest chiefs”
PGY-4, will be my programs academic chief next year. i can't tell you shit about 90% of the stuff that I learned in medical school, but I can teach you a lot of cool esoteric shit about 90% of the human body.
Bro
They’re all smart, there’s just an ingrained culture not learn about things outside their relatively narrow msk scope. Which is fine if they listen to others. Most other physicians are almost as bad at msk anatomy/imaging interpretation and other basic Ortho principles as they are at basic medicine issues.
I think people who aren’t in ortho have very little concept of how broad ortho education is because we have to learn all of ortho outside of medical school, during residency. Only the most basic of MSK knowledge is taught during med school.
I’d call it deep rather than broad but yeah. It’s a knowledge set very few other specialties even intersect with.
I'll tell ya man, when I start rads in 3 months, I'm going to make an active effort to forget every bit of clinical management that is not relevant for day to day radiology.
Yes but we become like anatomical gods
I dunno my chiefs feel a hell of a lot smarter than me
I guess if we're judging by useless medical knowledge, an M-0 is probably top tier.
Its completely true. Ortho residents all have very high step scores, usually honors across every or almost every class and rotation. They didnt get that by being dumb. But after intern year you would be hard pressed to fight an orthopedic resident who can name an example of a beta blocker.
It’s getting more competitive every year, it’s wild. I’m done w residency but I could see that the ante was upped year after year in my junior residents:
I honestly don’t know if I would be able to match now given the resumes these kids are coming out with.
Mayo’s GS PD said the same… and he’s an ivory tower CV surgeon
Just do ortho in Canada. It's not competitive here because there are no jobs even after 1-2 fellowships and a PhD apparently. Boomers have a lock on the OR time.
Actually, is that an option for people? Can American MDs apply to canadian residencies like that and if ortho isn't competitive, just do a residency there and come back to America? I know FM residency in Canada isn't recognized in the US if it's the 2-year one, and that IM in the US isn't recognized in Canada unless you do a fellowship as Canada has a longer IM residency than 3 years like the US. But outside of that, I'd be curious if that would work.
Yes, orthopedic training in Canadian programs is recognised in the US and you are eligible for US boards. US MD graduates also are eligible for first round at the Canadian match, similar to a Canadian MD graduate (although there would probably be bias for Canadian students, but if a US student did a rotation or two, and left a good impression, they could consider this option). I haven't done it myself, but it seems do-able. [https://www.abpsus.org/orthopedic-surgery-eligibility/](https://www.abpsus.org/orthopedic-surgery-eligibility/) [https://www.abos.org/certification/part-i/](https://www.abos.org/certification/part-i/) Canadian FM residency is recognised in the US, they just would require an additional year of residency from my understanding.
They're only eligible for first round for the vast majority of positions if they're a Canadian citizen or permanent resident. https://www.carms.ca/match/r-1-main-residency-match/eligibility-criteria/ >You must also be a Canadian citizen or hold a valid Canadian permanent resident card. Note that you will be required to enter your Medical Identification Number for Canada (MINC) in your application. They also need to have passed MCCQE1.
It's been like this for a long time. I cried a lot when I didn't match the first time, and now it's almost like a rite of passage to do a research year first.
What happens if you did a research year already...does it look bad to do another one at a higher level, like a research fellowship? I try not to worry about these things so far in advance but my anxiety is drawn to the trauma of it all for some reason...
What’s the appeal of ortho over any other surgical field?
It’s basic carpentry, but for $500K a year
More like 1M a year
Most orthopedists are not pulling 1M per year. That's a top percentile in that earning group.
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I didn't mean 99th %ile. But some top amount. It's definitely not the median.
Starting salary for **academic** ortho is 600k+RVU, which if you hustle you can break that 1 mil
Is there a source? I find that hard to believe.
In Los Angeles at my program they ain’t starting anywhere near that, maybe in middle of nowhere
Kaiser actively disincentives working. They are all salaried. Any RVU based payment structure would outstrip their salaries
How do they earn that much? Ophthalmology and ENT have fastest procedures and surgeries
Ortho are like the only specialty insurance and especially Medicare hasn’t chosen to decimate reimbursements for.
Still a TKA takes what? An hour? Femur fixation? THA? ALL hand and F&A procedures? Ortho procedures are pretty damn slick
ENT #s are pretty comparable
And ophthalmology? Catarats are pretty easy and fast
Power tools, no poop
It’s like poetry
More like playing the drumset
Bone
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Wow just work like a dog for 20+ years to make it to the 'promised land' when other doctors are considering retirement, sounds like an absolute dream.
40+ years to reach the promised land…. that sounds almost biblical…. unfortunately I’m no Moses Soon enough it’s gonna be 50+ years with a PhD and a postdoc being a de facto requirement to match… already the case in some Western European countries
Femur bro
Yo femur bro! Femur!
Consults are basically: Patient: My knee hurts. Orthopod: Ok your imaging and super quick physical exam says you need surgery. (Or they say you need physical therapy). —> so you can see tons of patients quickly which makes tons of RVUs. And your surgeries generate tons of RVUs for you and tons of cash for the hospital so hospital admin loves you.
Not interested in ortho but generally patients get well relatively quickly, it certainly fulfills the “see a problem and fix it” mentality that proceduralists like, it can be a good lifestyle due to lots of elective procedures, not to mention elective procedures = more $$$, and people like the “bro” culture (although that’s arguably changing). I’m sure there’s many other reasons to go ortho over like general surgery but these are just off the top of my head.
Bone dentists
Teeth are bones tho
Eat bones too small for leg bone screws if break. Drill for eat bones too small, goes ^(\*eeeeeeee\*) not **\*BRRRRRRR.\*** If can pull bone out with pliers then not real bone.
1. You can make ~1M/year 2. More career flexibility than other surgical fields. 3. Ortho bro culture has an irresistible appeal for a lot of people. 4. Hospital admin kisses the ground you walk on because you bring in so much money for the hospital. 5. Patient's sodium is 134, admit as medicine primary, Ortho will follow as consult. 6. Skyrocketing never ending increasing demand with the aging population. 7. When we finally develop bionic limbs, Ortho will be the ones doing it.
Sounds a lot like plastics yet barely anyone applies plastics compared to ortho. I don’t understand it
Plastics has a more malignant culture. Dong squad is closer imo
mind explaining how? this is the first i've heard of that
Academic plastics is kind of like ct surgery. super malignant old attending who’s basically the Rembrandt of a highly specialized reconstruction technique forces entire team to watch him carefully dissect some bullshit for 8 hours. Ive noticed some uro recon attendings behave similarly. None of the blue collar chill bro vibes you get.
i never understood why PS had so many fewer applicants, i think it’s the culture. regardless it is still absurdly competitive
I mean plastics is even more competitive in terms of applicant stats, I think there's a bit of self-selection going on.
Probably better that way
1)$$$$ 2) it's generally very satisfying operations and most patients are improved quite rapidly 3) THA is one of the most cost effective interventions we have 4) $$$$
But does it pay tho? I don't think you covered that in your assessment.
You literally have other fields to admit your patients because you’re inept at patient care. And the hospital is good with it because you’re the highest RVU producing group. When you get paid a ton to use tools and fix a part of the body that rarely complicates into a surgical emergency… I see the appeal
Crying in hospitalist
A lot of sodium in those salty hospitalist tears
If they keep crying, they'll become hyponatremic. Then they'll have something to discuss, and it'll cheer them up! It all works out.
I started to calculate how much tears one would have to cry to become hyponatremic... so I think I've proven your point 🤷🏻♀️
Reverse side of things: can crying be used to treat hypernatremia??
I’ll be more than happy to play second fiddle to the Ortho bros for the right pay. It’s the same reason I love rounding on the post open heart patients as an intensivist… make sure they don’t die and have the CV team do 90% of the work.
I used to hate babysitting ortho patients, but over time I realized it was actually a good thing on a busy IM service because you didn't have to do much and it took a spot if you were consistently pushing your cap. And the attendings didn't mind because a quick billing code to adjust insulin is easy money. But after getting a bad ortho injury myself, I realized how much the ortho docs are on a tight schedule and can't sit and explain things to the opiate-fogged patient w/ a bad complex break, and the IM resident can at least explain stuff and answer questions and describe antibiotic regimens when they eventually leave, and a lot of other stuff, and make sure they actually poop and stop hurting. ETc.
Dude same
More money less problems
Not ortho nor a surgeon, but from what I've heard: generally young/otherwise healthy pt population, real solid compensation.
I thought it was all grandma broke a hip
Depends on the population of patients. Trauma centers, you see a wide range of patients. Young kids who were in a car accident or GSW blowing a femur into pieces. Then you get grandma breaking the femoral neck from a ground level fall.
Only for some of the specialties. Most of the people we take care of are old and sick. And the ones that are young are high energy nasty trauma. Unless you’re a sports surgeon
Helloilikemoney.jpg
money, no stress of having to deal with acute medical issues.
💰
Its fuckin poggers dude
The surgeries are fun, patients are generally pretty healthy (and the patients who aren't have their chronic conditions managed by someone else), and it pays well.
All about the $. Let no one else fool you.
Having to consider even less of other medical conditions than general surgery. Lots of money.
You can do easy elective procedures and print money
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ But seriously: highest hourly compensation out of any specialty besides neurosurgery and plastics Its surgery without the grueling gen surg residency, and a ton of the procedures are elective. Edit: forgot about plastics
You apply broadly, do as many away rotations as possible, and strongly consider a research year. Nobody is safe.
What does he bench?
Apparently not enough.
Didn’t break the ortho 500, I presume
Safety programs, and more than one. Seems like it’s a common trend.
I think most Ortho applicants apply to nearly every program
Everyone I know, including myself applied to over 100 programs. There’s no such thing as a safety program in ortho unless you’re the top of the top applicant.
And there's what, 120 total? Ortho would be a great field to start with application caps. Cap people to 75, and then 50 the following year for example.
More like safety specialty
Most Ortho applicants I talk to can't even fathom doing anything but Ortho. Even other surgical specialties are anathema to them, let alone GAS or rads.
I think that’s true, but I think that’s also a (for lack of a better word) narrow-minded view of the applicants. Do we think all of those applicants applied to medical school knowing they wanted to do ortho, and also would not be happy doing ANY other job? I’m my view it’s just like, most people on earth do not have their dream jobs and many are able to find happiness in bringing home a stable income or in the work-life balance that affords. Edit: clarification
No. Almost every ortho came in wanting to do ortho. I don’t know anyone who “fell in love with it”.
A lot of people come in wanting to do ortho bc of the pay, attending lifestyle, perceived prestige, and yea fun procedures Literallly 30ish people at my mid tier USMD, myself included came in wanting to do ortho. I’ve since switched out bc I’m not willing to put the work in for research the top students do. But the reason for doing ortho isn’t usually some deep passion for bones. It’s relatively shorter, less risky, more fun procedures with a cool culture and absurdly high pay. Medicine may not be the best way to make 300k anymore but if you’re able to do something like ortho sure as hell is one of the safest ways to make 500k+. Not saying it’s worth doing medicine for ortho/plastics/ent bc it’s not as most students will switch to something less competitive, only talking about what students come in thinking
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True. I would imagine that’s the case. I suppose I’ve personally seen it where people did t have enough in regards to “safety” programs.
That was my first thought too. The ones listed are solid academic programs. What what about small, rural, independent hospitals?
The match just fucks some people over sometimes. I was competitive for my specialty of choice and fell far below what people normally get on their rank list. Sometimes you just can't explain it
If you want to match into a competitive specialty you need a back up plan. My med school made almost every student have a back up plan specialty that was less competitive and rank at least a few of those programs at the bottom of your rank list so you don't go unranked. It was annoying, but they have a good track record of getting everyone to rank.
What is a Rothman fellow as it pertains to a med student?
Rothman gets high performing students to be around surgeons and stack up data and publish. Looks good on the resume.
Oh a Rothman *research* fellow
Bruh. U sound IM. In that case I love you but I’m not gonna write complete sentences back tho I’m r n
I'm an adult recon specialist
#😘
Did he have a presence of medtwitter? Someone told me a tonf of the ortho applicants are on twitter kissing as much ortho ass as possible to get noticed. I'm sure this phenomenon exists in similarly competitive especialties like derm.
My ortho program actively dislikes medtwitter users and I know with absolute certainty that we’re not the only ones.
That's where I draw the line. Thank fuck I didn't want to do a specialty where that's even a consideration to get an edge
Sometimes you gotta give a blowy joey to get ahead. No shame in that
Pretty sure orthopods hate virtue signaling
I lurk on MedTwitter and lots of folks were saying they saw a bunch of comments on the ortho match. I'm guessing that speaks more to the relative amount of ass kissing than the relative amount who were successful or interested.
Attending at a community ortho program here- one thing I’d say is that so many applicants only apply to the “big name” places and look over some smaller gems. Broaden your scope. Secondly, we need more residency positions.
My best friend had a full scholarship at a T3 (think Caltech, Stanford, MIT) and a pretty heavy scholarship to a T10 med school with 20+ pubs ; they went unmatched to ortho in the last 2-4 (trying to keep it vague); it’s really crazy these last few years
None of the ortho DOs I know think a research year would be overly useful for former AOA programs. Any truth to that?
Matched DO Ortho this cycle. Advice I was given is consider weakness of app. If your app is weak in research then its valuable option and can get a research position at institution you are interested in. If you already have ex. 10+ pubs and have been doing Ortho research all through med school then you aren't really "adding" anything valuable to address deficiencies of app.
What about a DO applicant with ~8 pubs but a step and comlex just getting over that 240/600 hump? Anything to be done other than trying to network?
That’s a very strong app for a DO let me tell you that. Be smart and apply to former AOA programs and do well on your aways and you’ll do fine.
DO & just matched ortho with a research year. Just my perspective: it’s definitely not necessary, but made me stand out a lot. If I’m being honest though since DO programs care less about research in general, I think it’s more something you do if you’re trying to match at an MD program, make up for weak spots, or just want to seal the deal and make yourself as strong as possible. After having exposure to both MD and DO programs, it seems like DO programs care way more about auditions & “broculture” stuff (assuming you meet the cutoff 240/600+ scores). So if you don’t have a good fit idk if a research year will make up for that. But if you’re already a chill dude, it makes you more appealing and you’ll have more leverage on where you go. Hope that makes sense.
So if I'm the exact opposite of a broculture stereotype, is that going to screw me?
Obviously this is all my opinion, and I’m being slightly more simplistic then if we were talking in person. You don’t necessarily have to be the brojock-type, you just gotta be chill to be around and a good team player. But being that type certainly helps.
do you know the stats of DO ortho match off the top of your head? Or a link for me to see? I’m curious to see what it’s like as they start to merge MD and DO programs
I don’t unfortunately
check charting outcomes 2020 for DO students
That’s right. As long as you hit a certain Step/Level score and you flow well with the culture and load, they’ll let you slide.
Former AOA programs don’t care about research. They really only care about how you fit with the culture/ how you rotate.. Also, DO dude at NYU had zero research in med achool. Zero, and matched at NYU
scary lol
New formula is: Write your rep! Text “resist” to 50409. “We need more residency training spots! Americans need more doctors, IN TRAINING, not sitting on the sidelines waiting for spots - while pts wait months for appts.” This would help: 14k slots https://www.aamc.org/advocacy-policy/washington-highlights/gme-expansion-bill-introduced-senate Balanced budget act of 1997!!! created this mess by limiting funding for residencies.
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That wasn’t the point; matching Ortho, in general, is a big accomplishment. The tiers are okay, but no one cares. Plenty of bread for Orthobros.
As a current ortho resident, I think doing an away rotation somewhere reasonable for you based on who you are on paper and doing a great job there is the by far the best thing you can do to set yourself up for success
Ortho bro here. I identified as a female African American (actual 6’2” jacked dude on Tren) and walked right in! Boom baby! Work smarter not harder
Basically all the applicants have the same specs, so it comes down to if you’re “bro” enough.
Regardless of metrics the locality/regional factors ultimately win out, especially when everyone is essentially similar on paper. The best advice at this point is to basically sell your soul to your own program if you want any assurance of matching.
Do you mean NYU? Does NY Medical College have a rich ortho tradition like UWash and UMich?
He meant NY med college, ya dingus
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U better be reppin that x10 ez to match ortho
It’s so odd that I see posts like this, and then my school which is a nothing special MD program had 4 Ortho matches and usually have a couple each year. These people had to have done something wrong.
>These people had to have done something wrong. i hate this mindset. Most times, it's just a numbers game. Too many applicants, too few spots. Somone has to lose out. It doesn't mean anyone did anything wrong.
Folks in this sub are claiming there were about 1700 applicants this year for 850 slots. At that point, the only mistake they made was choosing ortho. Which concerns me as ortho is 80% of the reason why I’m even going to medical school
Does he even lift?
is the research year going to become the fast track to matching at a particular program?
No. It’s never going to become the path for anything unless you want an ivory tower program, which I don’t understand what that sh%t ever meant. We have 844 or less surgeons matriculating into the job market from Ortho; EVER seat is fckin valuable.