Advice for the unmatched.

This is going to be a conglomeration of postings and information that I got from various people that didn’t match, and ended up matching the next time. Please feel free to add on to this.

If you didn’t match and you have your heart set on ortho , there are two options that are generally accepted as being good.
1. Do a Year of research.
2. Do a year of gen surg prelim at a place you want to match at.

Research: this is a mixed bag in my opinion. If you take this route, be sure you hook up with an established researcher –like Richard Lackman at UPenn- who has multiple things you can work on. This worked out well for my friend Dr King who matched this year. Also, it pays to choose someone who has powerful connections (if you didn’t realize by now- the match is very political at times). You must attempt to get involved and work your ass off on any paper or project you can get your hands on. So why didn’t I do this? I didn’t know of any open positions for a research fellow last year that weren’t already taken after the match. Otherwise this is a pretty good option with the caveat being that you are working for someone who fits the above description.

Gen Surg Prelim: After talking to different chairmen, this is the accepted plan if you dont make it. Bite the bullet and scut it out for a year. This is the route I chose. I was fortunate to go to a place where the chairman was well known in the usual circles and his letter went a long ways in securing several interviews. So, as above, pick a place where the people writing your letters have powerful connections. When you get there, your one and only job is to work your ass off. This will suck for your family (if you have one) but it is only one year. Go to a place where you are enthusiastic about being there, and a place where you will want to do ortho. It may seem like you are putting all your eggs into one basket, but again, if your letter writers have connections, this should not be a problem.

Assuming you have done the above: Talk to the general surgery program director, or whoever makes the schedule. If there are enough prelim residents then manpower wont be an issue and you can ask for electives. If at all possible, set up your year as close to an ortho intern’s year. This will allow you to get PGY2 interviews which are exceedingly rare, but possible. At the very least, you MUST get an ortho rotation before you apply- this will allow you to obtain letters in a timely fashion. If you get screwed and don’t get an ortho rotation, then you must take it upon yourself to spend your free time scrubbing into ortho cases to make yourself known to the program. Easier said than done because all surgery interns will get worked like you are in a concentration camp. You will be tired and miserable, but instead of going home- pop into the ortho rooms to see whats going on. This is definitely a violation of work hours, but if you have the time- do it.

Next: attempt to hook up with some research at the place you scramble into. This will only help your cause and get you more connections.
Third: go to all the journal clubs or other events that you can. This shows interest, and will make them remember you even more.

All of these recommendations are made with the assumption that your gen surg department doesn’t dick you over in terms of work hours and schedule. Also, make sure that you are allowed time off for interviewing. Schedule your vacations around interviews if possible. I got 12 interviews and had no problems going to all of them.


Lastly: a few words of encouragement. If ortho is in your blood, and you cannot accept doing anything else, be prepared to fight the good fight. Even if you are in a world of $hit (which you will be at times) done lose sight of your dreams. It is really easy to get bogged down in the gen surg lifestyle of not sleeping, eating like crap, not working out etc. Don’t believe the hype that reapplicants don’t match because they do! This isn’t easy- and for those that matched the first time congrats. For those that didn’t, you will get in. There are gen surg residents at my program who are PGY 7 or 8 because of research or other things. It is worth the extra time spent in the hell that is general surgery residency in order to match into ortho-something that you will do for the rest of your life.

For re-applicants that matched, please add to this post. The more info we can get, the better we can help the unmatched.

Mr Mustard.