Advice from Ortho Residency Coordinator

Thanks um, poopy pants, for clarifying that and you are correct. And some programs will let you know you're in their top 10 or 30 or whatever and some will not tell you anything. So long as they don't request you make any promises or deals with them, or vice versa, you're ok. You're also correct when you say it's a bad idea to tell several programs you plan to rank them first. I know of students who ruined relationships with attendings by telling them they 100% wanted to attend our program and they clearly ranked someone else higher (since we ranked them highly and they matched somewhere else). It's ok to change your mind, but don't tell a program they're yours if they want you and then rank another program more highly. I often have students at our school tell me how we are No. 1 and then they don't match with us. We're not going to rank you any higher just because you want to come here, so it really doesn't do anything except make you look like a liar. It could come back to you when those people are your colleages in a few years... 'I'm very interested' or 'top 3' should be enough, No. 1 should be reserved for No. 1, you know?

Your information has been great. It's nice to find this much advice from a coordinator. I have a quick question for you. I'm an ER intern who has decided to attempt to switch to ortho after a rotation this year (really my first exposure to ortho). I read earlier that you should have a story about low board scores/GPA, etc. Well here's my tale. I scored a 217 on step 1, a 250 on Step 2, and I finished right at the top 3rd of my med school class. I scored all A's (we had letter grades) during my rotations except for pediatrics and neurology. My story for the low step 1 score is that my mother died of lung cancer a few months before step 1, and I got married in between the two events. I never brought this up during interviews, because I didn't want people to think I was making excuses. So, in your opinion, 1) will being an ER intern hurt/help/not matter, and 2) how should I handle the Step 1 story? Thanks again for your help.

Well first let me say I'm sorry for the loss of your mother. I'm sure taking the exam at that point could not have been a very high priority.
As for being an ER resident, I don't think it will hurt you per se, I would just explain in your personal statement why you're choosing to move. I always say there are two kinds of ortho candidates, those who have wanted to be an orthopod since they were 3 and those who decide when they absolutely had to make a decision. Those who have always wanted to sometimes have a hard time giving the guy who just decided a break. But if you explain what has drawn you to it and make it clear that you're not just hopping around until you find what suits you, it shouldn't be an issue. You at least have some more clinical experience and in theory should have some maturity that other candidates might not have yet.
As for your 'story', it's a tough call. This is a good example of when taking that Step 2 was a wise idea, I think the 250 will really help you. I've seen people mention in personal statement if they had a very valid reason for a lower score on your step 1 (I would say death of a parent is valid, you chose to get married just before the exam so I think it's less valid and a lot of people may have been in the same situation). If you do choose to mention it, make it a very quick one line statement. That's terrible to say since obviously the death of your mother is not a one liner. And your scores are not terrible so you might not even need to mention it.
We debate when we get letters sent with stories of misery and sadness from candidates... do we cut them a break and give them a chance to interview? My boss is a nice guy and wants to, but also says what about the guy who has the same story but doesn't choose to say anything about it and just goes on what he can present with, should we not give him the same? It's a tough call and as always very program dependent. If you're talking after you're offered an interview, if someone outright asks you about the discrepency in your scores, I would say Step 1 came at a very difficult time for you personally, in the aftermath of a parent's death. If they choose to ask further you can go with it, but I think one line that is spcifically in response to that question is appropriate. If they don't ask, I wouldn't offer the information.
I think you'll do ok, any non traditional candidate is going to raise some flag (in your case that you're an ER intern). That red flag can either work against you or in your favor depending on the program and how you present yourself. Don't make excuses but present yourself clearly and honestly.

Hi Rescoordinator,

Thanks for your posts - they've been really helpful. I'm actually just starting out in medical school and I've always been interested in ortho to the point where I can't really see myself being nearly as happy doing anything else. As I'm planning to get involved in research this year, I'd like to hear your opinion about whether basic science research looks better than clinical research since clinical research often involves mindless number-crunching and takes less time to get published. Also, how important is it to do research that is entirely initiated by you as opposed to tagging along with a group on an existing project?

Thanks.

To be completely honest I don't really know the answer to this question. I would imagine most students are tagging along with other projects and not doing their own, most of the published articles I see are with several people. But I do not know what is prefered, clinical or basic science. Sorry!

Hey ResCoordinator,
thanks for all the help you've been to the applicants on this website. I also am a coordinator and try to offer some help to them. I noticed that one of the posts was about pre-interview social attendance.

Our interviews were this past weekend, and we were expecting a "weather event" which ended up being next to nothing, but just in case I sent all of our interviewees a message letting them know and asked that they not put themselves in peril in order to make the social. It's nice to attend, but not totally necessary. Many of them mentioned to me during interviews that message really meant a lot to know that someone actually cared about their anxiety and attendance at these events.

Communication to applicants is essential during this time and I would ask that all coordinators make an effort to work with these applicants in a more caring way. We are their first contact with our program and as I tell them "you have to like us as much as we like you...and by virtue of the fact you're sitting in the interview room, we already like you."

These applicants are our next generation of orthopaedic surgeons and we should be their lifeline to their next step.

I wish that more people had the above outlook. It appears that this is a "sellers" market and that we should be greatful for any crumbs that are thrown under the table for the rats to fight over.
The most specific example of this is my experience with Henery Ford. I responded to an email within 2 hours and did not hear back from them. I decided to call approximately 30 hours after the email, and was told that all the spots had filled. This experience was such a turn off to this particular program. First of all I do not understand why they use these practices, and secondly this practice may actually hurt them. How could one be certain the some of the more favorable applicamts are not shut out?
This is just one example.....however I have been impressed with the majority of the residency coordinators that I have delt with thus far.

rescoordinator-
Thanks for all your info, very open and honest, which is appreciated. I'm hoping that this question has not been asked elsewhere, but here goes. What is your take on whether an applicant should have a step 2 score to report when applying or interviewing. I understand this answer may vary depending on the applicant, the step 1 score etc. I am hoping that you might take a minute and just briefly give your take based on a low step 1, an "average ortho" step 1, and a higher step 1. Thanks again.

First, nsimons, nice to see you, I'm presuming I know who you are and it's nice of you to come on out. Please feel free to comment on any of the comments I've made. I've pointed out that I'm hesitant to say too much since we're only one program, but if it's agreed upon by another I think it seems more valid.
I would say the majority of coordinators do care about the candidates simply because they care about their residents. And they know that any of these candidates could end up being their residents. It's just the type of person in this job, that sort of maternal instinct kicks in and for the most part, I think they reach out and try to make the experience as positive as possible. I'm sorry for the way some of you have been treated. I think some of that comes from a coordinator and some comes from an inefficient review process. To me, it's unfair to have a process that would allow anyone to be left out in the cold and unsure of where they stand. It has to be done to some degree, such a wait list. But efficiency is key. As a coordinator I know how difficult this time is for the students and I can't imagine anyone would make life more difficult for them.
Anyway, after that.... I would have to do a bit of research to really see how Step 2 effected each group (those with lower, average and higher Step 1s), I don't know off the top of my head. I've noticed that very few people drop significantly on their step 2 if they take it by the time they're applying. So there is the group who have high step 1 and high step 2 (obviously good), those who have average step 1 and average to high step 2 and those who have lower step 1 and lower or average step 2. On occasion I see a lower Step 1 and super high Step 2, which can definitely be a plus but won't cancel out the step 1 score. Maybe sort of average it in the reviewers mind. And on occasion there is a high step 1 and a much lower step 2, but like I said, not often. I don't think anyone takes notice as to IF someone has taken step 2... they will look at your score if it's there. If you have a very low step 1, it might be questioned why you did not take step 2 and try to raise that image. But in general, I don't think it's considered a negative if you have not taken step 2 by the time you apply.
Just a note, I've read around here with people being upset about getting a last minute interview. The "everyone else is hiding under a rock so do you want to come" attitude is unecessary. We have a lot of good candidates and it may be something very small keeping you from the person next in line. So just because you got that last minute interview does not mean you are not wanted or you should be thankful for that spot. It just means someone canceled and we feel you would be worthwhile enough to interview to hunt you down the day before and see if you want to come in. I promise you, you will be on equal footing.

hi rescoordinator

first of all thanks for your advice

i would really appreciate some help.
i'm an img, just graduated. i really enjoy and cannot see myself do anything else.
i know that as an img, getting into ortho will be tough.
my question is, if i do a PhD in biomechanics (or related field), will it help my chances?

any advice/ help would be really appreciated

thanks

umm, I thought rescoordinator was nsimons; now I have to come up with another guess...

IMG - Anything will help, but to be honest I think it's really a matter of being in the right place at the right time. I know what our department's 'feel' on IMGs is, but I also know that programs vary greatly in their thoughts on the subject. I'm sure some would not consider matching an IMG and some would put you on equal footing. How to know which is which? Research I guess. This website is probably a good place to start. But even so, these things change all the time, with PDs changing or new faculty, etc. But additional degrees and lots of research will help at those institutions who will consider IMGs.
Ironman - Sorry about that... I'm not as good as nsimons! She really knows what's up. No need to guess... it's better you guys don't know because I can be more open about our practices and policies. If I said where I was writing from I wouldn't be able to tell you as much.

throughout all my and my co-residents interviews and travels we collectively could think of 1 IMG that we ran into that was a Ortho resident. He was from Oxford. Do I think its fair? No. But you gotta be realistic that you have a huge strike against you (at least in most programs eyes). I wish you the best of luck

res coordinator and bonedoc

thank you for sharing your thoughts on the matter. really appreciate it.
i think i'll take things one step at a time. right now my main aim is to do as well as I can on the STEPs

thanks

rescoordinator-
Thank you once more for giving insight on this site. I am a M2 attending a U.S medical school. I was wondering how your program and other programs (if you know) view medical school rankings. For instance someone applying with great Step 1, 2 scores but from a medical school that is not necessarily deemed the cream of the crop?

What are some of the things that your program look for in a candidate's application etc?

BoneKollector, check out:

Bernstein, Orthopaedic Resident-Selection Criteria
J. Bone Joint Surg. Am., Nov 2002; 84: 2090 - 2096.

BoneKollector, check out:

Bernstein, Orthopaedic Resident-Selection Criteria
J. Bone Joint Surg. Am., Nov 2002; 84: 2090 - 2096.

bonekollector...I'm a senior resident who is now involved in the residency selection process for our program. Here's my take on the med school reputation thing: if you go to a top medical school or one that is highly regarded, it will help your application. It's an unspoken rule but it's ridiculous to ignore the fact that it does sway many people. However, if you're from a middle of the road school with great credentials (step 1, grades, etc), the fact that you're from an "average" med school will NOT hurt you. In other words, your med school can only help you, but it won't hurt you.

My chairman put it best: He does not think medical school reputation is important, but he cannot help but notice it and it probably influences him to some degree even though it shouldn't. He says that if you're from Harvard or Hopkins or the like, at some point in your academic career someone thought you were hot sh*t. And that makes him take notice, deservedly or not.

There are some programs that interview mostly applicants from top tier med schools unless you have stellar credentials. This is where I think the importance of your med school comes into play more so than after the interviews.

There are people who disagree with me on this but having sat at our faculty ranking session and talking to them after interviews, I can tell you that your medical school certainly makes an impression although it certainly is NOT the decision maker BY ANY MEANS.

IMG-

I have noticed a few programs have IMG residents listed on thier website, two of which come to mind. Alberst Einstein, NY has a PGY 3 from Montreal Canada, a PGY 4 from Israel, and a PGY 5 from Puerto Rico, and NYMC Brooklyn has a student from Ross. My guess is you'll get the best idea of which programs are accepting of IMG's by looking at where their residents and alumni came from. Most websites don't list this, so you may have to do some digging.

Just to clarify, students who train in Puerto Rico are not IMGs. They are considered US Applicants.