I am applying now and just dealt with this decision. I had similar Step 1 score and class rank. I elected to take CK right after I finished MS3. While taking it early exposes you to the risk that you don't do well, you have demonstrated you are a good standardized test taker. Worst case scenario, you score a few points lower than your step 1, which is still well above average. I ended up scoring higher on CK. Having a solid CK score gives program directors another piece of evidence that you are a top candidate. As a student at a middle-tier medical school, I think it's worth the risk to maximize your chances of going to the best program possible. Hope this helps.

Cool thanks man. Good luck on the interview trail!

Hey guys,

Good info on here so far. I would appreciate some objective feedback if you guys have the time.

MS3 from a mid-tier US school

I will make this brief. I have always had an interest in functional movement and musculoskeletal medicine, both from personal experience and current rotations. I have kept an open mind during school and my surgery rotation has led me to lean towards that as a career. I am a non-traditional student, and a pretty average applicant in general. Unfortunately this places me in the bottom tier of potential ortho applicants.

Preclinical: mostly pass, some high pass
Step 1: 225 - yea, I know this is crap but it is what it is
Clinical: first two high pass, hoping for that or honors in surgery
Research: Was a research coordinator for a while - initially did not plan on medicine as a career
- 3 years of qualitative primary care research prior to medical school at a large academic institution
- Published three times - JAMA, Journal of Int Med. Unfortunately none of these are ortho related.
Work exp - Variety of jobs/careers prior to shifting gears into medical school

I have always been realistic and know that any shot I take will be a struggle. I assume my step score will get me initially screened out of most programs, leaving few options for any potential interviews. I am going to talk to professors at my school as well to get a feel for where I stand.

Do you guys think it is worth taking a year to do research, and go all in on trying to match, or just move forward with something else? I am unsure I will be able to get any interviews given the nature of the current applicant pool.

I appreciate any feedback and good luck to everyone this upcoming cycle

Not gonna lie, it's gonna tough with a 225. Definitely want to do well in 3rd year, especially surgery. Take step 2 early and crush it. Like get through the Qbank twice. Most important thing for someone with a 225 will be to pick your aways very carefully. Probably will want to do 3 aways and at programs that most orthogate posters would call "lower tier" (doesn't mean they are bad programs but just not fancy names). You'll definitely want to look to rotate at programs in locations most applicants will consider less desirable. Unfortunately it's just the brutal reality. Not sure if research year would be huge benefit for you since you already have good research experience (doesn't matter that it's not Ortho) and since the programs you'd be more competitive for probably won't care about research too much. Also, if you haven't already go ahead and make concerted effort to build relationship with your home program.

I appreciate the feedback from you both, and imagined much of that would be the case. I'll continue to get input and go from there. I know any decision to apply will be an uphill battle so we'll see what makes the most sense. Thanks a lot.

In a similar boat to breit31, albeit with ortho-specific research. Should a midwest student be rotating at multiple places in different geographical regions? "Top-tier" programs make sense...but what programs are "lower-tier"? Anything that isn't top-tier?

Trying to figure out how to optimize my chances (which are probably highest at home/regional places) and increase interviews. Thanks!

I would not recommend rotating at geographically different programs because I do not think it will open up that region. If you really like the program and you do well on the away then you will probably get an interview, but do not expect other interviews in that region. This is based on personal experience and this seems to be the consensus with the people I have talked to on the interview trail. If I were you, I would actually try and do aways in the same region you have either grown up in, went to college, or are at medical school. Those programs are your best shot of getting interviews.
As far as tiers, community programs are more likely to be forgiving if you show a strong work ethic during aways and have solid letters of recommendation. That being said, I would also rotate at 1 university program you believe would be a good fit and you are very interested in.

I agree with what mdizzle said about not really believing the "opening up a region" talk. If you're from the SE and have a 225 you should probably rotate at as many SE programs as possible. If possible, you could also try to find out which programs don't get w ton of rotators and rotate there.

Also I'd like to clarify my "tier" comment. I don't believe in that tier crap, I just used the term because people on here do. I think there are lots of programs that orthogate would label "low tier" that have better operative experiences than "top tier" places. However, as an applicant with a below average step score, you should probably use forums like this to figure out what programs have fancy names that impress boatloads of Ortho wannabes.