rotate. far and away the best way to get your foot in any door. discuss this immediately with your fiance. show her this website, and let her make up her own mind if she is not supportive of the idea. i'm married with kids, and believe me i know where you are coming from. but if she is not on board now, it will only get worse. your numbers are solid, but i think you already know that none of us are really distinguished by having good numbers anymore. if you are comfortable leaving it up to the powers that be, then stay home and take your chances. if you want to do something, anything, to improve your lot, then suck it up and rotate. i personally was not interested in just riding the tide.

and no, this is not an annoying question. by asking it once, you may be helping others with a similar circumstance. just be sure to give back as you start to accumulate some answers. it makes the world go 'round.

cheers

What's up dude,
I'm just a 4th yr. waiting to match so keep that in mind...To answer your first question about whether you'd be an average applicant at "competitive programs", it is difficult to say. Obviously your step I score and class rank are competitive, but you gave no indication about research/publications, strength of LORs, strength of medical school, volunteer work, etc. and all these variables seem really important, especially at the top programs where everyone who gets interviewed has great scores and rank.
Also, I do think you will be hurting yourself (big-time) by not doing away rotations, esp. at the top programs. It all goes back to the "known quantity/who you know and who knows you" thing. Keep in mind that the JBJS Nov 2002 article indicated that over 50% of candidates who matched did an audition elective at the place they matched...Also, PDs deemed that the most important thing about a LOR was whether they knew who was writting it. I don't know how strong your home program is, but not doing aways will hurt your chances of potentially getting great letters from well known people (which will carry you a long ways when it comes to getting interviews). Basically what I'm saying is that you really have to sell-out and do everything you can, and don't underestimate how competitive your fellow applicants are. Anyway, good luck and I hope things work out for you.
Skull

Sirbonesalot,

Why do you have to be so annoying!!! ) Seriously, your question is a valid one, glad you asked. I can only share my personal experience relating to your problem. I generally fit your qualifications profile as well and was surprised and disappointed as to where I got interviews or not. Most of us I think agree that it's a largely random unpredictable thing as to where you get interviews. The only thing I feel safe saying is that if your numbers are strong, you'll get an ample number of interviews (>12). They just might not be all or many of the places on your wish list despite being strong number-wise. I've given up trying to figure out all of the why's of it and I think there are just too many variables at play when it comes to who gets interviews where. For a discussion of some of these variables, do a search for terms like 'regionalism,' 'research,' and 'away rotations.' What school you hail from seems to be a possilbe issue as evidenced by what I was told during one interview: 'there are some schools that we never have, or likely will interveiw people from.' A little surprising, but probably a wider reality than not.

I too am married with kids as is Rocketscientist. I agree very much with what he said regarding inviting/prodding your fiance to get on board. I got my wife reading this board early on and I have seen how it has paid off when it came to what's perceived as necessary to match (aways, $$$, traveling, working harder than your fellow students, etc). And there's no doubt that if she doesn't get on board you'll have problems that will snowball into very difficult problems down the road. And believe me when I say that just because my wife has been very supportive that it has by no means been easy nor do I believe it will be. I just can't imagine setting out on this without a solid level of support and understanding.

Concerning aways, I am somewhat skeptical that they are totally beneficial as discussed in another post. But I think that one thing they can do (if you do well) is establish that you are all the great things that the guys at your home school say you are (ie in letters of rec, phone calls, etc). I think most applicants get strong recomendations and grades from their home ortho dept, so that becomes a common denominator for many of us (just like Rocketscientist pointed out with good numbers being tough to differentiate yourself). I am convinced that a great letter of rec I got from a chairman at a program I rotated at opened some doors for me based on the comments I got during interviews regarding his letter. There are many other potential benefits from doing an away rotation and these have been discussed ad nauseum on this board. I'll leave you with a valuable piece of advice that I got from my PD that I think is important to consider: An away rotation may often help a marginal or average applicant (on paper), but has a lot of potential to hurt the applicant who would otherwise get an interview just based on his/her paper application (ie high step I scores, AOA, etc). My personal experience has been that there are opportunities galore at every turn during an AI to either impress or unimpress and everyone is trying to do the same thing you're doing...impress and do well. Just talking about it makes me glad I'm done with it. Best of luck and I'm just realizing this was long-winded but with not much else to do but wait for 7 more days...

OF

Doing an away rotation can do more than just help you get into a program. It can, and will give you a great opportunity to see how life is in another place; See a different hospital system. Meet different residents and attendings; See different ways to do the same things; Even pick up a few tricks that may stick with you forever.

Mimicking the sentiments from above, all I can say about residency is that it is a whole new world in terms of time committment and stress. It certainly is manageable and as a guy with a wife, a 2.5 year old and another one anyday now, I can tell you that it does get easier as you move up the ranks.

If you aren't sure about your level of committment now, you need to step back and think about it. How are you going to handle it, if for some reason you don't get in to a program right our of medical school. Do you think you will regret not doing all that you could? I just got finished interveiwing candidates for our program and I can tell you that I interviewed more than one person with your academic credentials who were going through the interview process for the second time. Don't take the chance. Most of your peers are doing a rotation so your only answer to the question, "Why didn't you do an away rotation?" will be. "Uh, I thougt my scores were good enough that I didn't need it." DOesn't sound so good, huh.

Anyhow, don't look at it as work. Look at it as an opportunity to learn something more about ortho (it will only help you in the long run), and learn something more about yourself, i.e. do you have what it takes to stand out amongst your peers. I gotta tell ya, I didn't have numbers like you and it made me feel like I had to do an away roatation. I didn't get into that program, but the letters I received from attendings there certainly helped me to get in somewhere else. Good luck.

I have to say that I disagree SOMEWHAT about the importance of the away rotation when you DO have the scores and grades. Remember, aways have been traditionally a good way for a candidate who is average on paper to get noticed above the crowd. Once you fall into that "group" (>250, near top of class, and I would specifically say AOA+), then you are highly likely to get a lot of strong interviews. You may not get ALL of them, but you will also probably be offered more interviews than you will have the time or $$$ to take. It seems to me that once you fit into that "group", an away rotation really only comes into huge play AT the program where you did your rotation (i.e., might nudge you into their "ranked-to-match" list). I only did one away rotation and still managed to get a lot of encouraging feedback from many other programs.
Be prepared, however, to answer WHY you didn't rotate away, or why you are specifically interested in Program X (just as rotators often have to defend their choice of awaya to other programs when they interview). The problem with NOT doing an away is that you lose the opportunity to see a different program/city, which can help solidify in your mind exactly what you ARE looking for in a program.
Would it kill you not to do a rotation? Probably not.
Would you learn a ton that could impact your decision about where to spend the next 5-6 years of your life? You bet.
Will spending a month apart destroy your marriage? If so, you're marrying the wrong person! (I'm married and have spent over 4 months away from my spouse... absence makes the heart grow fonder, right?)
Good luck!

let's not forget that the object of this entire endeavor is not just to get interviews. the point is to be ranked in the matchable range. who cares if you interview at 50 programs and they all rank you dead last? i submit that positive familiarity will put you higher on a program's rank list in the vast majority of situations. this opinion is supported by much conversation relevant to my own experience as well as the oft mentioned JBJS article. i'd bet a big chunk of change that if programs released their rank lists after match day, they would be top heavy with the good to neutral rotators, followed by solid local nonrotators and stellar nonrotators from far away places, with the "liability" rotators (hopefully this unfortunate label will never apply to those savvy enough to study this site ) bringing up the rear if they make the list at all.

thoughts? comments? informed opinions? other total guesses (like mine)?

I agree with Dr. Dre. Having been in a somewhat similar boat with my s.o. who did not always relish the idea of me doing a bunch of aways, I understand where you are coming from. If your numbers are what you say they are, then I must echo what Dre said and assure you that you will get invites regardless of whether you do an away or not. All those things that I pissed and moaned about in my previous post are unfortunately what interviews are made for in many cases. Numbers, AOA, research, grades, letters...all those things matter, and you are fortunate enough to have some of them in your pocket. The key, and this is what I am here to harp on, is that you need to do this for you and your fiancee. If I had not gone on my away, I may have ended up at a place I ended up ranking out of my top 3. The program looked great, people were always telling me to go check it out, and I loved the city. Unfortunately/fortunately the program was not for me and so I dropped it down my list. The point here is that you need to point out to your fiancee, especially if she is not a resident/student, that while you will be pretty happy at a lot of places regardless of what is going on outside the hospital, that SHE will be miserable if you go someplace where the program is great but the city sucks. Or visa versa. I will also echo previous sentiments that have stressed the importance of letters. I cannot tell you how many interviews I went on where people would go "How is Dr. X doing? I love that SOB." And I would just smile and thank my lucky stars for having worked with that guy. Letters are very important. You need to work hard to get them, but they help you stand out amongst a wall of numbers.
Best of luck

P.S. I want to emphasize that this IS a useful post. If you want to come on and ask "I have a [190-280] on my boards, am (+/-) AOA, have(not) done (the most ridiculous) research ever - what are my chances of matching?" Then the answer is 62.34% Yes it is a stupid answer but not as stupid as the question. I HAVE NO IDEA IF YOU WILL MATCH! I AM NOT A PD! If, on the other hand, you have a question like SIRBONESALOT (p.p.s - uh, nice name?) - "I am a good student with good scores, do you think I should do an away?" then fire away. I also want those of you who do not have credentials similar to the ones mentioned above not to stress. You all have a good shot. As good as any of us. Just try to assess where you stand as a(Great/Good/Average/Below average/Weak) applicant based on previous posts/common sense, and try to work towards vaulting yourself up to a higher level - for example, if you have average board scores and good grades, try to rock step II and work your butt off on rotations. These are common sense things that you should try and do anyway. Don't think, "well I got a 270 on my boards, I can blow off my rotations". Sorry for the rambling again.

I think that despite having great scores and grades, it is sometimes hard to get across how great you are during an interview day where they rush you in and out of rooms with multiple interviewers all asking you somewhat superficial questions. By the time 15 min is up, you've just started to break the ice and feel comfortable. By spending time (even if it's 2 weeks) at another program, the program will get to know you on a less superficial basis AND you can have the best view of whether or not you would be happy there for 5 years. I left most of my interviews feeling that they went really well, but a month later, I don't know if they would even remember me - having interviewed so many qualified applicants. You end up interviewing with dozens of people all in dark suits and looking alike with similar scores. It is likely that high scores and grades will get you an interview, but then it's up to other various factors. Programs usually remember rotators whether that be a good or a bad thing.

Personally, I did a local away where I commuted 30-40 min from home and an away clear across the country right after I got married. I missed my spouse, but he understood how important it was and it was only a month.

Ultimately, you have to do what is best for you and your family. Hope this helps.

..... I just got finished interveiwing candidates for our program and I can tell you that I interviewed more than one person with your academic credentials who were going through the interview process for the second time.....


OrthoDoc79....as a 3rd year looking to get into this whole process (who has a 244), how many people with >250 on Step I did you see (interview or applications) ?? I just wonder, I thought I was in the top 5% or something, and yet it seems like tons of tons of people are >250 (if only 5% of med students have these scores, are ALL the >250 people going into ortho ??).

Also, if you could "rank" your program if you will....top tier academic, community, whatever...

orthodoc79,

In addition to Giantboner's question for you, I have another. Without violating anyone's privacy could you elaborate a little bit about why, in your opinion, these applicants didn't make the cut the first time.

I know this topic has been discussed generally on this board and items such as not ranking enough places, only applying to more competitive programs (ie no 'safety net' programs--although do these exist in ortho?), performing poorly during the interview, and others have been mentioned. I think we all want to know that there is/are rational reason/s why things happen the way they do.

It would also be interesting to know how many 2nd or 3rd timers there were on the interview trail this year. Obviously no one was advertising whether they were or not and I don't expect many to chime in on this post whether they are/were or not.

Giantboner, if it is any reassurance to you at all, I think that the posts on this board can be rather anxiety-provoking at times. I recall reading very similar posts to the ones on this thread when I was in your shoes. I think we all--myself definitely included--get caught up in numbers and writing about how competitive ortho is, etc, etc. I think at times we all probably psych ourselves and each other out a little bit. I like to believe that this board generally represents some of the better applicants so that's something to keep in mind. Just try and use it as motivation to rock everything so that you are a strong applicant and can match at one of your top choices.

Giant____er(can bring myself to type it),

I am from a program in the midwest, that is likely in the upper tier of the middle third of programs (at least that is my best guess based on various sources). In any event, I would say that we interveiwed as many people above 240 as we did below 220. Most people fell in the range of 225-235 with some outliers (low 200's(2) to over 260(n=2)-yikes). The people who were reinterviewing listed many reasons that they thougt they didn't match, but most importantly they felt that they underestimated how hard it would be to get in based on their numbers alone. If you have a great Step I score and only apply to 10 places, and don't do an away rotation, and don't have research, and don't have many honors in your 3rd year rotations, even if you are AOA, it sure seems like you are hanging your hat on your good Step I score and expecting everyone to just take it on your word that you will be a great resident.

Take it from me, a guy with 224 on Step I, no AOA, some research, 2 Ms-III honors (Surgery, Ortho) and otherwise mediocre grades...I got in because I outworked all of the guys with 240's and 250's (a little luck didn't hurt either). It's like a score that high is a blessing and a curse. All it says is that you can take a test and retain information. That's important but do you think that your patients will ever care what you got on the USMLE board exams. All they want to know is that you passed. Beyond those tests, you need to be able to think on your feet, get along with people from all walks of life and amass a ton of information in a short period of time. Don't get caught up in the numbers. I am sure that it is nice to have those big digits, cause it will certainly open the doors to interview at a lot of places that I didn't get a chance to, but the bottom line is, not many people are going to accept you into their program if they don't like you or don't think you can stand up to the pressures of the training program.




Our program(and most that I am familiar with) looks for people with a history of academic success (that's just about everybody), and then for people who have a history of and are willing to work hard. It's very difficult to tell how someone is going to respond to the rigors of residency if you only get to know them for 15 minutes on an interview day. That being said, if you aren't going to bust your butt on an away rotation, stay home and take your chances not doing an away.