I'll throw my opinion in as a 4th year....

I've given a lot of thought to what I would do in this situation. I considered applying for Gen surg as a backup, but that's means a lot more hoops to jump through. You have to make a new PS (I don't think that ortho one will be too impressive), and you have to worry about what programs will think if you apply to Gen surg and ortho at the same hospital. I imagine those General surgery PDs will LOVE to know that they are your backup. Plus, the idea of leaving my career up to a roll of the dice come match day is not too attractive.

My strategy is to wait until programs stat sending out interview invites. If I find that I'm not getting as many as I like, I'll apply for a prelim. They are not hard to match into, but if you wait until scramble day, most of the good ones will be taken.

Good luck.

its a hard sell to a gsurg PD that you want to do lap choles for the rest of your life, when youve done 3- 4 months of orthopaedics (which they'll know from your transcript... and which youre probably going to do if you are like most ortho applicants). that, and if youre asked about where and what you applied to, you might have to lie. any reason to not rank an applicant can be used against you... like say, lack of certainty or commitment. which is how i interpret applying to multiple specialties.

if you dont match, which, from your numbers, sounds like you wont, then scramble. or do a year of research, get an MBA, or do a prelim year.

I don't think that last statement in the above post is true. There seems to be no reason you would not match. At least not any less likely then the rest of us. You step 1 is above average for last years match group. You have some research and like you said top 15% in class.

I do agree that scrambling is probably a better optio since they are unlikely to rank you high for Gen surg because it is obvious you want ortho.

if you dont match, which, from your numbers, sounds like you wont, then scramble. or do a year of research, get an MBA, or do a prelim year.

That statement is absolutely and utterly wrong. I have no idea why you think a 234, top 15%, and some research would make it seem more likely than not that someone would not match. I think that the original poster is probably in decent position and planning to scramble if needed seems reasonable.

i guess the double negative thing is a hard thing to figure out. my bad.

he wont not match... meaning, he will match for all the reasons overhaul pointed out. planning for a gsurg backup is unreasonable.

I applied for both Ortho and General Surgery. So far I've received interviews for GS but none for ortho. I'd definitely prefer an ortho residency vs. GS, but I just want something surgical, so as long as I match somewhere I'd not be too disappointed even if I match in GS and not ortho. I'm an IMG by the way, so my chances are very slim already for ortho, I just thought I'd give it a shot.