Black Monday 2009

I think a mediocre grade in OB/GYN is actually looked favorably upon from what I understand!
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Anyone else tell where they did away rotations at and where they ended up interviewing at? Was everyone going for some really competitive places?

I don't know what to tell you - those are all very competitive places, so you're putting yourself in thin air. Kinda like trying out for the Super Bowl champs - if you make it through camp (interviews) there, you're probably pretty good...and if you get cut, you probably land on your feet somewhere else. It becomes a numbers game. What I meant by my above posts - just like with interview invites (getting turned down by bad programs, but getting invited to top places), there is a certain random caprice involved. None of this means that you're not going to be successful, it's just not going to be right here, right now. This is a major gut check but if your heart is really in ortho, it's something you'll overcome, and it's something that is going to make you a better resident, if not person.

I already did research, decided to do that instead of a prelim. It was a more positive experience (i.e. more publications/posters and more advocacy by the attendings) and therefore paid off in the end.

You can do either gen surg prelim or research.

It doesn't matter if you "need" more research on your apps or not. The advocacy will be one of the most important things you can get.

You guys have some crazy scores and applications as a whole. I thought I got screwed last year being 250+ on step 1 & 2 with AOA. There is absolutely no explaination for you guys not matching. So don't sit down and try to figure out a reason. You were, and still are excellent candidates. The schools that passed on you are stupid. There is just to many people that know someone or have phone calls made, and that ends up screwing great candidates such as yourselves. This process obviously does not work if people like you are not matching. I can't say sorry enough, because I know exactly how you feel. Don't give up, you deserve whatever specialty you want. Try to improve however you can, which is tough when your already in the 260s with AOA and pubs. Show everyone how stupid they are for passing up on you.

Sorry guys/gals.....GOOD LUCK

It's actually pissing me off all over again reading these posts
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So i don't want to beat a dead horse, so i agree with all the above posts (i.e. you know your weaknesses try to use the next year to shore them up, if you don't have any, use the next year to build the contacts that will help you get in).

Since a lot of people are responding who matched this year after not, i thought i would just "add to the literature" that I matched after doing a year of research, not graduating, 2 A-I's during my research year, and having my mentors go to bat for me every step of the way...

Had 7 ranks/interviews last year, and 7 this year (i think more of the programs i interviewed at knew me better (due to the additional aways), and more importantly knew my research mentors really well...

Was given many kudos on impressively improving my application after not matching by programs i interviewed at last year... FWIW...

AS

I too am a little frustrated to read all this. I lost my faith in the match last year when I didn't match. I was fortunate enough to match the second time around, though, and I wanted to put a few words out there for those who got that devastating news today.

Those who didn’t match may hear familiar phrases like, “sometimes great applicants fall through the cracks” or “there’s some randomness to the match”. The most reasonable explanation I heard throughout this year while interviewing the second time around was sometimes all the programs that interview an applicant get the idea that a strong applicant is going to match somewhere else and they rank other people higher. Whatever the reason, not matching is an awful experience, but there is hope for better things to come.

The scramble tomorrow is always a possibility, but generally there are no spots available in orthopaedic surgery. It’s just the nature of this competitive specialty. Other than that there are really three main options: research, prelim year or change specialties. There are many opinions on the merits of these two options. I won’t comment on switching specialties other than to say it’s a very personal decision that you have to make and many people go that route. The prelim year puts you in the position to slide into a PGY2 spot should one open up through the year, but it may not do as much as research to actually strengthen your paper application and it’s most likely you’ll have to do PGY 1 again statistically. Research can certainly strengthen your application, but it does mean you have to start with PGY1 next year for sure and you have to be at the right place to get something actually done before applications go out again in a few months.

I chose the prelim route because I have a family and needed to make sure this year would be paid, and I wanted to try for PGY2 spots if they came up (there were 6 spots this year that I know of). This year has definitely been a challenge, but it’s doable. It’s worth it if you really want to do orthopaedics. I would encourage those who scramble into prelim spots tomorrow, however, to find out how willing the programs are to help you get the rotations the ACGME requires for a PGY1 if you want to try for PGY2 spots .

The important thing is not to give up, and once the cloud of all this has passed try to find ways to strengthen your application rather than spending too much time wondering what went wrong (other than to fix deficiencies). Honestly, after a year I'm still not sure what was wrong with my application and no one of the program directors where I rotated or the people who interviewed me can tell me. From what I've read there probably is not anything particularly wrong with a lot of applications. I wish there was a good explanation, but I don't think there really is.

It is definitely possible to match the second time around. A prelim year is not fun, but it is doable and worth it. I’m sure the research is doable as well. You can still be an orthopaedic surgeon if you put the work in and you’re truly dedicated to get into this field. Sure there are programs that don’t interview those who didn’t match the first time, but there are more programs out there that do. I went on just as many interviews this year as I did last year, and I even went to two places that I didn’t get an interview at last year. This next year will not be the highlight of your life necessarily, but it will make you a stronger applicant, and there are programs out there who will recognize that. There’ll be plenty of opportunities to get discouraged through this next year, DON’T BE. Some of the programs I interviewed at this year commented on how some of their best residents are those who didn’t get in the first time around. Don’t give up. Don't get down on yourself. Get back up, dust yourself off and start again. One more year will not seem like much in the end. You'll probably end up being a much stronger resident and eventual surgeon than you would have without this horrible experience. I hope things work out for you in the next go around. They did for me. It's doable.

congrats on matching jdoc, i know you were sweating it, can't wait to see where it's at!

I would contact every program you interviewed at, inform them that you didn't match, and ask what made them not rank you to match...tell them to be upfront. I think that's the best way to find out what you need to improve on for the next go round. Sorry if this is overstating the evident, but I think programs will respect your resolve and give you valuable feedback. Just my 5c worth.

Do most people who do a research year delay graduation for a year?

I think in deciding what to do next, it's important to pick whichever gets you more excited. For me, I really wanted to start my residency and get my intern year under way. When I thought about doing research for a year, it made me want to throw up. I didn't go into ortho to be a researcher. I didn't have any publications and that wasn't the strength of my application. The toughest thing for me was starting intern year and putting a giant shi* eating grin on every day. If you scramble, be very clear about what you hope to get out of the year with the program director (and it should include time off to interview and 2-3 ortho rotations early to get fresh letters). I was one of the lucky few that was able to get a 2nd year spot that opened up so in the end I won't lose any time. It was a round about way to end up in orthopedics and the program was one I didn't even get an interview at the first time around. Feel free to PM me with questions. Good luck to everyone out there. I will never forget the day last year as it felt like one of the worst of my life. It gets better and it makes finding a spot so much sweeter.

Looking through the ACGME requirements for the PGY-1 year in ortho, I noticed that you can have a "maximum of three months of orthopaedics". However, is there a minimum requirement, short of trying to get a month so that you have good letters?

I ask because my home program does not take non-ortho PGY-1s on the ortho service.

Thank you all for your help, this process is brutal.

There is no minimum requirement. Theoretically, you could do zero months of ortho. However, one of the most common questions I got on the the interview trail this time around was what orthopedic rotations have you done. One PD even wanted to see my evaluations from those months. Moreover, you really need to have fresh LORs. This is pretty impossible unless you are rotating on some ortho services. I recommend using one strong letter from the year previously if you can get that letter writer to "update" your letter including why they think you didn't match (or if they were totally shocked, etc). I would be wary of accepting a prelim spot at a school that won't let you rotate through orthopedics at all.

I don't know about most, however here are the reasons I delayed graduation:

1. Begin research sooner - I had one rotation scheduled to graduate so i dropped it and began my research as soon as was humanly possible after i was accepted. As was stated on some other posts, reasearch takes time so the earlier you start the more you get done before Sept. 1st (or whenever you submit your ERAS). I had 2 manuscripts published before i submitted my ERAS (but had to wait till the end of sept. for the second one - for those who want to know if it makes a difference when you submit ERAS...)

2. My research fellowship was unfunded - Allowed me to take another year of loans to support myself.

3. Allowed me to rotate as a visiting MS4 at 2 other programs (with my med school covering the malpractice - don't know how it works for prelim guys, but i've heard its difficult to do once you've graduated...)

4. All the chairmen and PDs that I spoke with after not matching suggested I do it from a purely statistical standpoint. I was told that based on the last few "charting outcomes in the match," 80% of US seniors match into ortho, where as only 40% of EVERYONE else (meaning US grads and IMGs) match.

Thanks for info. I was just wondering when you did your 2 sub-Is.

Great point, and absolutely correct - the paradox is that medico-legally, you are allowed to do less as a MD than you were at any point during your med school career...so unless you want to resign yourself to "observerships", it's best to maintain your MS status.

meh.
238 step I / 245 step II, no AOA but an interesting app, some research, a little non-traditional. i had to miss a bunch of interviews because of illness and my rank list was small - my non-match wasn't a big surprise as my interview season wasn't great (see aforementioned illness.)

i'm doing research in my home program and will try again next year. hopefully without the Black Lung.
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Actually, my post was in response to someone who asked if everyone who did a research year ended up delaying graduation... Sorry, probably should've quoted them...

To answer your question my research mentors gave me 6 wks off in Oct and Nov. Wasn't too worried about LORs because I already had enough my mentors (who are all attending ortho surgeons), therefore had the luxury of doing them later and with the express purpose of seeing if I was a good fit at their program.

AS

Good luck today on your choice of location to all those that matched. Don't forget to start a new thread this afternoon with the information about your stats, how many schools you ranked, how many you ranked, and maybe your first three choices and whether you made to one of those.
Again good luck and hope you start the threads as some of us want to be realistic about our chances by looking at you folks.