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  Monday, 22 March 2010
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Long story short, I did not match into orthopedic surgery. I was an okay applicant, Step I - 235, Step II - 231, CS passed, top 40 school, told I had good letters, really only 1 publication that is just submitted, but research currently on-going in ortho. NO honors and to be frank, kinda crappy 3rd year grades though decent written evals even with bad grades?!?. blah blah blah, you know the deal. I got 9 interview offers but could only go on 7 due to date conflicts,

I feel like I was a "decent" applicant. Maybe on the lower end of competitiveness to those who matched and maybe could have matched 4 years ago, but whatever. I'm not a particularly strong interviewer too btw.


ANYWAYS, so I did not match into ortho, but I decided to try to scramble and got an anesthesia position in probably a middle tier academic program associated with a public medical school.

Now, I'm just incredibly confused about several things and I have a few questions I want to ask orthopods about:


1. Did I sell out or betray ortho? I sort of feel that way. I feel like several residents liked me (at least as a person/ nice guy) here at my home institution who had reached out and given me advice during the process and encouraged me to pursue ortho instead of gen surg before then. Im afraid it may seem like my interest in ortho was insincere since I did not even try to reapply next year, and I just scrambled into anesthesia.

Truth be told, I think I had a chance to match next year if I did research and/or worked on my interviewing skills/confidence a lot, but I just know that after not matching, I would get even fewer interviews (maybe 3 or 4) and I would be even less confident on those interviews. The other option was try to reapply into gen surg next year, which sounds terrible to me too given the fact that after my 4 months or ortho rotations, I don't think I could do general surgery any more. Ortho was many times better...

How do you think residents who liked me would think of it? How about attendings who I worked with and especially letter writers?

2. What should I do with my ongoing research? It's a chart review I started in January that I could probably finish if I worked in the afternoons of my next couple of months and in the little bit of time between finishing 4th year and starting residency. I am about half way through with it. I have my internship year in the same city as the research project so I could conceivably work on it next year. It is still a good 40 minutes driving from the hospital/area I'll do my internship. I think there is potential to get published and it can be finished, but since I'm no longer going into ortho, is it even worth it? I could spend the extra month purely relaxing (or freaking out about my future, whichever comes first).

Additionally, I am sure there are a ton of first and second years at my school who would love to find ortho research!!! It is really hard to find at my school! I wish I got on a project like this earlier so it would be available for the time my application went out, so I could find someone who would want a project and it could really help!

3. Any recommendations on how to not be a shitty surgical intern next year? I learned a lot about ortho or at least how to manage patients on the floor, but gen surg patients and especially ICU/trauma patients, I'm a little horrified on their management. I'm thinking of reading a book on cardiology and pulmonary management and possibly renal since those are the systems I am weak on but I don't know.

Also, did anyone else not match... It seems like everyone on this site matched, so congrats to you all (trust me, I envy you) but what about the dark side of the match...

Thanks for your help!
16 years ago
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#55949
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Not sure exactly what your asking here, but here are a few thoughts. I didn't match the first time around, but did the gen surg prelim year and applied again and matched the second time. If I had it to do again, I'd do the same thing all over again (though it sucked). Everyone is different. I wanted to do ortho and nothing but ortho. I tried to picture myself in general surgery, anesthesia, radiology and so forth, but I knew that I would not like any of them as much as ortho. That was me. You have to do what you feel is best for you. It sounds like you found the best alternative to matching into ortho the first time around, and if anesthesia is better than trying a second time for ortho then great. Beyond that, what does it matter what anyone else thinks? If you really were set on ortho and dedicated to do it you'd try again. The fact that you didn't does not make you less of a person, doctor, whatever and it does not make you a traitor. It simply means that anesthesia is your thing if ortho didn't work out the first time.

As far as the research, I'd talk it over with the PI on the project and see if someone wanting to do ortho might want to take over your part if the PI would rather have a future orthopod on it. Often I'd think they'd rather have someone working on the project who is really interested in it, and you'd give a potential orthopod some research.

Being a good surgical prelim isn't that hard. If you want to fit in with the gen surg folks (especially in the ICU/trauma setting) pretend you know everything and blame the complications you cause on the patient's disease process. Well . . . that's a little harsh and overstated, but in general you'll always have a senior resident that can be reached, and all the other interns are in the same boat. I would say this, however, ICU/critical care stuff is anesthesia bread and butter so you should probably learn to love the intubated/vented patient and taking care of the critically ill. You'll usually have more than just your intern year to rotate through the ICU as an anesthesia resident. Pulmonary, cardio and renal are basically three of the most important areas to know well as an anesthesiologist, so your reading is a good idea. I'm sure you'll be fine. Internship is all about being lost and not knowing what to do now and then so you can learn and not be lost.
16 years ago
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#55950
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I think you need to stop worrying about whatever people think.

Move on with your life, if that's what you want to do. If you feel like you want to give it a shot, then try again (if you're allowed to?) In that case, finish the research and stuff like that.

It sounds like you have regrets..and you need to come to grips with that, or decide to move back in that direction...

good luck!
16 years ago
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#55951
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have some confidence in yourself. could tell based on that post that you might be a little shy, hesitant, etc. study hard, know your stuff, and yourself and be confident. and have fun.
16 years ago
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#55952
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Yeah, I was freaking out a little more earlier. Believe it or not, not matching and scrambling is just a tad stressful...

I'm a bit more relaxed now so I'm much less worried. But thanks for the replies!
16 years ago
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#55953
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1. Did I sell out or betray ortho?

No, and honestly I get tired of the "other-specialty"-bashing that goes on here. The moral is that "you should do what you want to do". I know a ton of folks who matched into Anesthesia (and other fields) who make fun of me because I work more and get paid less. And, I'm not nearly as good as crossword puzzles as them...

2. What should I do with my ongoing research?

Who cares? It honestly depends on why you're doing research: if you care about it, then you should continue. If you stay in lab only to match into another specialty or another secondary-gain reason, it's going to be transparently-obvious. In general, using research to match in a particular field at a particular institution is a very expensive process which often doesn't pay off... remember that you're trying to impress surgeons, not researchers.

3. Any recommendations on how to not be a shitty surgical intern next year?

From my brief stints as a surg intern, I'd say the most important characteristic is "not calling your upper levels". The less you harass your uppers about potassium, dressings, discharges, PT, OT, SW, etc. the better. No GenSurg intern at my institution gets to display any real surgical skills. If you consistently show up at afternoon rounds with a shorter list than was presented at morning rounds, YOU'LL BE A GOD.

Sorry for the rants, I'm having a tough evening.
16 years ago
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#55954
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From my brief stints as a surg intern, I'd say the most important characteristic is "not calling your upper levels". The less you harass your uppers about potassium, dressings, discharges, PT, OT, SW, etc. the better. No GenSurg intern at my institution gets to display any real surgical skills. If you consistently show up at afternoon rounds with a shorter list than was presented at morning rounds, YOU'LL BE A GOD.


Ummm, I think one's uppers would be less annoyed that you call them with a stupid question than they would be if you f#@$ed something up becuase you were too proud to ask for some help. But that's just me.
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