Failed a 3rd year shelf

honors in surgery is essential that is what you should focus on now, also try to get to know some people in your ortho department, send email to chair expressing your interest. but again honors in surgery is huge, and just try to kill the rest of your clerkships

There was a guy a year ahead of me who failed his psych shelf and had a HP average, but he still got into an ortho residency. But his board scores were quite a bit better ~250 and he had research.
If ortho is truly what you want then you have to go for it 100%. Work like crazy to get honors on your remaining rotations. Take step 2 early and do great on it. Earn the respect of your attendings and get them to write excellent letters for you... all the usual stuff.
Some schools will be out and you may have to do a year of research or a prelim year... in fact if you apply for a grant to do research between your third and fourth year that would really help (though I would suggest taking step 2 first because you will forget a lot if you are away from the floors for a year).
That's my 2 cents, and I'm just an MS4 so my knowledge is limited and others may be able to give you better/more suggestions... and I'm only relaying second hand info, that guy may have done more stuff that I don't know about.... either way good luck

Honors in surgery is essential...actually, that is a huge misrepresentation. At the orthopaedic educators course the last few years, they have presented research that showed that step scores and honors in surgery and orthopaedics were very poor at predicting what residents do well. The best indicators were honors in medicine, peds, ob and the non-surgical clerkships. It seems that those that try to do well in rotations that they don't like and don't think are important, because doing your best is "what you are supposed to do" actually make better residents. Steps are important, because it shows you test well and are likely to pass boards, but the notion that you only need to honor surgery is old thinking and is actually less important than doing well in the non surgical specialties. They also found that letters were useless, because almost everyone gets glowing letter.

that is interesting. I was told specifically that if you don't honor your surgery clerkship that is a problem however medicine is just as important. To my understanding all third year clerkships are important but ob gyn and peds hold considerably less weight. That is interesting data, I don't doubt there is alot of truth to that.

I guess you have to look at where you are getting your information. This information was presented at the AAOS educators course....a course that most program directors and many faculty attend at least once, more commonly every few years. While honoring surgery shows that you do well when you feel like you have to impress and that you do well in a surgical field, honoring things like Ob and Peds tell yo a lot more about character. Someone that works hard and does well on rotations that they don't necessarily like, will obviously work hard on rotations they like. You can teach orthopedics, you can't necessarily teach character and work ethic. Another thing that came out in this was that true black marks...things that really cant and shouldn't be overlooked are professionalism or ethical black marks. Again, those are things that cannot be taught. You either have it, or you don't.