Getting into residency with lower board scores, possible?

First, it is possible to match. Second, I would reconsider rotating at a place with cut offs for rotators if you had to beg to rotate. Whe it comes to interviews you could get cut again by their step 1 cut-off. There are plenty of places that will let you rotate and will then look at your work rather than just board scores. Consider community programs (though this is not true at all of them, as some perfer very high scores). lastly, you are taking step 2 on the late end with that step 1. You application might already be rejected by the time your step 2 scores are available. If you can take it earlier but also improve your score. I know a couple people who matched that scores similar on step 1 and got to about 220 on step 2 matched. though with only a few interviews and at places they rotated. Good luck

So you're saying there's a chance!

Seriously, the "big scare" should have come when you got your score back a year ago, not now as you are applying for aways. Based on hundreds of previous posts, it is no secret what a reasonable score would be to expect to match into ortho. Kicking it in gear and blowing away your clinical grades would have been a good strategy. There are MANY programs that cut-off their rotator list, and many more that will allow you to rotate, maybe even interview, but never really consider you a realistic applicant because of your step one score. I would bet that more programs than not cut off their interview list at or above 220. I'm not saying it right, but it is reality.
There are certainly stories of people with lower step one (even failing step one) matching, but for every one that has, there have been thousands that haven't. Usually the person with the low step one who is successful at matching does so because they are exceptional at something else, not just an otherwise "solid" candidate. 95% of those applying are "solid" and have better step one scores. Your best bet is to realize just how far behind the eight ball you are, and take aggressive steps to counter that fact. You need to do as many away rotations as possible at programs that are not as academically focused and literally smoke them all without rubbing anyone the wrong way. In my opinion, you would probably be better served rotating at a few community programs with fewer residents and staff so that you have a better chance of some face time with the chair or residency director. Many larger programs have several students rotating at the same time and can easily get lost in the crowd. Sorry for being so blunt, but I'm trying to be helpful.

My Step One was 206. I brought it up slightly to 217 on Step Two.

Middle ranked at a top 50 northeast medical school with Honors in most of my third year clinicals. I did several aways and got some "exceptional" LOR's (so interviewees told me) from fairly well known orthopods. At the time of interview season I had two pubs, one in JBJS. As far as I know I am pretty personable and interview well.

I got 12 interviews and went on 9.

Didn't match.

Just my rotten experience.

I agree with the comment on not relying on community programs to allow you to have board scores that are sub par. We generally cut off our interveiw list at around 230 to 235 and even then have NO problem finding more than enough people to interview for our three spots. i'd say you can do it, but you have an uphill battle.

I certainly didn't mean to imply that community programs "allow" sub-par step 1 scores. There are no orthopedic programs at this point that have to compromise their standards to get applicants. I trained at a lesser known community program and I would bet during my time there the our average step one score was at least in the high 230's if not low 240's with several residents above 250+ (myself excluded). Because we were small, however (2 residents per year) each rotator tended to get face time with the chairman and all of the residents pretty much knew all the rotators from personal experience. When it came time for rank lists, there were often rotators who impressed who were moved up the list with less than stellar step one scores because of their performance, (as well as those moved down with solid step one scores that came across as annoying or lazy). I was simply suggesting that it may be easier to be noticed and really shine during an away rotation at a smaller (often community) program, and possibly overcome a low step one score. Just my humble opinion.

I agree with the above statement. Big name programs are very difficult to shine as a rotator as you usually get lost in the shuffle & may only get to know a very small # of folks while you are there regardless of your numbers. Smaller programs are definitely easier to get face time with multiple attendings, residents, & don't forget the ancilary staff (ie, secretaries, OR nurses, PA's, etc). This last group of folks have usually been working with the attendings for years & can make or break you. I have seen it work both ways many times.
I would consider rotating at 1 or 2 away programs where they are known to work hard & play hard & get to know the residents. If you are a good guy/girl, they will tell you how to impress upon individual attendings that you need to be a future member of the team. Those programs generally put a lot of stock in what the residents have to say when it comes time to make a rank list.
There are very few, if any, programs that need to lower their standards to fill intern classes, but there are other ways to get into Ortho than by having stellar numbers & being the editor in chief of JBJS.
Good Luck

You can match but you need to be realistic and strategic. I agree that you need to do as many aways as you can. But you can't do an away rotation at a place that will not interview you or where you don't have a chance. That would be a waste. I would recommend looking for programs that have the reputation of favoring rotators, but that also do not have a lot of rotators. If you have any questions about this, go ahead and call a program and ask how many current residents are rotators, if they have board score cutoffs, and how many students rotate per year. This is an EASY way to save yourself a wasted month and put yourself in the highest yield rotation. If that one program said that they do not usually take people under 220, I would not waste my time there.

Your objective should be to match in whatever US program you can. You are not in the situation to be picky. So find some less popular programs. Don't rotate at UCSF or lots of the Cali schools or Big name east coast programs that have 50 rotators a season. Also, it is not in your best interest to rotate at a program with only two spots. Some programs have recently expanded and have not increased the number of rotators to match this.

As for community programs, some of them are tough because they can be run by a few high up attendings that make the decisions. This can be good or bad, depending on the impression you make.

As many people on this site will tell you, it can be done. Good luck.

I agree with some of the previous post. I would not recommend, however, bothering the secretaries or whoever the unlucky soul is that answers the phone at these programs to ask questions from someone who is going to sound like an underqualified applicant. The undertone of the conversation will get around and everyone will know that someone is trying to get in the back door. I would recommend getting on the website and contacting a resident at the program & asking these sorts of questions. Also, use this website to ask which programs are friendly to rotators and give them serious consideration at rank list time. Definitely look at programs that have at least three residents, but do not go for programs that have 5 or 6/year, as they tend to be the more academic places that are very interested in numbers.
Good Luck

The advice that you're getting in this thread is, in my opinion, quite good. At this point, you need to just concentrate on doing well on the tasks you have ahead. Don't worry so much about step 1, particularly since you can't change that now anyway. Concentrate on your away rotations. Pick realistic programs to visit. Engage the staff and residents, make an impression. If you stand out before they see your scores, the lower numbers won't seem quite as important. Your kick-ass performance will overshadow the scores.

I am a resident at a large academic program in the northeast. It should not be a huge mystery which one based on my username. I know for a fact that we have current residents with step 1 scores in the low 220s. That being said, we also have residents with scores in the 250s. There are also current residents with low scores that were ranked to matched solely because they really impressed an influential member of the admissions committee. I imagine that this is probably true for any program; numbers are important but the person behind the numbers is more important. And this is your in. Everyone knows that "good" (and by that I mean good grades) medical students don't necessarily make good residents or good surgeons. I'm pretty sure residency directors across the board recognize this.