In an effort to quell the collective anxiety of any who may read your post I will tell you that I do not see how you would not match ortho unless your application has red flags (negative/lukewarm letters, poor clinical evals, serious professionalism/personality issues, etc.). Your step scores place you on the side of applicants that matched (NRMP charting outcomes 2012), you have solid research experience, unique traits (J.D.), etc. As long as your performance on rotations (esp. gsurg, medicine, ortho) is strong, you secured strong letters and you mesh well with people I would not be stressing about prelim surgery programs at this point. Best of luck man we are all in this together.

I apologize I did not mean to give anyone anxiety I left out my red flag which is the fact that I did my medical school at Carribean school. It was much cheaper and allowed me to start in January was terrible mistake in hindsight, thats why I figured I would need to do some sort of prelim year. I did honor in my gsurg and ortho clerkship and my letters are solid.

It will be a harder road but doable if you want it enough given your record of good board scores, solid letters and rotation grades, and growing portfolio of ortho research. Nothing you can do about the past so I wouldn't worry about your decision to go to a Caribbean school but instead I would continue what you are doing in looking at the future and exploring all possible options to successfully get into ortho. Did you do any ortho away rotations in the States as you mentioned honoring your ortho clerkship (singular)? If not there are always programs that have room for a rotator even this late in the year. I would look into that option ASAP as through hard work you can earn the confidence of more faculty who could help you and you could get mentoring that would prove invaluable in optimizing your time and efforts for getting into ortho this year or the next.

I apologize I did not mean to give anyone anxiety I left out my red flag which is the fact that I did my medical school at Carribean school. It was much cheaper and allowed me to start in January was terrible mistake in hindsight, thats why I figured I would need to do some sort of prelim year. I did honor in my gsurg and ortho clerkship and my letters are solid.

Jesus that's a big thing to leave out on your first post. Do prelims where you think you would possibly like to stay as Gen Surg or Rads if ortho doesn't work out again. At least that's what I was told.