While there is no definitive place to find "what's really going on" there are certainly many residencies that fit what you are looking for. This site is excellent because med students, and those of us who just finished and will be starting internship in ortho next month, can give the scoop directly. The programs I'm most familiar with are West Virginia and Ohio State. Both match what you are looking for. Obviously Columbus is a much bigger city than Morgantown but Morgantown gets a ton of trauma because WVU is the major tertiary care hospital for the area and gets lots of trauma transferred in. WVU has better outdoor recreation as far as mountain biking, hiking, rafting. The ortho residents have their own Softball team. They certainly work hard but they play hard. Many of the attending play with them. Several of them bike, hike, and ride horses with the residents. At both WVU and OSU the residents hung out on their free time together, were close knit, and friendly. Ohio State has more big city attractions as far as concerts and things. Residents at both places landed fellowships at top places. Some decided not to do fellowships. And these are just two programs. There are all kinds of programs out there. I"m sure if you specify a program you're interested in, many people can tell you where to look or what really goes on. Happy hunting.

Thanks AceTabulum. I am currently in the midwest, have been my whole life and would like to move out toward the coast, preferably the west. Has anybody found this to be difficult or an uphill battle? I have already been told "you know we have bad people out here in the big city" and "you want to come here but you don't have any family, eh" well B this wasn't Canada and C it was only for a 4th year elective. Specific programs I would love to hear about are San Francisco Program, is call really q3 for 5 years as per Frieda? Also the Carolinas program, why is it considered the holy land of ortho or is it merely a mirage? Anyone been to the Portland program? Finally the University of Colorado -- this program has been especially difficult to find out about with the bare minimum on Frieda and their home page about worthless and applying for a clerkship there going down like nun's knickers!

I agree with the comments above on west virginia, I rotated there and liked it a lot, but the wife vetoed the location. I also really liked mich states program in kalamazoo (where i also matched!) They are kind of a community/university hybrid with a lot of the teaching staff being private attendings, but all the ones i saw really appreciate having residents and make it worth your while for being there. They also operate a lot (about twice the national avg of graduating chiefs, but who knows what those numbers really mean, I mean does one knee scope count as 3 procedures cause it has 3 ICD codes? i dunno) Also food is free and the city (kalamazoo ) is not too bad (a college town) They have other perks too, and they tried to get a 3rd resident last year and will try again this year (a lot of places i interviewed were trying for more spots and none of them got any). They put you up pretty well on aways, giving you an apartment and the food at the hospital is free. Overall i really liked my month there and look forward to spending my residency there.