These are excellent questions...one I wish I had the answer s to when I was on the residency trail. Most places are probably somewhat flexible and may offer some interviews to application highflyers even if they did not rotate but...by and large...I am under the impression that Cleveland Clinic, U of Chicago, Mayo Clinic and HSS among others are partial to indivduals who rotated there. I must emphasize, however, that this is merely hearsay and I am sure that there are people who get interviews there who have not rotated at these institutions. Nonetheless, I understand that these are institutions that ahve a reputation for being partial to rotators. Perhaps, some residents at these places might provide some further insight should they cath view of this thread. I would be interested to know for sure what the opinion is on the insdie...

u of chicago?...i think you mean northwestern. you can add miami and utsw to that list. i absolutely agree with mayo and hss.

I would include St. Mary's to the list. Also, keep in mind that rotating and doing a good job will increase your chances of interviewing and matching anywhere. That being said, it does not automatically grant you an interview at most places. At the same time, not rotating at a program generally does not preclude you from interviewing/matching -- I interviewed at some of the places mentioned without rotating.

Also keep in mind that some places that get TONS of rotators do not even interview all the people that rotate there. Sucks huh?

I think it is good when places don't interview all their rotators - if they know you and know they don't want you than you aren't going to match there anyway - while it is insulting to not get an interview at a place you rotated I think it is worse to get strung along and then waste alot of money and/or a valuable interview day in the middle of the season at a place you have no chance at. just my opinion of course...

of course, then you have to explain to all the places that ask why aren't you interviewing at this place where you rotated. It cuts both ways.

If you're interested in NYC, I'd add Mount Sinai and Lenox Hill to the list. They're both notorious, with little exception, for only interviewing rotators. Of course, they both get a lot of rotators as a result.

I would say as a generalized rule, with the exception of UI-C all of the Chicago programs fall under this umbrella. I would also add Emory and Georgetown to the list. I also think SIU (in Springfield) is very partial to rotators.

These are not hard fast rules, but in general they hold true due to sheer volume of applicants.

Some places get so many rotators and they are so desireable that they could pick the top 10 rotators and they pretty much are done with the selection process. (ie. Mayo, NW, Rush, HSS)

As always take the info you get here cautiously. I'm an intern at Miami now and there are 3 of 7 of us who did not rotate. Sure rotating does give an extended opportunity to show your stuff, but its not always a necessity. AS someone else pointed out with the number of applicants every little edge helps though.

mt. sinai does NOT only interview rotators. doing a rotation definitely improves your chances of interviewing and matching. that being said, we do not always interview all of the rotators. if you are not a good fit on the away rotation, you will likely not get an interview. we do not like to waste one of your weekend days during interview time if you aren?t a good fit with our program. congrats to this years matchees and good luck to the crop of green ones just starting the process.

Here are the places that I know for a fact favor rotators:

NORTHWESTERN: They pre-screen you. If you don't have a chance to get in, you can't rotate. there are 9 spots and 8 are usually filled with rotators. About 50 interview for those 8 spots, do the math - best chance in the country to get in. that being said, if you screw up, you will not get an interview so you MUST be a strong rotator.

BOSTON UNIVERSITY: Has an application, but doesn't pre-screen. Rotating on the busy trauma service in the summer and kicking ass can make you shine. Getting along with the residents is key. You will learn a TON about trauma, which is bread and butter orthopaedics. 3/5 this year were people that rotated.

TUFTS: Will give an interview to ALL rotators. But beware, they LOVE the numbers. If you don't look good on paper, don't rotate. At least that's what the old chairman last year told me. They now have a new chairman, but assume that's still true. The class two years ago had 5/5 that were AOA.

One more thing of advice. If you are from the south for example and know you want to go to the northeast for residency, do one away there. You don't have to do it in the exact city you want to be in, but rotating far from home shows that you really want to be there and aren't just doing a shotgun approach to applying. Looking at an application from someone from the south, who has rotated at home, and in the west, they're less likely to take you because they think you're less likely to go there. Programs like to match people high on their list, just as you like to match high on your list.

That's all I know, hope this helps.

Any word on if columbia or hjd favors rotators?

i'd say that about 1/3 to 1/2 of HJD's interviewers this year were rotators. before rotating there though, you should know that about 70-80 people probably rotate through there each year. And they only interview 72 people. so that's like a 1/2 shot of getting an interview if you rotate.. not the best odds but like HSS they have tons of rotators and if you do well, it can only help you.

I think every program will give a slight preference to rotators.

As the people above mentioned, some are very picky about rotators....I've heard that a lot about Northwestern.

If you rotate and do well, then you're set...From what I know, Columbia does not give a huge preference to rotators. However, if you go to Columbia and do a great job, then you'll obviously increase your chances. In addition, doing a rotation in NYC, and then sending that LOR to all the NYC programs will greatly increase your chances of obtaining an interview in the city.

As a note, I did not rotate at Lenox Hill (interview ~ 30 peeps) or St. Marys (interview ~ 25 peeps) - and I still was invited for interviews at both. So in many ways, this is a strange process. Also, St. Mary's usually matches 1-2 rotators for 3 spots.

The other issue to look at is that while rotating at a place like St. Mary's or Lenox Hill will give you an "edge", you also need to look at the total number of spots. St. Mary's has 3 spots and Lenox Hill has 2 spots.... So even if you rotate there and they love you, there are going to be other rotators as well. Versus other larger programs....Of course, if you want a program with a smaller number of residents, then this would work out fine...but it's something to think about.

Not sure how Lenox Hill could have gained a reputation for only interviewing rotators.

Just to set record straight, I believe only 3 of our current residents rotated here as medical students (there is one I am not sure about). Looking back over the past few years, I would estimate that rotators accounted for 1/4 of the applicants we interviewed.

Like many programs, we end up "knowing" 2 groups of applicants the best - our own students (range, 10-16 per year!) and those who rotate (range, 10-15 per year). That being said, we do not have any preconceived notion that if you do not rotate you are not interested or conversely that if you don't rotate we are not interested. We interview ~50-56 students each year from the 500 applications we receive.

We recognize that most schools do not allow students to do more than 3 sub-internships (1 at home and 2 aways) and therefore it is very challenging for students to spend meaningful time in programs which they may be interested in but couldn't coordinate a rotation.

This year, we matched 2 Columbia students, 1 rotator, 1 person who could not spend a month but coordinated spending a week with us, and 2 non-rotators whom we met for the first time on interview day. I would say this is about the norm for us - ~50/50.

Just remember a couple of "take-home" points about sub-internships:
1) If you are a "water-walker" on paper it can sometimes be difficult to match the expectations in person so be careful.
2) If you are a solid applicant who isn't a "water-walker" on paper, you can dramatically increase your standing with an outstanding clinical performance
3) Ultimately, try and choose your acting internships at programs that are a good match for you, taking into consideration - 1) geography; 2) size of program; 3) type of program - academic vs community; 4) your demographics with respect to the reputation (here you'll need your school or department mentors and advisors to assist you if you're unsure); and 5) recognizing where you stand in comparison to your peers from your own school.

I hope this information is helpful - if you have any questions please don't hesitate to email me at wnl1@columbia.edu or you can call anytime as well - office: 212-305-0762.

wnl

Like many programs, we end up "knowing" 2 groups of applicants the best - our own students (range, 10-16 per year!) and those who rotate (range, 10-15 per year). That being said, we do not have any preconceived notion that if you do not rotate you are not interested or conversely that if you don't rotate we are not interested. We interview ~50-56 students each year from the 500 applications we receive.

We recognize that most schools do not allow students to do more than 3 sub-internships (1 at home and 2 aways) and therefore it is very challenging for students to spend meaningful time in programs which they may be interested in but couldn't coordinate a rotation.

This year, we matched 2 Columbia students, 1 rotator, 1 person who could not spend a month but coordinated spending a week with us, and 2 non-rotators whom we met for the first time on interview day. I would say this is about the norm for us - ~50/50.

Just remember a couple of "take-home" points about sub-internships]wnl1@columbia.edu[/url] or you can call anytime as well - office]

Wow - thanks for the reply, Dr. Levine. It is helpful to have an attending's perspective, and very helpful to have a PD's perspective. Just curious, would you be willing to share what percentage of your residents are AOA? I'm guessing it is at or near 100%. Thanks again.

SOP
MSII

In general, ortho applicants who match are 30% AOA.

% of AOA in a competitive program (i.e. Columbia) will vary from year to year, but generally runs from 50-70%. I think it's very difficult for any program to have 100% AOA since some top medical schools do not have such distinction, and quite frankly, just because you are AOA doesn't mean that you have high board scores and massive amount of research, which are heavily factored into your application.

I hope this helps.

loving_ortho

Of the 56 students whom we interviewed this year 27 were AOA. I don't know off the top of my head how many of our 30 residents in the program are AOA but I can assure you it's nowhere near 100%. Noone remembers who's AOA once you are a resident in a program - it's your body of work that speaks for itself from that point forward.

Like many posts on this website have indicated over the years, people (understandably but regrettably) get far too concerned about the "numbers" - there seems to be a new post every few days by students worrying that their Step 1 score is "only 232", etc...

Keep in mind that every program in the country is looking for students who will become outstanding orthopaedic surgeons in the future and who ultimately will pass their boards - step 1 scores, AOA status, and bench press weights will unfortunately not help predict that desired outcome! So yes, these data are used by programs to help pare down the huge numbers of applicants (well hopefully not the bench press weight). However, there are still plenty of programs which recognize that some of the best residents are hard-working, mature, bright people who may not be the worlds' best test takers and actually scored in the 220's (or god forbid 219 or below!).

wnl

i agree with everything said so far .... and Dr. Levine is a smart man .... first of all, orthogate is a little slanted towards the eastside of the country and chicago .... there are a ton of good programs across the country, some are very regional .... if you are a STAR, i mean like a supernova, and you know who you are .... by all means go for the big boys .... if you are a star, but not a supernova maybe consider some other programs in the region of you choosing ...

there are a lot of programs out there that are programs in the rough or are small and unpublicized .... programs like MCW (people seem to love this program) ... and many others ....

if you chose to go with the big names, remember you will be there with a lot of others who feel the same as you ... think they are stars ... go to a smaller program or one with less rotators (get my drift) ..

and on what Dr. Levine said about numbers ... i totally agree ... we try very hard to weed through all the numbers and find the Tom Brady .... there are a lot of Ryan Leaf's out there .... the numbers and clinical acumen do not always coincide .... in our program, we only interview 30, so we take care in choosing those who we interview .... it is painful, let me tell you .... you try reading through all these personal statements