Settle down.
What I have been told is that this does not mean squat for interns. Each program has their own way of handling (and monitoring) scores. Relax, you can still go to do sports in Vail if you don't exactly rock this exam.
As far as the wild quesses go, I'm going into this exam with the idea that it is a practice run, batting practice before the big game. Learn the types of questions and the diffulty level tested.

what you mean you haven't already read hoppenfeld, rockwood, campbells, and that stupid orthopedic basic science book??? HA! I agree with what has been said that this does not count and it is to give you an idea (and motivate/scare you!) of what to expect. You can usually get a hold of previous years exams and anwers, although they dont have explanations, just references to articles and books (especially that ortho basic science book the academy puts out) Just take the test and dont sweat it.

Lots of specialty questions and, particulalry, tumor questions (or at least in comparison to the little tumor a general orthopod would see in practice). Old tests are usually available from the Academy.

The OITE means nothing for interns. Only a few interns across the country take it anyway (although this may have recently changed). I suggest just taking it cold turkey and not to waste your valuable sleep time on it. So if you don't know the answer, don't waste your time trying to figure it out this year.

However, after your intern year, I would try to "kick butt" on it to keep your chairman off your back and to help with fellowship hunting. Although, they are not suppose to ask about your OITE scores. However, if you do well, you can include it on your CV and in your letters of recommendations.

For the rest of the years, I would suggest reading a review book just before the test (to remember the minutiae) and going through as many old tests as you can. There are multiple repeaters (freebies). That's about all you'll need to pull away from the majority.

The whole idea of the test it to be able to compare yourself to your peers, so you know where to concentrate your self directed learning.

For those of you doing preliminary military internships, you should study hard for them, as well as for Step 3. It all helps when you come back from your operational tour(s) and apply for residency through the GME Selection Board (or civilian residency).