Rock Step II. I'm talking 250+. You need to try to get to know your own orhto dept as well as possible. Take calls with the residents, get to know them, etc. Take as many ortho electives as possible. Do externships early in your fourth year. Apply for them in Jan because they fill up fast. You will need someone to go to bat for you.
Do some sort of research.

Even with all of that, nothing is guaranteed. Unfortunately for some, fortunately for some, USMLE is the big equalizer. If you go to a less reputable school and rock the boards you look better than someone at a reputable school who does poorly on the boards. We all take roughly the same test.

If you can take step II early and rock it, that is your best bet, probably. There are review courses out there for it. Plan on taking a month off to study and you may want to invest in the review course. There is a killer one in Kansas City that a friend of mine took after she failed step I. She went up big time. She took the same review course prior to taking step II just in case and was very happy with her results. It is very expensive though. Plan on making rocking step II the focus of the next year of your life. It is hard to sacrifice 24-7 (I've done it) but in the end, you may get what you want.

AOA status will probably help.

I'm a MS IV so my opinion is just that. I hope it all works out for you.

My bible for the next year is Your advice, justmatch.
I will start studying for step II from this minute.
I know some ortho residents at my school already but will try to get to know them some more.
Externships and research are also what I will pursue.
Live 24/7 from now for a year for any ortho spot.

Any other advice, justmatch, or anybody else?

More advice I get, the better my plan for the next year will be, I think.

JustMatch,

"There is a killer one in Kansas City"-- I'd like to know more about it, please.
Can you tell me more about it? e.g., their phone number, etc.?

THanks sooo much again!

I'll ask my friend... and get back to you.

I'm not one to dissuade people from their dreams...on the contrary. However, one has to deal in reality and a 190 on Step I is barely passing if I remember right. You need to take a long, hard, no BS look at what you're after and the mountain you have to climb to get there. If you do that and really can't see yourself being happy any other possible way, then you have to go for it. I guess I'm just saying that you are in one hell of a hole already. I love ortho as much as the next guy, but contrary to what some people give the idea of, there is life outside of ortho and I think it's an easy thing to lose sight of. If you decide to go for it, good luck, but do your homework.

OF

If you think the score was a fluke, you might want to retake. If you ace it the second time the first score will still show, but the better one may show it was a fluke.

edit: Yeah my bad. Apparently you do have to fail to retake. Don't have to be a complete ass when you point this out though.

you cannot retake unless you fail

huktonfonix has reiterated an important point everyone must remember:

There are way too many people willing to share advice about something they know all too little about. This is a great site, but remember to take all the advice given on here with a grain of salt (goes without saying, I know).

i would tend to agree with the above. also, you knew damn well that you needed to rock step 1 to get into ortho. why didn't you make it your life to study then? step 2 will make almost no difference in getting interviews. if you are all that hellbent on ortho, then apply and be willing to do an ortho research year when you don't match. good luck. sorry to be the pessimist/realist.

There is a guy from last year on the "matched credentials 2002" heading who had a sub 200 step 1 who matched - you might want to check there

It's called good connections guys! Sub 200 score = divine intervention to match or incredible connections

Sorry dude, been away for a while interviewing. Here is the review program for Step II that I told you about.....

"The step 2 program in KC is through the UMKC university and they call it the IPP (Institute for Professionals Program). Just go to the UMKC webpage at there is a google search engine or I think the webpage is: http://www.umkc.edu/ipp/links.html

I am pretty sure that there is only a step 2 program at IPP once a year (August) but they may want to contact the program anyway and see if they can set up some individual guidance/testing/review ect. They are super helpful there and I am yet to hear them turn someone away without some means of support/help."

That is all she told me.

Good luck.

Orthogateboy,

Don't listen to some of these fools. I had 192 on Step I and got 242 on step 2, and matched at a top 20 program. You can't do any specific Step II prep until after 3rd year, but treat each of your clerkships as a way of "studying" for Step II. Read the appropriate Blueprint/BRS book several times during your rotation. Do additional "question" books at that time (A&L, Blueprints Q&A). You need to learn this stuff, not just know it for the test.

Get all A's in your clerkships, get good letters, use any connections you can think of, get a good advisor who knows people and is liked by people. Then, when your third year is over, give yourself 3-4 weeks to study for Step II. I used Kaplan Q-bank like it was my job. It tells you what areas you are weak in, and then you can go back and re-read those topics. Crush the boards is also a good book.

Assuming you do well on Step II, then do several AI's at attainable places, not just ones where they will grant you a courtesy interview. Being a likeable guy and a hard worker will get you farther than any 250. Finally apply to a ton of programs (I did over 55, and got 13 interviews - including places like Duke and Emory).

But for right now, all you can do is rock your clerkships and learn the material throughout the year. Just keep Step II in mind when your buddies are out drinking on a Friday and you are stuck at home reading Blueprints in OB/GYN. Good luck. Don't let others psyche you out. You know what you need to do, so go do it. It's possible. Good luck.

That is probably the best advice I have heard so far for the fledging Step 1 scores. Thanks IrishDoc