Timeline

I didn't know that I wanted to go into Ortho until after the completion of my third year. I think you'll be fine if you focus on scoring well on USMLE I and getting good clinical grades (AOA would be even better).

You're right in that the disadvantage to you will be a lack of ortho research expereince, but I don't think you'll suffer in terms of letters of recommendation. I feel that I was able to get great letters by working really hard during my fourth year rotations in orthopaedics.

Hope this helps.

I decided midway in my third year to go into ortho so I didn't start making any ortho contacts until then. However, if you know you want to do ortho earlier, you might as well start getting involved in some research earlier. But you don't have to do anything at this time. To echo what was said above, Step 1 is the most important thing in the first 2 years.

LOR, for me, all came from my fourth year Ortho rotations. I only knew one of my letters writers before I started fourth year.

Most applicants do 3 ortho rotations their fourth year: one at their home school's program, and two away rotations. I did my three consecutively from July-September. Some do a rotation as late as Oct or Nov but these are too late to get a LOR from since the application deadline for most programs is Nov 1.

I agree with the posts above; I decided on ortho in the fall of 3rd year. If you know you want to do it now, get some research under your belt & do well on Step 1. A great score isn't a guarantee but will at least get you invitations. Learn your basic science well the first time around so it won't be so painful once it comes time to review (my biggest mistake!).

I used one gen surg letter and one research letter from people I met in 3rd year; otherwise, all the other letters were from ortho attgs I met 4th yr on rotation.

As most everyone is saying, it is not necessary to make contacts early. However, it sounds like you have made or are at least leaning toward the decison of ortho as a first year, so you should go ahead and try to start making contacts now. You don't have to devote a ton of time or even get involved in a major project to make contacts. For example, my school has an ortho club that had speakers, suturing and casting clinics, etc. One of the surgeons agreed to be the club's advisor and is happy to help out future orthopods. He offered opportunities to shadow in the OR, help on projects, little stuff here and there that you can fit in to your schedule. If your school doesn't have an official club, look in to starting one. Second year is a great time to run a club and you can start making contacts. It is possible to get good LOR's based on a strong 4th year rotation, but showing some interest early will just make those letters better and easier to get. Plus if you already know a surgeon or two at your program prior to 4th year, you can work more with other docs during your 4th year rotation and increase the number of letters you have to choose from.

For now, rock Step 1. It's the first key to making the process a little easier.