Do not do pro bono work, unless you can get a written agreement promessing you a spot. Especially if you're weak on paper.
most places who allow these situations
will abuse the sh*t out of you and will look
to keep you in that situation. The longer you work at and/or the better you are at your pro-bono functions the more they are incentivised to keep you there. Just think, there will be another kid just like you available next year, so why promote you, when they can just wait for you too give up, leave and then get someone else.
Research or pre-lim are the best options (research being the best option)
if you do a pre-lim:
1. ask every one under the sun for a letter
2. make sure your rotations fullfill the AAOS req. for an ortho intern
3. log all your cases with ACGME immediately after you do em.
4. keep a mentor in Ortho real close (the more powerful the better) trust me something will open up and they will have to go to bat for you. They will push doors open, you would have had to otherwise knock on.
5. If you are a pre-lim at your almamater (sp), keep going to ortho functions whenever you can. This is good for many reasons (trust me)
6. Have a plan B, your dreams (as you probably still have them at this stage) can be fullfilled in other fields. and prepare for the worst.
Good luck
and remember the following
1. assume that there are no such thing as nice people in Medicine
2. Incentive makes the world go round
3. act positive but, expect the worst