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rescoordinator
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PostPosted: Mon Nov 28, 2005 2:03 pm Post subject: Advice from Ortho Residency Coordinator Reply with quote


Hello all... as you may or may not know, some residency coordinators come onto orthogate to check out what students have been saying about their programs. It's a good way for us to get feedback from those who are not in a position to be criticizing. Your comments can help the coordinator to improve their interview process and understand what's on a student's mind at this point in their training.
With that said, I see a lot of information being posted about what you should and should not do when it comes to interviewing and what you do and don't need in your application. Some of it is right and some of it is just plain wrong (I read somewhere that the 3 digit USMLE score is disregarded by the PD because they only understand the 2 digit?? Definitely not true).
I'm attempting to keep myself anonymous simply because I don't wish to be a sounding board for OUR program, but just to help you out while in a difficult time of your lives. That being said, this is coming from my perspective and every coordinator does things differently. If you're interested in hearing my HONEST opinions based on a few years experience, I'd be happy to give you feedback.
Thanks for reading and best of luck to all of you this interview season.
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BobAEPi
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PostPosted: Mon Nov 28, 2005 2:22 pm Post subject: Reply with quote


Thank you very much for your advice.
I think one of the biggest frustrations for us is the fact that many interviews fall on the same days forcing people to choose between programs while those who have multiple interviews within the same geographic region are unable to schedule them during the same weekend because the dates are so inflexible. I am hoping that something could be done about this. I realize that a lot of constraints are due to OR schedules, logistics of getting attendings to be present, and maybe even the desire to limit the number of programs we interview at. But, if program coordinators communicate with each other, I wonder if a few changes could be suggested:

1. Could programs in the same city / vicinity schedule interview dates in succession - for instance, it would be very convinient if the two programs in Cleveland could interview on successful days.

2. It would also be helpful if there was more flexibility in interview dates. Some programs only offer one date, and often this date is shared with several other programs. While I am ok with one date interview, I hope that some effort can be put in to making sure that that one date is not the most popular one. Perhaps program coordinators can circulate amongst them suggested dates and try to work out a schedule that limits these conflicts.

3. It seems that some programs send out more interview invites than they have available spots. I hope that a message can be passed on that this practice is somewhat unfair, and it results in us being extremely paranoid about checking email.

Anyway, thank you very much for your post. I hope these issues can be at least discussed among your fellow program coordinators, and hopefully this process will be less frustrating in the future.

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rescoordinator
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PostPosted: Mon Nov 28, 2005 2:39 pm Post subject: Reply with quote


Thanks for your post.
To address your first point... there is an organization called the Association for Residency Coordinators in Orthopaedics (or ARCOS). Annually, a representative from that organization puts together a list each year of interview dates which is then distributed to all coordinators who are members (most). Whether or not the coordinator chooses to look at it and consider it when choosing a date, is dependent on the program. However that effort is made.
Our program offers more than one interview date and I personally do not feel it is fair to only offer one date. I do not know whether those programs with one date check the above mentioned list to try to accommodate or not, but I can certainly suggest it at our next meeting.
I have no idea why a program would send out more invites than there are spots. As a coordinator that would stress me out immensely, so I can't think of what the positive would be for doing that. It seems much easier to send out invites to additional candidates as open slots become available (which is what we do).
I hope this was somewhat helpful, if for no other reason then for you to understand how we do things. Our dates are similar each year, but we try to mix up the days of the week to accommodate our attendings so the same ones don't miss their OR or office hours every year.
There is an ARCOS meeting during the AAOS meeting this year in Chicago, I would happy to bring these issues up at the meeting. Maybe I could make some changes for those who come after you.
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Breakabone
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PostPosted: Mon Nov 28, 2005 2:58 pm Post subject: Reply with quote


Is it looked upon poorly if we can't make the pre-interview social due to travel constraints?

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rescoordinator
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PostPosted: Mon Nov 28, 2005 3:08 pm Post subject: Reply with quote


I would say it's always beneficial when possible to make the event, but any program that would hold it against you is not really one where you want to be. I would make a point (although do not gush... most coordinators don't want to hear gushing) that while you are very interested in the program and wish you could attend the event, you unfortunately have another interview. I'm not sure how formal other programs are with regard to this... how much feedback they get from the residents about the behavior/personality of the attendees. We try to get feedback about each candidate, just a brief impression. Definitely let the coordinator know ahead of time you will be unable to make it and just make sure they know you want to, but just can't adjust your schedule. I don't think any decent program is going to drop your ranking because you couldn't party with the residents. I think it's half to check you out and half for you to get to know the residents and see if it's a good fit for you and the programs know that.
In short, if you can't make it you can't make it. Don't stress over something you can't control.
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dfagod
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PostPosted: Mon Nov 28, 2005 3:34 pm Post subject: Reply with quote


Thanks a lot for offering your help.

Since you mentioned step 1 scores, can you give us some insight as to how your program deals with them? Also, how much consideration do you give to step 2 scores, if the applicant did not have a fantastic step 1 score?

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rescoordinator
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PostPosted: Mon Nov 28, 2005 3:53 pm Post subject: Reply with quote


Sure. Our program splits up applicants based on Step 1. Over 220 goes through the 'regular' review process, under 220 gets reviewed individually by the PD to see if there is anyone outstanding in that group. He will generally pick out around 10. Those 10 then get put into the batch of "over 220s" and go through the review process. Often the thing that might swing them is a very high Step 2 score. Although in all honesty a very very low step one score is hard to rebound from. 215/245 is one thing, 193/230 is another, Step 2 can pick you up from decent to moderate, but likely will not pick you up if you're in the bottom batch of scores. Every program's review process is different and that number (220) will vary. But, as I advise any student in my own school who comes to me with a low step one and step 2, it's a good idea to have a backup plan. I never want to discourage someone from going for where their heart is. But at the same time, it's wise to be realistic. As my boss tells me, some people think that ortho is EVERYTHING and they will not be happy doing anything but. He says, if they could see me every day doing stacks of paperwork, they'd think differently!
I hope no one is offended or hurt by my comments, as I said I just want to be honest. Everyone needs to make their own decisions in the end.
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PostPosted: Mon Nov 28, 2005 4:20 pm Post subject: fmgs? Reply with quote


so, this is a question some ppl on this board have asked, but have been told to do a search.. only to find half-decent information. i'm a FMG-to-be and i'm currently in a MS3 from st. george's university in grenada, but i'm a US citizen. we do our 3rd and 4th years in the US, mainly NY/NJ. I'm really interested in going into ortho, but don't know what my chances are. I was wondering how you, as a residency coordinator, would look upon an applicant with decent scores from a school like sgu. I got a 245/99 on step 1 and currently have a 3.75 gpa after my first rotation (med-got an A). I'm planning on getting involved in some ortho or surgery-related research.

thanks

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rescoordinator
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PostPosted: Mon Nov 28, 2005 5:17 pm Post subject: Reply with quote


Well this is a tough one and I'm sure very program dependent. Some programs will not, under any circumstances, interview an FMG. Others will consider them but at a lower level. I'm not sure if there are any that consider them on equal footing. This is becoming increasingly complicated since ortho is getting so competitive. My best suggestion is to pick a few places where you feel you have a chance and you feel would be a good match and do an away there. Then go and really do your best to knock their socks off. Having good scores as an FMG is good, having good scores and showing the program in person that you're a great candidate is better. I imagine your school probably has stats on their past graduates - how many matched to the programs they wanted. This is a good place to start to see what the numbers are. Our program is becoming more difficult when it comes to FMGs, whereas we used to be more open to them, it's become a direction the PD and Chairman prefer not to go.
I haven't looked around much to see, but I imagine there are some good posts from residents on how to do your best while on a rotation. I would read up on those and take them seriously. There is a fine line between knowing your stuff and being cocky - our program does NOT like cocky. There's not much you can do to force yourself to be the perfect rotator, other than be yourself. But definitely look into what qualities they are looking for. The best rotators we have are said to be "like having another resident on service". Anticipate the resident's needs, learn when shown something the first time so you can do it for them the next, work hard, stay late, be interested!. You don't have to be the smartest or know your anatomy better than anyone else. But they want to know if you were on their team, they could feel confident trusting you.
Best of luck.
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PostPosted: Mon Nov 28, 2005 6:48 pm Post subject: Reply with quote


Another thing I forgot to mention to the FMG candidate above is that some programs have 6 year slots with a year of research. This may be another 'in' for him and others who maybe don't have the scores or resumes as others. It all depends on who is applying that year, but they might have a better shot at some of those tracks instead of the traditional 5 year.
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PostPosted: Mon Nov 28, 2005 10:30 pm Post subject: Reply with quote


With regards to so many programs offering interviews on the same day: Dr. Simon at UChicago told me that it is done to help weed through the many applicants in Ortho each year. B/c you can only go to one a day, multiple offers helps the individual programs interview candidates more interested in that particular program, not those who want a long ROL. Also, Dr. Levine at Columbia picks his date so that no one will conflict. I've heard that the HSS / Lenox Hill conflict isn't a mistake either.

Good luck, interview at Miami.........

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PostPosted: Mon Nov 28, 2005 10:31 pm Post subject: Reply with quote


With regards to so many programs offering interviews on the same day: Dr. Simon at UChicago told me that it is done to help weed through the many applicants in Ortho each year. B/c you can only go to one a day, multiple offers helps the individual programs interview candidates more interested in that particular program, not those who want a long ROL. Also, Dr. Levine at Columbia picks his date so that no one will conflict. I've heard that the HSS / Lenox Hill conflict isn't a mistake either.

Good luck, interview at Miami.........

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rescoordinator
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PostPosted: Tue Nov 29, 2005 7:25 am Post subject: Reply with quote


I have no doubt that the above is true, particularly for the big name programs. They feel like if they offer one date you should be honored enough to take it. And that if you're going to think of taking someone else's offer on that date ahead of yours, they don't want you anyway. Along those lines, if I have a bunch of people who can't make one full interview date and want to be wait listed, I often feel like, "obviously they are choosing another program over ours and are just willing to come here if it's on a day they have nothing else to do. I'd rather offer the spot to someone on the wait list who will be happy to get the invite regardless of when it is". However, while that's in the back of my mind, we do keep to our system for the most part. I don't feel someone should necessarily know before they get here whether or not this is the place for them, so forcing them to choose by purposely putting your interview date the same as another strong program or only giving one date thereby making people choose doesn't seem to make sense. I'd rather give them the opportunity to check the place out and make that decision. If they get an invite and are no longer interested in the program, just turn it down and we can invite someone else who is.
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PostPosted: Wed Nov 30, 2005 9:39 am Post subject: Reply with quote


rescoordinator-
Not sure if you are still fielding questions, but I thought that I would throw one out that I have always been curious about. When a student is offered an interview, does that mean that he or she has a good shot of being ranked highly (assuming fitting in well, making a good showing during the interview process, etc) irregradless of their application? Another way of asking the same question would be, is the ball in your (the applicant's) court once you have been offered an interview? The reason why I ask is that I know there a many applicants out there with astronomical numbers (boards, grades, etc.). There are also many students with good numbers that will always approach this process with a mentality that the chips are stacked against them, and that when it comes down to it, it will be hard to convince programs to pick them over the guy with better numbers (obviously this assumes the guy with the big numbers isn't a social misfit). Do you think that this is misguided anxiety, or is there reason to be wary of this reality?

On a separate but related topic, I know alot of students on this forum have read that Bernstein JBJS 2002 article about residency selection. In that article, Program directors listed away rotation at director's institution, Step 1 score, class rank, politeness at interview, and appearance of candidate as the top 5 criteria for selection. Do you feel that this accurately describes the most important criteria at your institution or at the institutions of your colleagues? Do you think that residency selection criteria has changed at all since the time of that article?

Thanks- I know that was a lot to digest all at once.

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PostPosted: Wed Nov 30, 2005 6:59 pm Post subject: Reply with quote


Jude,
Thanks for your quesitons, I'll try to cover them all from my perspective.
1. First, all programs handle their ranking differently so it's VERY difficult for me to tell you how that's done for anyone else. But impression wise, I would not say everyone coming to interview is on equal footing. I'm not just talking numbers. I know of students who had fairly decent numbers and did not match and those with average numbers who did. I imagine there are some programs that are all about numbers. We are looking for someone who is a good fit. We have more than one person interview candidates and all interviewers discuss the candidate and their impression of them together to come up with a composite idea. Often it's as simple as, "Nice guy, good numbers, I don't know if he's a good fit for our program". Or conversely, "Nice guy, average numbers, but seems like a hard worker and a good fit for the program". What determines those things? Nothing you can really control... it's just personality, what seems important to you, your priorities and expectations, etc. And you should be honest about these things and not try to put on a show, because you will only end up in a bad fit if you put on too much of an act.
I would not say the ball is in the applicant's court once they are offered an interview. Just like the ball isn't in a job applicant's court when he goes to interview with the boss. If your numbers are astronomical, you're probably at a better footing then someone with lower numbers. But you'd best believe if that guy comes off as a weasel, cocky or disinterested or like he's going to be unable to step up to the plate, his numbers suddenly don't matter as much. In summary, yes board scores help, yes it sets up high expectations. But the interview DOES matter. Average board scores (220s, 230s) are still very good candidates, presuming you make a good impression and your interviewers think you're a good fit, you'll do well. Below 220s you've got you work cut out for you, but just be yourself and be confident. Know that you can do a good job, play up other aspects of your application without being pushy and stand firm when questioned on your scores. Actually, everyone should stand firm (or at least have an answer prepared) on any less than stellar performance (class rank, grades, scores, etc).
2. As far as the JBJS article goes, I'm presuming since it mentions 'politeness at interviews' that this is AFTER you've been selected, not determining IF you'll get an interview. I would say if you have high board scores it's a plus, without a doubt. If you have lower board scores they want to see something special about you, but again this is something you can't plan for, it's mostly fit. Which goes along with politeness, although I don't know about the appearance. I have never seen someone walking into an interview in jeans... frankly you all look very much alike on interview day Smile If it's referring to race or sex, I'm sure some programs do take that into consideration, I am a part of a very diverse program so it never comes into play for us. I would say more than class rank your rotation grades tend to be discussed more as in "he high passed 5 rotations and only honored 1". So I would put that above class rank. Letters of recommendation are reviewed and mostly noted if they have something outstanding to say, "Dr. so and so raved about him and said he's the best student to come through his program in the past 5 years" (good thing). Or three letters saying, "He is a good candidate, we recommend him for your program" (ie YOUR program, not ours). I myself wonder why if someone is SO gung ho about our program (calling me incessantly asking when invites will go out because they so want to go to our program) why they did not do a rotation here? For the candidates that DO do a rotation with us, it's a risk but it's a necessary one. Either the residents liked you, didn't like you, or didn't have much to say one way or the other. If they didn't like you, it's not a good thing. We will not rank a rotator who the residents deemed poor highly, they will be the ones working with the student once they become a resident and they know who they want to have as part of their team. However if you're good, we know it, we want you.
I know THAT was a lot to digest. Hopefully it was somewhat helpful to you. I think a lot of what it comes down to is candidates trying to mold themselves to what they think a program wants to hear. But that's a bad idea for everyone involved because if you make yourself out to be something you're not, you may match, but to the 'wrong' program. At this point, you've done all you can do as far as your grades, rotations, board scores go. All you can do now is show up to your interviews, put on a nice suit and brush your hair, be polite to everyone you meet, and be yourself. If that means being more quiet, that's ok. If it means being talkative and laughing it up with the residents, do that. One tip: if you've done any research, KNOW about it. I've often heard interviewers say, "well I asked him/her about their research and they sort of hemmed and hawed, but it doesn't appear THEY actually did any of it". Even if you're more on the shy side - especially if you're on the shy side - think of some things to talk about so there isn't too much dead air... a question to ask about the program, something interesting to share. Interviewers don't like sitting in a silent room any more than you do, be prepared in case it happens.
I guess this ended up being more of a 'tips for interviews' which I could do in a separate message if people were interested, I imagine most of your schools have some sort of program where this is reviewed, I don't know that I'd have much more to offer than they would.
I hope this answers some of your questions.
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img
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PostPosted: Wed Dec 14, 2005 7:46 pm Post subject: hope for img with PhD Reply with quote


hi rescoordinator

first of all thanks for your advice

i would really appreciate some help.
i'm an img, just graduated. i really enjoy and cannot see myself do anything else.
i know that as an img, getting into ortho will be tough.
my question is, if i do a PhD in biomechanics (or related field), will it help my chances?

any advice/ help would be really appreciated

thanks

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PostPosted: Wed Dec 14, 2005 11:40 pm Post subject: Reply with quote


umm, I thought rescoordinator was nsimons; now I have to come up with another guess...

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PostPosted: Thu Dec 15, 2005 1:04 pm Post subject: Reply with quote


IMG - Anything will help, but to be honest I think it's really a matter of being in the right place at the right time. I know what our department's 'feel' on IMGs is, but I also know that programs vary greatly in their thoughts on the subject. I'm sure some would not consider matching an IMG and some would put you on equal footing. How to know which is which? Research I guess. This website is probably a good place to start. But even so, these things change all the time, with PDs changing or new faculty, etc. But additional degrees and lots of research will help at those institutions who will consider IMGs.
Ironman - Sorry about that... I'm not as good as nsimons! She really knows what's up. No need to guess... it's better you guys don't know because I can be more open about our practices and policies. If I said where I was writing from I wouldn't be able to tell you as much.
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PostPosted: Thu Dec 15, 2005 4:02 pm Post subject: Reply with quote


throughout all my and my co-residents interviews and travels we collectively could think of 1 IMG that we ran into that was a Ortho resident. He was from Oxford. Do I think its fair? No. But you gotta be realistic that you have a huge strike against you (at least in most programs eyes). I wish you the best of luck

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PostPosted: Tue Dec 20, 2005 10:33 am Post subject: ortho for img's Reply with quote


res coordinator and bonedoc

thank you for sharing your thoughts on the matter. really appreciate it.
i think i'll take things one step at a time. right now my main aim is to do as well as I can on the STEPs

thanks

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PostPosted: Fri Dec 23, 2005 11:31 pm Post subject: Reply with quote


rescoordinator-
Thank you once more for giving insight on this site. I am a M2 attending a U.S medical school. I was wondering how your program and other programs (if you know) view medical school rankings. For instance someone applying with great Step 1, 2 scores but from a medical school that is not necessarily deemed the cream of the crop?

What are some of the things that your program look for in a candidate's application etc?
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PostPosted: Sat Dec 24, 2005 4:56 am Post subject: Reply with quote


BoneKollector, check out:

Bernstein, Orthopaedic Resident-Selection Criteria
J. Bone Joint Surg. Am., Nov 2002; 84: 2090 - 2096.

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PostPosted: Sat Dec 24, 2005 4:59 am Post subject: Reply with quote


BoneKollector, check out:

Bernstein, Orthopaedic Resident-Selection Criteria
J. Bone Joint Surg. Am., Nov 2002; 84: 2090 - 2096.

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PostPosted: Sat Dec 24, 2005 8:03 am Post subject: med school Reply with quote


bonekollector...I'm a senior resident who is now involved in the residency selection process for our program. Here's my take on the med school reputation thing: if you go to a top medical school or one that is highly regarded, it will help your application. It's an unspoken rule but it's ridiculous to ignore the fact that it does sway many people. However, if you're from a middle of the road school with great credentials (step 1, grades, etc), the fact that you're from an "average" med school will NOT hurt you. In other words, your med school can only help you, but it won't hurt you.

My chairman put it best: He does not think medical school reputation is important, but he cannot help but notice it and it probably influences him to some degree even though it shouldn't. He says that if you're from Harvard or Hopkins or the like, at some point in your academic career someone thought you were hot sh*t. And that makes him take notice, deservedly or not.

There are some programs that interview mostly applicants from top tier med schools unless you have stellar credentials. This is where I think the importance of your med school comes into play more so than after the interviews.

There are people who disagree with me on this but having sat at our faculty ranking session and talking to them after interviews, I can tell you that your medical school certainly makes an impression although it certainly is NOT the decision maker BY ANY MEANS.

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PostPosted: Tue Dec 27, 2005 4:49 pm Post subject: IMG's in ortho Reply with quote


IMG-

I have noticed a few programs have IMG residents listed on thier website, two of which come to mind. Alberst Einstein, NY has a PGY 3 from Montreal Canada, a PGY 4 from Israel, and a PGY 5 from Puerto Rico, and NYMC Brooklyn has a student from Ross. My guess is you'll get the best idea of which programs are accepting of IMG's by looking at where their residents and alumni came from. Most websites don't list this, so you may have to do some digging.

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PostPosted: Tue Dec 27, 2005 5:54 pm Post subject: PRs are not IMGs Reply with quote


Just to clarify, students who train in Puerto Rico are not IMGs. They are considered US Applicants.

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PostPosted: Tue Dec 27, 2005 10:44 pm Post subject: Reply with quote


rescoordinator-
thanks for your posts and advice! much appreciated! i'm one of those, i guess, lower-tiered would-be applicants (m3 w/4 mos to go til m4, 218 step 1, planning on working my hiney off for a >240 step2 , good mix of honors and high passes through the years, a 1st author pub -albeit in EM - and some interesting extracurriculars) who is trying to decide between ortho and a non-surgical specialty. i've always harbored an interest in ortho, but i'm honestly quite afraid that my application won't fly due to the competitiveness of the field and my mediocre app. i'm hopefully going to have more insight after my ortho sub-i next june ... so i'm really appreciative of your posting on here and the perspective of a residency coordinator. Smile thanks a bunch!

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PostPosted: Wed Dec 28, 2005 9:15 am Post subject: Reply with quote


This is the perfect time of year to get in on some ortho research. In almost all my interviews I have been asked about or commented on my research. Or attendings say, Dr. XXX has a project that you will really like, or some attending even comments that it would be nice to have someone match there with my reaserch interests......
In your case, specific ORTHO research may make you or break you......honestly its hard enough with a 240+ on steps I and II......so make sure you have some good ortho research......
Having EM research is nice, but if some guy is interested in the topic of a paper you have written it will make you stick out in his mind.....and with a low step I score you are gonna have to be extra impressive.....

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rescoordinator
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PostPosted: Thu Dec 29, 2005 7:06 pm Post subject: Reply with quote


Good advice all. To Bone Kollector, I would say Micky has a pretty good handle on things. If you're looking to go to top top programs only, they likely are very interested in top top students from top med schools. As for the rest of the country's programs, there are other things that are much more important than the name of your med school. And we've seen residents come through who went to great med schools who don't do as well as those from 'average' named schools, and we recognize this. Getting into a big name med school is no small feat, but at the same time everyone has had 4 years to come into themselves and that is taken into account. We'd much prefer you now have high scores, show you have interest in ortho, will be a hard worker and team player, would fit in with the group and are generally bright. Micky put it well "your med school can only help you, but it won't hurt you."
perpetualpriapism, I agree about the research. It's not necessary but is a definite plus if you were strongly involved and understand it thoroughly. It shows interest in ortho and a willingness to put forth the time and effort in a field you want to dedicate your life to. The interviewers will ask, and if you know your stuff, will impress.
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PostPosted: Fri Dec 30, 2005 1:10 am Post subject: Reply with quote


rescoordinator

Glad you are still answering questions. All of your responses have been insightful. Hope you have time for one more. I am a first year MSTP student and highly interested in ortho. I will complete my PhD in biomechanical engineering in an ortho lab (started research this year). My preclinical grades are so-so, but no where near impressive. Question: HOW IMPORTANT ARE PRECLINICAL GRADES? I've heard anything from non-important to very important. I want to go into academia.

Should I reduce (or eliminate) my pre-graduate school research in order to honor more classes? I'm fairly sure that if I put in the time, I can do better. I just like spending my time on other (while ortho-related) activities. Thanks.

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PostPosted: Fri Dec 30, 2005 11:54 am Post subject: Reply with quote


Hi ResCoordinator

First of all, thanks for all of your wonderful advice and for your clear message of stewardship and care for your residents and applicants. I come from an east coast school with a very involved PD who communicates high expectations to his residents but who always leads by example, and his influence on me, even as a fourth year, has been great.

I have a few questions that I was hoping you might answer, as they've been weighing heavily on my mind as I head into Interview Month, and the answers I get when I ask people tend to be either self-protective or conflicting:

1) The lack of a chairman. I am interviewing at some programs that have been playing around with interim chairmen or no chairmen, some with no resolution in sight. Other schools have aging chairmen that _ARE_ the program but might retire soon, and thus the threat of graduating from a residency and applying to fellowships without the benefit of that support looms large. How much would you weigh the role of the chairman/PD in ranking programs?

2) There are rumors about a few of the schools that the operative experience is either "top-heavy" or actually deficient. PD's will invoke the number of cases logged, but I've seen cases logged where the PGY-3 is 4-deep to sticky-handed attendings, multiple fellows and chiefs. So my questions: should I be worried? Is there any way to actually evaluate, from a distance or on interview day, whether the residents will get a chance to operate and whether they emerge well-trained?

3) During interviews, how would you rank the following, as expressed by the applicants: enthusiasm for the program, knowledge of the program, being interesting and unique, formality, poise and demeanor, knowledge of orthopedics, ability to characterize personal strengths and weaknesses, friendliness/congeniality, ability to talk about research, ability to talk about non-orthopedic interests? I'm wondering what are the factors that play into going from an academically-qualified interviewee to a ranked-to-match interviewee. I know the textbook answer is "how well does he/she fit with the program," but I'm wondering if that can be broken down somehow.

Much thanks! It's a great thing that you're out there.
Happy New Years!
Rankled RANKL

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rescoordinator
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PostPosted: Wed Jan 04, 2006 4:34 pm Post subject: Reply with quote


Back to business after the new year I suppose...
RANKL:
1) I think if you're visiting a program that is lacking a chairman, you first should consider why the chair is lacking. Is the program in trouble and they bailed or did they retire, etc? If you determine that the program seems to still be intact, I would hope the PD would address concerns during the interview, and I would certainly feel confident asking your interviewers what the plans for the program are in the absence of firm leadership. I would also ask the residents when you meet with them what their impression is, they will likely be honest about their own fears if any. It's something to consider but if a program is strong, I would not let it effect your choice if you feel confident about other aspects of the program.

2) Ask the residents. I often hear our PD discuss good students who end up going to big names where they will likely not do much surgery. Whereas our program allows a good deal of surgery at all levels. I would ask your clinical interviewers what cases are like with them and how much experience you should expect to get at what levels. I think with this one though your best bet is the residents, again, they will likely be honest. If they're bitter, you'll know it. We do have fellows so I hesitate to say to avoid programs with a lot of them. But if the program is set up properly this should not effect the juniors all that much. Ask the coordinator for a rotation schedule, so you can see how many residents are on each service. If there are 5 residents on every service, chances are the juniors are going to get the short end of the stick more often. If there are several rotations where there are 1-2 residents, your chances are better. But I believe most programs just "do" or "don't" allow a good deal of operative exposure. The only way to really know is to ask.

3. Always a tough question. I believe you've read my other posts before and I think I addressed this a bit. It's very difficult to come into a stressful situation like this and be cool as a cucumber. I don't think 'formality' is something our program looks for at least. We're not particularly stuffy so we would likely feel that being around a more formal person makes us a bit uncomfortable Smile But surely there are more formal programs, where that might be more appropriate. Friendliness is important, but not overly (the interviewers aren't your best friends). I think it's just 'appropriate' that we're looking for. Imagine for a moment you are the interviewer, how would you want to feel around a candidate? It can't hurt to have some basic knowledge about the program so you can ask a question or two to your interviewers that applies directly to the program. Enthusiasm for ortho is important, moreso than enthusiasm for the program. If you are not from the area you can mention why you would want to come to that area of the country. I don't think any of our interviewers is testing you on your ortho knowledge... you're a med student and they don't expect all that much specific to ortho. If you did research, know about that. Have something to say (prepare something to say in the event that there IS nothing to say). I can't tell you how many times I've heard an interviewer say "it was like pulling teeth" to speak to them. Now you may be nervous and therefore go blank. I'd suggest some relaxation techniques for that. Just keep the conversation going, keep a few topics in your backburner to discuss just in case things get cold. You never know, the topic you bring up might spark something that really impresses your interviewer.

The bottom line, as much as you all hate to hear it is, you can't MAKE yourself something you are not. And it's going to be tough for you to fake it for 5 years. And if you don't fake it, you'll likely be unhappy. Be yourself, be yourself, be yourself. Be a prepared yourself. If you think you have poor interviewing skills, go speak to an advisor or student affairs dean, etc. Ask them for advice and to maybe do a mock interview with you so they can give you advice. It's very hard to know what you are like when you're not looking at yourself. They can give you great feedback.

Most of our residents are very happy, so in my mind I always think well, regardless of where you go, you're going to stick it out and be ok for 5 years. But I realize not every program is like ours, so I understand being concerned about various aspects of a program and how to really know what's going on behind the scenes. For those of you who have asked about the social events, etc. I think this is a good time to chat with the residents in a casual way. If they're truly unhappy with their training it will come across and you will know that maybe it's not the best program for you.

Good luck!
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novas
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PostPosted: Wed Jan 04, 2006 9:25 pm Post subject: Reply with quote


perpetualpriapism wrote:
This is the perfect time of year to get in on some ortho research. In almost all my interviews I have been asked about or commented on my research. Or attendings say, Dr. XXX has a project that you will really like, or some attending even comments that it would be nice to have someone match there with my reaserch interests......
In your case, specific ORTHO research may make you or break you......honestly its hard enough with a 240+ on steps I and II......so make sure you have some good ortho research......
Having EM research is nice, but if some guy is interested in the topic of a paper you have written it will make you stick out in his mind.....and with a low step I score you are gonna have to be extra impressive.....


yeah, i realize that you make a good point; it's one i've thought about often. my first 2 years of med school (and part of my 3rd) i spent thinking i wanted to go into EM, so i got pretty involved, got some research in the area and that research is still ongoing (i should have a paper out by this summer) and i was thinking it'd not only look unprofessional but would also be kinda turd-like of me just to jump ship and abandon the project (kinda leaving the PI hanging; i'm the main person on the project) to get in some quickie ortho research before i (attempt to) match ... wouldn't that just kinda look sketchy? i really can't help that i came across the ortho interest kinda later in the game (mid-to-late m3 year.)

and maybe it would hurt me that the research is in EM, but i guess when it comes down to it, i don't want to give this project (and this lab) the shaft by bailing when the project is culminating. i don't know, it just doesn't seem right. *shrug* i keep up with new areas of ortho/ortho research, and they interest me, so hopefully i at least get the chance to talk about those. we'll see, i guess. Smile thanks for your opinion on the subject, though (and yours, too, rescoordinator.)

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alosh_2
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PostPosted: Fri Jan 20, 2006 11:45 am Post subject: Reply with quote


Hi rescoordinator,

I would like to know what your advise and opinion is regarding my situation.
I am a foreign medical graduate. I completed my medical school in St. Kitts, BWI.
I was an above average student.
I completed my step 1>> 203/83 and step 2-CS on my first attempt.
I cannot see myself doing anything else except ortho. But looking at posts on this site and talking to others .. I feel I have no chance of getting in to orthosurg. I am doing spine surgery research currently. I hope to acquire good recommendation letters and maybe even get my name in publications this way.. do you think my chances are still too grim ??
If i dont get through in the place i am doing this research ,,, what are my chances of getting into other programs... if i work hard and get a 240 in step 2.
thanks in advance..
al

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perpetualpriapism
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PostPosted: Sat Jan 21, 2006 10:21 am Post subject: Reply with quote


NOvas,

I agree that you should stick out your EM research. I completed a nice little clinical project in about 3 months that we are doing a poster presentation at the academy this year. So it is possible to come up with something reasonable in a few months if you work hard. ER research will show that you can do/are interested in research.

However, you have to think of this whole process as like getting into a fraternity. A lot of qualified guys apply and are rejected every year. So you have to ask yourself how do you get into a favorable position. If your project interests one of the attendings then they will remember you and if they know the attending that sponsored your project even better. In your interviews you will spend a decent amount of time talking about the attedings you know and they ones that have written you letters.

You have to think of this as like getting sponsored by an attending (someone who is willing to vouch for you) You have to make friends with some powerful attendings and then they will support you. So if you come from an ER background you are gonna have to work to integrate yourself into the culture that is Ortho. Grades/ Step Scores ? Letters are all huge but you have to get the "boys" to like you and go to bat for you or none of that matters. Thats why the ortho match is so crazy cause that "gut feeling/ fit" is ultimately how most places make up their rank list. And research is a great way to immerse yourself in the ortho culture and show attendings that you have what it takes.

I know this sounds like a lot of jibberish bit I cannot over emphasize how much of this is untimately not in your control and you need to do everything to stack the deck in your favor.

Also, some programs just filter with step 1 so it wont even matter at some of the more competitive places.

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novas
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PostPosted: Sat Jan 21, 2006 12:07 pm Post subject: Reply with quote


perpetualpriapism wrote:
NOvas,

I agree that you should stick out your EM research. I completed a nice little clinical project in about 3 months that we are doing a poster presentation at the academy this year. So it is possible to come up with something reasonable in a few months if you work hard. ER research will show that you can do/are interested in research.

However, you have to think of this whole process as like getting into a fraternity. A lot of qualified guys apply and are rejected every year. So you have to ask yourself how do you get into a favorable position. If your project interests one of the attendings then they will remember you and if they know the attending that sponsored your project even better. In your interviews you will spend a decent amount of time talking about the attedings you know and they ones that have written you letters.

You have to think of this as like getting sponsored by an attending (someone who is willing to vouch for you) You have to make friends with some powerful attendings and then they will support you. So if you come from an ER background you are gonna have to work to integrate yourself into the culture that is Ortho. Grades/ Step Scores ? Letters are all huge but you have to get the "boys" to like you and go to bat for you or none of that matters. Thats why the ortho match is so crazy cause that "gut feeling/ fit" is ultimately how most places make up their rank list. And research is a great way to immerse yourself in the ortho culture and show attendings that you have what it takes.

I know this sounds like a lot of jibberish bit I cannot over emphasize how much of this is untimately not in your control and you need to do everything to stack the deck in your favor.

Also, some programs just filter with step 1 so it wont even matter at some of the more competitive places.


nah, it doesn't sound like jibberish. in fact, it's the feeling i've been getting all along. i'm a networking kind of gal, so i have no problem getting out there and meeting people. it's what i've been doing for a couple of months. i'm pretty aware of what i have to do and what i'm up against, so what you say makes a lot of sense. Smile hearing it, actually, makes me less afraid of following this path.

as far as the research goes, both my ortho faculty mentor and another ortho faculty member at my school, as well as several residents with whom i've talked have said the same thing you have - i'm sticking to the research. i actually have a strong research background and can talk about several of the projects i've done with confidence. no worries there. thanks for your thoughts on it, too. Smile

the more thought i put into this and the more meeting people in the field that i do - the more i realize this is the path for me. if i can't make it happen the first time around, for whatever reason (be it the 218 step 1 or the non-superstar grades,) i'll do what i can and try again next year.

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jjbones
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PostPosted: Sun Jan 22, 2006 9:03 pm Post subject: question about USMLE Step 2 Reply with quote


rescoordinator:

I have been reading your advice and want to thank you for all the helpful information. I do have one question for you that I haven't seen answered so far. I am a med 3 who is planning on going into orthopedics. I have good grades through medical school so far, have done a little orthopedic research, and got better than a 250 on Step 1. Now, I have some questions about scheduling my USMLE Step 2.

I have heard conflicting information about when to schedule Step 2. Many med 4 students that I have talked to have said to hold off and take it as late as possible because you can't do anything but hurt yourself after such a good step 1 score. I have also had one attending physician at my medical center tell me that if I can score that high on Step 2 again to take it early because that can just solidify my position. At our school, we are required to take Step 2 by the end of December of our fourth year so in reality I can't take the test that late. In your mind is there any real benefit to taking Step 2 early or later (with late being no later than end of December of the fourth year)? I would appreciate any advice you can give.

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jmedfsu
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PostPosted: Thu Jan 26, 2006 5:51 pm Post subject: prelim.'s Reply with quote


ResCoordinator -

I want to piggyback what everyone else is saying - it is GREAT to have you on the site helping to answer these tough questions. It is truly appreciated.

One question that comes to mind that I don't think has been brought up is the question of the prelim. surgery year --- if a candidate is in 220's on Step 1 and has GREAT prelim. year is that a bonus or are they "damaged goods" due to the prelim. year?

Also is being a "known quantity/entity" a help in getting a position at the place you do your prelim. year?

Thank you for your help.

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rescoordinator
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PostPosted: Tue Jan 31, 2006 10:41 am Post subject: Reply with quote


Hello to all. I apologize, it's been a while since I've logged on. Interview season is going well but is keeping me busy.
jjbones: I tend to agree that it can only hurt you to take your Step 2 early. Mind you, I rarely see someone with over 250 on Step 1 who then bombs Step 2. So chances are you will do just fine on Step 2. Although I would say as long as you get somewhere above 225 or so it won't hurt you tremendously. But if you go below that there is the thought that you aren't consistent, which is something programs are looking for. They want to see a pattern of success, that will carry over to residency and the boards. In the end it is up to you, if you feel you have enough time to study and be successful, I think you will do just fine. But if you are doubting it and feel like your initial success was a surprise to you, then you might want to hold off. I will say that generally if someone has a very high step 1 score, they mysteriously have not taken Step 2 yet...
jmedsfu: As for prelim years, we have in the past matched residents who did a prelim year in GS, but not often. How did you do on Step 2? Did you do the prelim year because you didn't match the first time in ortho or because you weren't sure you wanted to do ortho and didn't apply? Whenever someone doesn't match the first year, there is always that black mark - why? I'm not saying it's impossible, but it's tough. If you just are doing a prelim year and decided to switch to ortho from something else, then you should say that in your personal statement somewhere and have your letter writers comment on it. You don't want to leave too many questions in the application reviewers mind, because they don't want to use up interview slots on someone who is a greater question mark then most others already are.
It never hurts to have your PD or Chair or someone who knows the Ortho PD or Chair to give a call in your institution and say hey, this guy/gal is here, they're a superstar, they want to go into ortho, trust me this will be a good move for you. If that is how they feel. But just having someone at the institution probably doesn't mean all that much. Since I've been here we've never had anyone from our school apply from GS who had not already not matched in Ortho with us prior. But if they did, I would imagine they would be reviewed the same way as everyone else. If they got an interview and the PD was curious, they'd probably just call over to the GS office and inquire about you.
Hope this helps.. I'm still here and will try to check the site more often. Good luck to all.
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rescoordinator
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PostPosted: Tue Jan 31, 2006 9:37 pm Post subject: Reply with quote


I received a PM with a question, asking me to reply to all so everyone could hear the answer. The question involved what to do if your #1 choice changes between December and the end of January and they are no longer your #1.
First, we always have a history of people who go on about how we're their #1 and they want to match with us, but we know from their placement on our list and where they matched that they did not rank us first. Does it look good? No. Will it come back to haunt you? Maybe, but I doubt it. It's nice that you want to clear up miscommunication or a change of heart, but frankly by telling someone you are no longer their #1, depending on the personality of the PD or chairman, they may lower you on their list. And unless you are prepared to not go there at all, I don't think it's worth it. If you're #1 doesn't choose you, or your #5 or whatever, and you end up matching at this program, they don't need to know that it wasn't your top choice.
Maybe this is dishonest, I don't see it that way. I don't know how other programs do it but we do not base our rank list at all on who we think will come to us... the match is set up so this does not work to our advantage or disadvantage. But like I said there's a lot of shmoozing going on at this point, and if someone who told me we were their #1 ended up matching elsewhere, we chalk it up as his/her loss and move on. You'll have to explain in 6 years when the PD of the program is your colleague Smile. Hopefully they'll forget you by then. Possibly just best to tell a program they are among your top choices and would be very happy to match there. This gives you some movement. This is of course, all presuming that this program is very much wanting you... if they don't, it's a non issue. Good luck!
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dfagod
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PostPosted: Thu Feb 02, 2006 5:58 am Post subject: Reply with quote


rescoordinator, I was wondering if you could comment on how you approach couples matching? I obviously want to do ortho, but if I couples matched with my significant other, how does that affect my chances? Anything you can share would be helpful. Thanks!

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rescoordinator
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PostPosted: Thu Feb 02, 2006 7:16 am Post subject: Reply with quote


I do not even look to see if an applicant is couples matching, as it does not effect us. If someone gets selected for an interview, their personal situation may come up (ie, my S.O. is going into Optho and we are planning to stay near each other), but again, this will not effect our rank list. It does us no good to move that person down because they may not end up being able to come here. We do our rank list purely based on who we want and in what order we want them. That is what is great about the match system, we do not have to read anyone's minds to figure out who wants to come here.
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Micky
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PostPosted: Thu Feb 02, 2006 8:47 am Post subject: ranking Reply with quote


Comment on telling programs they're you're "Number 1".

I cannot agree more with residency coordinator. I remember when I was applying I thought it was so important for a program to know that they were my top choice. Really it is a non-issue. Fact is that programs rank applicants they want REGARDLESS OF HOW MUCH THEY THINK YOU WANT TO GO THERE. Don't get caught up in this. Chairmen and faculty are not that concerned about where you rank them. Telling a program they're you're number 1 choice WILL NOT change your ranking on their list unless the Chairman is a lunatic egomaniac

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BoneBlaster
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PostPosted: Thu Feb 02, 2006 5:09 pm Post subject: Reply with quote


micky,

funny you should say that if your location really is pitt!!! just look around your town and i am sure you will find a "lunatic egomaniac".

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SwiftGhoul
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PostPosted: Thu Feb 02, 2006 5:22 pm Post subject: Reply with quote


I must disagree with the statement that programs always want the 'best' without any consideration of whether the applicant wants to be at their place. 5 years is a long time and a 'great applicant' who has a neutral attitude toward the program probably would be passed over by some programs who would rather desire a competitive person who would love to be at their place. I personally think letting a program know they are your number one would probably make them rank you higher. They would rather be with a happy soul for 5 years than a miserable 'superstar'.

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