over the past few years many rotating students have not matched at our institution and hopefully they didnt match at other institutions as well. it doesnt have much to do with board scores, grades, whatever. and its not much to do with personality or that other nebulous thing called 'fit'. since it seems to be more and more popular to do fairly well through med school and then just totally suck it on your most important rotations, i thought a handy guide would be save some people some time. here goes...
things ive personally witnessed from students (going into ortho) on their ortho sub-i:
1) ask for days off for leisure. going to that pool party is important... and, its gonna be awesome. programs dont want someone who is totally one-dimensional.
2) say you cant be on-call or round on the weekends because youre a third year. maybe this policy was specific to the institution where i trained, or maybe the school there was just full of chumps, either way, a great way not to match.
3) ask 'do i have to round on the weekends?'. if you want to unsuccessfully not match, replace this question with 'when are we rounding this weekend?' this will convey a willingness to work that programs looks for in people they want to actually be in their program.
4) go home early. you lucked out--you got the laid-back resident on the cushy sports rotation that gets done operating at noon. when he tells you, 'do whatever you want', definitely go golfing--do not find out if there are other services that might need a hand. you werent assigned to those other services, why should you help them. you dont want to break the rules, right? and definitely dont go read about upcoming cases or anatomy either--huge waste of time.
5) if a conference isnt that interesting to you, just leave. this is a great time to go eat. for double points, ask someone if you can leave. this will show them your profound lack of insight into how uninterested you really are and how poorly this looks.
6) show up on time. forget being early, thats for gunners and people who want to match.
7) dont take any of your insignificant responsibilities seriously. you could make sure the list is up to date, print out OR schedules, or see that there are dressing supplies for morning rounds, but the resident can also do that. they get paid to after all. you don't.
VIII) if you dont know an answer to a question, dont look it up. you're not supposed to know 'all of orthopaedics' --you're there to learn and thats it. your name badge says student and you're paying a lot to 'work' and wear that stupid badge-- these guys should really be teaching you.
9) wear scrubs everyday (and dont shave). its practically the uniform for the unsuccessfully matched.
10) dont take extra call. call is just plain hard, and you get really tired. sometimes, you wont even get to sleep or eat on call. why would someone sign up for that?
11) alert everyone when youre almost over your work hours. this way no one will give you more stuff to do--after all, residents never work more than 80 hours since the ACGME made all those rules.
12) ask a lot of questions in the OR. this shows youre interested. if its a difficult case, make sure to ask even more questions. this will help alleviate some of the stress of the case from your staff and residents.
13) if youre forced to do a rotation at your home program--and its not where you want to be--make sure you dont go the extra mile at any time. this will remind the residents and staff youre there to not match, and nothing else. its just such a stupid process, you wouldnt be here anyway, except some programs want a letter from your home program. what a waste of your time!
14) call in sick. orthopods are doctors, they understand these things--people get sick. they definitely wont remember how you said it was your buddy's birthday party the night before.
15) complain about how heavy a lead apron is. and complain about how hard it was to hold that leg while they put on the splint. this just shows people how observant you are.
call me a curmudgeon. i am. what i am not is some self-aggrandizing, hardliner- elitist. its still hard to believe, all these things actually happened. and, yes, in every case, it was a different student. sure, there are probably legit explanations for some, but its really gotten out of hand (sample size of one but even seeing a single student act this way once is enough). if you dont like to work, if you dont like being in the hospital that much, this is probably not the career path for you. you are there to prove to the residents, the staff, and mostly to yourself, that you can hang with working 100+ hours a week, read for cases, know anatomy, work every day for a whole month and still pretend to really be interested. why? cause i know, cause ive done it, and that the hardest week on a sub-i wont be anywhere near an even average week as a resident. if you dont want to or cant do it, then get out now. everyone will be better off. and if you simply didnt know any better, then thanks for reading.
