Incoming med student.

So the chances of your actually sticking with ortho after 4 years is probably about 50:50 but what ortho programs are looking for is the same thing every program is looking for regardless of the specialty. They want what you can imagine, grades, scores, research, and letters of rec. What you need to know at this point is that you really don't want to limit yourself on what you can do early by not performing well during the basic science years, and not doing well on step 1. If you do well during the first two years and really kill step 1, it makes the next two years really fun because you KNOW you can do anything you want with regard to a specialty choice. I can't imagine its very fun walking into a rotation thinking to youreself "well there's no chance I could ever do this even if I loved it."

The importance of doing well in the first two years isn't so much for the grades in pre-clinical classes, most residency programs look at that about as closely as hair color. But, paying attention in the first two years will make Step I a lot easier, and that is probably the most important part of your application and will make everything else substantially easier if you really do well on it.

Ya I agree with you for the most part, but I will say that one thing that surprised me is how some programs do look at things you'd think they wouldn't really care about. Some of these competitive programs start to look at things that you wouldn't think are real important as another way to stratify applicants. I don't think anything is ever in the 100% "they don't care about this" category. Overall though I do agree that preclinical grades aren't things to sweat that much over.

Use the first two years to start establishing relationships with junior residents in the ortho dept, who will be interviewing you when you're applying, doing research between your 1st and 2nd years, and scrubbing into cases during your down time. All of the above will give you an early view of what youre getting yourself in for and help you see if you like it. Also, you will be a step ahead in getting your foot in the door. Do this cooly and calmly without being an over eager little beaver.

Trust me, scrubbing into cases during your down time will make you an over eager little beaver.

Just study hard, have fun, and work your ass off for Step 1. If you really want to do some research between 1st and 2nd years, it won't hurt.