Residency Review Thread 2011-2012

Med School: Midwest (low-tier)
Boards: Step 1: 250ish; Step 2: 270ish
Rank: Top 10%
AOA: Yes
Preclinicals: Mostly A's, a few B's
Clinicals: All A's
Ortho: 3 aways; All A's
Research: 1 non-Ortho publication, 3 other Ortho projects
Extracurriculars: Nothing crazy here, Surgery Interest Group stuff, volunteering at a low-income clinic

What I was looking for in a Program: Academic over community, good operative experience, good fellowship placement, research opportunities

How many Programs:
Applied to: 72
Offered Interviews: 28
Attended: 17

Tier 1:
Mayo - Great program, amazing atmosphere, strong fellowship placement, no real weaknesses, can go to SHOCK for better trauma experience

Cleveland Clinic - Another great place, much like Mayo, go to Akron for Peds rotation

Pitt - Interview day is quite a show, but I have no doubt you will leave here a fantastic surgeon, residents work hard, good fellowship placement, rotate through the VA - which offers lots of autonomy

Hopkins - Maybe a little high on my list because of the name, good fellowship placement, have heard that younger residents don't operate as much (I didn't see this directly, but heard through the grapevine)

Baylor - Very similar to Pitt, become a fantastic surgeon, work hard, good fellowship placement, nice facilities - Texas Medical Center is amazing, rotate through a HUGE VA hospital - lots of operating, rotate through MD Anderson for tumor

Tier 2:
UC-Davis - Great faculty, good location, good fellowship placement

MCW - Really impressed with this place, all specialties covered, good group of residents, VA experience

Allegheny - Great faculty, not in the best part of Pittsburgh, PD is a great guy

Minnesota - Surprised by this place, liked my interview day, work all over the Minneapolis/St. Paul area though - lots of driving?, VA experience

UIC - In a great city, good program overall, not much to say really

Beaumont - Seems like a great program, in the nice part of Detroit, really good fellowship placement, nice facilities

Tier 3:
Cincinnati
Indiana
Kansas-KC
Loma Linda
Henry Ford
UM-KC


NOT RANKED: 0

Matched at: Tier 1

Advice for future applicants: Ortho has become extremely competitive (maybe the most competitive specialty now) - I know many people who were surprised on match day about their residency placement. All aspects of your application are going to matter, so make them all shine. Also, don't trust everything you hear from programs and other applicants - everyone is looking out for themselves in this process.

Med School: Top10 USNWR
Boards: Step 1: 260, Step 2: 260 (didn't submit until Feb)
AOA: Yes
Clinicals: Honors in everything except Family
Ortho: Only did one away, honors in both
Research: 4 first author papers (JBJS/Spine/CJSM); 2 2nd author, others in process
Extracurriculars: lots of athletic achievements

What I was looking for in a Program:
A great overall operative/educational/research experience w/ good interaction bw residents and faculty that would help launch an academic career.

How many Programs:
Applied to: 30
Offered Interviews: 26
Attended: 14

Top 4: In my opinion, I think these are the top 4 programs in the country. They all didn't end in that order on the rank list bc a lot of what goes into that is personal, family, location, etc. But in terms of helpfulness to future applicants, I think that these are the best programs in the country hands down from what I saw and heard about. I tried to come up with a 5th, but no single program stood out as better than the others in a long list of very very good programs.

Harvard: “The view from the top is nice” A large program consisting of 4 large level 1 trauma centers in Boston. With 60 residents in the program, everyone seemed to be able to find their group of friends in both the same and other years. Operative experience really starts to pick up PGY3 year during their 6-month dedicated block at Children’s. You really have to be a self-motivated person to do well at this program as residents “can get lost,” according to residents and faculty alike. Not a huge pimping program and I didn’t sense a hint of malignancy. They have (vs. HSS) the best perks in the country and are very well taken care of. Juniors yrs can be a lot of watching and if you don’t commit yourself to make sure you’re up to speed by the time the heavy operative experience comes around, you may find yourself at a bit of a loss. However, residents at the PGY3-5 level were universally happy and thrilled they had come to work at the best hospitals in the country, if not world. All graduating seniors walk into the best fellowships in the country in any area (and even one went straight into private practice last year which is a bit rare.) Overall, outstanding residents, attendings for the most part extremely dedicated to teaching, and great support from the program throughout the program. Rotations are primarily apprenticeship outside of trauma and vary between residents given the size of the program. Biggest knocks are the delay in heavy operative experience and short white coats during pgy1 gen surg yr. There are a lot of fellows, but are now completely separate services for the most part. Interview has a fancy dinner at the top of the hub the night before w/ plenty of drinks. Interview day is long as there are tours of all the hospitals in am/pm and a bunch of committee style interviews in the other half, some w/ ethical or scenario type questions. They only have your personal statement and no stats, fyi…and only 65-70? Interviewees for 12 spots is a great ratio. Ended up in my top 5 programs.

WashU: “The Best…if we weren’t in St. Louis” This program is like a perfectly well oiled machine. The PD Rick Wright is a great person and an amazing salesman of the place who truly has the residents best interest and education as a top priority. Rotations are setup to go through twice and many are in the apprenticeship model. Facilities, research, didactics are all top notch. Probably best known for hand and shoulder, but all specialties are truly very strong. Residents seemed nice and happy. A strong balance of males/females currently. Most residents own houses/condos nearby by the middle of their residency. Barnes is one big hospital and everything is there except sports which is at a cool outpt place 15 mins away. There’s just no weaknesses really and would probably be at the top of most people’s programs if it wasn’t in St Louis, although people who live there say it really isn’t that bad at all (and they’re probably right). There are an average # of fellows, but they don’t seem to distract from the focus on the residency at all – possibly w/ shoulder? It just doesn’t get the same kind of attention as coastal places do which is unfair, but true. Interview day is a nice bar and food the night before and 3-4 committee rooms often w/ one attending and a resident or two from varying years all w/ evry get-to-know you type questions. Very amicable and good down-home comfort food for lunch. Three interview days midweek makes it easy to attend and well worth it. Ended up being in top 5.

Mayo: “How medicine should be” This program defines excellence, efficiency, and outstanding pt care in everything it does. It must feel good to be a resident there. The facilities are like a 4 seasons hotel w/ an amazing gym that residents can use. Top notch record system. Apprenticeship model w/ varying experiences – I think the whole A/B track is orthogate lore, but some residents do feel like they didn’t get a chance to work with the “best” attending. 2nd yr basic science afternoon didactics sounds really cool as you still do clinical work in the mornings. Research heavy residents can take the whole yr for research and still graduate in 5yrs by doing heavier volume rotations. Strongest in joints and hand, but so well balanced that many residents go right into practice while others pursue the best fellowships. Only relative weakness is sports which you can go to Jacksonville mayo for to get more operative experience. There are no junior/senior rotations, so after 2nd yr you’re a “senior” resident getting to do what you’ve demonstrated competency with. Living is extremely cheap, and w/ that great price comes 8-9 months of winter…and it’s cold…like really cold w/ high wind. Great interview day split into 3 parts: tour, interview, promo talk. Interviews are 2 1:1 w/ a faculty member that knows your chart well. Only knocks are a q4 in house trauma required rotation as a chief and the away for sports…and the location. Oh yeah, and it bothered some people to wear a suit and tie, but it didn’t seem like a big deal to me. Ended up being lower on my list due to location and personal/family reasons.

HSS “Bone Palace NYC” I didn’t rotate here, a lot of my friends did and the interview day answered a lot of my other questions. This place teaches you to operate like none other. 2nd yr is primarily spent in queens or other places where you get to take a resident car to every morning and from what residents say is your typical, work hard, good basic stuff type of ortho program. Then comes HSS for pgy3-5 where you operate 4 days/week. Residents have all the paperwork/dc stuff taken care of by the army of PAs and don’t take in house call. They can come in on Saturday to make extra $ working cases and doing H&Ps and even by doing dc summaries. They live a really good life in upper east side and have tons of perks. They are strong in every area and the biggest life stresses for residents seemed to be making endless .ppt presentations and sucking up to the big name attendings. I expected to not really like the residents, but they all actually seemed like really nice guys and I enjoyed the committee interview room w/ them. Obviously, everyone gets great fellowships and they publish a ton (average 13 papers!?) bc they have all the resources and data at their fingertips. Biggest knocks for me are the short white coat and feeling like I would have to outwardly express my awe of how amazing my attendings are every day. It also isn’t a teaching hospital, but I don’t know if that matters to much although some subi’s thought that residents were expected to work fast or not work at all and some of the longer tenure PAs could kind of boss them around. Interview day has a technical skills room, research room, and a clinical room and a chief resident room. Pretty stressful day overall. Ended up ranking low on my list due to location and personal/family reasons.


Other Tier: I think these programs are all equal and each I could see someone convincing me is the next "best" program, whatever that may be.

Stanford: “400 million dollar commitment + Stanford reputation = The next big thing” Stanford has it all – great weather, nice facilities, outstanding academic reputation. 10 years ago, all it needed was a good ortho program. And now, it’s there. The program has made huge strides over the past 5 yrs in terms of opening a fancy new outpt surgical center, new faculty, higher quality residents, etc. The school put a ton of money toward making Stanford ortho the best and it’s about ½ way there. The rotations are still imho pretty bad, the worst being 5 months of trauma at the county w/ q3 home call (not really) during pgy2 and another 5 months as a chief. A highly recommended VA rotation is on pause (ie, stopped) until they get approval for their 6th or even 7th resident. This will likely create a night float system which would benefit the current call struggles as well w/ the work hour changes. Interview day was actually pretty funny w/ one attending standing up during a pause in the presentation and calling people out about why they wanted to go there, but I think it was kind of just one guy’s weird behavior bc both PD Cheng and the chair seemed like they had no idea what was going on. Interviews were 3 or 4 rooms about various issues, ethical, research, clinical, etc. and then one quick 5 minutes w. Cheng or Maloney. All in all, ended up in my top 5 due to location, reputation and personal reasons.

UCLA “Kick back, relax, and learn ortho” Forget UW, UCSF, or Stanford when you’re thinking about bouncing from the OR to hit the surf or throwing your flip flops in your bag for after work. If you want that lifestyle, UCLA has it to offer. Happiest residents I met on the trail. Really nice facilities w/ a brand new bone palace just opened on our interview day that looks really nice. Santa Monica is beautiful and minutes from the beach. The presentation on interview day was excellent and def. struck a chord with those interested in work/life balance. All areas are covered well, but the best is probably sports. Call is never too busy, but residents were quick to point out that they felt they got sufficient operative experience and felt prepared. They universally got very good fellowships and were thrilled at their choice of UCLA. Two residents are needed to take a yr off s/p pgy2 for a research yr which is usually filled by 2 willing participants. It sounds like a great yr where u can dedicate yourself to the lab, do a bit of research and moonlight, or truly just do whatever you want and recharge on the beach for a while with a little clinical research thrown in for good measure. The opportunities are endless with a large, dedicated ortho space. The biggest knocks are that it is part of the UC system and potentially susceptible to budget woes, but residents say they are rather insulated given the profitable nature of the Reagan hospital. Pay is insufficient for buying anything and most residents live in smaller apts near the hospital. There also is a fair bit of driving required for the different sites: VA, orthopedics, UCLA, etc. All in all, a great place to train w/ the Cali lifestyle. Ended up in my top 5 for aforementioned reasons.

UCSF “Big Dogs look nice…but can carry a bite” So you want flip-flops, early afternoons, and chill attendings – don’t look here. This place is serious business and with its world-class reputation comes a very big expectation for long hours, hard work, and research. The county hospital offers up some of the best trauma west of the mississippi (other than UW) while the main hospital gets all the complicated joints/spine cases. The sports program is smaller, but has energetic attendings and a brand new outpt surgery center than runs flawlessly. Hand and f/a are okay. The hospital as a whole carries with it an east-coast, no bs vibe and is represented in the ortho program. Residents are pimped quite hard in conference, in fx rounds, and in the OR…sub-I’s are also fair game. PGY2 yr is killer, but you come out knowing a ton. With very few fellows, residents get to operate a ton, early and often. The key issue is the county and its heavy, heavy trauma – 4 months per year for all 5 yrs. The place is extremely busy and you operate a ton. You also don’t have any support staff or a logical records system. The VA rotation is extremely operative heavy and is highly well regarded as the PD Kim is there. Vail is a very hands off chair, but is very well respected in the joints community. As far as san Francisco, one of the greatest cities in the world with everything you could want. They adjust the pay to allow for a life, but it is expensive. Residents are a extremely cohesive, tight-knit group that enjoy outdoor activities that are truly at your finger tips when you have time…also a large # of women relative to other programs. With a new dedicated childrens hospital and a brand new county hospital opening within a few yrs, its future is only getting brighter. Interview day is one of the more stressful days consisting of panels asking tough questions from research to clinical to ethical. Overall, ended up lower for heaviness of trauma and personal/family reasons.

Vanderbilt “We do this right” This program reminded me a lot of WashU. 5 residents per year going through 2 sets of rotations as a junior and senior. Amazing facilities all in one location (peds,main,VA). Energetic interested attendings. Everyone attends morning conference together creating a huge team dynamic that is really cool and palpable among the residents. The main difference is that Vandy’s mission is to make you the best surgeon in the world and they feel they do it better than anyone. How? With practice, practice, practice. This is a high volume place where you operate early and often. However, long hours and tons of cases are helped by an awesome EMR (think doing orders on your own ipad) and support on trauma. There aren’t two many fellows and the residents are very proficient by the time they’re chiefs. That said, research is there, but def. an afterthought to the mission of teaching you to operate. Fellowships aren’t as easy to come by as, say from Harvard, but the program’s reputation of churning out great clinicians helps overcome the less research. Call is Q10 for pgy2/3 and is killer bc you cover all the hospitals. Residents often earn top ED consultant awards, etc. However, it’s more like Q5 bc during busy calls (read most) the backup resident is called in to help. This can get draining but it’s like going into battle – on the other side you come out a different person. Nashville isn’t for all, but I loved it. Affordable housing. Great music and nightlife. Weather’s hot in summer, but mild winters. A lot of residents own. Interview day is pretty standard with mostly 1:1 interviews that are casual and kind. Dinner night before is fine. Ended up in top 5 for aforementioned reasons. Biggest knock for me was the slightly less focused research opportunities and number of residents primarily interested in private practice.

Hopkins “Changing tides” Hopkins had so many rumors on orthogate that when I went to visit I didn’t know what to think. Malignant? Lack of operating experience? Old facilities? In my opinion – all wrong. I think it carries one of the best lifestyles of any program in the country w/ their 24hr PA support while on call. There is tons of research time during 3rd/4ty yrs (two dedicated blocks) and there’s lots of great perks like the Orioles games, the nice ortho jackets, loupes, lead etc. There are very few fellows as well so it’s focus is definitely resident education. The best part of the program is the PD LaPorte. She is amazing – she was kind, nice, engaged, smart, advocate and got absolutely rave reviews from the residents. She has a great resident centered vision for the program and is a huge plus for the program. The elephant in the room is obviously their lack of chair which will surely change some aspects of the program. However, they’re going to get someone very good from the outside to help get their finances in order and with a brand new billion dollar hospital, should have no problem finding them. They’ve expanded recently getting new attgs in trauma (so they don’t go to shock anymore) and in sports. Spine is huge. Sports takes care of the O’s and Navy football and Peds is always busy with Sponseller leading the helm. Residents all had lives w/ some living pretty far outside the city. They have a really cool skills lab which is part of LaPorte’s training vision, but I don’t think its to make up for the lack of OR time. Subis and Hopkins students said they operate a ton, and I believe it. The pay is extremely lousy for an affordable (but not cheap) city meaning that some of the newer (read nicer and safer) areas of Baltimore are off limits for families unless you want to be really crunched. Everyone gets great fellowships w/ a lot of the residents I spoke to going into F&A based on their experience at Union and they have obviously a hx of good sports/spine/peds matches. This program ended up just out of the top 5 based on other/nonortho reasons and the thought of starting a family in Baltimore.

Penn “Stand straight, chin up, and shave” This program drums up opinions like none other on orthogate. True rumors: requirements are to be clean shaven, tie into and out of hospital, take any consult with a smile, be and look the best at all times. Anything less than excellent is not tolerated. We use US news and world report to gauge our self esteem w/ absolute goal being top 5 program in next few years. We will push and pimp you hard to make you the best. We will operate at all times throughout the night and expect you to want to be over hours on trauma or you will be looked down upon. The things that aren’t true are mainly about the turnover importance and Dr. Levin. He’s actually a reasonable person w/ an absolute burning desire for excellence and everything he does or requires seems to stem from that. He gets a lot of great things done for residents quickly – c-arm in the ED, new ortho hospital!?, etc. You pretty much just need to drink the koolade and get on board or you’re going to be one unhappy salmon swimming the wrong way. That said, most areas are strong including sports/shoulder – spine being the absolute weakest w/ only one attending that just came from UVa. The facilities at HUP are old and have paper records I believe, but theyre moving to presby soon w/ the new bone palace being built. CHOP peds is obviously amazing as well. Call sucks as a pgy2 bc you cover all 3 hospitals which requires driving in the middle of the night to do ED visits – called the “triple threat.” The 6yr option looks very enticing with one resident even scoring an R01 grant following her research yr that is completely call/service free. Tons of trauma including lots of penetrating trauma from all the gunshots if that’s your thing. Biggest knocks were described above in rumor section and phili overall for some people. Overall, I went back and forth on this program. No doubt you’ll get great training, but at what price for sanity? I decided I just wouldn’t be a great fit for a more militaristic type of program and ranked it lower accordingly. However, I think it will be one of the most respected programs again in a few years and encourage everyone to take a look to see if it’s the right fit. I have no doubt that if you’re willing to fall in line and work w/ Dr. Levin’s requests, then he will be an amazing advocate for you throughout your career.

Utah “The Outdoorsman’s dream” If you love skiing, hiking, the outdoors, and don’t mind a few weird drinking laws, then this is the program for you. The PD Aoki is awesome – down to earth, resident advocate, energetic and into teaching + he throws a great post interview party at his sweet house. The Utah program is extremely well balanced, has great rotations repeated for junior/senior experience. This program fits right into the WashU/Vandy mold – they’ve found their sweet spot with regards to rotations and experiences and are sitting well. Night float for 10weeks as pgy2 eliminates other call. PGY1 has even a sports experience to get you used to the arthroscope. Rotations feel truly education rather than service based. Residents were universally happy. Attendings at times wish their residents were more research focused and were a little odd in some of the interview rooms, but seemed genuinely interested in education and teaching. I truly have nothing bad to say about the program – great facilities, cohesive group of residents, maybe a little less academic than the other programs on my list, but it’s def. there if you want to focus on it. Top fellowships aren’t handed out given its slightly less known name, but they’re there if you work for them. The only question was how much the large #s of fellows interfere – rotators and residents, however, were quick to point out that the volume was sufficient and there wasn’t too much watching going on. Interview day was looooong including a tour and 9 (yes 9!) 20-30minute unstructured interviews. However, party at Aoki’s place was fun afterward. Ended up being a little lower on our list just bc of national recognition (ie, name) and mormon laws.

Yale
“Choose your own destiny” In classic Yale fashion, this is the most hands-off program I interviewed at. They have tons of dedicated research time which can either be for research or for “travelling Europe” “playing xbox” or “doing a bit of both” (all quotes from residents at interview day). I really liked the place – pretty nice facilities, really kind and nice residents, and the program had that feel that they’re pretty comfortable with themselves and aren’t looking to change too much. That said, the program is very resident run in terms of…well, pretty much everything. Call, didactics, etc. The residents complained about the poor didactics that were all resident given and I wasn’t too impressed about the turnout for a “good” grand rounds. The faculty are a large mix of private practice and academic faculty so that could be a plus/minus for some. Either way, residents get good fellowships and it has a good national name, but I think most people consider it a touch less prestigious than some of the other programs I interviewed at if that’s important to you. I also had questions about how much I was willing to have such a good lifestyle (lots of free time, very good pay) vs. how much I wanted to be the best orthopedist after 5 yrs. For the latter reasons, it ended up in the bottom half of my list, but I think it would be a great fit for others.

Columbia
“The Will Levine Show” The PD Will Levine (who runs orthogate and answers q’s on here frequently) is probably the best student/resident advocate in the country who I’ve met or heard about. He has a great vision for orthopaedic education and is an inspiring leader in orthopedics. He has the reputation of being very academically/surgically demanding while also being approachable and a pleasure to work with. Most sub-I’s and residents who rank columbia highly speak of his presence and leadership of the program as one of the top reasons. As for the other aspects of the program, the facilities seemed a bit dated and the residents I met weren’t as enthusiastic as I would have anticipated them being about the program. I think some of that stems from the fact that call is bw a few hospitals and when on home-call, you would have to subway or take a cab into work in the middle of the night coupled w/ the fact that the resident compensation is relatively low for living in nyc w/ few if any perks. Not being from nyc and having an significant other, that was an issue for me since it would mean a major lifestyle change. Also, you spend 4 mo in Baltimore for trauma/spine trauma for which residents give high remarks, but you still live in apt above a strip club across from Shock. As before, it’s for some, not for others. There may be also some issues re: double/triple/quadruple scrubbing that some of the subis had mentioned being an issue, but I can’t personally comment. As for interview day, you cant find a better social event on the trail. A wonderful mix of lots of drinks, good sushi, and nice people. Overall ended up lower for aforementioned reasons, but was as expected at the top of many of my friends lists for all the positives discussed and the allure of nyc.

Matched at:
#1

Advice for future applicants:
Most of your application starts early with relationships made with attendings, research, step 1 and 3rd yr grades. Subis and 4th yr are pretty much just to formalize those relationships and to explore other programs. Sell yourself and your interest at interviews. It's a long, stressful experience for everyone. Have fun and make friends on the interview trail - they're your future colleagues and a great resource throughout the process. PM me with any questions!

Come on boys and girls! Ortho is as popular is ever - we gotta have a few more people out there that will post some reviews for underclassmen applying for aways and soon-to-be interviews.

I'm sure that I missed a few because some years have multiple threads regarding ROL and post-match thoughts, but at least I found something from every year. Enjoy.

2011:


2010]viewtopic.php?t=6382[/url]

2009]viewtopic.php?f=1&t=5631[/url]

2008]viewtopic.php?f=1&t=4741[/url]


2007]viewtopic.php?f=1&t=3887[/url]

2006]viewtopic.php?f=1&t=3063[/url]

2005]viewtopic.php?f=1&t=2290[/url]

2004]viewtopic.php?f=1&t=1605[/url]

2003]viewtopic.php?f=1&t=1016[/url]

Top 5 Ranked Programs (in alphabetical order):

1) Dartmouth—Absolutely loved this program. Major positives of this program are great operating experience and the residents were tremendous. On interview day, residents seemed to genuinely enjoy their program. Attendings are committed to teaching residents. No fellows at the program. Negatives are that you spend 6 months away as a PGY2 for Tumor and Peds. It should be said however that you spend the 6 months at Harvard, so the program is seriously committed to training balanced residents even if the program does not have a Peds hospital or Tumor expertise. Also, Lebanon and Hanover are small towns…you have to consider if you want to live here or a bigger city. Overally, would have been happy to have matched here.

2) Brown— Another great program. Have to say that the research here is second to none. If you want to do research, this is one of the top places in the country. Heavily funded and multi-disciplinary. Resident interview days are early (starting at 0530) and ALL of the residents show up. This shows the kind of commitment that Ehrlich (Chairman) has to the program. Negatives for the program (potentially) is that it is a 6 year program, so the 6th year is a “super chief” year with a salary of $150k or so, but it is an extra year of training as opposed to fellowship. The 6th year is 50% trauma and 50% research, so you have to think really hard if you want to spend an extra year there. “Super Chiefs” universally seemed to like having the 6th year as it transitioned well for them to other fellowships or private practive. Regardless, I would have been lucky to match here, as PD and Chairman are great and Trauma is supposed to be tremendous. Providence as a city is so-so. Definately didn’t love it, but it is also close to NYC and Boston and it is overall, fairly affordable.

3) Hopkins— This is Hopkins, so the name certainly helps. Positives of the program are some of the Sim and Skill Labs that JHU Bayview has, as well as numerous collaborative research opportunities. Interview day was a little “sparse” as I only had 2-3 interviews altogether and had a hard time getting a feel for the program. Word is that the program is way more “friendly” than it used to be. Also, a positive is that you cover the Baltimore Orioles and Navy Football as a senior. Still ranked it very high, as chief residents seemed to be comfortable in their skills and got great fellowships. Baltimore is much more nice as a city than it used to be.

4) Iowa— One of the top programs in the country. Phenomenal Program. Dr. Buckwalter may be perhaps one of the nicest people you will ever meet. Program definately let’s its game speak. NIH funding is one of the top in the country. Call schedule is one of the best. Incredible balance in this program. Loved the rotations, as you rotate through services as both a Junior and a Senior so you have multiple exposures. Not a single area of the program is deficient in terms of specialties, so you get great training. I liked Iowa City ok overall, but the major question for most people will be if they can live in this type of town. It is in the middle of the Mid-west and will be a factor for people. Definitely a college town and not a major city. You have to see it for yourself to determine if it is right for you.

5)Utah— This program completely blew me away on interview day. Not a single weakness to be found. Dr. Aoki is Chair of the Residency Selection Committee and was amazingly conversational and truly seemed to be an advocate for residents (as well as being well-known for Sports). Overall, the program seemed very similar to Iowa, with rotations as a both a Junior and Senior. Dr. Saltzman (used to be at Iowa) is leading the charge here. Residents seemed the happiest of all out of over 15+ interviews. Seemed like the faculty new everything about you on interview day. Definitely did their research and chose applicants carefully. I did not see a single program on the interview trail that had the balance among sub-specialties that this program had. All subspecialties covered. Perhaps most important is that attendings were superstars at all levels (early v mid v late career). This program is training the next generation of top Orthopaedic Surgeons. Salt Lake City is affordable and a great place to raise kids. Program has a lot of fellows, but it seems like the program is resident driven and the operative volume is quite large for the area. Overall, would have loved to match here.

Other Programs

Mayo—tremendous research for sure. There is no program in the country that has research like this program. Major negatives for me were the size of the program, operative experience and location. 12+ residents per year means 60 residents in the program. Didn’t feel like residents knew each other and did not interact very much. Little class cohesion. Also, substantial variability in rotation based on faculty for the preceptorship type model. Didn’t feel like residents (even senior level residents) operated much at all compared to other programs. Also, Rochester is just sub-par as a location. Freezing cold most of the year and just not for me. Another major negative is having to spend 6 months away in jacksonvillle/Arizona.

Minnesota— Loved this program. Solid all around. Great residents who work really hard. Many residents are married and have kids. Trauma experience here is insane and you will be outstanding in this area if you train here. The number of faculty is pretty ridiculous. On interview day , you probably interview with 30 -50 faculty members in multiple “room-type” interviews. A negative for me was that the network of hospitals was quite spread out and it seemed like residents spent a lot of time driving between hospitals. Again, though, a tremendous program in a good city; Minneapolis is affordable and is family friendly…if you don’t mind the cold.

Indiana University— Enjoyed interviewing here. Pediatrics and Tumor are strengths here. Indiannapolis is very affordable and you don’t have to go away for any rotations. Residents seems ok overall. Program absorbed a residency a few years back so 7+ residents as PGY4 even though normally Cons are that researched seemed marginal overally.

University of Washington— If you are “single” this is the program for you. Absolutely incredible, in all aspects. Drs. Chapman (Chair) and Hanel (PD) are so approachable and are leaders in their field (Spine and Hand, respectively). Residents were awesome. Appears that the program is front loaded, with not much operating on the front R1 and R2, but heavy experience on the back. Major negative for me was expense….Seattle is ridiculous…plus, multiple hospitals all over the city, so I feel like a lot of driving was involved. Also, back end operating experience and huge number of fellows. Would have loved to have spent a month here to better determine OR experience. Also, it seemed like most residents did not have families which could be a significant factor for some applicants. Other than that, research and program is great.

Just typed a long post and when I tried to submit I lost internet connection and therefore my entire post. In brief, this is what it said.
School: Top 10 USNWR
Scores: 250’s on step 1 and 2
Grades: All honors preclinical years, all Honors (except Psych) clinical
AOA: yes, as junior
Publications: 5 first author, 1 second author
Away Rotations: 2
Applications: 28 programs, 20 interviews offered, 12 interviews accepted (plus my home school program)

Suggestions for applicants.

1) Find a program that has what you are personally looking for. There is no such thing as a perfect program. All programs have strengths and all programs have weaknesses. Just find one that has strengths in areas that you care about and weaknesses that you can tolerate for 5-6 years.

2) Don’t put too much stock in what you read on forums like this, including the post you are currently reading. Trust people that you know personally and can get a sincere individualized description of a program from.

3) Ranking programs is rubbish. There is no standardized valuation given to all the unique attributes that are taken into account when ranking a program (ie research, autonomy, city, surgical experience, attending/resident interactions, cost of living, trauma volume, “big name” program, call schedule, perks, etc). Because there is no standard valuation for each of these things there is really no way for me to rank programs and expect that my ranking should have any applicability to you. I would say that I agree with about 60% of what abcd1234 posted about programs. That does not mean that he/she is wrong, it just shows that we all view programs through different eyes and have different perspectives on things. I do think that not including Iowa on either of their lists was a poor omission though. That said, here are the “top” programs that I feel I have some idea about (I am sure that there are several other programs in the country that I did not interview/rotate at that could compete with these 5.

TOP 5 PROGRAMS in no specific order(w/brief explanation since my longer post was lost):

1. IOWA- A program is only as good as its leaders and Dr. Buckwalter is fantastic. He is top in the country in NIH funding for an orthopod and has held every leadership role but is still the nicest, most sincere guy you will ever meet. All faculty seem to have genuine interest in resident education and really love their program at Iowa. Great mix of established “big name” docs and up-and-comers. Idea balance across all specialties. All work done at a single hospital and VA just down the road so you don’t waste time travelling. Consistently one of the best programs in the country for research for the past several years. But only require 1 project if research is not your thing. Best call schedule of any program in the country. Iowa city is a Midwestern city but is affordable and an easy place to live. Will get the fellowship that you want.

2. WASH U- similar as above. Great leaders interested in producing the future leaders of orthopaedics. Great clinical balance. Do have to travel to hospitals/clinics but only a rarely. Great research emphasis and opportunity. People I knew who have lived in St. Louis think that it is a decent place to live (despite all the crap that people talk about it).

3. UTAH- Rotated here. Great up and coming program. Great leadership. Attending/resident relationship is of mutual respect and treat each others like peers. Research is not the strongest of any program but is available for those who want it. SLC is a great place to live. Affordable. Not sure what “mormon laws” abcd1234 is referring to but the only thing you would even notice in 5 years is that many shops are closed on Sundays.

4. CMC in Charlotte- sleeper program. Best mix of academics and private practice in the country. Building their academic/research arm with new addition of PhD’s and ancillary staff to help with research. Recently expanded from 3 to 5 residents with plenty of work to go around. Lots of perks. Charlotte is a great place to live and is affordable. Will give you a great start to a career in private practice or academic medicine.

5. HSS- Rotated here. Since one main goal of residency is to get you the fellowship you want and then the job you want I had to include this program as a top 5. Great city if you like big city programs. Lots of perks make it almost affordable. I can only speak to the service I rotated on but there were several things I didn’t love. 4 out of 5 residents I worked closely with were fabulous, down to earth people. 4 out of 5 attendings I worked with appeared more interested in their own agendas than resident education. Great work schedule with plenty of time to enjoy NYC. Worked at several different hospitals but cars provided to travel to the Bronx. As far as abcd1234’s comment about great surgical experience and being in the OR 4 days a week, I completely disagree (based on my month experience there). The 3’s and 4’s that I worked with had less surgical experience than most 2’s I have worked with at three other programs across the country. They did spend 3-4 days/week in the OR but were watching the attendings do 80% of cases and the fellows do the other 20%. (I spent 5 days/week in the OR as a medical student but this surely didn’t teach me a lick about surgical skills). The 3 and 4’s spent more time making powerpoints for pre-op and post-op conferences than they did with a surgical instrument in their hands on any given day. Great research experience with all the ancillary help that you would want. You may ask yourself why I still included HSS in my top 5 with all of the less-than-ideal attributes....it goes back to the purpose of residency training. Training at HSS you will be around top notch residents and will be able to go anywhere that you want to go in your future career even if the surgical experience is not ideal and the interaction with attendings is not what I would hope for.

Long story short, find a program that fits your personal desires and will teach you in a way that you like to learn. If you would rather have your hand held a little and learn well from watching others, find a program like that. If you learn best by getting thrown in the fire and want to lead a case in the OR as a 2, find a program that you will have this opportunity. Your personal valuation of each attribute of a program could be very different than mine so my list may have no meaning to you.

One thing I have learned over the past 9 months is that there are a lot of great programs in the country and a lot of really good people going into Ortho. The future of orthopaedics is in good hands. Good luck.

I have told multiple people over the past few months that location became far more important to me as the course of interviews went on. I found that there were ALOT of great programs throughout the country and most of the programs will teach you similarly.

Also, fellowship placement is much easier to accomplish than residency placement, so it's not really fair to judge program quality based on fellowship placement. Pick your programs based on what is most important to you - i.e. operative experience, location, didactics, research...

Absolutely agree with 2 above posts. Ranking is for the most part an individual activity. I included that portion because I knew as a student who wanted to do academic practice and have all the doors open, it does help to know what are the "best" or "reputable" programs in the country. While I'm sure fellowship will create the most career opportunities, I'm sure some of those are developed during residency as well. As I hoped to get across, there are a ton of very, very good programs. Leaving Iowa out of even the general discussion was poor form - I just completely forgot about it when typing up the list since I didn't apply due to location. The majority of what's written is my thoughts I wrote on the planes back from the interview, edited for personal omissions, etc. Also programs that weren't on my list bc I turned down interviews, but know many similar students were interested in off the top of my head are Brown, UW, NYU, Iowa, Rush, Jefferson. I'm sure training from these programs is great too....oh, and mormon laws referred to weird drinking, restaurant, bar stuff primarily (no happy hours, sunday, %abv, food requirements, the need for a club membership until recently - pretty dumb stuff mostly.)

Thanks to everyone who has already posted. Would love to here from some people with board scores in the 230s-240s.

Med School: Top 20
Boards: Step 1: Step 1 250 / Step 2 260
AOA: yes
Clinicals: Honors 7/7
Ortho: Honors 3/3
Research: Several first author abstracts and papers, middle author papers in JBJS and Spine
Extracurriculars: Advanced graduate degree, research, competitive athletics

What I was looking for in a Program:

I agree with much of what was said above.

I was looking for the best clinical training program in the country. Name was less important. I wanted a program with significant trauma experience and generally high operative volume. The program needed all subspecialty areas well represented and with depth and several established attendings in each subspecialty area. I wanted a program with a strong research tradition and the infrastructure in place to crank out projects and to support me to attend conferences.

My decision ultimately came down to trauma heavy vs subspecialty heavy. In this regard I opted for more trauma as a benefit. The exposure to trauma is essential. Trauma is the “meat of orthopaedics”. The next branch point for me was operative experience as a resident. Many big programs have huge operative volume, but most cases will be done by an attending and an attending will ALWAYS be in the room. This is bad for resident education. Residents need more autonomy to learn and make mistakes -- mistakes can only be made if they are holding the knife and doing the reductions.

Next, I wanted an academic program. In this case I am using academic to mean more research exposure, infrastructure and a departmental expectation to produce meaningful research during the residency.

Lastly, “FIT” is the most important thing that I looked for. Do I fit in? Do I like the residents? Do I like the staff? Do I like the geography? Do I have a good gut feeling about this place? The answer is not always yes.

How many Programs:
Applied to: 75
Offered Interviews: 60
Attended: >20

Tier 1:
UCSF
Top 5 program. Robust trauma experience at SFGH where residents run the show. All subspecialty areas well represented. Early operative experience beginning as a PGY2. Smart residents. There is a huge amount of talent within the faculty. Spine, joints, trauma are world class. Hand and sports have improved dramatically with new faculty and are uniformly considered to be excellent at this time by the residents. The program makes up for a relatively weaker pediatrics program at UCSF with rotations at Childrens Hospital of Oakland and Shriners in Sacramento. Although, a new Pediatric hospital is under construction and will change the ped’s program dramatically. Residents at UCSF get worked really hard and a lot is expected of them, but they deliver and have a good time doing it. Very tight group of residents that is collegial and also has a lot of fun outside of work. This is easily one of the best if not the best clinical training program in the country, but it is not an easy residency. San Francisco is an amazing city and Northern California is a huge asset. New general hospital will also be built within the next year or two. Drawbacks are the intensity of the program (+/-) for some, cost of living, lots of driving.

UW
Top 5 program. Robust trauma experience, much more trauma than at most others. All subspecialty areas well represented with hand as a particular strength. Very similar program to UCSF. West coast intensity, with a work hard mentality. Less early operative experience here, made up for later. Residents don’t operate until PGY-3. PGY-2s run the ED. PGY-5s, however, operate like crazy and rarely go to clinic. Residents appreciate the physical environment of Seattle as well as the cool vibe. Residents are very bright and the faculty has tremendous depth. This is easily one of the best clinical training program in the country, but it is again not an easy residency. The program is actively ramping up its focus on research. This was emphasized repeatedly during the interview day. They will be firing faculty that are not “teachers, researchers and clinicians” and will be replacing them with those that are. So expect some faculty turnover. Drawbacks heavy trauma overshadows some other aspects of the program, geographically spread out, TERRIBLE TERRIBLE traffic and lots of driving, cost of living, numerous fellows.

Utah
Top 5 clinical training program. Almost a perfect program (see drawbacks). Great group of residents with a friendly hands on chair and PD. The department is expanding rapidly and has built a beautiful orthopaedic center at the edge of campus. All subspecialty areas well represented and the research program is expanding rapidly. Good trauma volume, however, call is not killer. Active residents like to be outside when not working, resources for skiers / bikers/ hikers / climbers … hard to beat. Program has a VA and 2 pediatric hospitals. Bit of a sleeper program, smaller name, smaller research program, smaller reputation – this will all change. They don’t interview many people for residency spots. If you get an interview you should go. Low cost of living and no driving round out the pluses. Drawbacks Utah is a tough sell for many, no county hospital (the University hospital is the county hospital), its very white and the LDS population is still a significant force in the state despite easing liquor laws.

Case Western
Top 5 clinical training program. Some would argue that it doesn’t belong in the top 5. I disagree. This is a WONDERFUL training program. Chairman Dr. Randall Marcus is dynamic and hands on. The program is expanding and has a large research program in place. Rainbow Babies Children’s hospital is attached to University hospital and the VA is a 5 minute walk away. Metro is the county hospital is where residents get a huge amount of hands on experience and autonomy. A brand new cancer hospital and ED were new additions to University Hospital. The program has no weaknesses. Joints, spine, hand, tumor and sports are well represented. Residents work hard, but receive excellent clinical training. Cleveland seems to be the sticking point for many. It can be a tough sell. If this program were in a more desirable location, it might be the best in the nation. Winters are cold and grey and typically last November to April. The rest of the year is beautiful and cost of living is low. Cleveland also has unparalleled arts and culture for a small city -- including the best symphony in the world (strange I know). Commutes are easy and the people are nice.

Minnesota
Very similar to Case. Top 5 clinical training program. Some would argue that it doesn’t belong in the top 5. Again I disagree. This is a WONDERFUL training program. 2 level 1 trauma centers, with 2 pediatric hospitals, a University Hospital and a new outpatient specialty center for elective procedures. If anything volume is too high. This works for some but not others. Dr. Clohisy is a stable chair and has kept the department pointed in the right direction. The program has everything. Really, it might be the most complete program in the country. Drawbacks exist. The program is more regional than the others mentioned above with many residents from the Midwest, although it is starting to have more of a national pull. This is a family program and many residents are married and would probably not be as good a place for single people. Winters are COLD (no joke). The cost of having something like 8 major clinical sites is driving a lot.

HSS
See posts from others. Quickly. A wonderful opportunity for a select few. If you want to go here rotate here, it helps and shows you what the program is really like. The perks are huge as is the prestige. Minimal trauma experience and you have to drive to Queens to get it. As many fellows as residents and as many PAs as both residents and fellows added together. One of the best places in the country for elective orthopaedics, AMAZING place for fellowship.

Harvard
See posts from others. Most of what I said about HSS I would repeat for Harvard. I found the faculty to be very accessible and amazingly friendly. This program is HUGE. 4 hospitals that could each have a program of 5 ortho residents. This means 4 chairs and a ton of faculty to navigate. Lots of night float, less trauma and later operative experience made this a less appealing option for me. If you want to go here rotate here, it helps and shows you what the program is really like. The perks are huge as is the prestige. Minimal trauma experience, lots of driving, lots of fellows, AMAZING place for fellowship.

Duke
Michigan
UC Davis

Declined interviews at: Wash U, Vanderbilt, Mayo based on location. These are also without a doubt top tier programs.

Tier 2:
Yale
Brown
NYU
Stanford
Rush
CCF
UVM
U Chicago
UT Southwestern
U Maryland
Ohio State
Henry Ford
UVA
Tufts

Matched at: the right program for me.

midwestorthogator - Your thoughts on trauma volume and number of operations where THE RESIDENT is actually making operative decisions are spot on. Exactly how I feel. Many training locations will have numerous fellows and attendings who do 80% of the operation - this is not good! Residents need to operate to learn and yes, making intraoperative decisions will be an important aspect of our training. I don't believe that just doing the exposure and closing up is enough.

Certain programs (Baylor, Pitt, Case, etc.) are known for providing amazing operative experiences, and I think there are a few things that unite them. They all have busy trauma services, many have a VA association, and many have a large county hospital association. These factors give the resident alot of autonomy and allow the resident to enhance their surgical skills.

My thoughts on a few programs I rotated at/interviewed at.

Miami
This place is great. Great operative experience at Jackson, their public hospital. Also pretty nice facilities at their other hospitals. Particularly strong in spine and trauma. Residents were cool and got along great. They do not take you to a strip club for this interview. This is not necessarily a female unfriendly place as their PD is a woman. Speaking Spanish will help, but it is not a necessity here as plenty of the residents did not and they have easily accessible translators. Miami is a super fun city. Residents do well for fellowship. They have a nightfloat system and it’s a fairly big residency so lifestyle is decent. I’ll say if you don’t like the beach, to go out, or an occasional inappropriate joke this place may not be for you. Overall, awesome training with good people in a fun city.

Harvard
Rotated here. Big academic program, residents can choose the fellowship they want. Boston is a cool city, albeit very pricey. The didactics were excellent, usually given by attendings in a 3-4 hour block once a week. They have multiple established attendings in every specialty. Operative experience appears to begin as a pgy3, lots of night float even into pgy4 year, also decent amount of regular call, and none of the hospitals except Children’s have fully electronic records. I enjoyed working with all the attendings. The service I was on had two attendings and 4 residents, so on any given case someone was double scrubbed. I didn’t see the intern get to the OR ever. The PD was retiring this year and it will be interesting to see who takes over that job. Harvard has a great name and fellowship placement, but you will have to decide if the training experience works for you.

Emory
Rotated here. Training experience here is hard to beat. Grady, the big county hospital, allows for plenty of autonomy in both trauma and general orthopedics. Grady has full electronic medical records (EPIC), a newly renovated trauma ER, dedicated ortho ORs (usually 3-4 a day) and a floor PA. This allows a few of the interns to have already nailed >20 long bones as 1st assist. PGY4 and PGY5 residents were comfortable with periarticular trauma and very impressive in the OR and resident run clinic. Stand-alone Emory Ortho and Spine Hospital is cush and also offers a great operative experience. Spine program is one of the strongest in the country. Residents do well for fellowships. Downsides are that residents cover a lot of hospitals and take a decent amount of primary call. Altogether, residents get along great and rotating here is just a lot of fun. Very rotator heavy program.

HSS
Impressive place. Powerful academic name that will get you whichever fellowship you want. Particularly strong in sports with something like 27 sports attendings. Nice lifestyle with no overnight call during the week throughout your entire residency. Tons of perks and convenient and inexpensive housing opportunities. Is in a great location in NYC. Most people I spoke with enjoyed their rotations here. Interview day is actually pretty entertaining where they have you do some suturing and run through a case. I definitely felt this place could open some doors in my career.

Vanderbilt
This is a very well balanced program. Good operative experience, good lifestyle with q10 in-house your pgy2 and pgy3 years, and Nashville is an inexpensive city with plenty to do. Really very few drawbacks to this program. All of the rotators I spoke with enjoyed their rotation. I don’t think you can go wrong here.

Washu
Washu and Vanderbilt are very similar. Balanced programs with depth at every specialty. Washu suffers from its location in St Louis, but I didn’t think the city was that bad when I was there. Residents do very well for fellowship. I didn’t rotate and can’t comment on operative experience. Very pleasant interview day with no surprises.

UCSF
They have multiple locations spread throughout San Francisco which I felt was a downside. They do have a county hospital that gives the residents a decent experience. I heard rotators complain of some significant inefficiencies at the SF general hospital. Interview day they get after you a little bit with asking you to walk them through fairly complex operations. More women than most programs. San Francisco is absurdly expensive, and while they do pay you a little more, I’m not sure that it covers the difference.

University of Wisconsin- Madison
An excellent program. Most efficient and pleasant hospital I have seen. Everything is at one location. I liked the residents and lifestyle was great here. They have nightfloat for two months during pgy2, but the NF resident only worked 5 nights a week with every weekend off. They have to cover only one hospital and with a NF system their call was one of the best I saw. Operative experience was good. Morning conference 5 days a week was excellent. Madison is safe, inexpensive, has great public schools, and would be great especially if you are looking to raise a family.

Med School: Southern, public
Boards: Step 1, 2: 250s
Rank: Top 15%
AOA: Yes
Preclinicals: 2/3 honors
Clinicals: All honors
Ortho: Home rotation (honors), Utah (high Pass), OHSU (honors)
Research: Summer ortho project: 1st author published paper, poster presentation
Extracurricular: President of a student group, member of several committees, lots of sports, volunteering, and hobbies
Post Interview contact/thank you letters: 0

What I was looking for in a Program: Would like to pursue academics but also wanted to operate a ton without fellows breathing down my neck. After my aways I realized that location wasn’t as important to me as I first thought so living in a cool city took a back seat to being in a place where I loved the people and where I was going to get the best opportunity to become a complete baller.

How many Programs:
Applied to: 51
Offered Interviews: 24
Attended: 13

Tier 1:

Mayo
Enough people sing the praises of this one so I will try not and bore you. Preceptor model, 1 on 1 with attendings (eh hem, I mean consultants), less scut, and more OR time than most. Only work with fellows during 6 months of your 2nd year when you are doing your basic science coursework otherwise it’s just you and the boss. Cool group of residents from all over the place, however due to the fact Mayo doesn’t have any resident info on the website it is a little hard to know exactly what the class demographics are. There was a good showing both at the social (p.s. wear a sports coat) and interview day. Attendings (consultants) were serious but cordial. Didactics are attending run, grand rounds Monday, one service conference a week, during basic science months go to all conferences plus educational activities from 12-4pm. Basic science education is for 6 mo during your 2nd year + optional masters for the whole year. You do 3 months of peds, plus/minus a sports rotation, in Florida. New option of going to Boston shock trauma for a trauma rotation. Reputation is huge. The only downside I saw was the Dan Funk award, which goes to the resident who gets the worst collection of rotations each year since all consultants are not created equal in the eyes of the residents. Dan Funk apparently started this award after a legendary shitty year and now gives $1000 to one unlucky recipient every year. Very non-uniform experience from res to res with 9 months of elective during your 5th year. O yeah, Rochester eh. That’s a downer too. It was cold but not as small as I thought, 100K population. Kind of reminded me of the burbs where I was raised, minus the tundra background. Lebanon, New Hampshire made this place look like a bustling metropolis. My Gut feel was that this was the best program I interviewed at combining both academics and OR experience. In the end I considered terrible weather and having to wear a suit minor details and a fair price to pay for the mayo experience.

UTSW
Like most Texas programs this place offers a fierce trauma experience with tons of OR time and getting your hands dirty. Also arguably one of the best pedi experiences in the country due to your 6 months at the Scottish Rite where you are basically an acting fellow. Your 5th year you also do a rotation in England where you get a pretty autonomous experience dabbling under the grey skies of socialized healthcare. The only downfall right now is they don’t have a foot/ankle guy (work with well respected group of podiatrists) and they recently lost their Hand guy/gal. Program leadership has been chaotic. Losing both their PD and the Chairmen this last year. The Chair stepped down right after interviews were over and this was never communicated with the applicants before rank lists went in. Many say a new chairman will be a good thing for the program. Residents were my favorite part of this place. They didn’t take themselves too seriously, had a great sense of humor, and they all seemed very close. Smith machine in the call room, schwinggg. The residents go play air soft with their big trauma attending (its Texas, they like to shoot each other). Attendings take residents out for dinner and breakfast post call even which I thought was telling. Every Friday those who don’t have responsibilities meet for happy hour. Attendings seemed genuinely interested in me on interview day and knew my application well. Didactics include daily conferences. Dallas is a great city with tons to do, pricey, but you also get paid here more than any other residency I interviewed at, 5th year puts you around 60K, plus its Texas baby so no income tax. Gut feeling – one of my favorite programs with some fantastic operative experiences with one of the best group of residents in one of the better cities in Texas.

Cleveland Clinic
These guys operate a ton right from the start, however not so much on trauma. Only 4 months of all out trauma during your residency and very trauma light call at the main campus, but the sheer volume and amount of operating you will do around the city will also include enough trauma I suspect. They have a preceptor model, as a lower level pretty much no scut work, seeing patients in clinic and following to OR for continuity. Intern runs the patients on that service. Nice group of residents who seem mostly from Ohio. Over 60 Attendings on staff, core are really nice and approachable, mix of young and old. Didactics are once a week, seems to be a mix of resident and attending led lectures, have anatomy early in the fall, skills lab later in the year. Fresh frozen cadavers abound. Research year available, power of the CC research money and facilities at your exposal, excellent chance to churn out papers. Get tons of money for books, affordable city, call is light (x1 week) twice with night float as a 2. You get to moonlight and also get sports team coverage. To summarize, great reputation, weak on trauma, big city with plenty to do, and shitty, shitty weather. More precipitation than Seattle, a fact UW is quick to point out. Tons of benefits, full medical coverage. Gut feel is that the big name will open doors later on and despite the light trauma will have a great overall operative experience.

Campbell Clinic
Operate early and often. No fellow interference to really speak of so you get tons of OR time. Team model on trauma and preceptor model for everything else. On interview day and at the social the residents were very clickish and not overtly friendly. Despite this I heard from people who rotated here that they were a good group of guys who I would fit in with. Half married/ half single, many party hard. Very southern frat boy feel (google Alabama swoop for the prevailing hair style), big team environment, everyone works well together. Attendings have great relations with residents, no hierarchy issues. Didactics were only once a week, resident/attending ran, and they serve beer afterwards, a plus. Research was apparently not as emphasized in past but they claim to be improving. Most of the residents go into private practice. When not getting killed at the Med on trauma this is pretty cush place. The city may suck for some but I have good friends who rave about this place. You can have fun downtown as long as you don’t go to certain places at certain times. I was asked for change by dozens of vagrants during my brief stay, but on the bright side I suffered no penetrating trauma. Gut feeling was that I would have one of the best operative experiences here but a little light on academic/research side of things. Overall a great program with an interview day that could use some work.

UW
Seattle, my favorite city of all my interviews. Unfortunately OR experience is heavily back loaded while your first two years are heavily fortified with a heaping scoop of scut. On the bright side research and didactics are awesome here. Conferences/lectures are once a week. The programs overall average score on the OITE this year was in the 97 percentile. I talked with people who rotated there and it seems as a 5th year you will have to be battling with the 8 trauma fellows to do tibial nails which blows. Residents and attendings were a great group of outdoorsy, bike riding, microbrew happy types. The social had a great turnout and the residents seemed genuinely happy, even the 2nd years. Downsides of Seattle include, grey skies, traffic, and big city prices. You have to drive to each location, 15-30 min each. Gut feel is that you would get great training but end up operating a little less than I would want compared to my peers across the country.

Tier 2:

Dartmouth (5 and 6 year)
Has the early operative experience of a community program combined with the academic power of the bigger institutions. As a two you will be putting in joints/nails, no fellows, only 4 months on trauma, q6 call as upper/lower, residents feel competent coming out and go to top fellowships. Not a trauma palace by any means but the bread/butter exposure is good. Residents are cool group of outdoorsmen, half married with kids, older crowd, wide range of backgrounds. Lots of resident interaction including an Orthoacolon competition and an annual winter party. Many chiefs matched number 1 choice for fellowship this year (Vail, San Diego, etc.) Attendings – surprisingly included 2 Texans, all approachable, friendly, treat you like upper levels from the start. Daily morning lectures, heavily attended by attendings (up to ten). You go to Boston for 3 months each of peds and tumor. Otherwise you spend all of your time at the home institution which might get claustrophobic after awhile as it is not a big place. Residents admit that there can feel like “there is nowhere to hide” and everyone will know you business, i.e. drauma, drauma, drauma? Research can include a Masters year in health policy / research, can publish 1-4 papers, must publish 1 paper, lots of NIH money and research abilities, known for SPORT trial and research in outcomes. The town is F’n small, talking like 10K, but it’s inexpensive, most buy a house, can live in Vermont (10 min away), get money for attending sports games, team docs for all Dartmouth sports. Good reputation for research, not a household ortho name but will get you your fellowship of choice. Once again tiny, tiny town, single life would be hard but plenty of outdoors to keep busy, Dartmouth brings a lot of arts to the community, lots of races, skiing. Summers awesome, water sports, would freeze ass off in the miserable winter. Gut feel - would be a great surgeon with a strong research background if came here. Might not be much for night life/bachelorhood, but I would be a racing/outdoor machine.

UVA
Before I went on this interview this place was in my top 5. I heard great things about it from the operative experience to a robust academic environment. They operate a ton, especially at the Roanoke hospital which all the residents I talked to really seamed to enjoy. The social had a poor showing, only about 6 residents were at it however they were all nice, got along well, and I really enjoyed drinking with them. When it came to interview day this was by far my worst experience on the trail, both the PD and Chairmen rooms grilled me for 20 minutes each on very serious interview-by-the-book questions like “greatest weakness?”, “greatest adversity?”, “what kind of teacher are you?”, “what does leadership mean?”, and so on and so forth. Absent was the usual cheery bullshitting that usually goes on in the PD/Chair rooms. This was followed by 20 minutes of ethics questioning only to be followed with 20 more minutes of radiograph grilling. I don’t know if I had a target on my back or something but other interviewers had really nice experience while others felt the same way I did. Either way when I left the interviews I was quite disenchanted with the program. I had a couple residents confirm that the chairmen wasn’t the most approachable. Charlottesville is an awesome city. The say it’s very much like Austin, TX which is my favorite place on earth. Lots of outdoor activities. I still ranked this high just by strength of training and reputation but not that high because of my overall gut feeling after the interviews.

UTSA
Another trauma heavy hands on Texas program. Dr. Quinn, former PD of New Mexico, will be the new chairman by the time residency starts and I have heard only great things. He apparently did wonders over at New Mexico and the hopes are he will do the same thing here. Trauma is heavy but when you’re off trauma you escape from it, unlike UTH or UTSW. Residents are similar to the two aforementioned programs but a little more family oriented here, quite a few bros from Utah if you catch my drift. I didn’t really meet that many of them however because I didn’t make it to the social and less than 10 were around during the interview day. I interviewed with several residents and they all seemed cool, down to earth, and happy. Interview day consisted of 19, 15 minute interviews with one 5 minute break. That’s 5 hours of “So do you have any questions?” Bring your chapstick. The interview presentation consisted of one dude reading very informally from a note card so I didn’t get a whole lot of info about the logistics of the program and the website is little help. So all around interview day wasn’t super enlightening but I had multiple close friends rotate here and they all loved it. San Antonio is very fat and very diabetic but there would be plenty to do, like gain weight, foot debridements, and breakfast burritos (which originated here). But joking a side, a good cheap city with lots of stuff going on, and a good amount of great camping and outdoors around. Gut feeling – would get a great operative experience thanks to the trauma but not necessarily research/didactics driven, not really drawn in by aspect of living near the Alamo. I don’t speak Spanish either which they tell you on interview day would be of great, great benefit.


UTH
With only 3 residents a year and a trauma center that is arguably the busiest in the country (over 300 acetabular injuries a year) these guys do an s-load of trauma. You basically walk out of here with a trauma fellowship. I calculated it out and if you include the LBJ county experience (mostly trauma) were talking over 23 months of trauma. Working inside the largest medical center in the world would be neat. The med center is the size of most cities’ downtown. The residents here had the best operative ability of any I saw. They are a group of down to earth guys who see a lot of each other and therefore are very close. There has been a new influx of attendings lately as the program expands. Three new trauma guys and one pedi/sports. Didactics are noticeably weak here because they are just too busy operating and don’t get to read that much. Research potential is huge here but once again being so busy puts a damper on that too. UT Houston historically doesn’t have the best benefits. As a 5th year you don’t break $50K and medical benefits are not great. Houston however is cheap with tons of great places to eat and drink. Summers are hot and muggy. Over 40 days in a row of +100 degree heat last summer. But that being said Houston has everything you could possibly want to do, from microbreweries, concerts, museums, races, and more. The beach is 45 minutes away. Great places to road bike and run. Gut feeling – overall this program would offer me the best operative experience and autonomy however they are overworked and under read. If they expanded to 6 residents this program could be the best program in Texas.

Tier 3:

GHS
Another trauma heavy community program with great benefits in a kick ass location (see JPS). Residents were a close group of down to earth dudes and dudettes from all over. This program does its best to interview folks from every part of the country. Most are married. Attendings were sincere nice guys. Made me feel very welcome. Didactics exist and residents say it is one of the stronger points of the program. Research does also exist. Benefits include moonlighting, free food, cheap place to live, the outdoors, great weather.
Greenville is a pretty sweet town. Super impressed with the amount of outdoors around plus the downtown was really surprisingly hip. I could see myself drinking down there for 5 years easy. Two hours away from Atlanta. Gut feel - great community program where everyone gets along and treated super nice by hospital and staff. Strong peds with Shriner experience. No traveling outside of Greenville but you do rotate at a couple of hospitals.

JPS (5 and 6 year tract)
Community program. These guys operate early and often at their busy trauma 1 center in Fort Worth. Residents were friendly, mostly Texan. Many had families and a cheap house. Attendings were really nice, approachable, and resident oriented. Didactics take place one half day a week. Research is improving here due to their connection with the UNT DO school. Just added brand new 6 year research spot. This place has the best benefits of any program in the country. Full health coverage. You can’t moonlight but you can work football games, jail clinic, and get an educator salary your 5th year so they claim they had someone make 90K one year. Reputation is a weakness. Currently no foot/ankle or spine guys so you work with podiatry and neurosurg. Gut feel was that this was a solid program but didn’t have the strong reputation and overall training I was hoping for.

UTMB
Poor ole Galveston, still recovering from the hurricane that smacked it several years ago. These guys have to drive 45 minutes to Houston for many of their rotations. Luckily its reverse commuting and your ortho hours will miss most traffic. Also you get to rotate at places like MD Anderson so it’s a partial blessing. The driving was a big downer for me but as the island recovers hopefully this will improve. They also have the conferences and some of their clinic off the island. Seems like some residents live on the island, a few live in Houston, and most live in between. In general there is a ton of driving. Residents were diverse and seemed happy. Attendings were all very, very friendly. The Chairman was incredibly friendly and played classical music during the interview, which was a good example of the tone of the interviews in general. Overall it seemed like everyone was feeling the benefits of working on an island (You can see the ocean from the hospital windows). With Houston 45 minutes away and living on the coast there would be plenty to do, call is apparently light and mostly at home. Lifestyle would be fantastic here but I think your residency experience might suffer as they lost so much in the hurricane. Gut feeling – laid back, good training, great group of people, and entirely too much driving.

AMC
Felt like this was the JPS of Atlanta. Community program. Inundated with trauma much like Emory. These guys actually rotate at Grady as well. You operate early here, more out of necessity than anything else. As a second year you jump right into the OR to help out with the s-ton of trauma. Residents were cool group of mostly southern guys. Attendings were the nicest I met on the trail. They were very welcoming and sold me on the program and Atlanta pretty well. Weaker reputation. Weak research. You work one on one with a lot of good private guys out and around the community but this also leads to a lot of driving. Traffic sucks here so all that driving could be frustrating. Gut feeling, great place to go and get your hands dirty if you plan to head straight out into private practice. Atlanta is awesome.

NOT RANKED: none

Matched at: 1st choice

Advice for future applicants:
If you have a place that you are dying to go, by all means rotate there. You might be surprised however. My biggest regret was my away at Utah. I had heard that Utah didn’t interview many of their rotators but I didn’t head this warning. I did not get the call despite getting great feedback and a letter from the chairman. In fact I never heard a word from them, not a peep. I was pretty livid about it. It seems about the half the people I rotated with did not get an interview so I would consider this before rotating here, not that I didn’t have a great time/experience, just that you have a 50/50 shot of an interview.

Also when applying to aways I was anxious so I applied to four and ended up getting accepted by all of them. I had to turn two down, which were places I would of really wanted to go to. I did not receive interviews from those places I turned down. Don’t know if it was directly related but in retrospect it probably did not help. I would only apply to as many aways as your willing to accept because they are easier to get than you think, just apply as soon as VSAS will let you.

Lastly make sure you have some interesting stuff on your application. Quirky pastimes and accomplishments set you apart and will give you something to talk about during the hours and hours of interviewing ahead. Your interviewers will be thankful. Just be ready and knowledgeable about whatever subjects you put down because you might get grilled on it. So whether it be cooking, ultimate Frisbee, or hog wrestling just try and set yourself apart.

Med School: South, public
Boards: Step 1/2: low 250s/high 250s
Rank: top 10%
AOA: yes
Preclinicals: All "A's"
Clinicals: All Honors
Ortho: Did not receive grades for any, was this common elsewhere?
Research: 2 first author pubs, 1 pending, 2 posters
Extracurriculars: usual hobbies, etc. stuff from undergrad came up most often

What I was looking for in a Program: Learn how to operate and good people. I don't have a family, but besides what I just mentioned does anything else matter? It's a temporary location and you can publish research anywhere. I would agree that reputation (different from name) matters to some extent, especially for fellowship.


How many Programs:
Applied to: 45
Offered Interviews: 29
Attended: 12

Tier 1:
(Please describe programs here in detail)

Vanderbilt: Good operative training and good people. Honestly, I did not feel culturally diverse enough to fit in here (or match here), but I enjoyed my conversations with everyone I met. They get a broad mix of experience and enough trauma. A buddy of mine rotated here and loved it. Nashville is great.

Campbell Clinic (rotated): Hands down the best operative experience in the country. 4th year residents were more competent than trauma fellows I worked with on other aways. You probably do more total joints here than anywhere else as well and there are more than enough scopes to go around. All specialties are represented well. Great group of guys, but it's a club. Once you are in you're a brother. Great fellowship placement, despite lean to private practice. Memphis is underrated (seriously).

Emory: Great operative experience, similar to Campbell. Guys here were awesome and more open to the applicants. I felt like it was a great fit for me. Really a combination of the above places. Operate, good people, etc. This feels repetitive. Love Atlanta.

Iowa: Broad experience without overwhelming trauma. I agree with posters above that orthopaedics is trauma/trauma is orthopaedics, but it was nice to see something else that works. Great group of residents and faculty. Very family friendly. Fantastic reputation in orthopaedics, despite the name (middle of nowhere state school with average other programs). This is what I mean above. I would have to get used to Iowa.

Tier other (alphabetical):

CMC (rotated)
Duke
Florida
Greenville
Pitt
UTSW (rotated)
UW
**home program not listed

NOT RANKED none

Matched at: Not my number one, but tier 1.

Advice for future applicants: Think about want you want from your training.

Med School: Public
Boards: Step 1 and Step 2 in 270s
Rank: No rank at our school
AOA: yes
Preclinicals: All H, 1 HP
Clinicals: All H
Ortho: H for home program and two aways
Research: Did ortho research summer after 1st year, one presentation, no pubs
Extracurriculars: Typical stuff (clubs, TA, tutoring, sports)

What I was looking for in a program: Balance between operative experience, didactics, and program reputation were key for me. I'm very strongly considering a career in academics so going somewhere with strong connections was important. However, it's no mystery that some of the most prestigious academic places are a little lacking in terms of operating so that's where I felt "balance" came in to play.

How many programs:
Applied to: 80
Offered interviews: 47
Interviews attended: 16 (I only went into detail for my top tier)

Tier 1: in the order of my rank list

1. Iowa - One of the best overall programs in the country. This place has it all: amazing reputation, great operative experience, incredible research productivity, down to earth residents and faculty, great place to live, amazing call schedule, only two hospitals which are practically next to each other, and of course the obligatory comment about Dr Buckwalter (this guy is a rockstar yet very humble and welcoming). I could go on and on but a lot has already been said on this thread and others. Iowa city seems to be the big thing that comes up as a potential deal breaker, I loved the city and thought it would be a great place to be for the next five years. In terms of academic orthopaedics, it doesn't get any more big league than this place. I encourage anyone looking into academic ortho to check it out.

2. Vanderbilt - This place surprised me. I had heard nothing but great things about it from my classmates that rotated there, so I was really looking forward to the interview. They have a great program with tons of trauma and operative experience, and the academics and research are certainly there. The residents I met at the social were some of the nicest on the trail, and you certainly can't go wrong with Nashville. This is definitely a top program in all regards, and I would have been very excited to have matched here.

3. CMC - Someone else already called this place a sleeper, and I would go further and say that this place is already a well known great program. This is a community program turned academic, and they do both very well. Residents here operate a ton, get great exposure to private practice, and have the opportunity to get very involved with research if they want to. This place is turning out great orthopaedic surgeons, and it's only getting better, fast.

4. Mayo - This thread had already written a novel on Mayo so I wont add anything other than yes, it's Mayo and it's that good. The only drawback for me was the size of the program, I was looking for something more tight-knit and the 12 residents a year and mentorship model weren't my favorite. Clearly those are personal reasons, and based on what I was looking for otherwise Mayo had all there is to offer.

I'd write more about the other places I went, but quite honestly I just dont have that much to say about them so I dont know how useful it would be.

Matched at: Top tier

Advice to future applicants: I'll assume most people looking at this thread are 3rd or 4th years about to be going through this process. The best advice I think I have is to just be humble and work hard. I know that's not rocket science but, honestly, it's incredible how far that will take you. Especially on interviews, just be nice and be yourself and people will recognize what you've done and you will stand out. It's easy for me to say all this now that I'm on the other side of things, but don't worry, the vast majority of you that are willing to prepare and put in the time to research and understand this process will be right where I'm at before you know it. Best of luck to all of you, it's a great process and 100% worth the time and effort!

Since I have visited this site hundreds of times preparing for away rotations and interviews, I am going to reply to this thread a little differently to pay it forward. My intention is to provide future applicants with information that will assist them in their upcoming decisions. That being said, I’d like to say a few things off the bat concerning advice in general and rank lists:
1) Always consider your source. Inherently, previous applicants will base their advice primarily on their own anecdotal experience and that of fellow applicants/friends. Even in anonymous message boards like this, whether conscious or subconscious, people’s opinions will be influenced by their experiences throughout the process. Your best source of information regarding your competitiveness is current program directors/chairmen. They know with certainty what makes a candidate desirable-not recent applicants. Beyond that, they will have access to your entire application (not just your board score) and determine your status. That being said, my advice is obviously flawless and the best you will read…
2) Orthogate is an intimidating beast. Looking over the previous posts on this thread, I would be trembling in fear if I were applying this year. Not everyone has a 260-270 step 1 and first author publication in JBJS. Not everyone gets interviews at the majority of places they apply to. I know people that matched with scores that would be torn apart on these forums…and I know others who did not match with very competitive scores/grades.
3) Rank lists are very subjective and conditional. Subjective in that if you are a city person, you will rank city programs higher. If you are engaged/married, it won’t bother you if the program is not in a hot spot. If you want a big name program, you will rank big names highly no matter what. If you want to live in a certain geographic region, you will rank all programs outside that area low. Conditional in that you can’t rank a program you didn’t get an interview at, and if a program pleasantly surprised you it will knock other programs down your list that you still love.
4) There are no true tiers. Sure it is fun to try and name the “top 5 programs” or rant about how “hands down this is the best program in the country,” unless someone interviewed at every potential top program no one really can say. Much like medical schools, all ortho programs are great. The best “tier” is the one that best fits your personality and aspirations.

I am not going to give my stats here because I honestly don’t see the point. There are two aspects to getting into a program: the invite and securing a position. To get an interview you need to meet that program’s minimum criteria for grades, steps, ECs, LORs and they need a reason to want to meet you. To secure a position, take the interview very seriously and sell yourself better than other applicants.

What I was looking for in a Program: I am leaning towards academics, so having a program that left doors open for me and had great fellowship placement was important. Beyond that, it was all fit.

NOT RANKED-rank everywhere. You would rather be an orthopod at your #20 than have to fight the long uphill battle of scrambling/reapplying.

Matched at: #1

Advice for future applicants: Be humble, polite, respectful, know your application, smile, have fun with fellow applicants, sign up for frequent flyer miles, buy a new blue/gray suit, and enjoy the ride/free drinks.

Good Luck!

Well said orthorover. There really is no way to rank all the programs in the country, because like I said before there are so many good programs and everybody's rank list is so subjective. I think you give some good advice that applicants need to look at our rank lists with the idea that many factors went into how we ranked our programs. However, I do think this board is helpful and that you can get a lot of great information about programs around the country that you might not have access to otherwise. I think most of what you read on here is true information but how people rank their programs might not be the best way to consider what program is right for you.

Med School: Top 40 Research
Boards: Step 1: 250, Step 2: 240
Rank: Top 25%
AOA: No
Preclinicals: Pass
Clinicals: Honors: Surgery, Peds, Psych
Ortho: Honors at home and 2 aways
Research: Ortho research, no publications. 1 submitted publication (non-Ortho)
Extracurriculars: Random interesting/awesome stuff.

What I was looking for in a Program: Good vibe and nice feel + Well rounded academic program with a high volume Level 1 trauma center, research and excellent fellowship match.

How many Programs:
Applied to: 70
Offered Interviews: 12
Attended: 12

Programs: I don't find any benefit to listing programs and giving my version of "tiers." There a lot of excellent programs out there with well recognized surgeons. The best way to find out what you like and where you want to be is to research programs in which you would be interested (both geographically and academically) and apply for aways at a couple. Talk with your home program Chairman, PD and mentors to find out more info regarding programs and the application/interview/match process.

Advice for future applicants: Ortho is so competitive these days that there are far more than enough applicants who can meet or exceed the numbers threshold. It's the qualitative parts of your application that will set you apart. My best advice is to establish a relationship with a mentor at your home program who will write a strong letter, advocate and make calls for you. Crush your Ortho rotations and get strong letters from those you impressed. In the end, I felt that my board scores and grades got me through the filters, but my letters and established relationships helped me MATCH at a top notch program.

Look, everyone knows that you need great board scores, tremendous aways, letters of rec from big names...AOA...etc. But the key is to go here and try to find out what each of these programs is about. What do each of you find special in these programs as you have gone through this process? What are pros and limitations? That is incredibly valuable advice and the hope is that the true value here is in the totality of the advice that is described in this thread. Let's keep posting info about everybody's experience about each program...general advice is certainly helpful, but what I thought also provided guidance (at least for me) was multiple different opinions about programs.

Since I was a little brief with my previous post, I wanted to expand a little bit.

Mayo - I really liked this program. The atmosphere at Mayo is incredible and it just feels as though you are part of something special. Also, the residents get strong fellowship placement, but as others have mentioned - this isn't really a stand out part of the program as many programs get people into great fellowships. The mentorship model isn't for everyone, but I think overall it's not a bad way to do things (although I'm sure some residents have amazing schedules and others get kinda screwed). The 2nd year you can make a research year without lengthening your residency, which is a nice bonus since the research opportunities are endless. The didactics are Mayo are the best in the country. Second year you spend 6 mos. in lectures/dissections every afternoon. Specialty conferences and grand rounds are well attended by faculty and residents. One thing I am a little skeptical about is the operative experience compared to other programs. Mayo compared to other residencies receives very little trauma, and subsequently offers rotations at SHOCK to make up for this deficiency. Also, there is no VA or county hospital experience - you just get the great subspecialty training that Mayo offers. Additionally, I'm imagining that alot of your cases are complex/crazy stuff, thus not allowing you to get much autonomy in the OR.

Cleveland Clinic - It's a really great program and they have a fun group of residents. It is relatively "family friendly" and the attendings are all very approachable. Another plus is that you only have to round on patients that you actually operated on. The fellows and senior residents can't dump their dirty work on you - which is a nice bonus. The facilities are beautiful and living in Cleveland wouldn't be all that bad. Just like Mayo, the research opportunities are plentiful. You do have to go to Akron for your Peds experience, but I've heard that rotation is great. Also, you go to Case for trauma, since CCF doesn't see much operative trauma. I've heard from rotators that the operative experience is good, although again there is no VA or county hospital experiences (so a similar experience to Mayo in regards to subspecialty training).

Pitt - Interview day is quite a show, but I have no doubt you will leave here a fantastic surgeon. Freddie Fu is great - he is extremely friendly and approachable, plus I've heard he is a great chairman and resident advocate. I do think the residents work hard (especially their PGY2 year), but it seems it all culminates in producing fantastic surgeons. They have great fellowship placement. Residents rotate through the VA and have a busy, busy trauma service. Morning report for the trauma service is a great learning experience, attended well by faculty. One thing about this program, the PGY2s get destroyed I've heard. They create many/all of the presentations and take alot of trauma call. By doing this though, it makes the PGY3-5 years a little more cushy. Pick your poison I guess.

Hopkins - Maybe a little high on my list because of the name, although I had a good experience overall at JH. The residents are all very friendly and easy to talk to. They just built a brand new $500 million hospital, which should be very nice. They have good fellowship placement. One knock - I have heard that younger residents don't operate as much as they should (I didn't see this directly, but heard through the grapevine). Also, while Baltimore has nice areas, I'm not sure it is for everyone.

Baylor - I felt this program is very similar to Pitt - these are the best two operative experiences in my Top 5. The residents work hard, but become fantastic surgeons (I really believe this is one of the best "academic" operative experiences in the country). They have a good group of residents, who like to work hard and play hard. The PD is a great guy and really easy to chat with. They have good fellowship placement - especially in hand and spine. The facilities are awesome within the Texas Medical Center - Baylor Clinic, HUGE VA (second biggest government building behind the Pentagon), Ben Taub, Texas Children's, MD Anderson, Methodist, and a Shriner's. In regards to the VA hospital - new building, lots of operating and tons of autonomy. Ben Taub is a busy county hospital and much of your trauma experience is spent here. It's an academic program with many research opportunities, but the time required to produce the research is not always available. They were trying to find a chairman a few years ago, but currently have an interim chair that has stabilized that situation.