To be brief I am a 4th year at a small primary care geared school with aspirations of going into ortho. 255 on step1 and 270 on step 2. Honors in my clerkships but I have no publications. What is the best way to discuss or get through my lack of publications. I do have "ongoing" research to show my interest which was later then most. Any advice or tips would be greatly appreciated.
You've already answered your question quite well - you come from a small program with little orthopaedic background and your opportunities sound like they were pretty limited. As you will find throughout this website research is just one of many variables that are evaluated in determining whom would be a good fit in a residency. Your USLME scores and 3rd year clerkship grades will obviously get you noticed by many programs and then your letters of recommendation will be helpful.
Ultimately, when you are in an interview and this topic comes up (which it likely will) be prepared to discuss what your limited access was and what if anything you've done. Remember, not everyone knows when they show up to medical school that they want to be an orthopaedic surgeon. Some of the best residents over the years at many programs have been students who decided very late and had little to no orthopaedic research experience.
