I am currently an MS3 and am now very interested in orthopaedics. I was previously only thinking of Neurosurgery, so I completed a summer research project/fellowship in NS. Would obtaining a research project during my fourth year be essential in terms of being competitive (currently a 240 step 1, probable top 1/3, a HP average during 3rd year)?
It is not essential - the only advice I would give you though is to make an appointment with the PD in ortho if you can just so you're on the "radar" - if you are completely unknown to the ortho department that can be more of a challenge. Of course if you can get involved with research that would be terrific as well.