Step 1 Cut off - Need your info

As for switching from family med to ortho in 4th year...hmmm, thats a head scratcher. Yeah, I do have a little bit of a problem with that. First, this is 3-5 years of your life, to flip flop so easily shows that during the first 3 years you took very little interest in this, and its not a decision that should taken half heartidly. Seriously, I've seen this many a times where people flip flop, end up in that specialty, then match out of it again after internship year. This is five years of your life, it should be taken seriously, and I don't think rash decisions should be made over a one month elective in a certain specialty.
Secondly, look at the difference in lifestyles between the two. If you were interested in surgery, why not G-surg, or ENT, or Neuro, or anything like that, why family med? You do know that the only residencies really having problems comforming to the 80 hour work week are the surgical ones. From my experience most people interested in family med hated their surgery rotation, hated the lifestyle, and hated the attitude...for me I was a surgery junky, I loved being in the OR REGUARDLESS of what it was....and you get a chance to experience this in 3rd year.
Thirdly, we're talking about 4th year here...if you are unsure at that point which specialty you want, maybe you should think about preliming. The other poster mentioned she made her decision during 3rd year, which is where you get your surgical experience, where you get to explore your personality and what fits you well in medicine. If your interested in ortho, EXPLORE IT THEN, why wait later(especially 4th year, which is last minute)??? Go to the lectures, grand rounds, spend your free time in ortho clinic/OR, research ortho...this is the looking into things during the first 3 years I talked about. Yes, I know some private docs in surgical specialties who decided late, however, this was in an era before the match, and they had a chance to explore surgery in there internship before committing to a specialty. Its a much different boat. Nothing is wrong with a prelim year, if your unsure, just do it, in the grand scheme of things 1 year is a small small portion of your professional career
I can say one thing that sums it up. There was a student I rotated with who was b/t Plastics and ortho, 2 at least surgically related specialties...you know what one of the residents said to him "Oh, so you aren't really seriousl about ortho then?" It doesn't matter what I think, it doesn't matter what you thin, it matters what the powers that be think, and that kind of sums up alot of the attitudes I've encountered. If you want it, you better be dead serious about it, not some passing fancy in your 4th year to PC....

If you didn't mean to hijack the thread or start a heated debate, why did you even state your original post. Basically, you said friends told you to explore ortho, and you were interested because you were a cheerleader and you heard some programs favor female applications. You even mention that MAYBE you will do an elective...If you were a hard working die hard bleed ortho from day 1, wouldn't you be a little ticked off to have someone come on a board and say that? Seriously, as a third year medical student you should have learned how to communicate effectively with patients, colleagues, residents and attendings...that post obviously shows that you don't. There are people in medical school (and I have met them) that really don't have a solid reason for going into ortho other than its so competitive, and I want to go after a competitive spot, or some other half arse reason like that. Your post seems to reiterrate similar sentiments.

As for the whole board score argument, I talked to my PD before the 4th year. He told me that 210 is more of a common point than 220 or even 230. He says some of the competitive programs may use higher scores, but that alot of the PDs he knows use 210...thats just for what its worth.

Going on further with board scores, ladies and genlteman, this is the game we play. Its a numbers game, and with 200-300 applications, they can't read them all, they need something to quickly sort them. Thats all, once you get passed that and get your foot in the door...ITS MUCH MORE THAN BOARD SCORES...but you have to get your foot in the door. For those MS3s or younger reading this, if you don't have those scores, or feel you may not be competitive, DON'T BACK DOWN, if ortho is truly what you want, go for it, I know that I wouldn't be able to look myself in the mirror if I didn't at least give it the ole college try. There are other ways to get interviews, i.e. away rotations, that don't require the 230+ board scores...at the end of the day, no matter how many interviews you have, it only takes 1, ala the NFL draft, to take a chance on you and let you in....

in other words, board scores, grades, personal statement, and whatever else are not necessarily good for predicting who will become a great orthopaedist....they are simply ways (or hoops, if you will) of differentiating the candidates from one another in terms of studying ability, "game-day" performance, being a nice guy, and willingness to do the little things even if they don't seem to matter.

MD007-- it is true that board scores or clinical grades or reputation of medical school etc are not accurate measures of how good of an orthopaedist one can be, but when schools receive hundreds of applications, what other information is there that can differentiate one candidate from another? They have to make judgement somehow... I suppose if I have to make a gripe about the process, it would not be with how programs choose applicants, but rather the testing format and grading process themselves because they create the measures by which we are chosen. The boards for instance...is there such a huge difference by someone who gets 225 from someone who gets 232? or 232 from 245? Sure, someone who gets 260 probably has something more to offer in that category than a 225. AOA or not AOA -- it varies from school to school. Percentage of honors vs. not honors varies at each school, and even how the clinical years are graded varies as well. Having the hoops to jump through are not the problem, even if they are sometimes not great indicators of future performance, but making sure the hoops are designed well is more important.

I agree we as a group probably put too much emphasis on board scores. If you look at the study put out by the NRMP last summer (which I think I memorized by this point) you see that people did match with a broad range of scores. Not only that but even with lower scores i.e. 200-210, more people matched into ortho than not.

I think that just reinforces the point that programs look at more than just how good a day you had between 2nd and third year. Now obviosuly if you scored high you are in a much better position, but if you did not so well, you aren't f@%#ed.

Duke - 205
U of Michigan - 205
MUSC - 205
Wake - 205
UCLA - 230
UC Davis - 205 (rotated)
Loma Linda -205
San Francisco/St. Mary's program - 230
Stanford-205
Yale-205
University of Florida - Jacksonville - 230, 205 (rotated)
University of Illinois - 228
Southern Illinois University - 228
University of Kansas - 228
UMKC- 230
University of New Mexico - 230
University of Oklahoma - 230
Oregon Health Sciences - 205
Brown - 228
West Virginia - 205
HSS - 215 (from the PD)

Stewie and others - I appreciate your responses. I accept that this thread is not going anywhere in terms of useful information for future applicants. However, I am also extremely disappointed at what I interpret to be a group of applicants that, on the whole, is simply buying into old myths.

What is our frickin problem with Step 1 scores? Why treat them as if they are a judgment from St. Peter at the pearly gates. Sure, they are predictive of how one does on the next standardized exam, not how good of a clinician they will be, not how good of a person they will be, and absolutely certainly not how good they will be at nailing a femur!

Overall, it is my opinion that we as a group need to take the lead in shaping the culture of medicine, or just orthopedics for now, where we stop making these invalid judgments all the time. Why not debunk the myths now, why wait? I am not understanding how objective (as possible in this context) information can perpetuate a myth. It either supports it or it doesn't.

That said, I can certainly sympathize with wanting to remain anonymous. Your posts could be all or part of your information, your friends information, or that information received from a program director. I just hope that your desires to remain anonymous aren't due to wanting to hide an "unworthy" score on some standardized examination. If that is the case, then we, as the next generation of orthopedists, are completely failing in creating a healthy atmosphere in which to learn and practice. But then again, that seems to be a big part of why so many people who would have been excellent educators have left the ivory towers for decades on end.

This thread really only perpetuates the psuedo-myth that step 1 is they key to matching at a program. I think it will best serve the interests of everyone if it's brought up again after the match. I know the numbers at a few of the programs are lower than stated on here - however, I don't think people are going to be as willing to share their board scores and give up anonymity at this point in the process.

Ha! Yeah, the only reason I threw that up there was because it seemed ludicrous. But that's straight from Williams, so who am I to disagree?

While the last post above may be a little hard to swallow I can back Da Gooch up on that HSS number...my friend is currently a resident there and he/she scored a 211 on Step 1-no joke...and they did not rotate! However, the person was a golden child otherwise-15+ pubs (took a year off to do a presitgious research fellowship), a couple of their studies won multiple national awards at conferences, they were an awesome college athlete, and held multiple leadership positions and volunteered at various places during medical school. Just shows, if you throw up a brick on test day, you are not necessarily screwed!

Whats really funny is my friend almost didnt even turn in an application to HSS because they thought they had absolutely no shot and figured they'd save the money!

UCLA - 230
UC Davis - 205 (rotated)
Loma Linda -205
San Francisco/St. Mary's program - 230
Stanford-205
Yale-205
University of Florida - Jacksonville - 230, 205 (rotated)
University of Illinois - 228
Southern Illinois University - 228
University of Kansas - 228
UMKC- 230
University of New Mexico - 230
University of Oklahoma - 230
Oregon Health Sciences - 230
Brown - 228
West Virginia - 228
HSS - 215 (from the PD)

I agree with the above. I just got done with an interview up at Mayo, and the program director, Dr. Hanssen, referred to this article as to how the Mayo applicants were scored. Not that every other program is using this scoring system, but it's a good thing to be aware of (especially if you want to go to Mayo)
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. The citation for the article is below. There's also a bunch of other good articles in that month about fellowship selection and other ortho residency topics.

A Quantitative Composite Scoring Tool for Orthopaedic Residency Screening and Selection.
Clinical Orthopaedics & Related Research. 449:50-55, August 2006.
Turner, Norman S MD *; Shaughnessy, William J MD *; Berg, Emily J *; Larson, Dirk R +; Hanssen, Arlen D MD *

Everyone handles applications differently, obviously. If you really want to have some facts, instead of just opinions, maybe you should check out the August 2006 issue of Clinical Orthopaedics and Related Research.

Geeze, I didn't mean to hijack this thread. I was just trying to get some more info based on what some people told me. I wasn't trying to rub anything in anybody's face. Just exploring different fields like all MS3s do. I don't think there's anything wrong with switching fields from family to ortho early in 4th year if you feel strongly about. And in regards to "TibulaDoc"s comment, I'm sure I'm not the only one looking forward to winter break after a working hard during third year.

I can't say that I totally agree to the perceived double standard that my friends describe. And we don't even know if it actually exists, or if these people even match after interviews. But I'm at least going to explore my chances of getting into ortho. OK, I'm not going to say anymore about this. This thread will be very useful for future applicants like me. I wish I new actual numbers so I can contribute, but right now I'm only a leech.

All great points, at least most of them! We are, on some level, certainly all in this together, so let us now please get back on track. Please start another thread if you feel you have to prove some other point. Many of you have said this info can be useful to other applicants, but dportugal is the only one to have contributed.

If you or someone you know scored less than the number mentioned and was offered an interview this year at the program listed, please copy, paste, and update the list. Add programs as necessary in alphabetical order by state, indicate if rotated.

UCLA - 230
UC Davis - 205 (rotated)
Loma Linda -205
San Francisco/St. Mary's program - 230
Stanford-205
Yale-205
University of Florida - Jacksonville - 230, 205 (rotated)
University of Illinois - 228
Southern Illinois University - 228
University of Kansas - 228
UMKC- 230
University of New Mexico - 230
University of Oklahoma - 230
Oregon Health Sciences - 230
Brown - 228
West Virginia - 228

and i also forgot to add:

maybe it didn't come across that way in the first place, but my point was that in no way should someone rely on the i'm a woman, i'm a minority, etc etc to get into ortho. my point was that if you are already behind the 8ball with a low step one, you can overcome it by working HARD and proving your interest and capabilities. female, male, black, white, yellow, whatever.

I am a woman, but that was the least of what made my application unique among the sub-mean crowd. I am sure there are programs out there that are trying to interview more women (though this does not at all mean they have any plans to match them). However, I feel confident that there are plenty of women out there who rocked the boards and did research (two from my school who matched high on their rank list last year) that they could pick instead of seeking out low scorers. I highly discourage anyone who isn't truly set on ortho to apply just because they think they have a chance. That said, if there is nothing more you want in life than to be in ortho, but you screwed up on step 1, this thread can be helpful to show where your application will at least get considered.

hmm... that wasn't my intention in replying to rub anything in anyone's face. i was merely stating that i did start out with a 218 and an idea of going into primary care (peds, actually, and not family) or ER and when i found surgery, and more specifically, ortho and changed my mind, i busted my ass to get where i wanted to get. i was only trying to show it was possible to go the ortho route without having a 230. that's all.

i'm not trying to trivialize anything here, nor rub it into anyone's face. i'm going to give you the benefit of the doubt and assume you've strongly misread my post, rather than that you're insinuating my change of career goals and what i did to attain the new (ortho) goals are in any way trivializing all of our struggles with this application.

just because i wasn't ortho from day one doesn't mean i'm any less deserving of a spot in the field, and in no way am i saying my progress in this application cycle is just because i'm a woman. i worked my ass off for the last year trying to get where i am right now. i can't speak for the other woman poster, but in no way am i some flighty girly girl playing around here. i'm also staring down thousands of dollars of debt for 67 applications and over 40 rejections at this point. we're in this together.

Amen to that!

Don't worry, banging_bones, I think that someone who's "tired of busting [her] butt off and can't wait until winter break" is going to go about as far in ortho as you could throw a big bear.