Orthopaedics Guidebook

A Students Guide to Landing an

Orthopaedics Residency Spot

Version 1

Prepared by Orthopaedic Applicants from the Class of 09

Introduction:

Applying and matching to a position in an orthopaedic surgery residency program can be a challenging and frustrating process. Along the way you will receive plenty of advice (some good, some bad) from other students, residents, mentors, and academic advisors. Our purpose in preparing this guide was to compile the advice from 4th year students who have successfully matched in order to give you a head start on the process. We have done our best to be honest and thorough in our summary, while recognizing that we have certainly missed a few things. Hopefully you will find this guide a useful resource as you move forward in your training and please update this guide for future generations as you see fit. There is no magic bullet that will help you land a spot, but hopefully the tips provided in this guide will help you reach your goal. If you picked up orthopaedics a little later on in your third year, feel free to ignore the first part of this guide and move on to the later sections.

Thanks for reading and best of luck! The Classroom Years:

The five of us could likely debate the importance of the first two years in terms of your application to orthopaedics for hours and not come up with a single right answer. You will likely hear many different viewpoints from your peers and advisors during your training. Until we sit on admissions committees down the road, we wont know the truth. On the interview trail, we did not encounter any interviewers who seemed concerned with or even asked about grades from the first two years. This included courses that would seem relevant like anatomy. We can say that every program has a different formula for ranking candidates and a few of these may factor in grades from the first two years. The Deans letter lists the courses you honored in during the pre-clinical years, but does not list the courses that you didnt honor. However, schools do receive a complete transcript.

Even though programs may not look at pre-clinical scores doesnt mean that they arent important, and heres why: USMLE Step 1 and Junior AOA. Studying hard and learning the material is vital as you prepare for USMLE Step I at the end of your second year. There are studies linking performance during the pre-clinical years to performance on Step 1. As well, you will be doing yourself a service when it comes time to study for Step 1 if you paid attention during the previous 18 months. In addition, Junior AOA is determined, in large part, by your pre-clinical grades. If you honor all of your courses, you will be in the running for Junior AOA. The committee typically selects six students for Junior AOA and must choose from a group of 10-15 students that honored all of their classes in the first two years. This means that your grades help you make the cut, but decisions will also be based on your research, leadership work and community involvement.

Also consider taking the orthopaedics elective in your first two years. This course is a weekly lecture series by faculty from various orthopaedic subspecialties. Not only will you learn a little about orthopaedics, you will have the opportunity to meet faculty members you can approach about research opportunities or a foundations preceptorship.

USMLE Step I:

USMLE Step I is probably the most important test you will take during your four years at CU. Residency programs use Step I scores to screen candidates and they may decide not to interview candidates below a certain score. Top programs may use a higher cut-off like 235-240 while others may look for a score above 220-225. These numbers are purely speculation on our part programs dont advertise their cut-offs. Each year the student affairs office sends out a report on the match statistics that serves as a useful guide. To give you a general idea, the average board score for candidates that matched into orthopaedics was 236 (2008 numbers).

If you are reading this guide, there is a decent chance that you have already taken Step I and your scores are set in stone. Lets say you didnt score as well as you had hoped and you are sitting in the 220s or low 230s- dont freak out and begin contemplating a career in family medicine. There are many CU grads who successfully landed an ortho residency position without stellar Step I scores. These folks emphasized the importance of doing well on Step II CK as a way to improve your competiveness. Take this test early on in your fourth year- your third year clerkships will still be fresh and you will be able to get the scores out before you apply to residency. Consider taking the month of May off to prepare and take the exam. Be aware if you choose to release your score and do poorly it will absolutely hurt you, despite what you may hear from advisors regarding Step II carrying no weight. You can also strengthen your application through research work, publications, doing well in Sub-I rotations and strong letters of recommendation.

We could write a lengthy segment on how to prepare for Step I, but this would duplicate what you will hear in various forums. You will have plenty of practice exams, study sessions, and panels on the topic as you get closer to test time. Our advice is to work on your own timeline and do your best to ignore your frantic classmates. Also consider purchasing a couple of board review books mid-way through your first year and use them as a guide to determine what material is really important. Clinical instructors often give a little too much detail or may miss a couple of key points. In addition, it is beneficial to familiarize yourself with the review books (and maybe even add some notes to them) early on so reviewing them later will be easier. Potential books to purchase may include FirstAid, BRS Pathology and Physiology. Additional practice tests that you can purchase (and take) through the NBME are also helpful. Also recommended are the Goljan pathology lectures (if your classmates havent started talking about them, they will) and book. Great to add to your ipod playlist and start listening during your second year, especially if youre not a book learner.

Third Year:

First, congratulations for surviving the classroom and starting what will hopefully be a more rewarding period of medical school. Second, you have now hit the point in your training where orthopaedics programs will be paying close attention to your performance. Doing well in the clinical years can be challenging because the grading process seems so subjective. You dont necessarily need to honor all of your rotations, but there are several courses that you should work hard to excel in. Surgery and medicine are clearly the most important. Some may tell you that OB-Gyn and Pediatrics may be important depending on the residency program. For example, the chairman at Brown is pedi-ortho and his formula for ranking candidates includes your grade in pediatrics.

There is more to third year clerkships than just that honors grade. Comments by the faculty and residents on your evaluation sheets are also very important since they show up on the Deans letter too. Programs will certainly be looking at these to determine if you work well with others and were respected by the team. You should also start to think about letters of recommendation during your third year as well. Many orthopaedics programs request or allow you to include a non-orthopaedics letter. If you have a great surgery or medicine experience for example, definitely think about asking for a letter of recommendation. It often benefits you to get that letter sooner while you are still fresh on the mind of the faculty member.

As part of your pediatrics rotation, there is a two-week block of musculoskeletal where you can chose between orthopaedics or PM&R. Though brief, this rotation is a perfect opportunity to explore orthopaedics with very little pressure and hopefully make some connections that will be valuable later on. The course mostly involves work in the clinic, but try to sneak into the operating room as much as you can. Denver Health and the VA may be better rotations to try to sneak a little OR time. It may be helpful to brush up on the basics of physical examination prior to the rotation (hip, knee, hand and shoulder). Also review your anatomy. Your real objective here should be to figure out of orthopaedics is the best fit and to get to know residents and faculty. Like any other rotation, consider the following when evaluating orthopaedics as a potential fit: the people you will be working with, the medical problems, the anatomy, the procedures, lifestyle and length of training. Spend as much time getting to know the residents as you can. Volunteer to take a night or two of call while on the rotation. It should be a fun experience and you will get a better sense of what your life will be like as a Sub-I and resident.

Unfortunately it will be difficulty to get much ortho time outside of your musculoskeletal block because you will be so busy on rotations. There is an opportunity to work with a preceptor for foundations in orthopaedics if you havent already. Consider working with a faculty member that you know through research or clinical work. The better you get to know them, the stronger your letter of recommendation will be. If you are really leaning towards private practice, you may want to consider working with someone in the community. This may be one of the few opportunities to do so since not all residency programs have you spend time in a community practice. The downside is letter of recommendation situation. As we understand it, letters of recommendation from the community are nowhere near as valuable as those from faculty (unless the private practice person is really well known or has academic ties- e.g. are you applying to their alma mater?).

Senior AOA is determined by a combination of your grades from the first three years of medical school. The top 25% of the class will be looked at and the Junior AOA (your classmates) will decide who receives Senior AOA. They will receive a list of how many honors points you have received through the first three years, and as of this writing HP is not figured into the honors points equation. Beyond that, they may decide that someone with 85 honors points is more deserving that someone with 90 because of involvement in the school, community, and research. The number of honors points you get from a course depends on how many hours the course has, so medicine, and surgery will be weighted more heavily than neurology. AOA is certainly figured into the match ranking, but it will certainly vary from program to program. During my interviews several programs would have a standardized evaluation sheet and AOA was definitely a part of all the forms I noticed. Research:

Research has always been an optional component of your residency application, but we would argue that it is becoming mandatory as orthopaedics becomes increasingly competitive. While interview for residency positions, each school usually has a research-oriented interview so it is always helpful to have something to talk about. The majority of your peers will have been involved in some type of research so getting involved will help you keep pace while publishing or presenting at a conference will help you stand out. The Department of Orthopaedics will likely help sponsor your trip if you are invited to present at a conference. Make sure you are very familiar with your research work before you head out on the road. Interviewers will want to know about your role, outcome of the project, etc.

One of the keys to research is getting involved as early as possible. Many of the projects take a while to complete and set up. An early start will allow you to publish and include the paper in your residency application. The summer between first and second year is an excellent time to begin a project. Dr. Wolf (UCHSC), Dr. Hak (Denver Health), Dr. Chang (TCH) and Dr. Dayton (UCHSC) are all excellent resources for potential projects. Also consider contacting the faculty at the VA or Childrens hospital. There is always a ton of work available; the challenge has been finding it. It would be wise to encourage the orthopaedic interest group to track down and organize the project opportunities so folks arent duplicating efforts. Dr. Wolf keeps a list of potential research opportunities throughout the department and the professor involved, this may be a good place to start. Also consider looking into research scholarship opportunities, like the scholarship offered to medical students by the Orthopaedics Research and Education Foundations, which may help fund your project and looks great on your CV.

There are two more things to think about when evaluating research projects, your role and the type of project. Obviously we would all love to be involved in a randomized control study because it is the gold standard, but the reality is that this wont be possible in your four years of medical school. Most of the projects will involve retrospective/database work. You may also consider getting involved in case reports and review papers. Just beware that many interviewers on the residency trail dont consider case reports or review papers true research. Also, make sure to iron out your exact role in the project ahead of time with the principal investigator. The more involved you are, the better it will sound to residency programs. The tradeoff is that you will likely need to put in more time, which may be difficult to do during classes or clinical rotations. Fourth Year:

Schedule- You will schedule your fourth year rotations online in conjunction with the student affairs office in Jan/Feb of your third year. The schedule system is online and allows you to put in the courses that you want and assign priority to the more difficult to obtain courses. The first course you need to get scheduled is your Sub Internship. If you are really interested in staying at CU, we suggest taking your ortho Sub-I in July (i.e. the third block is best) so you are able to work with the new chief residents. After all they will be on the residency selection committee and will be resources for your Chairmans letter. If you do schedule your sub-I third you will have two blocks prior to that rotation. If you need to take Step II CK early to make up for a poor Step I score you should take it during these months. If you have a solid Step I score, use this time to prepare for your Sub-I. A couple of good classes to take before the Sub-I were radiology and sports medicine. These courses are not intense, so you get some break before hell starts, but you also get some exposure to imaging and the orthopaedic physical exam that is invaluable to know before you begin your Sub-I. Note: Radiology and especially Sports Medicine were tough rotations to get early on so you may want to rank them the highest and have a backup plan. The time before your Sub-I may also be used for research, as we mentioned above it is best to start this research as soon as possible and hopefully you could use a research month to wrap up and write the paper. Whatever you do with this time, make sure you are prepared for your Sub-I. This means spending time reviewing anatomy and the key components of the physical exam.

Not all of us took our Sub-I in July, roughly half of us signed up for June instead. One advantage of taking your home Sub-I sooner is that you can hit the road sooner for externships and potentially do more externships or have more time for other things (weddings, applications). Think about what is important to you in the process and chose accordingly. You will definitely be at a slight disadvantage when you apply to CU since you havent worked as much with the new chiefs, but the reality is that there are tons of programs out there and many of them will be a better fit than CU.

When we applied for externships each school had a separate and sometimes complex application. Be prepared to get unnecessary vaccinations, antibody titers and needless paperwork in order to complete these applications. The VSAS is now being used and may make this process easier. Start to figure all of that out in January because it can take several weeks to get it done, especially when you are on clinical rotations. Also, start talking to students ahead of you and advisors to figure out where you want to rotate. Know that some programs will really only interview rotators (Northwestern) while other programs dont necessarily guarantee you an interview if you rotate there.

Finally, if you have not yet taken Step II make sure you make some time to take this exam as it is required before Nov 1 (unless you get an extension from Dean Garrity- in that case you will have till the end of December to take the exam). Two weeks of studying should suffice. Also make sure to schedule December and January off for interviews or take a class that will give you the flexibility to travel when and as often as you need to.

Sub-I

Prior to your Sub-I rotation, you will want to make sure you are appropriately prepared in terms of your knowledge and resources. The majority of questions that faculty or residents will ask are directed towards your knowledge of anatomy. Being able to provide the right answer quickly will go a long way and often they wont ask you any additional questions if you get the first couple correct (they will assume you know the rest). Since your anatomy course ended roughly three years ago, it might not be a bad idea to spend time reviewing things in the month or two leading up to your rotation. There may be some questions related to specific diseases, especially when you are on specialty services like hand or spine at other institutions.

There are several great resources available that will help you succeed on rotation. Being able to quickly read about a particular fracture pattern prior to seeing a patient can be extremely helpful. Here is a quick summary of several popular texts that students carry with them:

Netters Concise Atlas of Orthopaedic Anatomy: This is a great pocket reference that comes in handy as you review anatomy and prior to heading into the OR. Unlike the full Netters, this version focuses on the relevant orthopaedic anatomy while also covering common injuries/ailments and diagnosis.

Kovals Handbook of Fractures: This text is another must, especially while you are rotating at Denver Health. It describes the common fracture patterns in adults and kids for just about every region of the body.

There are tons of other great orthopaedic texts out there that you may consider. Many students shelled out the big bucks for Hoppenfelds Textbook of Surgical Approaches. While this is a great resource, you can usually find it in the orthopaedic library or residents room. Why pay $220 for a book your residency program will give you in a year or two? The same applies to many other great texts like Greens or Skeletal Trauma. These books are extremely expensive and most residency programs offer a yearly stipend for books. Save your money for things like interview travel, youll need it!

In addition to the books mentioned above, you should also buy some trauma shears. As a Sub-I, you will be doing lots of dressing changes and splint removals. Doing this without shears is a real pain and you will drive your resident nuts if you are constantly asking to borrow theirs. Along with your shears, pick up some tape on your first day and keep it with you. On morning rounds, make sure you have some basic bandaging material with you so that you can help out with dressing changes and dont have to be running to the supply closet right off the bat.

So now you are appropriately equipped for your rotation and you know your anatomy cold. The last words of advice are captured in a list of does and donts for your rotation. Many of these are pretty logical, but we thought we would list them out just in case!

Do show up early and be ready to go

Dont ask to leave early or take an extra time off

Dont call in sick unless you are calling from a hospital bed

Dont kiss up- faculty usually see right through this (especially Smith)

Do read ahead on your surgical cases and clinic patients (this second one isnt possible everywhere)

Dont talk poorly about your fellow student rotators, residents or faculty

Dont drive faculty nuts with questions in the OR

Do see patients and write notes in the morning without being asked

Do fill out H&Ps after seeing a patient

Do get casting, splinting, or suture material together before the resident comes down to see the patient

Do offer to go get started on a consult if your resident is busy

Do offer to write up the case report on the interesting patient

Do stop by all of your patients for a post-op check even if you arent asked. Write a note if allowed and give it to your resident to sign off on.

Do carry extra H&P and surgical consent forms with you on call nights

Think of your ortho rotations as a job interview. Both faculty and residents are looking for students that they would want to work with 80 hours a week for five years as a resident. You dont learn a lot about orthopaedics during your first three years of school (other than anatomy) so working hard and being easy to work with goes a long way. Nobody wants to work with a complainer or someone who cant carry a conversation.

Externships

Externships are another must for the orthopaedic surgery applicant. At almost every interview you will have someone ask you where you did your away rotations, and youre expected to have an answer and be able to talk about the program. This is your job interview and all of the advice above applies. Most applicants do two externships, but this is certainly dependent on what youre looking for in terms of residency. If you know you can stay in Colorado and want to, then maybe one away would suffice just to expand your knowledge of whats out there.

Think carefully about where you apply and how many applications you send out. If you send out ten applications and only accept two externships- you may be burning bridges at 8 schools that you really might like to interview at. Before applying, give the coordinators a call to ask if their program typically accepts all interested students and how many students they typically take each month. You may want to think twice about rotating at a program if they take a ton of students each month because you will have a hard time standing out from the crowd (or getting involved).

The rotation will vary according to institution and you will likely be with a number of people from across the country. Do your best and be supportive of your fellow rotators and residents. You want to be appropriately enthusiastic without being too overbearing. Help out as much as you can, but try not to step on anyones toes.

Make sure to ask for a letter of recommendation from each program you rotated at if you think you can get a good letter. Residency programs put a great deal of weight on letters outside of your home program. Many directors feel that you any student can get a good letter from someone in their home program so they really like to see that you were well liked everywhere you went. Externship letters of rec can also carry a great deal of regional weight as well.

Here is a list of programs we have rotated at:

Stanford:

General: The program was on probation about 4-5 years ago, but is on the rise. Their new chairman Maloney is a pretty big name in joints and came from WashU. The program is rapidly expanding and has recently taken most of UCSFs sports department, along with their chief of sports (the team docs for the 49ers).

Faculty: Great faculty and are continually expanding. In a discussion with Dr. Maloney, he says that hes looking to add more trauma and foot and ankle soon. They are probably strongest in spine, sports, and joints. They also have great coverage in hand, foot and ankle, and trauma.

Residents: The residents have a pretty typical laid-back California feel. Most of them are extremely smart and relaxed, though they did take a few residents from a program that closed down a few years back, who may not be as sharp as the others. They are very tight knit and hang out outside the hospital. While rotating I was able to go out to a bar with residents several times and even go paintballing.

Program: The program is academic and will prepare you well for any career you want. They cover Stanford, Santa Clara Medical Center (like Denver Health), Lucile Packard Childrens hospital, VA, and are adding another community-type rotation. Didactics are excellent, every Wednesday morning they have lectures on all topics of orthopaedics and board review questions with answers prepared by all the residents out of current literature.

Operative experience: Operative experience at Stanford is excellent, however, this may vary a bit depending on service. At the University residents operate early on trauma as interns and second years. The junior is typically involved on almost all cases, but this may change a little if they are early in the year and involved on a pelvic fracture. The VA has second years putting in hip and knee replacements and doing knee scopes. They are 1 on 1 with an attending. The chief is typically in another room doing a similar case. Shoulder scopes are more often the chiefs territory.

Call: Stanford is all home call. This can be good and bad. They dont often have to come in, but may be up all night letting people know that a temp of 37.9 isnt a reason to come see a patient. With home call the 80-hour rules dont apply and they may be back in the hospital the next day.

Brown:

General: Brown is a well-established program that seems to be very highly respected. The program offers very balanced sub-specialty coverage and the only major drawback to the program seems to be the sixth year. The Chair is very interested in research and works hard to provide unlimited research opportunities for residents. This program a six-year program, but is unique in terms of how it is structured. Unlike others where you do a research year, after completing the program at Brown you are also awarded a trauma fellowship. As a 6-year resident you are junior faculty and get paid as such (around 120,000).

Faculty: The faculty at Brown are excellent and are great resident advocates. Dr. Ehrlich, the chair, is a very well known pediatric orthopaedic surgeon and has been excellent in getting residents into coveted fellowships across the country. As a rotating student, he will take the time to sit down with you and give you feedback on your CV and personal statement. Dr. Digiovanni, the new program director, is another great resident advocate. The program is also very strong in hand particularly and has good coverage of all other subspecialties. The faculty group as a whole love to teach and work with residents. Dr. Ehrlich works hard to ensure he brings in faculty that allow the residents to operate.

Residents: The residents are all very bright and get along well outside the hospital. There is a good mix of married and single residents.

Research: Research opportunities are world class, Brown has a lot of money to throw at projects and you have time budgeted into your schedule as an upper-level resident to complete meaningful projects.

Operative experience: As a junior resident on trauma, you essentially run the ED and prepare cases for your upper level residents. On other services junior residents get their hands dirty, but the trauma experience may be a bit frustrating as a 2. The flipside is that you get a ton of trauma operative experience by the time you graduate, especially as a 6 where you are running your own cases. The residents that I worked with seemed very skilled in the OR.

Didactics: Brown has a very strong didactic program to prepare you for OITE and Boards. They also have regular talks by visiting faculty that exposes you to world-class specialists from around the country (very helpful when you are applying to fellowships). Also a daily morning fracture conference.

Call: Call is typically very busy and you are on Q6 as a junior for in-house call.

Location: Providence is a more affordable place to live in the northeast. Get plenty of volume without living in a big expensive city.

Davis:

General: Davis well-known strength is trauma, and youll see a ton of it! They have a young, enthusiastic trauma staff, who are eager to teach. Morning fracture conference was a great experience because of the teaching involved, followed by an hour of formal teaching. A note of caution: they tend to take on a lot of students. You can get lost in the masses, especially on trauma service. You may want to request to rotate on a different service, such as spine, pediatrics, or sports.

Faculty: Great trauma faculty, they will push you on knowledge.

Residents: Nice group with a somewhat laid back group of guys. They are happy to teach, but you need to want it.

Research: They offer one 6-year program spot that includes a year of research following the second or third year.

Operative experience: I (Jenna) rotated on the Sports service and had a ton of operative time. The operative experience wasnt quite as good on the trauma service because you were splitting time among four students. In addition, you didnt get to do much because there were usually a ton of people scrubbed on each case (attending, fellow, chief, and a 2 or a 3).From another rotator:

General: This is thought of as one of the strongest programs in California- though our CU rotators might disagree. It is not as academic as UCLA or UCSF. We heard that it was really strong hands on training but were disappointed with the level of involvement of faculty and fellows in cases on the trauma side. It is extremely well known for trauma and pediatrics. Trauma heavy like CU, but doesnt seem like you get as much hands on operative experience. Overall would say that the program is similar to CU so might be best to rotate at different program to have a new experience (unless you are really interested in UC Davis of course).

Faculty: Well known Chairman, DiCeaseare, from HJD. Trauma faculty are top notch. Currently they do not have a tumor surgeon and have just newly acquired a foot/ankle surgeon.

Residents: In my opinion they were worst part of the program. Two of us rotated at UC Davis and we had some conflict with the residents. I felt they were overworked and their fund of knowledge stunk. They didnt seem very motivated to prepare for cases and really learn the material. The residents lead two of us to turn down interviews at the program.

Program: The program is a nice mix of academics and hands on experience. They cover the University hospital (a level 1 trauma center) and Shriners Childrens Hospital.

Operative experience: This depends on which service you are on, but in general it is good. There are two trauma fellows that take the majority of the cases, which is a bad thing. Often a junior resident is standing and watching the fellow operate.

Call: In house call for junior residents and home call for senior residents. Call is very busy and it is rare you get much sleep.

Wisconsin (Madison)

General: Very well recognized Midwest program. Strongest in Spine and Sports. Gets enough trauma, but definitely not a trauma heavy program. (They get a lot of farm trauma instead of urban trauma like DH). Program is very highly regarded by most everyone we met in the country and Madison is a great place to live. Program leaders are straight shooters and well connected to residents.

Faculty: Well connected faculty (especially in Spine). Overall the faculty is very resident friendly. The Chair and Program Director are really advocates for the residents and make sure that any malignant personalities are shielded from residents.

Residents: 5 per year. Definitely a strength of the program, I didnt run across any resident that I thought was a jerk and/or incompetent. Tight knit group of residents, most are from the Midwest. About 50/50 married w/kids vs. single.Call: Night float as an R2, in house call on weekends for juniors and home call for seniors. Call is busy in the summer, relatively light in the winter.

Research: Madison is considered more research/academic than the Milwaukee program. They publish a lot of spine literature. Research is emphasized in their interview, I think there are opportunities to do as much or as little as you want.

Operative experience: Very few fellows around to steal cases (just 1 spine and 1 sports fellow, there didnt seem to be much overlap with the residents). There is enough case work to go around and everyone seems to get enough experience. Faculty were pretty hands-off in the OR.

New Mexico

General: Pretty under the radar program as far as national reputation, although seemed to be gaining respect from other places I interviewed at. The program continues to improve under new leadership and is definitely gaining respect. The faculty that are there seem to be in academics for the right reasons. Similar patient population to and case load to Denver. University Hospital is only Level I in the state, and they actually get a lot of trauma flown in.

Faculty: The faculty are awesome. A lot of younger faculty who relate well to the residents. The Chair, Dr. Quinn, is really involved and is an awesome guy.

Residents: I thought New Mexico had the happiest group of residents I had been around. They really look out for each other seem to have fun outside of the hospital. The residents really sell the program to the rotators. The ortho intern covers all the floor stuff, which is nice for everyone else.

Call: Night float as an R2. Otherwise its in house on weekends for juniors and senior are home call. Pretty reasonable schedule unless you are on trauma. Typical schedule is 6:30 am to 5 pm.

Research: Didnt get a great sense of how much research is done. I dont think it is a huge emphasis of the program.

Operative experience: Surprisingly a lot of cases to do. No fellows around and lots of attendings who want to have residents in their cases. The juniors get to operate early and often. One nice thing is they have a Super-chief rotation as an R5 where you basically have no specific service and just scavenge interesting cases from other services. This is nice because it allows you to strengthen areas of weakness or improve areas of interest as you are completing residency.

Other Recommended Classes There are tons of classes that you can choose from in your fourth year. The key is to make sure that you have a little fun because you will be working hard during your ortho rotations and during residency of course! Radiology and sports medicine rotations are certainly valuable. Sports medicine can be a great prep course for your Sub-I as you learn the physical exam or later in the year as you are looking for fillers. A SICU rotation would be valuable as well.

Definitely take advantage of research months if you can. The expectations are often very low and you can wrap up any project work that you need to. You are allowed to take up to three research months in your fourth year. Also consider a SICU month, a month in private practice or rheumatology.

Step II CS/CK The timing and intensity of step II should be based on your Step I scores. If you didnt ace Step I and need to make up ground, consider taking May off to study and improve your scores. Your third year clerkships will still be fresh and you will be able to include your score in your residency application. If you did well on Step I, feel free to enjoy your summer and think about taking step II later on in the year. Dean Garrity will let you take the exam as late as December if you have done well so far in school and you get her blessing. Step II is much easier than Step I and as such the time you need to prepare is less. People averaged two to three weeks of study time. Most people used First Aid and Step II secrets as review books. Reading these through a couple of times is plenty of preparation for the exam. People also used either the Kaplan Q Bank or USMLE world (cheaper option) for questions.

Sign up early for Step II CS as spots disappear quickly! Dont hesitate to take this one early while you still remember thinks like the cardiovascular exam. I would recommend that you get this done before interview season starts in November. Your interview schedule will be exhausting and the last thing you want to deal with is an extra trip to take this exam.

On your application, you will have to decide whether or not to release your scores before you see them. It might not be a bad idea to get the score results back first just in case things dont go quite as well as you had hoped.

The Female Applicant in Orthopaedics: by Jenna

First Id like to refer you to the Ruth Jackson Orthopaedic Society. They have a great guide available for cheap on their website (www.rjos.org) that addresses many different issues facing women in orthopaedics.

Sodo you think you have it easier than the boys for getting accepted into an ortho residency because they need a token female and the pool of female applicants is smaller than the pool of male applicants?

(Please let me know if you DONT get this question at least once because I will be amazed)

Ladies, the tide is turning in ortho, as in medicine, but perhaps a wee bit more slowly. Orthopaedics is still one of the medical subspecialties with a significantly lower number of women. This presents the female applicant with the following unique situation: you are either viewed as an asset to an evolving program or a liability to programs who are not quite as comfortable having women in the OR. I think we can all agree that goal would be to view as an applicant not a female applicant. Trust me, there are programs that have gotten to this point, which is awesome! There are programs working on being more comfortable with women, admirable. There are also programs who arent there at all. Dont worry, they just wont interview you.

I dont bring this point up to debate the morals and ethics of women in surgery, the good, the bad, and the archaic. I bring it up for you to raise your antennae during interviews to get a sense of where the program you are interviewing at stands on the issue. The first step is to decide where you stand on this issue and what you want out of a program. My stance was that I wanted it to be a non-issue. While I respect the ground breaking work of the women who have come before us, I think residency is going to be hard enough without the added pressure of trying to be even better than the best because Im the girl.

My advice: look and listen carefully during your interview. Are there women attendings and residents? Do your interviewers ask you about being woman in ortho? How do the male attendings and residents talk to you at the dinner? I wanted to see that I would have female mentorship within the department, both in residents and attendings. I paid attention to resident interactions with each other, male to female, and with me.

I absolutely cannot and will not tell you which programs are women friendly, both due to my limited experience and the political implications this may have for my future career. Sorry.

A note on a few obvious issues. Im not going to address relationships, flirtations, etc that may arise because Im going to expect that you all can appropriately carry yourself in the professional work environment. No, you arent as strong as the boys, but you can do anything they can do with a little leverage and good technique. ASK FOR A STOOL. Use your entire body to retract, not just your biceps because they get tired fast. Be empathetic, have a great bedside manner, were female its our strength, dont abandon that! Dont ever ever let anyone speak to you in a disrespectful manner, make lewd comments or inappropriate jokes at your expense. Its up to you to decide how to handle a situation like this, but bottom line is you dont have to take it and you dont have to end up at a program that allows that behavior. Youre the consumer here, looking for the right residency for you, dont forget that!

Finally, one question to consider before interviews, because you will get it: do you plan to have children during residency? I actually argue this is a reasonable question for programs to ask, and here is why. Ortho programs are SMALL. Losing a resident in a 5 person surgical program to maternity leave has a much larger impact on other residents and attendings then it would in a 30-person program. I cant tell you how to answer this question, what the right answer is or that you should lie, because I think all of those things are personal decisions. Just think about the questions and answer honestly in relation to your given circumstance.

Dont Get Discouraged! A note on being an atypical applicant. By Jenna

Before we get to applying, if youve read this far you are either mentally checking off the boxes you have successfully completed or reprimanding yourself for your failures. Put down the whip, stop the self-abuse because we are all far too hard on ourselves in medicine anyway, take a deep breath and listen. As someone who doesnt fit the mold when it comes to pre-clinical grades, Step 1 scores, and Junior/Senior AOA, I want to point out there is more to an applicant than grades and scores. While you may find some programs dont like what doesnt fit in this tightly pre-wrapped orthopaedic applicant package, some love it (something I didnt know until I hit the interview trails)!

First, let me be clear that you must, in some form or another, be outstanding. Whether this be academically, as a community leader, as class president, clinically, in research, you need an area in which you shine. Then you need to capitalize on it. No one gets into orthopaedics by being a slacker, but where you choose to exert your energy is your choice. If you love politics and health policy, get involved with the Colorado Medical Society, if you have a masters degree or want one, go do it for a year, if you have a biomechanics background, get in the lab, volunteer, coach, tutor, the options are endless. Feel free to break the mold, in fact I encourage you to. I only caution you to do so with sincerity, not for resume building. Interviewers love having something new and different to talk about with an applicant and if you are honestly enthusiastic about what you have to offer they will take notice.

Secondly, get people in your corner. Never underestimate the power of a well-written, personal, letter of recommendation. Build a relationship or several with faculty members. Work hard, be enthusiastic, this shouldnt be a stretch since this is what you want to do.

Third, you must have at least one kickass USMLE Step score. If Step 1 didnt go well, do whatever it takes to raise your Step 2 score. These scores are printed side by side in your application. Get it done well and early so every program will see your improvement.

Lastly, be a team player. Start during your clinical years. Dont dupe other students out of OR time, dont answer questions over other students, dont bring breakfast in every morning. What I mean is work hard, in every rotation, every service. You are first and foremost learning to be a doctor. Prove that you have the ability to work hard and learn in any and all circumstances, any topic, anytime. Show up on time, be enthusiastic, be someone people enjoy working with. Your hard work will be reflected in the comments on your MSPE letter. A strong and long MSPE full of positive feedback will boost your desirability immensely! Programs really care that you are someone they want around for the next five years. Orthopaedics knowledge is teachable and programs know this, people skills are not!

Remember, never, ever, ever give up!

Applications:

Timeline

Try to get your application in as early as possible, even if this means that you turn it in before all of your letters are completed. Start your CV and personal statement in the spring (March/April) so that you will have them completed prior to ERAS opening up. This will give you plenty of time to talk to advisors to get feedback and finalize things. You will also be able to hand out your CV and PS to letter writers. You are basically going to be loading your CV into ERAS, but be careful because some symbols dont necessarily copy well. Personal Statement

Your personal statement is definitely important, as this is a great way to differentiate yourself from other applicants. Dont go overboard, but certainly discuss anything that makes you unique like another degree, where you grew up, or a special project you have been involved in. Make sure that you and 15 of your friends proof read it a million times so that there are no errors- this looks really bad if you screw things up. Dr. Wolf and Terri Belvins can help you brainstorm ideas. Be concise as well unless you have a really fascinating story. Shoot for of a page or so.

Also try to customize your personal statement if possible for each region or school. If you can mention why you have a specific tie to a location or are really interested in a program, your application will likely stand out from the 400 other generic personal statements.Letters of Rec

This is a tough thing to sometimes ask for and get delivered on time. Think about who knows you well and could write a good letter on your behalf. Take the time to set up a meeting and sit down with them if they are willing to go through your application quickly. Bring all of the necessary forms with you- the ERAS letter writer form, your CV, your personal statement, boards scores, school specific forms (Yale, Vandy, Washington, and Wash U for example all have their own forms), grades (yet another reason to finish your personal statement and CV early), and an envelope with a stamp to mail it in to the school. Try to ask for your letters as soon as possible, if you wait too long after your rotation you may be forgotten. Give them plenty of time to get it done too. Dont necessarily shoot for the biggest name, the person who knows you best will do a better job most likely.

Dont focus on asking just orthopaedics faculty. You will likely need a letter from someone outside of orthopaedics as well. After you finish up your ortho Sub-I at CU, set up a meeting with Dr. DAmbrosia (or whoever the chair is) to get a Chairmans letter. You are responsible for this and several schools require it. It may take several weeks to get this completed.

Letter writers may need a little prompting to get the letter out on time. Make sure you keep in touch and make them aware of your deadlines. Send reminder emails, send thank you notes for the letter, and send emails to ask them if they need any other information. Do whatever you have to do because it is your tail on the line. Most of us asked for extra letters just in case one didnt come through or if you need to use one for a specific purpose (like you are applying to their alma mater).

Also try to ask for letters of recommendation during your away rotations too. These letters mean a lot and can give your application a boost. Definitely ask early and even give the person a heads up that you are looking for a letter. Picking Programs

Figuring out where to apply is a challenge because you are often forced to decide between programs with very little information. Start by considering your lifestyle and interests outside the hospital- you arent going to be happy if you hate the rain but are applying to OHSU in Portland. Residents, faculty and especially students ahead of you are all great resources. Even students that you rotate with will be helpful because they can tell you a ton about their home program. Orthogate has reviews by students and rotators, but these must be taken with a grain of salt since you dont know the motivation or interests of the writer.

Think about what you are interested in as well. Do you want to go into oncology or spine? If so, make sure to find programs that are stronger in that area.

Extra Information

First, make sure you are nice to the program coordinators prior to, during, and after interviews. They usually will weigh in on admissions committees and no program wants a resident that cant work well with all of the staff. Second, dont drive the coordinators nuts checking on the status of your application. Feel free to contact them if necessary, but dont flood them with emails or phone calls. Do consider sending them an email or giving them a call to make sure your application is complete and they have downloaded all of your letters. When you make that contact, let the coordinator know that you are really interested in the program and would love to interview there.

If you are struggling to land interviews, consider calling programs in the week prior to their interview date to see if they have any openings. Spots often open up at the last minute and they wont bother offering them to waitlisted applicants so close to the deadline. Calling to express an interest might land you the spot even if you didnt make the initial interview list. One of our applicants two years ago was having trouble and ended up matching at the program where he called in this manner. He found out three days before the interview date that there was an open spot and said he could make it.MSPE

The MSPE or Deans Letter is largely out of your control. You will receive (usually in May) a questionnaire from Dean Garrity to complete. The information in this questionnaire will be used to complete the unique introduction of your letter. So as you might expect you should spend some time and do a nice job. Your job is much easier if your CV is complete and up to date as most of the questions can be copied directly off your CV. You will meet with Dean Garrity some time from June to August to review a draft of your letter. The rest of your letter is a summary of your third/fourth year rotations with grade and attending comments included. Not every comment is included, but all poor or less than stellar comments will be. Just another reason to work hard and be well liked during your clinical rotations. Lastly, Dean Garrity will email a final draft to you in October that you need to proofread. In our experience there is a ton of mistakes in these letters (anything from wrong grades to misspelled words). Proofread, proofread, proofread. If there are any mistakes or you think the wording could be stronger, be sure to be aggressive and advocate for yourself. They will be automatically loaded into ERAS for download on Nov 1.

The last sentence of the MSPE will include your class rank. Not a true numerical rank, but it will list your performance into one of four quartiles. These rankings are assigned mainly by honors points by a committee of faculty.

Interviews:

Scheduling

We will start off by saying that scheduling interviews really sucks. Not only will you have to shell out the big bucks to interview around the country, you will also likely have some tough decisions to make about which interview to accept. Orthopaedics programs typically interview on Fridays and Saturdays with some exceptions. This means that there are only so many possible interview dates for the 150 plus programs to pick and there will be a ton of overlap. One helpful resource in this regard was a calendar put together by Dr. Levine, the program director at Columbia, posted on Orthogate. This lists many of the anticipated interview dates for programs around the country- buyer beware though as some of the dates may not be correct. Even with this list, scheduling is quite challenging because you never quite know which interviews you will land. Our recommendation is that you schedule each interview for the earliest possible date. Dont be too nervous about back to back interviews either, it is likely going to happen no matter how hard you try to avoid it. The key is trying to keep them in the same region if you can.

A few other scheduling tips:

Check your email frequently. This is when a phone that can check email comes in extremely handy. Programs typically offer only two dates so an early response will ensure that you get the date that you want. In some cases you may have less than twenty minutes to respond to an email before the date you want disappears (its true, happened this year at the University of Washington, Vanderbilt, Wisconsin, and many more).

Consider calling programs when you get that invite email. Sometimes the phone call will allow you to move up the list and get the day you want because program coordinators wont bother checking email till the end of the day.

Orthogate is a useful resource as you try to figure out what programs have offered interviews and when those offers went out. Sometimes programs send out invites to home students and rotators first so it isnt always accurate. Beware that checking orthogate may become habit forming, we will talk about counseling opportunities later on.

Rescheduling- you are likely going to have to reschedule at least one interview at some point and may be nervous about what sort of implications it will have for the interview that you are moving. Dont worry, it did not negatively impact our chances and the program coordinators were usually very helpful in making the switch for you. There are usually other folks in the same boat who are looking to make the opposite switch. Call the program coordinators or email them as soon as you know about the conflict! Dont rely on asking someone on orthogate for a switch, however, this may work.

Canceling interviews- Hopefully you will all be in a situation where you have enough interview offers that you will need to cancel a few. Please do your colleagues and future applicants from CU a favor, cancel interviews as soon as possible. If you cancel at the last minute, programs will likely not be able to fill your spot so some poor soul is missing out on the opportunity. In addition, canceling the week of or the week before an interview reflects poorly on our school. That program may be less willing to interview CU applicants in the future if we cancel at the last minute. Some may say that three weeks is enough in advance, but certainly cancel as soon as you can.

Travel- Most interviews start in the morning sometime between 5:30 and 8 am. The day is usually over by 4pm at the latest. Typically there is a social event the night before. This means that you will fly in the afternoon or evening before the interview and can fly out during the afternoon on the day of the interview. There are plenty of exceptions though. Wisconsin and Colorado interview in the afternoon and have the social that evening. At USC or Utah your interview may go all day. If you are serious about a program, considering spending a little more time in the area to get a feel for things. You can always ask to spend the day after the interview shadowing residents to get a better feel for the program.

Preparation

Preparing for an interview can be challenging because there is often a limited amount of information out there. Your best resource is usually the program website that will hopefully have some details about the faculty, residents, rotations, call schedules. One key is to look for anything out of the ordinary in terms of how the rotations or call are set up. If there is anything unusual, your job on interview day should be to learn more and see if it is a good fit for your training. Also look at the distribution of faculty, are all of the subspecialties well covered? This is usually a good indication of how well balanced a program is. Try to figure out how many hospitals the residents rotate at- are you going to be spread too thin or traveling a bunch for different rotations? How many fellows are there and does this potentially impact the training?

Other resources may include faculty at CU or peers on the interview trail who may attend or have rotated at programs of interest. If your colleagues from CU interviewed first, they may be willing to tell you a little bit about their interview day and what to expect. Orthogate may also have posts on programs from either interviewees or current residents that may be useful. Questions

It is very important that you have a set of questions ready for each interview day. Most interviewers will leave time at the end of the interview for your questions and a lack of questions may be interpreted as a lack of interest on your part. In extreme cases, some interviewers may not have any questions for you so you will be dictating the interview in this case. Below is a list of potential questions that we used or heard on the interview trail. Think about which aspects of a program are of interest to you and chose the appropriate questions. Your questions should stem from your research on the program. If the program doesnt advertise research and has more of a clinical feel, you probably dont want spend too much time asking about research opportunities. On the other hand, if the program website mentions a unique call schedule or they run the ED shifts differently, you will certainly want to ask about it and how the residents liked that experience.

Questions for Faculty:

Do you anticipate any changes in program or department leadership?

If so, how do you think it will impact the residency program?

Will you be adding any new faculty or do you anticipate any leaving?

Are there any changes being made to the residency curriculum?

What impact if any do fellows have on a residents training?

Strengths of the program?

Relationship between faculty and residents?

How early do residents get operative exposure?

What is the overall case-load at graduation? Does this include reductions?

What are you looking for in applicants or what characteristics do you think will make a resident successful in this program?

What percentage of the residents go on to do fellowships?

Faculty support for fellowship applications?

Availability of research projects?

What type of projects do residents typically do (basic science versus clinical)?

How do residents perform on Boards or OITE exams?

What is the departments reputation in the hospital? Do other services enjoy consulting your service?

Questions for Residents:

Why did you pick this program? What do you do for fun outside the hospital? Do you spend much time with your co-residents outside of the hospital? What is the call schedule like as a junior and senior resident? How well does the program support you in terms of book funds, conferences, loupes, lead, parking, and money for food? What percentage of the residents are married or have kids? Strengths of the program? Any areas where you wish you had more exposure or operative experience? What is your relationship like with the faculty? Where are you headed for fellowship? Is that what you were hoping for? Where do residents typically live? Average home costs in the area and what percentage of residents own?Evaluating Programs

Program evaluation is a personal process. We say this because it greatly depends on your career goals. If you want to be a community orthopod with a general practice you will want a well-rounded program with good trauma experience. If you want to go into research and or academics, you want to look at more research heavy academic programs. If you already know your subspecialty, look for programs with good mentorship and a good reputation in that field.

Another thing to consider is where you intend to practice. While you dont necessarily have the freedom to choose the program and the region, ask questions about where graduates end up. What is the programs reputation in the region/country? If you cant be where you ultimately want to end up, can you get there?

Also think about your learning style. Do you prefer to study up on your own or do you want a lot of scheduled learning time? Programs vary greatly in the conference schedules, cadaver labs, and dedicated teaching time. Think about what fits your learning needs.

Gut feeling is ultimately going to be your guide. When it comes time to evaluate programs, you already will have all of these aspects in mind. When you walk out of the interview day, you will have a gut reaction. WRITE IT DOWN! You were likely analyzing all of your priorities during the day without realizing it, leading to your final solidified reaction to the program. Go with your gut. You know what you want, dont want, love and hate. Taking notes can also help you sort out the programs on the bottom of your rank list.

Finally, take a personal inventory first. Before you hit up classmates, fellow applicants, orthogate for the skinny on a program, think about it yourself. Dont be pressured by name, reputation, others opinions of the programs because we are all-different and want different things from a program. This is your career decision! Dont get sucked into the game (e.g. ranking a particular program more highly because you know they like you)! Also, take all of the overtures made by programs with a grain of salt. They may tell you that you are at the top of their rank list, but this isnt necessarily true.

Second Looks

Second looks are a way of showing that youre interested in a program. They arent necessary at most programs, but if youre hoping to go to Duke or Pittsburgh you likely have to make the return trip. You can always ask the secretary if the program likes 2nd looks and they are usually straightforward. Ditto for thank you letters. You usually contact the program coordinator to set these up. Your goal should be to interact with as many residents and attendings as you can. Hopefully you can sneak into the OR as well to evaluate the operative skills of the resident and how much they get to do during cases. Second looks can also help you land a spot at some programs because they want to match people that want to come there.

Rank List

Sit down with advisors before finalizing your rank list. Get their opinion on programs at the top of your list. Consider having them make a call on your behalf if you know them well. Some advisors may focus on names and which programs have a stronger reputation or well-known surgeons. This isnt necessarily all that helpful, as you need to determine which program is the best fit for YOU. Tell them about your interests and what you are looking for. A good advisor should help match you to a program that fits your interests and personality.

Make sure you rank programs based on where you want to end up. It is very tempting to rank programs that like you higher so try not to fall into this trap. While it may feel good to rank in your top three, if one of those programs isnt the best fit you wont be nearly as happy. Alumni

Be sure to take advantage of the CU alumni as you set out on the interview trail. These people can be great resources (and advocates) as you interview at their programs. They may also offer to put you up for the night or show you around if they have time. Since this is a new project, we dont have any contact information for the folks ahead of us, but the school websites or program coordinators will likely get you at least an email address. You may also want to check if the surgical society has any of their contact information.

2009

Dale Cassidy- Brown University, Providence Dale_Cassidy@hotmail.com

George Chaus- University of Colorado, Denver George.Chaus@ucdenver.edu

Jenna Godfrey- University of New Mexico, Albuquerque

Eric Linford- Medical College of Wisconsin, Milwaukee elinford@yahoo.com

Josh Sykes- University of Tennessee, Campbell Clinic

2008

Imran Choudhry- University of Cincinnati

Sarah Clutter- University of Kansas, Kansas City

William Kramer- University of Kansas, Kansas City

Jordan Schaeffer- Duke University

Michal Taylor- University of Colorado

2007

Bret Peterson Duke University

Pat Siparsky St. Marys/SFORP, San Francisco

Chris Espinoza- UTSW

2006

Craig Hogan- University of Colorado

Timothy Judkins- University of Colorado

Kelly McCormick- Hamot Medical Center

Christopher Vincent- Indiana University

Orthopaedics Programs

Alabama

University of Alabama Medical Center Program

University of South Alabama Program

Arizona

Banner Good Samaritan Medical Center Program

The Banner program is an old program, Maricopa, revamped and will be accepting its 4th class of residents this year. The program is based on an apprenticeship model, so regardless of your year you will always be matched one on one with an attending. Good exposure to different populations at both public and private hospitals. Program director, Dr. McLaren is very hands on. Lots of teaching. Residents were very nice. Required yearly research project. Advice would be to apply and use as a back up school, but as they have yet to graduate a class it could be a risky venture.

Newer program (started in 2007), will have PGY1-4 in 2009. Program director is a really nice guy who is super interested in education (he grills basic science into the residents). Only program in Phoenix so there is a ton of cases available. Residents all said the faculty are all pumped to have residents again. My thoughts were this program will be really good in a few years but may have growing pains initially. My general impression of newly started programs are the faculty are usually good, the residents are a little sub-par because the program is forced to be a little less selective based on the newness of the program.

University of Arizona Program

Arkansas

University of Arkansas for Medical Sciences Program

California

Loma Linda University Program

UCLA Medical Center Program

Heavy academic focus, may not get as much hands on operative experience

Havent had much success landing an interview there amongst our class

University of Southern California/LAC+USC Medical Center Program

Solid program in the heart of downtown LA. Very hands on program with tons of hands on operative experience with a huge amount of trauma. Program takes ten residents per year and usually has very diverse group of residents. Unique intern year with 6 months of ortho (ortho onc, ortho id are examples). Seemed like an awesome program if you are willing to work hard and like life in a big city. Coverage of sub-specialties seemed solid though they had lost a big name on their joint faculty recently.

Larger program with 10 residents per year located in downtown LA

Program is very busy as it is the only county hospital in the city and sees all of the trauma in the area.

Residents arent quite as close as a whole because of the large numbers.

Lots of independence and OR time because of volume

Probably more balanced than CU with strong sports and joints.

Hospital has brand new billion dollar county hospital

University of California (Irvine) Program

University of California (Davis) Health System Program

See above comments on externship. Very trauma focused, so if thats your area of interest it is definitely a place to consider. Dr. Hak spent several years there and is a great resource for this program.

Naval Medical Center (San Diego) Program

University of California (San Diego) Program

Very interesting interview day with 4 different panel interviews. Faculty seemed very friendly and they are focused on finding the right fit. Program seems to be in transition with lots of new faculty added of late. Dont know how this will impact the culture or quality of training. San Diego is an awesome place to live and the residents were extremely bright. The program gets their pick of applicants in part due to location. Well known for pediatric orthopaedics, but this is the place to be for fellowship and not residency in that regard. Dont get very much hands on time in peds due to the fellows. Adequate but not overwhelming trauma experience. Overall it seemed like a solid program with some very smart residents. Is a six year program for all residents, everyone must do a research year.

St Mary's Hospital and Medical Center Program

University of California (San Francisco) Program

Malignant intern year in the gen surgery department

Strong program and very well balanced.

Numerous research opportunities.

Expensive to live in San Francisco, but a great area.

Stanford University Program- see comments above

Los Angeles County-Harbor-UCLA Medical Center Program

Colorado

University of Colorado Denver Program- you will get to experience this one for yourself!

Connecticut

University of Connecticut Program

Yale-New Haven Medical Center Program

Program was interesting because of the focus on private practice as part of the training experience. Apparently the program has had difficulty retaining faculty due to salary issues so many leave for private practice, but continue to teach. Really friendly faculty and a close-knit group of residents. Residents regularly spend time with the chair outside of the hospital. Very little didactics work during the training here. The program director emphasized how this program is really oriented towards self-motivated residents who seek to learn on their own. Make sure you dont miss the pre-interview dinner; it was one of the best on the trail.

District of Columbia

George Washington University Program

Georgetown University Hospital Program

Howard University Program

Florida

University of Florida Program

University of Florida College of Medicine Jacksonville Program

Jackson Memorial Hospital/Jackson Health System Program

Orlando Health Program

University of South Florida Program

Georgia

Atlanta Medical Center Program

Emory University Program

Really solid program that you likely havent heard about. Get a ton of hands on trauma starting as a two when you work at Grady. Like CU, residents cover several hospitals and are spread out around town. This means that you will take more call and work harder, but residents really seemed to love their experience. Thought the residents all seemed very bright and enthusiastic. Very good spine and tumor experience as well. Definitely a southern feel. Externship students do their interviews during the rotation and dont need to come back during interview season. It is hard to say too much negative about this program other than the location.

Medical College of Georgia Program

Dwight David Eisenhower Army Medical Center Program

Hawaii

University of Hawaii Program

Tripler Army Medical Center Program

Illinois

McGaw Medical Center of Northwestern University Program- Dont interview non-rotators

Rush University Medical Center Program

Gentlemans program

Light on hours

Fellows teach in some rooms instead of attending (attending run 2 rooms)

University of Chicago Program

University of Illinois College of Medicine at Chicago Program

On probation (09)

Go to a wide variety of hospitals >6ish

Not service oriented (may do hand in the morning and finish with spine with some joints in between)

Loyola University Program

Southern Illinois University Program

Indiana

Fort Wayne Medical Education Program

Indiana University School of Medicine Program

Iowa

University of Iowa Hospitals and Clinics Program

Excellent program

Iowa City is a drawback. Almost all residents are married with kids.

Trauma poor

Huge names in all other subspecialties.

Numerous research opportunities.

Kansas

University of Kansas School of Medicine Program (Kansas City)

Great program with many CU alums. The attendings were incredibly nice on interview day with a good mix of attendings who had been around for years and some excited young faculty in trauma and sports. Seemed to be a very well rounded program with no strong emphasis on any one area. Kansas City has 2 programs, this one being the strongest with the better reputation. Residents very friendly and happy. Highly suggest checking out this program, consider rotation here as well.

This is the good program in Kansas City (See UMKC review below)

High volume of cases, little emphasis on research

2 CU alumns there

Residents said hours are relatively easy

Overall seemed like a relaxed group of attendings and residents

University of Kansas (Wichita) Program

Kentucky

University of Kentucky College of Medicine Program

University of Louisville Program

Louisiana

Louisiana State University Program

Ochsner Clinic Foundation Program

Tulane University Program

Louisiana State University (Shreveport) Program

Maryland

Johns Hopkins University Program

Union Memorial Hospital Program

University of Maryland Program

I think the best program in Maryland

Trauma Heavy with Shock Trauma. As a chief you act as a fellow at Shock trauma.

Great program with good group of residents.

Very strong in joints and trauma.

National Capital Consortium Program

Massachusetts

Boston University Medical Center Program

Malignant program with limited early operative experience.

Trauma heavy, but limited OR time for junior residents.

Harvard Combined

Tough program because you are very spread out and you wont get to know a large percentage of your fellow residents as a result. Take a large number of residents.

Tufts Medical Center Program

Very much a private practice feel to this program. Residents arent required to do much of the dirty work thanks to NPs and PAs so they get more operative time. The downside may be that they wont be as strong managing their patients down the road. Well known for strong joints experience at the Baptist but really lack good trauma training. Sports seemed strong here as well. They spend three months at Brown in order to see any level 1 trauma. Tufts hospital is only a level II.

University of Massachusetts Program

Michigan

University of Michigan Program

Very well rounded program with very strong sports and pediatrics training. On your sports rotations you dont take any call and get to cover the Michigan sports team of your choice. If you pick football, you will be on the sidelines during games. Located in a great college town about 45 minutes outside of Detroit. Very competitive and I was told that their board cut-off score was more like a 250. Residents seemed to get along well and were very happy with their training. Didnt hear really any negatives about this program while on the trail.

Detroit Medical Center Program

New program with a lot of baggage from a bad breakup with Wayne State and subsequent shut down.

Strange group of residents, but they seemed happy

In downtown Detroit, they see a ton of trauma but you have to be in a pretty sketchy area of the city

Everyone on the interview day was straightforward about the shutdown and how things are better now, but I thought it was a pretty risky place to go. Some of the old residents that transferred when the program was shut down posted on orthogate that the chairman (still there) stabbed them all in the back and wouldnt help them find new programs etc. etc.

Henry Ford Hospital Program

McLaren Regional Medical Center Program

Pretty interesting community program in Flint. Small group of residents (2 per year), most with ties to the area. They have a ton of volume and everyone seemed pretty happy.

One bonus is moonlighting is built into the call schedule so upper levels clear close to $100,000 per year

Flint is just about the most depressing place Ive ever seen

Grand Rapids Medical Education and Research Center/Michigan State

Kalamazoo Center for Medical Studies/Michigan State University Program

William Beaumont Hospital Program

Awesome community program in Royal Oak (north of Detroit). Facilities are amazing (they have 12 dedicated ortho operating rooms) and the hospital is a plush private hospital. This was the best community program I came across. Residents have a concierge service to get them food and whatever else they need.

Really good reputation in the Midwest, they have a ton of cases because most of the area North of Detroit gets sent to them

Only downside is you get killed as a 2, but otherwise the schedule is pretty cushy

Minnesota

University of Minnesota Program

Excellent program with several past presidents of the board

Great trauma experience with two level 1s that residents operate early and often

Only invite around 40 for their 8 spots

College of Medicine Mayo Clinic (Rochester) Program- see comments above

Mississippi

University of Mississippi Medical Center Program

Missouri

University of Missouri-Columbia Program

University of Missouri at Kansas City Program

NO!!!! Program director is truly a crazy asshole, which he will say within the first 5 minutes of his intro on interview day. Awful vibe here, backed up by KUMC program residents and staff who will tell you the residents at UMKC are miserable! Just say no!

St Louis University School of Medicine Program

Washington University/B-JH/SLCH Consortium Program

Very strong program with, what seems like, fairly early operative exposure

International experience during 5th year

Excellent didactics, for what thats worth

Nebraska

University of Nebraska Medical Center College of Medicine/Creighton University Program

New Hampshire

Dartmouth-Hitchcock Medical Center Program

Very solid program in a very, very small town in New Hampshire. If you love the mountains and want to work in a beautiful hospital, this program is for you. Residents described the program as somewhat joint heavy though this has leveled out somewhat in the past couple of years. Level I hospital, but dont see a bunch of polytrauma due to location. Also, not the best sports experience with no true dedicated joints faculty. Make up for this with four faculty who all do some sports work. Residents still seemed to be able to land top-notch sports fellowship though due to strong faculty support. Faculty were very friendly and they have a very strong (plus informal) relationship with the residents. Residents were extremely knowledgeable of the literature. Very family oriented program, almost more ortho kids than residents here. Four spots per year- two each year must do a 1 year masters program in outcomes research. Very cool option if you like that kind of stuff. Do 6 months of rotations in Boston (peds and oncology) plus a three-month rotation an hour away in Vermont that is private practice.

New Jersey

Monmouth Medical Center Program

UMDNJ-Robert Wood Johnson Medical School Program

UMDNJ-New Jersey Medical School Program

Seton Hall University School of Health and Medical Sciences Program

New Mexico

University of New Mexico Program

Great program with strong CU ties. Program director, Dr. Quinn is relatively new, having trained and worked back east (UConn, Mass General). He is very committed to building a strong program; expect him to know your CV inside out when you arrive. Quinn admits that UNM used to be more of a backup program in the past, but this has changed in his time. Your dinner conversation with him is essentially your interview so be ready. Well-rounded program with great trauma coming in from the reservations in rural New Mexico. Residents very nice and down to earth, residents and faculty enjoy a good relationship both in and out of the hospital. There was an academic feel to the program with encouraged research time and strong didactics but not overwhelmingly so. Definitely consider applying and rotation at this program.

New York

Albany Medical Center Program

Albert Einstein College of Medicine Program

Kingsbrook Jewish Medical Center Program

Maimonides Medical Center Program

SUNY Health Science Center at Brooklyn Program

University at Buffalo Program

New York Medical College (Brooklyn-Queens) Program

NSLIJHS-Albert Einstein College of Medicine at Long Island Jewish Medical

Hospital for Special Surgery/Cornell Medical Center Program

Extremely malignant interview. Multiple panel interviews with pimping.

No trauma, otherwise very well balanced.

All home call

Awesome facilities and top notch attendings.

Subsidized housing for all residents.

Lenox Hill Hospital Program

Mount Sinai School of Medicine Program

New York Presbyterian Hospital (Columbia Campus) Program

New York University School of Medicine/Hospital for Joint Diseases Program

Well-balanced program.

Strong research opportunities.

Chair is the new president of the academy

St Luke's-Roosevelt Hospital Center Program

University of Rochester Program

Truly exceptional program with top-notch research and orthopaedic training. The program leadership is committed to training residents rather fellows and the program is very well balanced. Residents loved the program and didnt have anything negative to say. Have a unique set up for their trauma call experience that you should evaluate for yourself. Rochester might not be the most appealing place to live, but it is extremely affordable with plenty to do in the summer. Most residents could afford a three-bedroom house and could support a family on just their salary. Definitely worth checking out if you wouldnt mind living in the area.

SUNY at Stony Brook Program

SUNY Upstate Medical University Program

New York Medical College at Westchester Medical Center Program

North Carolina

University of North Carolina Hospitals Program

Preceptorship model

I though the program lacked the academic feel and opportunities that other programs had.

Carolinas Medical Center Program

Duke University Hospital Program

Very academic program with CU alums. Excellent reputation in the field. Program director, Dr. Hardakar has been the director for over 25 years. He will know your name when you arrive and they have taken great care in selecting who they interview and why. Lots of teaching/didactics. Plenty of OR time. Well rounded, as they tend to have a strong reputation in many different areas. Great residents. Consider rotating. This is one place where you should do a second look if you liked it during your interview.

Really strong program, not much trauma but otherwise very well represented. Chairman really tries to recruit people he thinks will fit in well. Faculty are extremely well connected and residents get choice of fellowships.

Must do a second look and tell the school they are your number one choice to match.

No trauma

You do have to wear a short white coat and white pants as an intern.

Still a division of general surgery, so the g-surg department still dictates a great deal.

Wake Forest University School of Medicine Program

If you are serious about research, they have a 7-year research track, which can be a great in. They interview these candidates early so get in touch with their research director now.

Ohio

Akron General Medical Center/NEOUCOM Program

One of two (Summa is the other) private programs in Akron. They have about 30 interview days because they only interview 2 per day (they pay for the hotel). Residents get treated really well with excellent benefits.

Some question of operative volume, they compete with Summa for business

Lebron James house is within 5 miles of the hospital

Summa Health System/NEOUCOM Program

University Hospital/University of Cincinnati College of Medicine Program

Cleveland Clinic Foundation Program

Very good name and great fellowship opportunities afterwards

I worry about operative exposure, one resident told me he felt like he had to practice on cadavers for sports to feel comfortable with procedures

University Hospitals Case Medical Center Program

Two spots are six years, but you do not know if you will have to do a lab year before you matriculate.

Strong well-rounded program.

Mount Carmel Program

Ohio State University Hospital Program

Wright State University Program

University of Toledo Program

Oklahoma

University of Oklahoma Health Sciences Center Program

Oregon

Oregon Health & Science University Program

Pennsylvania

St Luke's Hospital Program

Geisinger Health System Program

Hamot Medical Center Program

Penn State University/Milton S Hershey Medical Center Program

Really strong program with great reputation

Chairman is President of Orthopaedic Educators, really involved in resident education.

Hershey is tiny, Harrisburg is the closest city (10 miles or so away)

Just added a 5th resident, when I was interviewed the residents said they were spread pretty thin and felt a little overworked

Most residents have families

Albert Einstein Healthcare Network Program

Drexel University College of Medicine/Hahnemann University Hospital Program

Temple University Hospital Program

Thomas Jefferson University Program

Very fellow heavy program. This definitely impacts your training while working at the main hospital, but spend a fair amount of time rotating elsewhere. Very hands on with a tons of operative experience during away rotations- all the residents raved about the trauma at Lehigh. Heavy focus on Spine and Joints at the Jefferson hospital, felt a little like a factory trying to make money in this regard. Rotate in Wilmington, DE for pediatrics. Typically only have one interview day so be prepared to interview with a crowd.

University of Pennsylvania Program

Allegheny General Hospital Program

University of Pittsburgh Medical Center Medical Education Program

Excellent program with very enthusiastic chair. Very dynamic guy

About as academic as you get with large number of fellows and research focus. 4/8 residency spots are 6 year with year of research.

Fellows definitely get the better cases and impact your education

Need to do a second look or rotate there to be strongest candidate

Work at several hospitals in town including several private hospitals owned by the University.

Crappy interview day since they interview 120 people in span of two days. Means you feel like cattle as you are shuffled through 1:1 interviews. Everyone gets 5 minutes with Fu and residency director.

Make sure you write Dr. Fu a thank you note.

If you did not rotate here you again will need to do a second look.

Puerto Rico

University of Puerto Rico Program- are you really going to apply here? Seriously??

Rhode Island

Brown University Program- see comments above. Contact Dale_Cassidy@hotmail.com for additional info or with questions.

South Carolina

Medical University of South Carolina Program

Palmetto Health/University of South Carolina School of Medicine Program

Greenville Hospital System/University of South