One DO applicant's experience applying to orthopaedic surgery (still helpful for other competitive stuff)

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I got 2 questions, anyone can answer though. I'm a MS1 at a DO school for reference.

1. To put out this amount of research, when did you find time? When was the bulk of it done? If it was pretty even throughout, did you take advantage of things like MS1 summer and breaks here and there? How the F*** do you manage to balance that with school? Was it mostly ortho related research?

2. Do you have family/friends/parents that are well-connected or were you able to get LOR from those people through networking? Any advice? I've heard attend ortho conferences in my area, but as an MS1 who probably isn't even competitive for ortho unless I grind these next few years I don't know if I'm just wasting my time (about to finish MS1, no research yet but started working on a few projects.)

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1. To put out this amount of research, when did you find time? When was the bulk of it done? If it was pretty even throughout, did you take advantage of things like MS1 summer and breaks here and there? How the F*** do you manage to balance that with school? Was it mostly ortho related research?
You make time. I’m not to the same level but I just got my 10th publication, and worked fairly consistently on research projects from first year through the end of third year. I definitely spent my MS1 summer and holiday breaks working on projects.
 
Please- I scrolled through this whole thread to look for a comment like this :)
I got 2 questions, anyone can answer though. I'm a MS1 at a DO school for reference.

1. To put out this amount of research, when did you find time? When was the bulk of it done? If it was pretty even throughout, did you take advantage of things like MS1 summer and breaks here and there? How the F*** do you manage to balance that with school? Was it mostly ortho related research?

2. Do you have family/friends/parents that are well-connected or were you able to get LOR from those people through networking? Any advice? I've heard attend ortho conferences in my area, but as an MS1 who probably isn't even competitive for ortho unless I grind these next few years I don't know if I'm just wasting my time (about to finish MS1, no research yet but started working on a few projects.)

My second big post in this thread talked about it. I devoted a couple hours a day to research through pretty much all of M1 and M2. I also utilized breaks or any chance I got.

No connections, my family is in the construction industry. Just worked my balls off to impress people and gratefully it worked
 
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How do you have a GPA in med school? Is that still a thing?
 
Not sure if this is an AMA thread but I’m curious to know how many hours you spent for school (class,research,etc) and how does that compare to your residency? (On a weekly basis)
 
Not sure if this is an AMA thread but I’m curious to know how many hours you spent for school (class,research,etc) and how does that compare to your residency? (On a weekly basis)

I answered school above and in my second post in the thread. roughly 10-20 hours a week

In residency maybe 3 hours a week. Still averaging a publication almost every month in residency thanks to some awesome med students and some clinical work combined. currently at 51. Just had one accepted in a top ortho journal this week that we thought up in didactics one day lol.
 
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I applied and matched orthopaedic surgery, but I think info like this can be helpful to other competitive stuff.

I promised a write up in the match thread, and here is my attempt to provide information I think is valuable. Stuff said here is mostly just my opinion and what I noticed from my experience plus having a pretty wide network among DO ortho applicants due to serving on national student ortho boards.

As a pre-med student I always wished medical students would come back and talk to us and give honest advice and numbers, and they never did. Unfortunately, the same can be said for those who match... they frequently ride into the sunset and are still vague about their stats and experiences and the rest of us are left with vague rumors and anecdotes from their friends who say they "think" that they must have had 260+ just because they had great success but we never actually get the full story.

This is my attempt to give y'all my full story because 1. I wish more people had done this so I could have gauged my own chances, and 2. with the merger and COVID it is a weird time to apply to residency and y'all might have to be even more selective about where you rotate and apply. This is not a meant to be a braggy post, and I am keeping it real in here even though I am somewhat embarrassed of my scores and rank and such so if you think this post is stupid just move on because it will be valuable to some people.



Stats:
USMLE Step 1: 237
USMLE Step 2: 241
Comlex 1: 634
Comlex 2: 650
Comlex PE: First time pass
GPA ~ 3.7
Rank: 41/110
Publications: 32 (all during med school, all original research, no case reports)
Presentations: 30+
Letters: One from home PD, one from chair of top 5 MD ortho program, one from a attending at my home program, and one from my research mentor.
Bench Max: ~20 pushups lol
Leadership: Multiple national and school ortho leadership positions held.

Applications:
Number of DO ortho auditions: 3 months
Number of MD ortho auditions: 1 month (mayo rochester)
Number of DO ortho programs applied to: ~30
Number of MD ortho programs applied to: ~140

Interviews:
Number of DO ortho interviews: 8 (6 attended)
Number of MD ortho interviews: 4 (Locations: Harvard/Mass Gen, Mayo Clinic Rochester, Univ. Buffalo, MSU Ascension
MD wait lists for interview: 3 (Oregon health science, St. Lukes, U. Kentucky)


So the elephant in the room is obviously my average scores combined with pretty crazy research numbers. However, something that people often down play the importance of is letters of recommendation. It was disclosed to me during other interviews that my letter from my home PD was one of the most positive letters multiple programs had ever seen, and disclosed where I would be ranked. I was told my letter from Mayo was "glowing", and my other 2 were also extremely extremely strong. I don't know anything else about them other than what programs told me so, kind of here-say on this one.

MD side commentary:
So, despite having (reportedly) killer letters, averaging almost 1 publication per month in medical school, excessive leadership etc. I only received 4 MD interview invites out of almost 150 applications. This to me honestly was slightly surprising, because I thought I would get a look from a few of the 6 year research programs (no offers from them). But, I understand my boards are lower and not being above 240 on USMLE 1 likely cost me a couple, and had I been above 250 I probably would have gotten a few more. However, most DO applicants I know with 240/250+ that applied to 100+ MD programs still only had 1-4 MD interviews so I basically got the same amount as them. I would have been a perfect case study for how far a DO could go if I was smarter (sorry fam lol). The DO that fared the best on the MD side that I know of did 6 MD auditions, had very high scores, met diversity inclusion, and got 4 non-rotator auditions from MD programs. So basically, if you are a DO with a good app you will likely get 0-5 MD non-rotator interviews. HOWEVER, my application is actually an amazing case study for the ceiling of DOs in ortho AFTER USMLE becomes pass fail. Once this metric is gone, I suspect DOs will fare worse on the MD side of things, and even with an extremely well rounded app they will probably only get around the same amount of interviews as me. Another important point is that this year DOs FLOCKED to programs that had taken DOs before. I know of AT LEAST 8 DOs that rotated at Mayo Rochester this year (nearly 15-20% of total rotators) and mayo usually takes mostly rotators and NONE of them matched at Mayo. The ones I personally know all put Mayo #1 besides me. So, if you are rotating MD, I would actually think outside the box and rotate somewhere without a DO so that you aren't competing in a flooded DO market. Also, in the upcoming COVID year I would suspect DOs will fare worse in the non-rotator aspect because MD programs will sending these interviews to MD applicants as their rotator pool will not be as robust. Just my suspicion. I did have pretty positive feedback from 2 of the MD programs and suspect I would have matched there if I put them above where I matched, so matching MD can be done and a good number of people did it this year.

DO side commentary:
I was even more surprised at how much the DO programs cared about my letters and research than that the MD programs didn't seem to care about it at all. In the DO world, prior charting outcomes basically said 5 interviews was the magic number. So basically, if you go on all your 5-6 audition rotations do well and get interviews at all of them then your odds will be pretty good. I only did 3 months of DO auditions, because my last 2 gave me really good feedback and I just felt like my odds were good so I pulled back. I also, did not get an interview at one of the programs I rotated at. So 6 of the 8 DO interviews I got were non-rotator interviews. I did not expect this, and I did not think DO programs would care about research but they did, A LOT. If you are a DO with good ortho research, it will carry you far. Same goes for ENT, my best friend had a similar number non-rotator interviews in the DO world (12ish pubs) despite similar average scores. Including the 2 programs I rotated at that gave me good feedback, I had 4 non-rotator programs that gave me VERY reassuring PIC, mostly citing my letters and that those combined with my interview really set me apart. I did the White Coat Coaching interview training and felt like I crushed my interviews thanks to this so definitely check it out (Not affiliated with them at all just really appreciate their work). However, the other people I know that faired EXTREMELY well on the DO side were those with insane board scores. The DO world still LOVES board scores and they can take you very far IF you are also a cool person and easy to work with. However, my experience shows you can have a great application season despite having average board scores if you have other aces up your sleeve such as letters or research. Another ace I had up my sleeve is that I went to didactics and fracture conference from my first semester of medical school until even this last semester at my home program. This was a huge advantage because I really didn't study a whole lot of "basic" ortho stuff throughout auditions and was able to focus more on the cases and such because I wasn't busy memorizing fracture classifications because I was pimped on them and committed them to memory as a first year. I do feel like my knowledge really helped me relax on auditions, and I didn't feel stressed at all.

Overall:
I fell VERY blessed to have ended up where I did and it was where I wanted to end up from day 1 of medical school really. I worked my balls off for the spot I got for all 4 years of medical school and it ended up working out in the end. I matched at a formerly AOA program (by choice) despite feeling confident I could have matched MD due to the post interview feedback I received. Main considerations I had for not going MD was 1. location (didn't like any of the MD locations I interviewed at) 2. My wife and her ties to the city we matched in 3. Wanting to be at a program that felt like family (both mayo and harvard have 13 and 12 residents in EACH class, and I really didn't like this when I was at Mayo), and where all the residents were extremely tight. 4. operative volume and 5. housing market and availability to afford a house that would fit my family comfortably.

Recommended resources for ortho:
Pocket pimped (I made this into an anki deck and that helped me study it)
White coat coaching videos and interview prep
Orthobullets anatomy questions
Talking to people who want to be a mentor and pick their brain.

If any of you have ANY other questions please ask. I really enjoy trying to help others out, and just thought I would try and pass this information along. As stated above, this post was not meant to be braggy, just very matter of fact. It is tough for me to post publicly that my stats and ranked were meh (for ortho), and I always played this card close to my chest as many classmates (who know who I am on here) assumed I was much higher. Many people on here know who I am in real life, so posting this information for sure stings my pride but I have matched and it doesn't matter anyways and I hope others in medicine will follow suit with candid information because it can help set expectations and goals for future applicants.

I hope this helps someone in the future, because if I had read a post like this last year I would have for sure altered my strategy a little bit. Seeing this post would have also eased my mind because I literally had nightmares that my board score would hold me back from ortho the second I saw my USMLE and class rank at the end of 2nd year, but I stuck with it and it turned out AMAZING so if you are an aspiring ortho bro / girl bro just know that hard work and dedication can carry you very far.

can you post your anki deck for pocket pimped?
 
Update:

62 pubs deep now.

1600 cases scrubbed in 21 months of residency. Many of the MD places I interviewed at bragged about hitting 2200 during their residency. I actually have to slow down my logs or I will go WAY over the 3k max ACGME recommends.

Highlights thus-far:

I did a posterior wall/column acetabular ORIF cut to close with my attending not even on my side of the table which was pretty badass. I feel pretty cozy with most bread and butter fracture work / scopes. Did my first lumber laminectomy the other day. My personal/family life is flourishing as I have figured out a little bit of balance now. My house has gone up 100k (25%!!) since the start of residency because I bought in a smart market and got a little lucky. I feel like many of my attendings and my PD are friends and mentors and not simply my superiors.

Did I make the correct choice?

F*** ya I did. Feels crazy to write 2 years later but seriously, by choosing a program based on 1. fit 2. camaraderie and 3. Personal factors (ie housing market, cost of living, safety, stuff for family to do etc) I am now more than stoked with my choice, and am even hoping to stick around after residency.

I would make the same choice again. Fit (from a program, family, and monetary standpoint) >> prestige. IMO!

Hope this helps. As always, happy to answer any questions .
 
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LOL

I will just post a list of the journals I have published in first so if thats all people care about they can read and move on , and then I will post my story below for those who want to read lol

Current number of publications 41 (also a number of these are accepted for publication and are in the copy edit process and should be published online or in print soon. (32 was when I applied in september). Also, 4 of these are abstract pubs and I finally got a case report this fall lol. So in total, 36 are full length original research.

Journals: The BMJ, JAMA, Journal of bone and Joint surgery (x3) (number 1 ortho journal in the world), Journal of the american academy of orthopaedic surgeons, orthopaedic journal of sports medicine, arthroscopy x2, Journal of arthroplasty, Injury (x2), JAMA-dermatology (x2), JAMA otoloryngology, Plastic reconstructive & aesthetic surgery, plastic and reconstructive surgery, annals of plastic surgery, international orthopaedics, pediatric otorhinolaryngology, among others these are the ones off the top of my head.

So, as AnatomyGrey said, lots of luck and hard word sprinkled with what I like to think of as divine intervention (you non-religious people can just call it more luck)

I picked my school (I got into like 10 DO schools) based on 2 things 1. They had their own ortho program and 2. there was this guy who supposedly let students do research and get publications.

However, I had ZERO research experience from undergrad so I knew it was going to be an uphill battle.

Early in my medical school career I talked to him (the PI) and was let on his "research team". He teaches medical students how to do research, and puts them on teams together to do these projects. He is an expert in methodological quality and really dives deep into evaluating the quality of published clinical research. Many of his projects are what you would call systematic reviews and met-analyses however they have their own twist to them. Journals LOVE his type of work. The pros to this type of research is 1. No IRB needed which saves a lot of time and 2. You can open a sweat shop and do the same project in multiple fields or sub-fields because it doesn't matter what specialty we are looking at the goal is still the same: to evaluate and report the quality of the work produced to ensure it is 1. reproducible 2. generalizable and 3. not fake findings lol.

So, he started me off on a team of medical students on a psychiatry study about October of my first year. I QUICKLY realized my work ethic was far superior to the others on my team and they would just slow me down. So, (without permission at the time lol) I broke off and took the methods and did my own studies on the same subject in Dermatology, ortho, and ENT. After I showed him my work he was amazed, and we developed a great relationship as I became my PIs work horse. This meant lots of 1 on 1 teaching and mentorship the other students did not get. For the rest of 1st year (from november on) I spent probably 2-3 hours a day minimum on research. How did those first 3 studies turn out? One was publish in JAMA - Dermatology, one in JAMA - Otolaryngology, and one in The Journal of Bone and Joint Surgery (number 1 ortho journal in the world). This success resulted in more attention from my PI, and the rest is history.

Now, I had developed some really good research skills. It takes me about 2.5 hours to write an intro on any subject and 4 hours for a discussion. So, I could churn out papers almost as fast as I could come up with ideas for them. Many times me and one of my best friends (who matched ortho the year ahead of me) would just get ideas from reading literature in other specialties on similar methodological issues and say "hey, we can do that" and we would just do it. Summer of 1st year the pubs started rolling in, and I was at like 7 by the time 2nd year started and I just kept rolling with this because it became clear it was going to be something that could set me apart especially if I had good board scores. Also, because I came up with my own ideas and liked to work with minimal teammates I was first author on about 80% of the papers I was on. Of those original 7 pubs, 6 of them I was first author on.

Fast forward to just after second year. I just got my board scores back and was devastated because I worked so hard and my UWorlds said I would be 250+ and now I am wondering if I should switch specialties or apply to a backup. Right at this time the PD at my home program was changed to an MD who was much more academic, and had a vested interest in getting the program to do more research. He also had some clinical projects that had just been sitting, and some great ideas for clinical projects. He heard about me because I had been getting the residents on research projects for the last 2 years, asked for my help, and because of the training I had in other types of research I 1. Knew how to write scientific exceptionally well 2. knew what methodological safeguards were important for quality studies and 3. knew how to navigate the submission and revision process and he let me fly on a few clinical projects that are now published ( one of which in the Journal of the American Academy of Orthopaedic Surgery (a top orthopaedics journal). Also, I now (and then) wrote all of the IRBs for the ortho program. I found IRB's are nothing more than basically protocols, which I had already been making for my other studies. Writing an IRB due to my training was NBD at this point, and took me an afternoon (at most). Working with this PD brought a ton of life back into my research endeavors and now all 3rd year and 4th year I was working on clinical research and the methodologic research with my original PI. Furthermore, this PD had TONS of faith in me and really took me under his wing. He did a lot of things for me that boosted my confidence as a person and applicant to ortho. The letter he wrote me (I now have a copy of) was honestly probably the GOAT letter. Despite wanting me to stay, he still wrote me a letter than opened up many more doors for me and for that he has my upmost respect and loyalty. In all reality, my research skills were more than just a cool CV booster. They helped me create relationships with my home program that I otherwise would have never had and as a result I was very involved in ortho from my first year forward, but especially after the PD switch.

Now however, instead of being the work horse on every study I had a group of 1st and 2nd year I worked with who would do the heavy lifting and I would more or less act as a PI and guide the projects. This allowed me to really continue the original line of research while also being the heavy lifter for the clinical side of my research. These projects all turned out exceptionally well. I am now currently a clinical research heavy lifter and a methodlogical researc mentor if that makes any sense.

The next step in my research transformation is, because I have done so much, I now had the knowledge to lead studies. So, asked the PD about some issues in trauma surgery and we decided to do a full blown systematic review and meta-analysis about a certain subject. I did the protocol, data extraction, wrote the paper, did the stats, and did the revision for this. All on my own, and it was published in JAMA. The largest ortho systematic review ever to my knowledge (over 100+ studies included). I am currently the PI for multiple studies I am running regarding reverse total shoulders, that I anticipate to be published in very high journals.

Now, the interesting thing is my original 3 studies actually made me an expert in this certain type of methodological study and I am asked frequently to peer review for big journals on this subject. I have peer reviewed for the BMJ, New England Journal of Medicine, and many others. Most recently the BMJ (a top medical journal in the world) asked me to write an editorial to be published soon regarding this same issue that I started my first 3 studies on the first year of medical school. God is very good, and it has been crazy to see things come full circle.

I am going to put this in all caps because this is the reason why I have so many publications: THE MOST IMPORTANT PART OF GETTING PUBLISHED IS 1. WRITING, ITS NOT ABOUT WHAT YOU FIND ITS ABOUT HOW YOU WRITE ABOUT IT 2. ANTICIPATION, YOU HAVE TO ANTICIPATE WHAT PEER REVIEWERS ARE GOING TO NAG YOU ABOUT AND ADDRESS THAT BEFORE YOU SUBMIT THIS STUDY (this only comes with experience), 3. YOU NEED A RECIPE FOR YOUR MANUSCRIPTS, DO THE SAME THING EVERY TIME. MY INTROS ALWAYS HAVE THESE 4 PARAGRAPHS (1. little bit of background 2. what others have found in other fields/studies. 3. what knowledge is missing 4. how we aim to address what is missing) DISCUSSIONS ARE ALMOST THE SAME (1. small summary of what we found 2. how our study fills in knowledge gaps 3. how our study compares to other studies 4. what are the clinical implications 5. what are ways we can change for better in the future 6. limitations 7. conclusion. DONE!!! I literally do that on every paper. BECAUSE I HAVE A SYSTEM AND STICK TO IT, I AM ABLE TO WORK EXTREMELY FAST AND KNOW EXACTLY WHAT CITATIONS I NEED BEFORE I EVEN ATTEMPT TO WRITE THE PAPER BECAUSE I WRITE ALL MY PAPERS THE SAME. HOWEVER, THE MOST IMPORTANT PART OF GETTING HEAVY PUBS IS NOT RELYING ON OTHER PEOPLE. YOU HAVE TO BE THE ONE WHO WANTS IT MORE THAN ANYONE, AND YOU CANNOT BE ABOVE DOING THE DIRTY WORK. I TELL MY YOUNGER STUDENTS "THE BEST WAY TO PUBLISH QUALITY AND PUBLISH FAST IS TO DO EVERYTHING YOURSELF. THE MORE HANDS YOU GET DIRTY THE LESS QUALITY THE WORK WILL HAVE AND THE LONGER IT WILL ACTUALLY TAKE".

I am happy to answer any questions about my work or give any advice needed, however, you are likely not going to have this degree of success unless you have a mentor like mine, which is why I feel very blessed to have went to the school I did.

I think its important to understand my success was due to 1. a high output mentor who taught me how to be high output myself. 2. A weird God given talent for writing (many studies accepted without revision) 3. A loving wife who let me do all this stuff without complaining about how hard I was working
Hi DNC! I have been rereading through this thread a few times to scour for any advice I can use to help me prepare to hit the ground running when I start medical school soon. I was hoping you could elaborate on the kinds of free resources that you used to learn the techniques you utilized. I know that a lot of what you learned was from the direct attention your PI gave you, but you had also mentioned early on reading through studies and applying similar methods. Would it be possible to share some of those studies you used as a catalyst?
 
Also, it seems like some places might not as high of Step 1 cut-off, or a hard/set in stone cut-off, as we may think. You hear of 240 and 250 cut-offs, so wondering if the letters may have helped get that Harvard interview
Some programs do holistic review (and of the programs that do…some do it better than others).
 
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