Welcome to the practical application of medicine!  

As you rotate through different specialties, you’ll start to see what parts of the healthcare system and what type of practice setup you enjoy.  Pay close attention to the reasons you like a particular specialty because sometimes what makes a rotation enjoyable has nothing to do with what life will be like in practice.  I had a great time on my OB/GYN rotation, doing ultrasounds, catching babies, scrubbing into C-sections, etc. I liked it so much that I considered it briefly.  But only briefly, because I soon realized that my enthusiasm was just giddiness from finally getting my hands dirty and working with a patient population that I could relate to.  The real aspects of the specialty, like primary care and vaginas, were far less appealing.

There is plenty of time to continue exploring your options but to give yourself an edge in your application year, here are some must do’s.  

one – Get to know your friendly local orthopedic surgeon.

If you can arrange it, schedule your surgery rotation early in the year.  This will get you comfortable with scrubbing, introduce you to the OR staff, and hopefully allow you to cross paths with some orthopedic surgeons.  If you haven’t established any orthopedic mentors yet, now is the time.  If you’re in a community hospital, the orthopedic surgeons may be in and out like ninjas and you will need to catch them between cases.  This may be difficult while you’re on other services but employ those stalking… I mean creative… skills and recruit OR staff friends to help you be in the right place at the right time.  In an academic hospital, it may be a bit easier as they may have office hours to drop in on.  Get to know them!  Why did they choose orthopedics?  Why did they choose this particular type of practice?  If your schedule permits, ask if you can scrub some cases, ask if you can shadow them in the office, etc.

Be assertive.  Be vulnerable.  Personally, the biggest barrier to getting myself out there was the fear of failure and rejection.  I was worried that I wouldn’t be impressive enough for someone to want to help me.  So instead of introducing myself to people as a student interested in ortho, I delusionally thought to myself, “Maybe if I just keep my head down and act busy, they’ll somehow instinctively know how much I want this… “  But by pushing those thoughts aside, however, I shifted perspective and I was able to get out of my own way and let curiosity be my guide.  Remember that we all have to start somewhere.  Every orthopedic surgeon was once in your shoes and even if not every person you approach is immediately excited to talk to you, keep it up and you will find many others that are.

Two – increase your orthopedic knowledge.  

There are many ways to do this.  Musculoskeletal pathology is minimally addressed in formal medical school courses so you’ll have to find information extracurricularly.  In addition, the language of orthopedics is very different from the rest of medicine.  Some good ways to learn about pathology and jargon are listed on our resources page.  If your schedule permits, go to grand rounds or didactics at your home institution.  You can also watch grand rounds posted online.  

Perhaps the most effective way to grasp the basic information is the Ortho Jump Start course.  This online course will walk you through the basics of orthopedics at the level expected of a student who is seriously interested in orthopedics.  Complete with videos and cheat sheets, it will take the guess work out of self study.  You should take this course before your orthopedic electives so you can start with a basic level of knowledge to add to.

Three – Plan out your fourth year.

Perhaps the most important part of third year preparation is scheduling out your away rotations.  Most osteopathic programs will only interview students who rotate with them.  This nearly narrows your options down to 2-6 institutions before you even reach application year!  

Allopathic residencies generally have a different philosophy and will consider applications from students who did not rotate with the program.  Nonetheless, a well done away rotation can still play a pivotal role in your chances of matching at that particular program.

There are many factors to consider when choosing which residencies to apply for rotations with, including geographic location, specialty exposure, culture of the program, etc.  

For the allopathic residents, a good resource for reviewing residencies can be found at the Doximity Residency Navigator.  For the osteopathic applicants, information is a bit sparse.  The AOA has a list of program information available that is variably accurate but a good starting point.  

The White Coat Coaching Osteopathic Orthopedic Residency Review 2016-2017 is a review of the past season.  This highlights the requirements and characteristics of the different programs, including information on how many applicants were interviewed and when, as well as COMLEX score cutoffs and how to book a rotation.  We will continue to add program director and resident information throughout the year.

A quick note on your board scores: Remember to take your Level 2 or Step 2 early.  If you did poorly on your Level 1/Step 1, this is your chance to show that you can master standardized tests.  Programs will see a poor score on both tests as a red flag. This may be insurmountable.  Never say never but it may be a divine sign to invest some elective rotations in alternative specialties.

Medical school can fly by!  A lot will happen this year, but keep these key steps in mind to make sure that you’re tee’d up for application year.