What You Need To Do To Get An Orthopedic Surgery Residency— From a Current Ortho Resident

Let me know if you have any other questions and I will try to answer as soon as I can.

Regarding how to choose away/elective rotations:

I have been asked multiple times about how to choose away rotations, especially regarding what strategy is best (regional vs. tiers). I rotated at 3 places that were all in the same geographic location, of 3 varying “tiers” if that is even a thing (one was a large academic place, think top 5 sorta place, and the others were well known regional institutions but less academic). These are all three places that have multiple residents from my medical school so I did not feel like I was wasting a month by rotating at a place like HSS that may be unlikely to interview me regardless of a rotation. For me, I wanted to stay in a particular city for personal/family reasons. I made that very apparent on my rotation, applications and during interviews. In the end it worked out for me. Of my classmates, all but 1 person matched at a place where they did an home or away rotation. In sum: do aways at places you want to match and think you have a decent shot of matching (e.g.: don’t rotate at HSS/UCSF/BestHospital with no research and 235 step). Now, to complicate things, I did my “top 5” away rotation at the very end of rotating season and as such had already submitted my LORs. In retrospect, I would have done it earlier in order to get a big name letter to include with my ERAS application, which may have helped me secure other outside interviews.

Research:

Try to get your name on some small papers. Talk to any ortho attendings or residents who may be able to help. Beg them, tell them you will be the corresponding author on their trash retrospective chart review from 2012 with n=20 patients, etc. Just get some sort of research down so you can talk about it. If there are multiple of you guys/gals applying from your school, perhaps make a review paper or poster (can be anything, like a review, or even bioethics stuff) and submit it to anything. Literally a quick google search will pull up something you can submit to. Even if it is not accepted it will give you something to talk about in interviews. Multiple programs have “research” rooms where the just say “Ok, tell me about your research.” And thats the whole interview. Have something to talk about. If you’re thinking about a large academic program it will be important to get some research before application time.

Tips for prepping and excelling on away rotations

  • Show up early (before the intern), ask if you can help with or do the list in the mornings
  • Stay late
  • Most programs will have a “bucket” that you carry around on rounds with supplies – ask the first day and from then on be in charge of re-stocking the bucket every morning for rounds
  • Always have trauma shears, silk/paper tape, 4×4
  • Go to the OR before your resident to help get the room set up/be able to text them that the patient is in the room.
  • When pt is in room, do helpful stuff (same as 3rd year).
  • Write notes if allowed in clinic (actively volunteer to write lots of notes). Everyone hates writing notes and by volunteering to do it you are being a huge help, especially in big ortho clinics where attendings may see tons of patients.
  • BE NICE TO EVERYONE (janitors, reception lady, residents, medical students, nurses, cafeteria lady, etc) This one is huge.

Resource suggestions (books, reading, websites, etc.)

  • Orthobullets (AKA “bullets”) – this is where you will get all basic info for everything related to ortho including surgical techniques and information about various conditions. (http://www.orthobullets.com) Make a free account, download the app on your phone. Always have and use this resource. Many residencies are using the Qbank on this site to help them study for the OITE
  • Netter for ortho (get the book on your iPhone, and i would recommend buying the hard copy and keeping with you daily). This is a resource everyone uses. (https://www.amazon.com/Netters-Concise-Orthopaedic-Anatomy-Updated/dp/032342970X)
  • Handbook of Fractures, this details the basics of most fractures, their classification, and treatment. Again, everyone knows, has, and uses this book regularly. Buy it. If you can get an electronic version very helpful to have on your phone. (https://www.amazon.com/Handbook-Fractures-Kenneth-Egol-MD/dp/1451193629/ref=sr_1_1?s=books&ie=UTF8&qid=1524747366&sr=1-1&keywords=handbook+of+fractures)
  • Hoppenfeld surgical exposures in orthopaedics, this one is a huge text book that someone sent me an electronic version of and dramatically helped me prep for the OR. It essentially has a step by step instruction of all surgical approaches (intermuscular, inter nervous planes, where to dissect, what to watch out for in each surgical approach, etc). I wound not necessarily recommend buying it right now, as it is very expensive and a bit of overkill for this stage of the game. That being said, i used it for nearly all of my OR cases and thought it helped me get tons of pimp questions right. So maybe scour the deep dark web for a pdf and put it on your phone/tablet for quick reference.

General advice

Be a guy/gal you would want to hang out with. Work hard. Know some stuff in the OR when asked, but don’t be overly eager with all the stuff in your brain. Know a little about a lot (ie: if you know what sort of service you will be on, do some reading for the basics before you begin, if they are general/everything rotations try to understand the basics of simple and common orthopedic problems). If you don’t know what the most common orthopedic problems are, go to OrthoBullets and to the “High Yield Topics” under each subcategory. Read that. Its a lot of info, but it will eventually sink in. For easy reference, here is a list of general stuff to know the basics about for any ortho rotation, if you know the anatomy, pathphys, treatment options, surgical approaches, surgical steps of all the stuff below – you are well on your way (don’t worry, no medical student will know all of this):

  • Joints- TKA
  • Joints – THA
  • Sports- ACL repair
  • Sports – Rotator Cuff repair
  • Trauma – Ankle fractures
  • Trauma – Hip fractures (intertrochanteric fx and femoral neck fx)
  • Trauma – distal radius fractures
  • Peds – suprachondylar fx
  • Peds – DDH
  • Peds – forearm fractures (both bones, monteggia and galeazzi fractures)

Final Remarks

Orthopaedics is an amazing field. I feel lucky and blessed to be apart of this community. The medical students I have worked with who are interested in orthopaedics are typically extremely intelligent and a pleasure to work with. Good luck to all the students applying in the upcoming cycle. Would love to hear how your journey is going. Feel free to reach out with any additional questions or thoughts.

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