r/orthopaedics

Got my step 2 score back today. Pretty devastated. Got a 233. Kind of late to the ortho game, switched mid 3rd year. Have about 3 pubs and 5 in the process and around 20 or so posters/presentations. Honestly really devastated because I love ortho with all my heart and have all these aways lined up. Really don’t want anything else but ortho. Please be honest or let me know advice to make this happen

Hi PTs,

I’ve been working on a free database that compiles post-op and general rehab protocols into one place. They’re all protocols that are free to access on the internet, and a majority of them are from academic sources. They link directly to the original online source.

I also added an official clinical practice guidelines section as well so that it takes only 1 click to get to it instead of navigating the confusing layouts of the APTA sites.

The website is intended to be used by physical therapists, not the general public.

Check it out and let me know what you think!

Ortho had the steepest signal effect of any specialty last cycle: 7% invite rate unsignaled, 37% signaled. A 5.6x swing on the same applicants.

Matched ortho this cycle? Take 5 minutes: rezumab.app/share-data - anonymous, no email needed, and it rebuilds the signal-lift data next year's class plans with. The why, below.

Specialty	No signal	Signaled	Multiplier
Orthopaedic Surgery	6.7%	37.4%	5.6x
Otolaryngology	10.6%	51.4%	4.8x
Plastic Surgery (integ.)	11.5%	54.6%	4.7x
Ophthalmology	13.2%	62.1%	4.7x
Urology	14.2%	54.2%	3.8x
Dermatology	15.3%	44.6%	2.9x
Anesthesiology	27.8%	71.3%	2.6x
Internal Medicine	38.9%	66.5%	1.7x
Emergency Medicine	52.8%	77.1%	1.5x

Same applicants, same year - the only difference is whether they signaled that program. But that is the 2024-25 cycle. Program counts, gold/silver splits, and applicant behavior shift every year. The only people who can refresh it are the ones who just went through it.

The form asks what you signaled (Gold/Silver, per program), which converted to interviews, where you matched, plus the basics - Step 2, # pubs, # programs applied/ranked.

-> rezumab.app/share-data · 5 minutes · you used last year's data, pay it forward.

Signal Lift Graph

I am ortho spine, have been in practice 5+years, 39 yo, and left my last private practice due to major shifts in the group that didn’t align with my long term goals. I am in the middle of a transition year, took 3 months off to spend time with our newborn (first kid), grew my consulting business, and then started a part time gig in month 4.

The part time gig has been slower than expected surgically, I haven’t operated in 5 months total. I’ve done ~1000 cases as an attending, and am confident I’ll be safe coming back albeit slower for first few cases.

I interviewed at my dream job recently, it looks promising. Have another interview for a solid job in 2 weeks. We are well setup financially, consulting business will bring in 500-600k this year, and we have large savings buffer (2 yrs of expenses). My backup is to restart practice locally after my 1yr non compete is up. My biggest worry is credentialing at next job in a situation where I’ll do just a few cases in a 12 mo period. Has anyone had experience with this? Any advice?

TL DR: ortho spine surgeon in transition year between jobs, will have 12mo where I’ll do very few cases (5 months with zero) worried about credentialing at next hospital. No financial concerns.

PGY1 in a 5-year Internal Medicine program in the Middle East and seriously contemplating switching to Orthopedics.
The main reason is that I feel like IM has completely drained my satisfaction with medicine. The constant exposure to chronically sick patients, endless social issues, difficult dispositions, and overall emotional heaviness is burning me out hard. Meanwhile, ortho looks very satisfying from the outside — fixing tangible problems, procedures, generally healthier patients, clear outcomes, the comradery during residency, etc.
The weird thing is that I’m actually a very cerebral/academic type of person. I enjoy thinking deeply, problem solving, pathophysiology, reading, all that stuff. I also have very minimal OR exposure, so I genuinely don’t know if I actually like ortho itself or if I just hate what IM is making me feel right now. Part of me worries this is just a “grass is greener” situation.
The catch is that switching isn’t simple. To even have a shot at ortho where I am, I’d have to resign from IM, work under the surgery department at my institution, build connections/CV, apply, and then start the year after if accepted. So best case scenario, I’d essentially be leaving IM around what would’ve been my PGY4 year.
I’m torn because I don’t know if I truly want ortho or just want to escape IM burnout. I worry I’ll regret leaving a field I intellectually fit well in but I also worry I’ll regret staying in something that’s making me miserable this early

Has anyone here switched from IM to a surgical specialty (or considered it)? Did the lifestyle/satisfaction end up being what you expected? Any thoughts from people in either field would really help.

PGY2 in Asia here.

I keep hearing that in the US and Europe, a lot of clinics do TKA/THA/Hallux valgus operations on a day surgery basis (admit and discharge the same day as surgery).

The explanation I am given is usually "It's so expensive to hospitalize someone there even for one day, so they can't afford to stay longer."

Some might say "Americans have always been a very independent people so they are good at taking care of themselves."

However, looking at our own cases, TKA and THA patients are usually still bedridden on OP day, and about half need a fair bit of encouragement to even get out of bed on POD1. I have a hard time picturing these folks being discharged and hopping on home. Even for very simple surgeries we might have the patient stay one night just to make sure the wound isn't going rip (or whatever crazy story that traumatized the attending when they were young).

Moreover, given the vast distances of the US and relatively difficult access to healthcare, wouldn't there be more incentive to keep the patients inhospital until they are really stable?

Does your institution do day surgeries for TKA/THA/HV, or anything else? If so, is the decision cost-driven, or do you see any other benefits? Do you think the patients would prefer to stay longer in the hospital if they could?

Hey everyone!

Just starting my M3 year. I've been planning on orthopaedics during med school. I currently have 2 young kids. Oldest will be 13 by the time I finish fellowship so really wont be in the home that much longer at that point.

I love medicine, but honestly get more of my satisfaction in life from being a present father. I know residency will be a sacrifice, but what is life like afterwards?

Are you still grinding as hard as ever right after residency/fellowship or do you get to choose more? Its hard to know how much weight to give each part of my life. Considering other options like ophtho or anesthesia, that while I may not like it quite as much, would still enjoy and probably have more time. Based on what I can gather.

But its getting closer to the deadline of when I need to choose. Any advice is appreciated!

PGY-4 ortho resident, fellowship match did not go my way last month and I am no longer interested in this rat race / struggle. I’ve been told it only gets worse as an attending. Obviously disappointed it has come to this but I can’t keep doing this to myself.

What alternative careers can I / should I consider?

Getting consistently 60-70% on Res Study. Trying to finish the database once before boards, but getting worried by my scores. Should I be getting higher?

And how many questions do people do a day?

Any other resources outside of RS, OB, millers?

Was wondering if what’s everybody go to software when doing their preoperative templating? Already delved from the old school tracing paper to Procreate and some microsoft powerpoint shenanigans. I’m already delving into Bonesetter since they already have the prebuilt implant templates, but would like to know what you guys use or what your institution uses for their trauma cases

M4 here halfway through my Sub-I at my home institution. Have 3 more aways with my last one in september at my top choice program.

I’m at a mid-tier state school with poor research.

Honored 5/6 rotations, HP surgery unfortunately.

Step 2: 269

Likely top quartile but school doesn’t tell is for a while. Hopeful for AOA

Research is likely my biggest weak point: 20 total items with only 3 publications with 1 first author (case report). 3-4 items submitted/in revision at time of ERAS but really only 2 of the 20 items are Ortho specific. I had to work with what I had so I did gen surgical outcomes work.

Leadership: President of community health organization and leadership roles in a bunch of other ones.

Volunteering: community clinics and health initiatives

I’m probably being neurotic, but even with “below average” research I’m still quite competitive for a spot somewhere right? As long as I work my tail off on aways over the next few months.

Hi, I have a few choices for my upcoming research year, and I'm not sure which one to choose. I have a meeting with my advisor soon as well. I'd rather not ask my mentor about this since he might be biased towards one choice (home program).

Research Locations & Their Pros/Cons:

1. Home ortho program: Weak research output, but will increase home program support - will help residents with their research + come up with my own

2. Go back to summer research location: Strong research output (4 pubs in 1.5 months), amazing attending support, but not really where I want to match

3. New location (where I want to match): Unknown research output and unknown attending support, but it is 100% where I want to match. My girlfriend and I are planning on getting engaged and she and her whole family live there.

For the AAOS annual meeting -- I see on the website that Sep - Oct is when abstract submitters are notified whether or not they're accepted. Is that true -- were you ever notified earlier than September? If you were notified in October, how late into October?

I'm an M4 planning on applying ortho this cycle and feeling a little unconfident at this point given recent Step 2 score and clerkship grades. Wanted to ask here what people's thoughts are on my chances of matching and if I should dual apply.

M4 at a mid-high tier US MD medical school

Preclinical: P/F - Passed all courses

Step 1 - Pass

Clerkships: H/HP/LP/P/F grading: Honors in IM, Psychiatry, Neuro; High Pass in Surgery, OB/GYN, Peds

Step 2 - 248

Research - Currently ~20 total pubs, abstracts, posters, etc. with 6 fully published manuscripts. Have a few things in progress so expecting ~8-9 fully published manuscripts with ~25 research items by the time I apply

Sub-Is - Currently have an ortho sub-I at my home institution + 2 aways, secured. Hoping to secure 1-2 more aways. Heard these are the most important so I'm preparing to grind my ass off on these.

Letters - Have one decently close research mentor who will likely write me a good letter, hoping to get rest of my letters from home sub-I plus first away. Home program seems solid and sounds like students get good letters from here but I don't really know many people at a close, personal level yet.

ORM male if that matters.

Honest thoughts?

I’m a first year orthopedic resident and honestly I’m struggling mentally with the learning curve and expectations of residency.

I’m trying really hard to study seriously outside work. Right now I’m slowly going through Miller’s Review. So far I finished trauma, anatomy, recon, spine and foot, and now I’m in hand surgery. My plan was to finish one full read of all the major sections (anatomy, trauma, hand, foot, spine, sports, recon, pathology, basic science), and then start re-reading everything repeatedly, kind of like how I studied for Step exams.

The issue is that even after reading hundreds of pages, I still feel like I barely remember anything. Sometimes I read 6–8 pages after a full hospital day and my eyes are literally closing. Sometimes I read something, think I understand it, and a week later it’s completely gone.
Other times I don’t even fully understand what I’m reading but just keep moving because otherwise I’ll never progress.

I also don’t manage to study every day. Some weeks I’ll have 2–3 days with zero Miller reading because:
I had a 26h shift
got home destroyed mentally
had morning meeting prep cases only.
stayed late at the department
or tried to have some actual life outside the hospital (dating, gym, family, etc.)

And honestly after bad days at work, especially after being scolded in morning meetings, sometimes I come home feeling terrible and I just can’t study.

What also gets to me is seeing residents just 1 year above me who seem SO much more advanced. They say concepts or clinical pearls that I completely missed in Miller or Orthobullets. Sometimes attendings ask me questions and I don’t even fully understand what answer they’re looking for. A lot of it feels like “department knowledge” or experience rather than textbook material.

The residents who basically “live” in the hospital seem to progress faster and also seem more appreciated by the head of department. Meanwhile I’m trying to balance being a good resident with still having some kind of personal life and not completely burning out.

One thing that really scares me is this constant thought:
“What if I’m putting in all this effort and still eventually get told I’m not good enough for the program?”
My head of department can be very harsh during meetings. Sometimes he criticizes all the first-year residents together by name, saying things like “you guys are doing this badly,” and even though it’s group criticism, internally I start wondering if he secretly thinks I’m failing specifically.

I genuinely care about orthopedics and I’m trying hard. I read after shifts, prep cases, try to improve, and think about residency constantly.

But I also constantly feel behind and scared that maybe everyone else is adapting faster than me.

For the more senior residents/attendings here:
Did you also feel this lost early on?
Is slow progress actually normal?
Is reading Miller slowly over time + repeated re-reading a reasonable strategy?
Did you feel like everyone around you knew more than you?
How did you deal with fear of not being good enough or potentially being let go?
And how do you balance studying hard with not making residency your entire existence?
Would honestly appreciate hearing how others handled this stage.

Sorry for the very long post, just had alot of venting to do lol

I want to take Step 2 during away Ortho rotation season, but I’m worried about whether I’ll realistically have enough time/energy to study and take the exam.

For people who took Step 2 during an away rotation:

• Was it manageable?
• How intense were your away schedules?

I’m aiming for a strong Step 2 score, so I don’t want to hurt my performance either on the rotation or the exam. Would appreciate any advice or experiences. Thanks!

Didn’t match this cycle so I’m doing a research year. I get one away rotation where I can choose. Does anyone who did a research year have places they recommend doing an away/places that take research year people for residency? I know I’m late to the game so need help asap. Open to community based programs as well.

Without doxxing myself, I’m from the southeast, doing my research year in the north. 260+ on step 2 and top 10% of my class, MD.

Anyone see the Doximity article on the ortho doc that was sued for a guidewire hitting the deep femoral artery? Thoughts? Do you think he pushed it through the far cortex or just aberrant placement? I think it’s insane that another ortho doc would testify against him saying it wasn’t standard of care. We should stick together unless something is obviously egregious.