1. Factors that are heavily considered during the application process:

• An applicant’s transcript, community involvement, research experience, and “fit” with the program culture are among the most heavily considered factors. Additionally, the experiences section in the ERAS is a chance for you to highlight those things that are special to you and that you want programs to notice above and beyond everything that is listed in your application - quality over quantity is key!

2. Research years:

• Several program directors shared that applicants should only do a research year if they have a passion for research and/or are eager to immerse themselves in orthopedic culture prior to residency. Students should not feel obligated to do a research year if research is not their passion, as there are many other ways to stand out and it looks worse to do something mainly to pad your CV. Outside of research experience, the mentorship you gain during a research year can help you secure top-tier, personal letters of recommendation.

3. Mentorship:

• Many national orthopedic organizations (MSOS, RJOS, Gladden Society, Pride Ortho, etc.) have mentorship programs that can help connect medical students to orthopedic surgeons passionate about mentoring. Aside from these mentorship programs, as a student you should feel comfortable reaching out to orthopedic faculty at other institutions.

• As you search for a mentor, remember it is crucial to find a mentor that can advocate for you during the application process and who also can provide you with an honest assessment of your competitiveness so that you effectively apply to programs.

4. Insight into the effects of Step 1 utilizing pass/fail grading:

• The absence of Step 1 scores has made all the other elements of the application more important, especially transcripts, Step 2 scores, letters of recommendation and research experience. Additionally, interviews are now more heavily weighted and are the main way in which program directors learn about who you are and what your goals are.

5. Letters of recommendation:

• Letters of recommendation are heavily weighted at institutions where you are unknown and/or did not rotate. Make sure to think critically about who you ask for a recommendation letter, as a lukewarm letter of recommendation will hurt an application.

• A strong letter of recommendation should speak to you as a person and can come from a physician or researcher outside of orthopedics. If you worked with someone extensively (ex. completed a PhD, did extensive research), you should get a letter recommendation from them regardless of whether they are within the field of orthopedics.

6. Advice regarding away rotations:

• Think long and hard about which programs you’d like to do away rotations at - do not apply to too many away rotations. If you have to turn down an away rotation at an institution you are excited about, it is important to signal that program and find other ways to demonstrate your interest.

• Have a discussion with the institutions you do away rotations at regarding whether they expect you to signal them to demonstrate your interest, as these expectations will vary by program. 

7. Signaling:

• Signaling is an important aspect to an application and was an informal way of capping residency applications around 30 and discouraging applicants from mass applying.

• Several program directors emphasized that the likelihood of receiving an interview at an institution you did not signal is incredibly low, unless you have demonstrated interest in that program in another way and the program advised you that it was okay to not signal (ex: home institution, completed an away rotation or a research year there, etc.).

8. Preparation for interviews

• It is important to be well-informed about the structure of a residency program and its unique features before an interview. With that said, make sure to check out a program’s website and/or social media prior to your interview to get a better sense of the program. Be prepared to answer standard residency interview questions and find ways to highlight who they are and what their personal goals are.

9. Advice for those who may be disadvantaged in the match process:

• Applicants who have any of the following factors true about themselves will be at a disadvantage when trying to match: (1) those who previously were unsuccessful matching into orthopedics, (2) low board scores and/or not passing STEP, (3) IMG applicant. For people in these categories, it is important to address the areas of improvement in their application, find strong mentors, and connect with programs of interest. Reapplicants should also have a strong answer to how they have grown and learned from their application experience.