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I remember these days. Trying to decide where I would choose my away rotations. It was right around January/February. VSAS opened up soon and I was still confused as to where I thought that I would be competitive and programs that I could see myself at. Also, to top things off, the medical school where I was at didn’t have a home program so most of the advice I received was from alumni’s that were able to match into orthopaedics.
It’s well known that in many specialties you typically don’t have to do any away rotations, but when attempting to match in to Orthopaedic Surgery, your visiting away rotations may just be the most important part. It allows the student to be judged on the professionalism and knowledge base. It also allows you to make a good impression on the staff and see if the program is the type of program you would want to be at. Nearly 60% of students match at a program where they rotated at. Needless to say, the majority of you will be doing away rotations if you want to match into orthopaedic surgery. Here are 6 tips to help you figure out where to choose your Ortho away rotations.
1. Know your application (Board scores) + personality
In 2018 the average STEP 1 score was 248 and STEP 2 score was 255. Based on this plus your overall application (research experiences, AOA, etc) you should have an idea of how competitive you are. If you have a stronger application (ex: 255 STEP 1, AOA, 7+ research experiences) then the places that you have a chance at matching increases. If your application is weaker (230 STEP 1, 2 research experiences) then the programs you apply to should be different.
If your application is relatively weaker compared to the competition, then try to rotate at some of the less competitive programs. If you have a stronger application, then you have more freedom as to where you can rotate. For students with weaker applications, recognize that your away choices are very pivotal in your chances of matching. We would suggest a 80/20 split. 80% of your aways should be at programs that you would be competitive for based on your stats alone. The last 20% of aways can be at the “dream programs” of your choosing.
Also, know your personality type. If you are more introverted or extroverted also plays a part. See the matrix below regarding personality type/ application strength and where you should apply. This comes straight from an article published by the American Academy of Orthopaedic Surgeons in 2017.
Also, if you don’t know the average metrics for the applicants that matched into orthopaedic surgery, click here and go to page 135.
Porter, Scott E., et al. “Survival guide for the orthopaedic surgery match.” JAAOS-Journal of the American Academy of Orthopaedic Surgeons 25.6 (2017): 403-410.
2. Go where you know at least 1 person
This was one of the most important factors that I considered while rotating. Even if you only know one resident or know one attending physician, knowing somebody that is already at the program you are thinking of can take you a long way. They have insights into the program that you may not have gotten otherwise, they may know the actual people that you need to talk to while you are on the rotations (the decision makers), and they can eventually be the person who may be rooting for you in your corner. I’d schedule time to meet with this person a couple times during your rotation to touch bases with how things are going and how you are performing. They can tell you information like what the residents think of you, and maybe (if you get the interview) how you generally did on the interview.
If you don’t know anybody right now, no worries, email people and tell them you are interested. Another thing you can do is go to the annual AAOS meeting, dressed sharp, and meet people there. This year it is in Las Vegas, you can find more info by clicking here.
If you are early enough, check out the Nth Dimensions AAOS Medical Student Symposium. Each year they sponsor students housing at the AAOS and have events geared directly towards medical students. The deadline has passed for the 2019 meeting already, but if you are reading this later in 2019, you can apply for the 2020 meeting.
3. Go where you will receive an interview during the rotation
So this is a split recommendation from Dr. Cole + Fitts. Below are the two sides.
– (Fitts) Some programs will offer you the chance to interview while you are doing your away audition. Other programs may choose to invite you later during the regular interview cycle. You can find this info out from staff, previous rotators, or various ortho surgery forums. Both of these situations have their own advantages and disadvantages. I would highly suggest rotating at programs that offer interviews during the away audition. It would be awful to waste an entire month rotating at a program and not hear back from them for the chance to interview. That’s a big risk to take, especially if you happen to be an applicant with a weaker application. On the other hand, you know the program is interested in you if you receive an interview invite from the program after your away audition. Something to definitely keep in mind when choosing your aways.
– (Cole) I rotated at three places, two of which did not interview at the end of the rotation. I was invited back for interviews at both of the places I rotated at. If you do a good job you should get an interview invite. On the other hand, half of the people I rotated with at one of the programs were not invited back for an interview. So it’s a chance you may have to take. Either way you should be aware of whether the program typically interviews their rotators.
4. Program type
Think about the type of program you want to rotate at. It may be good to rotate at a mix of different types of programs to see what you would like. Try an academic program, a community blue collar program, then try one in-between. You can also try larger programs vs smaller programs. There tend to be different vibes at different kinds of programs.
(Fitts) Personally, I found out I did not like programs with over 5 residents per year. Seemed like the close knit atmosphere is lost a bit with the larger programs. Aways also give you the opportunity to decide what you actually want in a residency (high trauma volume, autonomy, early OR experience, academics, small vs large class, etc). It’s all personal preference. You have to find what works best for you.
(Cole)- I liked programs that were larger and programs that were smaller. I ranked some programs that had over 10 residents pretty high on my list. Again, you will find what you like personally.
5. Location
Where do you realistically want to live? When I was rotating I knew that I wanted to live in a big city so I rotated at city programs. Do you want to live in a rural environment? A place where landscape is a priority if you like to mountain hike, boat, or be in the wilderness? Do you want to be in a city where there is alot of nightlife and things to do outside of work? Do you want to be close to your family? You may not have a bunch of time to see family starting off residency. Is it better to be far away, so when you have vacation you can spend actual quality time with your family?
Do you want to live on the East Coast? Live the West coast life with beaches and sun? Or live in the South or Midwest? Will you be spending more in rent? All of these are questions that you should ask yourself.
At the end of the day, you have to remember that you are committing to being in a new environment for the next 5 years. You absolutely want to be somewhere where you are happy. There is enough stress from being a resident in itself. You definitely want to be at peace when you finally have some ever so elusive free time as a ortho resident.
6. How many rotations to do??
This number varies between applicants. Many people do their home rotation + 2 or 3 away rotations. People with weaker applications should do more away rotations, because you have a greater chance to match at a place where you rotate. The more rotations you do give you another opportunity to audition for a new program and show your skills, knowledge, professionalism, and teamwork skills.
I know applicants that only did 2 away rotations whose board scores were high, vs applicants with lower competitive scores who did 3+ away rotations. Stay tuned for our upcoming article on how to crush your otrhopaedic away rotations be putting in your info below.
There you have it, the 5 tips to help you choose your orthopaedic surgery away rotations. Good luck!
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Written by, Wendell Cole MD, Jamal Fitts MD
