Like everyone else, you waited for the email that tells you whether or not you matched into your perspective field to come at 11AM EST. You were nervous, and when the time came, you didn’t get the “you’ve matched” email that others were getting. You may be sad, feel like your time was wasted, feel defeated, lied to… or on the other hand, you may just be going with the flow and have a backup plan arranged. For those that don’t…now what? What happens now?

1. SOAP

The Supplemental Offer and Acceptance Program is the process during Match Week through which unfilled positions are offered by programs to SOAP-eligible applicants. There tend not to be many unfilled spots in orthopedics. You would be lucky if there are 1 or 2 open positions per year. So, landing a spot into ortho may be difficult from the SOAP. Fortunately, there are other options available including preliminary and transitional positions into ortho programs. Some applicants “SOAP” into a general surgery preliminary position to help better their chances of matching into orthopedics during the next match cycle. Matching rates tend to be lower still when entering the match for a second time. 

This is the moment to be realistic with yourself. You have to ask yourself how important it is for you to match into orthopedics. There are also categorical programs available in other specialties that may be less competitive. Medicine, PM&R, general surgery, and family medicine (with sports fellowship) etc, are all other specialties that individuals may look into after not matching into orthopedics. Sometimes the option is matching into a different specialty versus fighting to get into orthopedics. 

Also, some programs have open PGY-2 spots (you’d have to do research to find where). So if you ended up doing a year of gen surg, you still get the experience managing patients, putting in orders, taking call, and (should) have a chance to develop your surgical skills prior to re-applying to ortho. It would also help if you worked on some orthopedic projects in this time to help your application. You should start to reach out to different programs to start to build relationships with the program directors, staff, etc. As we all know, sometimes it’s not just what you know, but who you know!

2. Research

We have personally seen this work for a few applicants. Finding a 1-year research track can be very helpful in securing an orthopedic residency spot. An applicant can easily get 12-20 research articles throughout the year in a good program. The trick to this tip is to be very strategic with the program you choose. Some orthopedic programs have a long track record of choosing the research resident for the following year’s ortho resident class. Personally, we would look for those programs and try to apply early. You may have to ask current residents to find some of the programs that have a history of doing this. It can be well worth the research if you land the right spot. 

3. MPH/PHD

Some may go on to start professional courses as well to better their chances of matching. We would say that this particular route probably has the lowest yield when comparing it to the others listed. Orthopedics tends to be very competitive and adding more degrees after the MD or DO may not necessarily make you a better orthopedic surgery candidate. We would suggest having a clearly thought out plan if using this approach. We’d also suggest you speak with your program director / medical school dean, or someone who can look over your whole application and give you advice.

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Takeaway

Just remember, not matching on the first go around is not the end of the world. This is just an addition to your life story. There are ups and downs in life; appreciate the times when you are so called “down” because that will make your ups so much better! In the future, you may be able to help out someone who is going through the same process. There are countless stories of people who ended up not matching in ortho their first go around, then getting in on their second go around who end up being outstanding Orthopedic Surgeons in the future!

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Written by: Jay Fitts, MD and Wendell Cole, MD

Edited by K. Milhouse (2019 DO candidate)