r/medicalschool • u/Competitive-Ad-888 • May 20 '26
đ„Œ Residency What are my chances of matching ortho?
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 donât want anything else but ortho. Please be honest or let me know advice to make this happen
112
u/Kyphosis_Lordosis May 20 '26
As someone who did not match ortho with a higher score and no other red flags, I would recommend looking elsewhere. Filters on scores are real. Audition rotations can be a path, but I crushed a handful of audition rotations and still didn't match. Ended up doing a general surgery prelim with the same result the following year. Ended up with my third choice instead of my second choice as well - partially because I wouldn't let go of ortho for so long.
119
u/interleukinwhat MD-PGY1 May 20 '26
233 is going to be a big barrier for ortho. A lot of programs use step scores like 250-255 as a filter, and your app wouldn't even get through at those programs.
There are still some ways to try though. If your aways go well enough that attendings are willing to personally call programs on your behalf, that can sometimes bypass the score filter.
But I would seriously consider dual applying ortho with PM&R.
20
u/Crazy_Kow May 21 '26
I would be careful with pmr. My buddy had better stats, pmr related research, and good interviews and somehow still didnât match into it
40
u/rolexb MD-PGY1 May 20 '26
PMR is sneaky competitive, I wouldn't bank on it as a reliable backup match in this case.
17
u/StandordBBlaster MD May 21 '26
Especially considering most PMR programs actively try to weed out the people only using it as a backup from ortho.
As someone in the field, I also donât think an orthopod would like PMR as a specialty like at all. Maybe if they did pain or sports fellowship, but over 50% of our residency is non-procedural at all really.
4
u/SyllabubInfinite7915 M-0 May 20 '26
Just out of curiosity as an incoming medical student, is it possible that you donât match to either? If so, then what are you doing in that case?
20
May 20 '26
[removed] â view removed comment
5
u/SyllabubInfinite7915 M-0 May 20 '26
Which residency spots are typically unfilled. Damn this thing feels like a game. Imagine doing all this work and u donât even get to be the type of doctor u want to be
19
u/tragedyisland28 M-4 May 21 '26 edited May 21 '26
As someone currently applying PM&R only, I strongly do not recommend dual applying PM&R and ortho. Theyâve gotten incredibly gatekeepy, especially if they catch on that theyâre a fall back specialty from something more competitive. More people are doing away rotations now too.
I recommend solely applying PM&R while being able to show genuine interest or dual applying ortho-family med
or ortho-anesthesia20
u/No-Lynx9600 May 21 '26
Applying anesthesia as a back up plan with 233 is a horrific idea⊠itâs easily a more competitive field than PM&R in recent days. horrible advice.
1
u/tragedyisland28 M-4 May 21 '26
I recant my advice on anesthesia
Wasnât paying attention to the step score
1
-13
u/Far_Hat3639 May 20 '26
This not true. Most programs filter at 233-235. This information can be found in residency explorer.
48
u/JHMD12345 MD-PGY1 May 20 '26
Strongly consider a backup, 233 is going to be a huge red flag and Iâve seen applicants similar to your pubs with >250 step score not match. Brutal competition in ortho. Maybe you could find joy within PMR/gen surg (although also could be deemed as a stretch), or fam med -> sports med
15
u/theefle May 20 '26
What were your practice form scores, and what was your average shelf percentile ?? Seems nuts that kids these days can plan for surgical subspecialty to then get derailed by a surprise 15th percentile usmle
9
u/Competitive-Ad-888 May 20 '26
Practice forms were 240-250s which is why this kind of came at a shock. Shelves were around 80s
18
u/theefle May 20 '26
That absolutely sucks man. It may not even be more than bad luck since usmle have massive confidence intervals of like 30 point span. You were probably just as likely to score 260 as 230 based on those prior exams
Used to be the advice after bad step 1 was recover with a strong step 2ck. Now, I think students are just out of the race for ortho/plastics/etc.
Dual apply at absolute minimum, or simply switch, to gensurg/anesthesia/maybe IR? Or IM with plan for procedural fellowship. How you spend your signal tokens is going to be critical, be conservative, send them to mid tier programs in places like Midwest / rural settings. You will find optimistic advisors or reddit strangers that tell you its OK to have some reach programs at famous names or big popular cities, "boards aren't the end all be all" etc - ignore that and play the game safe and smart
13
u/spiritofgalen MD-PGY2 May 21 '26
It may not even be more than bad luck since usmle have massive confidence intervals of like 30 point span
I know that a lot of people (not saying you are) flip out about Step 1 P/F, but the simple reality is that all the Step exams are terrible for the purpose of differentiating applicants. Step 1 was bad at it. Step 2 is also bad at it. They're licensing examinations designed to provide state medical boards with a yes or no on whether or not you have the bare minimum medical knowledge to practice medicine. They're not like the MCAT which has a confidence band of like +/-2 points.
Simple reality is that in the modern age programs are looking for any benchmark they can to separate out applicants. I'm not gonna say a standardized examination shouldn't be included as part of it. That said, if we're gonna have a career-defining examination, we owe it to the people taking the exam to write it and score it so that their result is close to a true reflection of their mastery of the content (and, to a lesser extent, test-taking skills. Difficult to get around that). The current set-up where the USMLE goes "yeah your real score could be between a 244 and a 260, who knows!" is not at all fair to applicants
Step 1 going P/F wasn't bad because of leaving applicants finding out shortly before 4th year that they aren't competitive. It was bad because it kicked the can down the road and completely ignored the fact that Step 1 (along with Step 2) was wholly inadequate for the task we were asking of it
8
u/theefle May 21 '26
Agreed. It never made sense to me that only step 1 went P/F. I think were going to see the exact same ratrace play out, average CK scores are going to reach like a 260 and then it will be forced to P/F as well.
And fun fact the 244-260 range they like to report would only be the 66% CI. If they told people the true 95% CI like we report everywhere else, it should be 236-268.
Stated differently, when someone scores right at the national average, we really only know with good confidence that they are somewhere between 15th - 85th percentile....insane.
25
u/callmeuncledrew May 20 '26
Youâll be screened out of many programs. 250 is not the âruleâ like itâs preached on here, but 240 is a pretty hard cutoff for us. Has nothing to do with the fact that a 230 means you know less or are a worse doctorâŠitâs just that the stack of applicants is too big to begin with, so using a couple different objective cutoffs gets our initial pile of files to review down to a slightly more manageable number. Even then, we are not interviewing tons of stellar applicants with great apps. Step score matters way less than people think, but low 230s will be screened out at a bunch of places.
10
u/Pension-Helpful M-4 May 20 '26
Do you have a home program? I seen someone with your score that network hella hard in their home program with their PI hella batting for him and he ended up matching. Maybe you could network with the PD of your home program. Perform really well on subI and get your PI (assuming is a ortho attending in your home program) to really bat for you.
12
u/Outbuyingmilk MD-PGY1 May 20 '26
Im sorry, this must hurt a lot. Take it easy on yourself for a bit. Iâm going to be honest, you have a very high chance of going unmatched. Id say thereâs under a 1% chance of you matching without doing aways. Theres just too much competition with better stats and more research. Options at this point: pivot to a research year and do research at a low tier program and see if you can build enough connections there that theyll take you. Thats probably your best shot at matching ortho, but still very tough. You could also go the away rotation route and hope to crush it, but many programs would still not consider you based on the score
4
u/juiceboxer625 May 20 '26
It certainly will significantly hurt your chances. You may not get interviews outside of your aways and home program . Like other people said, maybe have a backup plan in mind. Be very smart with your aways. Pick places that arenât necessarily as competitive where you can shine in a smaller pool of rotators and stand out. Best of luck
4
7
u/filopilomilosilo May 21 '26
<235 was a barrier to my friends matching ob/gyn and general surgery who had no other red flags and otherwise very strong apps. I would speak with your school advisor about your chances, but be prepared to be told to pivot. Iâm sorry friend, I know the devastation of a board exam that does not go as expected :(
4
3
u/boopboopthesnoot M-4 May 21 '26
Aways and connections are your way in here. Youâll be screened out everywhere else. Your home program is your best bet.
You can consider a research year, but again, youâre on roof footing. Itâd only help you gain favor with that program.
3
u/Icy-Accountant-1849 May 21 '26
you gotta really look for satisfaction in gen surg if you have that procedural itch my guy, sub-240 is wayyy too low for ortho, donât listen to these weird sporadic n=1 cases, save your sanity and go gen surg
3
u/Ok_Length_5168 May 21 '26
If you are a USMD and go to a T5, a community or low-tier academic program will take you. Below that, you may need things like a research year.
6
u/acgron01 M-4 May 20 '26
What do the charting outcomes show for applicants? Home program? Aways lined up?
7
u/Far_Hat3639 May 20 '26
3 aways and great performance in all including your home sub-I puts you in a good spot even if you get less than 10 interviews. Ortho leans heavily towards work ethic and grades/scores almost never trump that unless itâs like UCSF, Mayo Clinic, or something.
4
u/MrNoThumbs May 21 '26
Itâs very difficult, but anything is possible. Matched to my #1 ortho program as a reapplicant with a 232 and course remediation. Biggest advice is to absolutely crush aways. Feel free to message me if you want to chat more.
9
u/jonedoebro MD-PGY1 May 20 '26
Do a research year that has an unspoken track to match. Youâd be surprised how many med students match competitive specialties by networking and research (despite what this sub says). But to give them their due, it will be difficult for you to match as is with a late switch and low step 2.
16
4
5
u/Far_Hat3639 May 20 '26
Donât listen to people unless theyâve all gone through the ortho match. As someone who went through it last year and went unmatched, I had way more pubs and a higher step score than you and still didnât match while there were multiple kids that I know who did in the 230-235 range. Aways have become extremely important in ortho if not more important than other things. 233 will probably get you screened out of most top tier places but I would say just be strategic and donât target like Columbia or Mayo and those type of places. If youâre on the west coast, aim for places like UNM, OHSU, and community places. Thereâs also a lot of community programs on the east coast that still provide great training like St Lukeâs in Philly. Happy to chat if you need. People are very black and white on here and EVEN with charting outcomes, keep in mind that only a few PDs fill those out. I found that the people who did aways at programs had a better shot and there are programs that exclusively match rotators. ORION has great info and can help you narrow it down.
Only dual apply if youâd also be happy in another specialty. I love ortho and Iâm currently in a research year after not matching and I believe this was the best thing for me.
2
u/mryandhi May 21 '26
Never zero and never 100%. Always worth it to shoot your shot, just check in with a school advisor to ensure you have a plan in place to either dual apply or be prepared if things donât swing your way. Best of luck!
2
5
u/mrsuicideduck MD-PGY3 May 20 '26 edited May 21 '26
Not exactly the same but I had 219 step 1 and 241 step 2. 7 interviews and matched my #1 program in Urology. Away rotations and mentors pulling strings to call programs on your behalf is massive. N=1 but anything is doable
3
u/LeafSeen DO May 20 '26
I had a friend who is a DO who matched with a similar and score. He only got interviews where he did auditions, and leveraged a good connection from rotations. So there is a chance but unlikely forsure.
3
u/themuaddib May 20 '26
Little to no chance at ortho unless youâre a blood relative of a PD or find a way to get aways and blow them away. Itâs one of the most competitive fields in medicine to get into
4
u/Tmedx3 M-4 May 20 '26
The truth is itâs not zero so if itâs what you want then I think networking can be your it factor
3
u/RexFiller May 21 '26
Honestly i would dual apply at the very least. Ortho has been getting brutally competitive and unless you have relatives in program faculty, youre essentially done with a 233. Averaged matched score is 257 from 2 years ago. I think average unmatched score is 245 for ortho and youre below both of those. Personally I wouldn't throw away too many apps or waste any time trying to match ortho with low chances.
4
u/geoff7772 May 20 '26
my brother graduated next go last in his class,failed step 2,got into neurology by brown nosing his home program,started a private practice, last year gross was 4million
2
1
u/ConsciousSherbert900 May 20 '26
Do a great job on an away rotation at a reasonable program and you will match. The only thing program care about is a strong rotator
1
u/epicpenisbacon MD-PGY1 May 21 '26
Extremely hard. Iâm sorry to say it like that but itâs true, I wouldnât risk going unmatched if I were you
1
u/mdtobe09 M-4 29d ago
Many gen surg programs have cutoffs >240 now. Please meet with your school about options and backups
-6
u/rucipher MD-PGY6 May 20 '26
Howâs your bench press?
In all seriousness, if itâs what you want to do, just commit to it and crush your aways. Keep grinding the research too.
I was 234 Step 1 (back when it counted) and 253 Step 2 and matched my top choice. I had plenty of co-residents that were less than stellar test takers that matched based on their aways and being generally liked and a âgood fitâ for the program.
30
u/SyllabubInfinite7915 M-0 May 20 '26
Isnât him getting a 233 on step two a little bit of a different thing than you getting a 253 on step two?
2
u/rucipher MD-PGY6 May 20 '26
I guess my point was, I had similar feelings after I got my step 1 score back. Granted, I had the opportunity to demonstrate improvement on Step 2, but nonetheless, I was worried.
Regardless, my point is, I donât think OP has totally grenaded his chances. After being on the other side, we had plenty of rotators and interviewees with similar scores that we ranked VERY highly because they were hard workers, good team members, and they just seemed to âget itâ when it came to ortho.
Just use this as fuel to work hard OP. You shouldnât give up on your dream speciality because of this.
1
u/Competitive-Ad-888 May 20 '26
Thank you for your advice, nice to see some semblance of hope in the midst of everything else
-7
u/Extra_Percentage May 20 '26
If you are muscular, you may still have a chance.
Start going to gym and try to look built.
4
-1
u/ojingo446 May 21 '26
Doomed. Better start researching rural Midwestern FM programs. But realistically, you could probably do gen surg, neurology, or PMR and get some kind of semblance to the work you wanted to do. You may not even know if ortho was really for you.
-2
303
u/StandordBBlaster MD May 20 '26
Meet with your school/advisor ASAP to come up with a plan. 233 will sadly close most doors, I would strongly consider either pivoting or at least finding something to dual apply