FREE Consult: Master More - Faster - for Impressive Boards ScoresSCHEDULE CALL
FREE Consult: Master More - Faster - for Impressive Boards Scores

blog

How to Match into Orthopaedic Surgery in 2023

Want FREE Cardiology Flashcards?

Cardiology is key for impressive USMLE scores. Master cardiology from a Harvard-trained anesthesiologist who scored USMLE 270 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.

Subscribe
by Loyd Mokaya in How to Match

Are you wondering how to match into orthopaedic surgery? Or how many orthopaedic residency programs are there? Do you want to know everything there is about orthopaedic surgery residency interviews? Need to know how many interviews to match in orthopaedics?

In this article, you’ll learn everything you need to match into orthopaedic surgery.

Summary:

  • Orthopaedic Surgery is moderately competitive, in part due to having a very low match rate and fewer positions available
  • Due to the volume of applications, orthopaedic surgery residency programs use standardized screens to “weed out” applicants
  • Candidates with the highest chances of success will have a letter of recommendation in the specialty. They will also have stellar USMLE scores, demonstrate professionalism and ethics, and have excellent grades in required clerkships.
  • Historically, most orthopaedic surgery interview invites occur before November 31, and the vast majority before December 31

Table of Contents

How Competitive is it to Match into Orthopaedic Surgery?

How competitive is it to match into orthopaedic surgery in the US? Here we have the unmatched % of US seniors by specialty. The “Unmatched %” means the % of US seniors who applied for orthopaedic surgery who did not match during the given year.

This is one measure of specialty competitiveness – perhaps the most relevant if you want to match into orthopaedic surgery.

For more on the competitiveness of orthopaedic surgery relative to other medical specialties, see this article.

How Many Orthopaedic Surgery Residency Programs Are There?

Before we discuss how many orthopaedic surgery residency programs there are in the US, let’s review some terminology. For many specialized residency programs (e.g., anesthesiology, dermatology, radiology, radiation oncology, etc.), the specialty training begins during the second year of residency. This second year is also known as the PGY-2 (post-graduate year 2, for the second year after graduating from medical school).

Categorical vs. Advanced vs. Physician Orthopaedic Surgery Programs

Most residencies have three different kinds of residency programs applicants can potentially enter: categorical, advanced, and physician (R). Orthpaedic surgery, however, only offers categorical positions.

Categorical refers to programs that include all years of residency training. Orthopaedic surgery residency lasts 5 years. The first year of training, however, is a “preliminary” year in surgery. Most programs include the PGY-1 “intern” year – these programs are known as “categorical” programs.

How Many Orthopaedic Surgery Residency Programs and Positions Are There?

In the 2022 NRMP Match, there were:

  • 210 orthopaedic surgery programs offering 875 PGY-1 (categorical) positions,
  • No programs offering PGY-2 (advanced) positions, and
  • No programs offering Physician (R) positions

Thus, the total number of orthopaedic surgery residency positions in 2022 was 875. There were 210 orthopaedic surgery programs in 2022.

See the 2022 Main Residency Match Results and Data for more information on orthopaedic surgery match statistics.

How to Match into Orthopaedic Surgery: Impressing Program Directors

To match into orthopaedic surgery, you must first be invited to interview. According to the most recent program director (PD) survey from 2021, PDs shared what they look for in candidates they hope to interview.

For orthopaedic surgery, the top five most important characteristics for receiving an interview, according to program directors, were:

  • Letters of Recommendation in Specialty
  • USMLE Step 1 Score
  • Professionalism and Ethics
  • Grades in Required Clerkships
  • Leadership Qualities

Note that with Step 1 moving to pass-fail, Step 2 CK will almost assuredly take on greater importance for matching into orthopaedic surgery in the future.

The same data are presented more fully in a table. Here you will see the % of program director respondents who cited a factor as important for granting an interview, as well as the mean importance score (out of 5).

To balance the breadth of program directors citing each factor with the importance given to each factor, a “composite score” was created. This composite score takes the average of the % respondents citing a factor with the importance score scaled to 100%. For example, if 80% of PDs cited a given factor, with a mean importance score of 5.0 (out of 5), the composite score would be 90%. (The average of 80% of PDs citing with 5/5 – or 100% – for the mean importance, for a composite score of 90%).

Orthopaedic Surgery: Characteristics Considered in Deciding Whom to INTERVIEW (% of Respondents Endorsing)Orthopaedic Surgery: Characteristics Considered
in Deciding Whom to INTERVIEW (Mean Importance / 5)
Orthopaedic Surgery: Characteristics Considered for Interview Composite Score (Average of % Respondents Endorsing and Mean Importance / 5)
Letters of Recommendation in Specialty88.9%4.488.5%
USMLE Step 1 Score94.4%3.986.2%
Professionalism and Ethics80.6%4.484.3%
Grades in Required Clerkships86.1%4.184.1%
Leadership Qualities77.8%4.381.9%
Personal Statement (Overall)91.7%3.580.9%
Personal Prior Knowledge of Applicant69.4%4.478.7%
Diversity Characteristics83.3%3.778.7%
Audition Elective/Rotation in PD's Dept61.1%4.575.6%
USMLE Step 2 CK Score77.8%3.674.9%
Having Overcome Significant Obstacles63.9%4.173.0%
MSPE69.4%3.771.7%
AOA Membership69.4%3.771.7%
Class Ranking/Quartile63.9%3.971.0%
Consistency of Grades63.9%3.971.0%
Perceived Interest in Program63.9%3.971.0%
Perceived Commitment to Specialty55.6%4.168.8%
Other Life Experience55.6%4.168.8%
Involvement and Interest in Research61.1%3.868.6%
Awards/Honors in Clinical Clerkships66.7%3.568.4%
Any Failed USMLE Attempt41.7%4.666.9%
Volunteer/Extracurricular Experience55.6%3.865.8%
Grades in Clerkship in Preferred Specialty50.0%465.0%
GHHS Membership50.0%3.964.0%
Any Failed COMLEX-USA Attempt22.2%4.960.1%
Awards/Honors, Clerkship in Preferred Specialty36.1%3.856.1%
COMLEX-USA Level 1 score33.3%3.854.7%
Ability to Work Legally w/o Visa19.4%4.453.7%
NRMP Flag for Match Violation11.1%4.853.6%
Continuous Medical Education w/o Gaps25.0%452.5%
Medical School Accreditation Status22.2%4.152.1%
Medical School Reputation36.1%3.452.1%
COMLEX-USA Level 2 CE Score25.0%3.749.5%
Sigma Sigma Phi Membership19.4%3.948.7%
Away Rotation in Specialty Elsewhere19.4%3.847.7%
Passing USMLE Step 2 CS30.6%3.247.3%
Awards/Honors in Basic Sciences19.4%3.443.7%
COMLEX-USA Level 3 Score2.8%441.4%
Interest in Academic Career16.7%3.341.4%
Passing COMLEX-USA Level 2 PE8.3%3.741.2%
USMLE Step 3 Score5.6%3.537.8%
Fluency in Language of Pt Population5.6%3.537.8%
Visa Status13.9%2.835.0%
How Medical School Handled Virtual Rotations5.6%332.8%

Here are the composite scores for the criteria orthopaedic surgery program directors use for grading interviews.

What Do Orthopaedic Surgery Program Directors Look for When Ranking Applicants?

Getting an interview is only part of the process of matching into orthopaedic surgery. Program directors also rank the most important factors for creating their rank order list.

In the 2021 Program Director Survey, orthopaedic surgery PDs rated these criteria as most important for deciding whom to rank:

  • Interpersonal Skills
  • Interactions with faculty during interviews/visit
  • Interactions with house staff during interview/visit
  • Feedback from current residents
  • Diversity Characteristics

We can see the full list here:

Orthopaedic Surgery: Characteristics Considered in Deciding Whom to RANK (% of Respondents Endorsing)Orthopaedic Surgery: Characteristics Considered
in Deciding Whom to RANK (Mean Importance / 5)
Orthopaedic Surgery: Characteristics Considered for Rank Composite Score (Average of % Respondents Endorsing and Mean Importance / 5)
Interpersonal Skills83.3%4.788.7%
Interactions with Faculty During Interview/Visit77.8%4.987.9%
Interactions with House Staff During Interview/Visit75.0%4.885.5%
Feedback from Current Residents69.4%4.781.7%
Diversity Characteristics72.2%3.975.1%
Letters of Recommendation in Specialty63.9%4.375.0%
Audition Elective/Rotation in PD's Dept52.8%4.571.4%
Leadership Qualities58.3%4.271.2%
Personal Prior Knowledge of Applicant47.2%4.770.6%
Professionalism and Ethics50.0%4.469.0%
Grades in Required Clerkships50.0%4.267.0%
Personal Statement55.6%3.966.8%
USMLE Step 1 Score52.8%466.4%
Other Life Experience41.7%4.262.9%
AOA Membership44.4%462.2%
Having Overcome Significant Obstacles41.7%4.161.9%
Perceived Interest in Program44.4%3.860.2%
Involvement and Interest in Research41.7%3.959.9%
USMLE Step 2 CK Score38.9%459.5%
Consistency of Grades33.3%4.258.7%
Class Ranking/Quartile38.9%3.958.5%
MSPE41.7%3.757.9%
Perceived Commitment to Specialty30.6%4.257.3%
Volunteer/Extracurricular Experience30.6%3.954.3%
Any Failed USMLE Attempt8.3%554.2%
Any Failed COMLEX-USA Attempt8.3%554.2%
Visa Status5.6%552.8%
GHHS Membership22.2%4.152.1%
NRMP Flag for Match Violation11.1%4.550.6%
COMLEX-USA Level 1 score22.2%3.849.1%
Awards/Honors in Clinical Clerkships27.8%3.548.9%
Medical School Accreditation Status11.1%4.348.6%
COMLEX-USA Level 2 CE Score22.2%3.748.1%
Interest in Academic Career5.6%4.547.8%
Away Rotation in Specialty Elsewhere5.6%4.547.8%
Continuous Medical Education w/o Gaps8.3%4.347.2%
Sigma Sigma Phi Membership11.1%445.6%
Ability to Work Legally w/o Visa11.1%445.6%
Awards/Honors, Clerkship in Preferred Specialty25.0%3.345.5%
Passing USMLE Step 2 CS13.9%3.845.0%
Medical School Reputation13.9%3.845.0%
Grades in Clerkship in Preferred Specialty8.3%444.2%
Awards/Honors in Basic Sciences11.1%3.843.6%
USMLE Step 3 Score2.8%441.4%
How Medical School Handled Virtual Rotations2.8%441.4%
Fluency in Language of Patient Population2.8%441.4%
Passing COMLEX-USA Level 2 PE8.3%3.741.2%
Applicant Facility with Meeting Platform Tech5.6%3.537.8%
Other Post-Interview Contact5.6%332.8%
COMLEX-USA Level 3 Score0.0%0.0%
Second Interview/Visit0.0%0.0%

Finally, we can see the composite scores for criteria used to rank orthopaedic surgery applicants.

What Characteristics Do Successful Orthopaedic Surgery Applicants Share?

Here are the characteristics of matched vs. unmatched US seniors applying to orthopaedic surgery.

MatchedUnmatched
Mean number of contiguous ranks, US Senior12.25.6
Mean number of distinct specialties ranked, US Senior1.11.3
Step 1, US Senior248241
Step 2, US Senior256249
Mean number of research experiences, US Senior6.65.4
Mean number of abstracts, presentations, and publications, US Senior16.512.1
Mean number of work experiences, US Senior43.5
Mean number of volunteer experiences, US Senior8.97.5
Percentage who are AOA members, US Senior35.712.8
Percentage who graduated from one of the 40 U.S. medical schools with the highest NIH funding, US Senior33.421.5
Percentage who have Ph.D. degree, US Senior1.51.1
Percentage who have another graduate degree, US Senior15.320
Match Into Orthopaedic Surgery: Pass the Screens with High USMLEs

Orthopaedic surgery relies on standardized screens to weed out applicants. In the 2021 Program Director Survey, orthopaedic surgery PDs respondents reported that 37% of applications were rejected via the standardized screen. This ranked near the middle of residencies.

What Are the Step 1 and Step 2 CK Cut-Offs for Interviews in Orthopaedic Surgery?

As mentioned above, orthopaedic surgery ranks near the middle of programs using standardized screens to eliminate applications. Many orthopaedic surgery programs screen out applicants with failed USMLE Step 1 and Step 2 CK (see below). In addition, PDs use Step 1 and Step 2 CK score cut-offs to weed out applicants.

For Step 1, orthopaedic surgery program directors reported Step 1 score cut-offs between 224 and 236 as 25% and 75 %ile marks to screen out applicants.

Similarly, orthopaedic surgery program directors reported Step 2 CK scores between 229 and 239 as 25% and 75 %ile cut-offs.

For more on the USMLE cut-off scores for granting interviews – or weeding out applicants – see this article.

If I Fail Step 1, Can I Still Match Into Orthopaedic Surgery?

If you did not pass Step 1, you may be wondering if you can still match into orthopaedic surgery. A recent survey of program directors addressing this question shows that orthopaedic surgery programs are extremely unforgiving if you fail Step 1.

In 2020, orthopaedic surgery 82% of PDs reported they “never” consider applicants who fail Step 1, while 18% would “seldom” consider it. No orthopaedic surgery program “often” considers someone with a Step 1 fail.

Did you fail Step 1 and are wondering what you can do to recover? Read this article and consider scheduling a consultation.

If I Fail Step 2 CK, Can I Still Match Into Orthopaedic Surgery?

Similarly, you may wonder about your chances of matching into orthopaedic surgery if you fail Step 2 CK. Just like with Step 1, orthopaedic surgery PDs are unforgiving for not passing Step 2 CK.

In 2020, orthopaedic surgery 71% of PDs reported they “never” consider applicants who fail Step 2 CK, while 29% would “seldom” consider it. No orthopaedic surgery program considers someone with a failed Step 2 CK “often.”

Did you fail Step 2 CK and wonder what you can do to recover? Read this article and consider scheduling a consultation.

How Many Publications for Orthopaedic Surgery Residency in 2022

Research is an important characteristic for matching into many specialties, particularly the most competitive. So, how many publications do you need to match into an orthopaedic surgery residency?

In 2022, the mean number of abstracts, presentations, and publications for US seniors who matched into orthopaedic surgery was 16.5. The mean number of research experiences was 6.6.

Do I Need an MD-PhD to Become an Orthopaedic Surgeon?

You may wonder how much an MD-PhD helps with matching into orthopaedic surgery. It appears that having a PhD correlates with a modest advantage of 7% when applying to orthopaedic surgery. Specifically, the match rate for those with a PhD is 7% higher than for those without one when applying for orthopaedic surgery.

Note that those with PhDs are relatively rare among orthopaedic surgery residents. Only 1.5% of matched applicants into orthopaedic surgery had a PhD in 2022.

Orthopaedic Surgery Residency Interviews

When you apply to orthopaedic surgery, you may be wondering what the chances of getting an interview are. Here we present the outcomes of applicants per the 2021 NRMP Program Director Survey.

Note that orthopaedic surgery uses standardized screens to reduce the number of applicants. Roughly 37% of applicants that year were eliminated via a screen (e.g., Step 2 CK scores, visa status, failed a USMLE in the past, etc.).

When Are Orthopaedic Surgery Residency Interview Invites Sent vs. Conducted?

When you apply for residency, you’ll be doing a lot of waiting. Specifically, you’ll be waiting to hear whether – and when – you will be able to interview.

Want to know when you might expect to hear from orthopaedic surgery programs regarding your residency application? Here are when programs typically extend and conduct interviews. Note that the most recent data are from 2020.

Here are the same data presented differently. Note that due to rounding, sometimes the percentages can add up to more than 100%.

How Many Interviews to Match in Orthopaedic Surgery?

After applying to a program, applicants often wait anxiously to know whether they’ve received an interview invitation. Receiving – and attending – an interview allows applicants to “rank” that program on their match list. In other words, the more interviews you have, the more chances you have of matching into a given specialty.

So how many interviews to match in orthopaedic surgery with confidence?

For US Seniors, the magic number of interviews needed to match into orthopaedic surgery is 9-12. In 2022, having 9 interviews (and ranking them all on their match list) led to a 79% chance of matching. For even greater safety, though, having 10+ interviews led to a ≥87% chance of matching into orthopaedic surgery for US seniors.

How Many Interviews to Match in Orthopaedic Surgery as a DO?

For DO seniors, the number of interviews necessary to match into orthopaedic surgery comfortably are similar to US Seniors. To get past the 75% threshold, ≥ 6-7 interviews were needed. To reach the ≥ 90% threshold, 10+ interviews were needed in 2022.

How Many Interviews to Match in Orthopaedic Surgery as an IMG?

To reach the 75% threshold for IMGs, ≥5-6 interviews were necessary. Note that because of so few candidates with ≥ 6 interviews, the numbers become considerably “noisier,” and can’t be interpreted with much confidence.

Concluding Thoughts

Matching into orthopaedic surgery is a challenging proposition. The challenge may feel more daunting if we have perceived weaknesses in our application, or if we want to match in a top program, a desirable location, and/or couples match.

The good news? How to match into orthopaedic surgery depends largely on things you can control – your USMLEs, your clinical performance/MSPEs, whether you fail Step 1 or Step 2 CK, and how much interest you show in programs before, during, and after your interviews.

Looking for an Orthopaedic Surgery Residency Advisor?

Are you looking for an orthopaedic surgery residency advisor? Want help writing your personal statement? Need effective strategies for interviewing? Do you have things on your application – e.g., low USMLE scores, failed USMLEs, no research, IMG status, or others – you need help overcoming?

Be sure to check out our Residency Advisor service.

Want FREE Cardiology Flashcards?

Cardiology is key for impressive USMLE scores. Master cardiology from a Harvard-trained anesthesiologist who scored USMLE 270 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.

Subscribe