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Matching Into Orthopaedic Surgery Residency

10 min


Orthopaedic surgeons and residents in surgery.


Match into Orthopaedic Surgery Residency

From the Viewpoint of a Program Director

The NRMP conducted a survey to determine what factors Program Directors consider when deciding which candidates to interview and rank for their orthopaedic surgery residency program. The results were compiled into a “at a glance” tool, which is extremely helpful in gauging where your application packet stands compared to the applicant pool, and whether adding additional components, like a letter of recommendation (LOR) in the specialty, could give you a leg up as programs review your application.

The interactive table tool can be found here, and we recommend taking a look at the specialty you’ll be applying to before submitting your ERAS packet: https://public.tableau.com/profile/national.resident.matching.program#!/vizhome/PDSurvey_0/Desktoptablet


For Orthopaedic surgery residency specifically, major components of the survey you should pay attention to: 


  • Selection Criteria for an Interview Step 1 score is a MAJOR factor, while having an appropriate LOR in the specialty and AOA membership are also highly recommended.

  • Step 1 and Step 2 Scores:

  • Step 1 – Score


      • 250+ looks like a very solid score in orthopaedic surgery, with the median being 245.
      • Range programs do NOT typically offer interviews: 220-235 seems to be the minimum threshold we would recommend for having a good chance at enough interviews. If you’re below 220-230 range, we suggest having a back-up specialty you could consider.
      • Range programs DO typically offer interviews: 245+ seems to be the range at which you can feel comfortable in being offered interviews by a decent number of programs. If you’re in the 260+ range, you can likely be selective about where you apply.
      • If you failed USMLE Step 1 follow these steps.


  • Step 2CK – Score


      • 240-250 seems to be the minimum threshold at which programs will grant interviews
      • Scores below 230 generally will place you in a unfavorable position to receive an interview 


  • Step 2CK – Timing of Taking the Exam
  • Nearly 50% of programs required at least passing CK, and we do expect this number to grow. It is up to you to decide whether you take Step 2CK before or after you have submitted ERAS.


  • Failing Step 1 is more likely to be a show stopper: 
    • Failing Step 1 is a BIG deal in ANY specialty, and this is especially relevant in orthopaedic surgery. 65% of orthopaedic surgery programs will NOT consider you if you’ve failed Step 1, and 63% will NOT consider you if you’ve failed Step 2. So, if you’ve failed an exam, you can still apply, but you should apply to a BIG number (100+) of programs. 

  • Types of Applicants Considered:
    • International Grads (U.S. and non-U.S.) are more likely to have difficulty matching into orthopaedic surgery: There are no programs that consider interviewing or ranking non-U.S. IMGs on a routine basis, and only 2-4% consider interviewing or ranking U.S. IMG on a routine basis. About 30-36% consider U.S. IMGs seldomly, and 60-67% never consider a U.S. IMG for an interview or rank. If you are a non-US IMG, the chances are even lower, with 79-80% of programs never considering such an applicant. We recommend doing your homework to determine which programs may even consider IMGs, and definitely recommend a back-up specialty to apply into.
    • Osteopathic graduates have a slight chance to match into orthopaedic surgery: 6% of programs will routinely interview and rank DO applicants. 2/3 of programs will never interview or rank a DO applicant. With the remaining 27-26% that seldomly consider DO applicants, it is very important to do your research to identify these programs so that you can best increase your chances of matching.

  • Interviewees Get Ranked!: If you get an interview invitation, you are likely to end up on the rank list if you interview. We recommend ranking at least 8-10 programs, so once you receive 10 interview invitations, you can feel okay with starting to prioritize and cancel as more come in given you are likely to get ranked.
  • Expect to receive interview invitations in November: 50% of the interview invitations will be sent out in November, and over 20% will be sent out in October and December. 
  • Expect to interview in December/January: Only 13% of interviews will occur before December, which gives you ample time to prepare. More than 50% of your interviews will occur in January or later. For further discussion on how to prep for your interview, see our blog post on how to Crush your Residency Interview: https://elitemedicalprep.com/preparing-for-your-residency-interview/


After you’ve browsed your specialty, take a look at a few other specialties and note what’s NOT important for Orthopaedic Surgery:

  • Step 2 isn’t particularly important in Orthopaedic surgery
  • Commitment to the field isn’t particularly important for Orthopaedic surgery
  • Class ranking/quartile isn’t as important in Orthopaedic surgery as in other specialties



Summary for Orthopaedic Surgery Residency Applications:


  • A solid orthopaedic surgery application would include a 245+ on Step 1, 245+ on Step 2, a LOR from 1-3 orthopaedic surgeons, and AOA membership.
  • Orthopaedic surgery is not particularly IMG friendly, but it could be possible to match as an IMG if you do your research to identify programs with active IMG residents and establish proper connections.
  • If you’ve failed an exam, you can still apply in Orthopaedic surgery, but you should apply very broadly and apply for a back-up specialty.
  • Expect Interviews in December-January. Reach out to programs you have high interest in if you haven’t heard from them by mid-December. Once you have about 10 interview invitations, you can consider being a bit more selective about which ones you actually take (but not before).


Good Luck! ☺ 


If you need further or specialized assistance understanding which residency specialties you are best suited to apply to, you can contact us or visit our residency advising page to learn more about how Elite Medical Prep residency advising services.


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About the Author

Alexandra R., MD

Alexandra earned her Neuroscience degree from the University of Michigan, graduating with Summa Cum Laude recognition in 2014. She continued her education at the University…

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