Authors: Emily Jagenburg, Bill Woodhams, Marquisha Myles MD, Alfred Bayaton, Drew Albert MD MBA
Preparing for orthopedic surgery residency can seem overwhelming, especially when trying to find research opportunities and mentorship. Whether you’re an eager pre-medical student or a few months from applying, the following tips can help you build a strong orthopedic surgery application while staying authentic to who you are.
Connect Strategically
Reaching out consistently to surgeons, residents, and fellows can pay off. Fellows and residents often need to publish research and genuinely appreciate a proactive medical student who can help manage and complete projects independently.
Reaching out to alumni from your home program is also a great way to learn the ins and outs of your specific medical school curriculum and get advice on how to stand out locally. They can offer insight into which resources were most helpful for STEP prep, how to honor your clinical rotations, and how to choose programs that align with your goals.
Show Genuine Interest
Identify your subspecialty of interest (e.g., spine) and reach out specifically to fellowship directors or faculty members in that area. Demonstrating genuine interest, and know their recently published work and/or landmark papers. Do your research. Make your emails short and straight to the point. Follow up on a consistent basis, be respectful. Ask residents and/or fellows about which faculty would be the most supportive and ideal to do research with.
Persistent Communication
It might take multiple emails or messages over weeks to get a response. Being respectful, professional, and consistent in your communication can make a difference. After establishing a relationship with a mentor, whether it’s a resident or attending, don’t disappear. You don’t have to check in constantly, but shadowing or touching base every couple of months lets them know that you are still genuinely interested and committed to orthopedics. If you are doing research with someone you should update them without being told at least once per month.
Shadow and Participate
Regularly attend grand rounds, shadow in clinics, and scrub into surgeries—even outside of typical hours (think weekends, holidays, or late-night traumas). This effort stands out since many students aren’t willing to put in extra time. Shadowing is a great way to build relationships and get more comfortable with procedures, surgical instruments, techniques, treatment indications, post-op complications, etc. It also will help you make your final decision as to whether the specialty is the right fit for you.
Know Your Stuff
Be prepared to get “pimped” during shadowing experiences. Doing your homework beforehand helps you make a good impression and shows you’re serious. Before each day, set aside time the night before to review upcoming cases. Go in knowing the steps of a procedure and the key things to watch for during surgery. Ortho Netters is not as helpful as getting access to an orthopedic surgery technique book (study what residents are studying). For example: Wiesel’s Operative Techniques in Orthopaedic Surgery (https://www.amazon.com/Operative-Techniques-Orthopaedic-Surgery-package/dp/1975145070), do not buy this on your own, look for it in your medical school’s library, if it isn’t there request it from the library, or ask some fellow med students/residents/attendings to borrow a PDF copy if necessary. This textbook will show you what anatomy to watch out for, the intervals, and each step in the surgery that you need to know. Also check out our Ortho Conditioning articles here: https://orthoconditioning.com/journal/.
Step Scores Matter
While Step 1 is now pass/fail, Step 2 CK is highly weighted. According to the 2024 NRMP Charting Outcomes in the Match for orthopedic surgery, the average Step 2 CK score for matched applicants was 257, while unmatched applicants had an average of 246.1 This makes a strong Step 2 score essential to stay competitive. Do your absolute best to crush step 1 and let that knowledge base carry you into crushing step 2.
Research Can Be Your Foot in the Door for an Interview or Away Rotation
Orthopedic surgery applicants had, on average, 16.5 abstracts, presentations, and publications, and 6.6 research experiences¹. Quality > Quantity. A project you genuinely understand and can speak about at length, especially if you were first author, carries weight. What program directors care most about is follow-through: taking a project from start to finish. Try to get involved in research early, stay connected, and be realistic in your expectations. It is rare and not expected that medical students have ground-breaking research on their application. If you have a specific subspecialty interest, shadowing your research mentor in the clinic or the OR is a great way to strengthen your relationship, gain clinical exposure, and potentially earn a letter of recommendation from them down the line.
Away Rotations = Auditions
Doing a minimum of 3 away rotations at programs of interest is now the norm. These act as month-long interviews, so it’s important to bring your A-game: show up early, know your anatomy cold, and be the teammate everyone wants to work with. Complaining, acting disinterested, or hesitating to help out can tank your chances at that program, even if you are solid on paper. Programs are evaluating you on everything: attitude, work ethic, teachability, and how well your personality meshes with their team and staff. But it’s not just about them—this is also your chance to evaluate the program. Pay attention to how the residents interact with each other, what kind of support they get, and whether you feel you fit in with the program-specific culture.
Leadership and Volunteer Work Matter
Leadership and volunteer work matter, but not just because they check a box. Programs value team players, leaders, and individuals who show a genuine commitment to serving others. Activities like ortho interest groups, surgical skills clubs, or volunteering demonstrate dedication, but it’s just as important to show who you are outside of medicine. Don’t lose your personality trying to fit a mold. People don’t want to work with someone who only talks about ortho all the time. Be yourself. If that means leading the medical Spanish club, great. If it’s playing pickup basketball or performing in an orchestra, that’s just as valuable. Your hobbies and interests make you memorable and often become the most engaging part of your interview conversations. Focus on what makes you genuinely unique. When it comes to extracurriculars, depth > breadth. As Dr. David Bennett, an orthopedic surgeon, put it: “Every orthopedic surgery applicant I’ve encountered who matched did something significantly better than their peers. You don’t need to do everything—you need to do something very well.”²
Mentorship and Letters of Rec
Strong letters from orthopedic surgeons (especially well-known or well-connected faculty) can be game-changers for your application. If you’ve worked closely with a department chair or program director, that’s a great person to ask for a letter. That being said, don’t chase big names just for prestige. Getting a letter from someone you barely worked with can backfire. Imagine a program that calls that person and they say they don’t even remember you. That raises a huge red flag. It is much better to get a strong letter from someone who actually knows you, even if they are not well-known. Beware: some faculty who do not know you well may say, “Yes, I will write you a strong letter,” but end up writing a lukewarm one. Be very strategic and careful about who you ask. A genuine letter that speaks to your character and dedication goes a long way, and sometimes those mentors will even go out of their way to advocate for you by calling programs you are interested in. Mentorship often begins by making yourself known at your local program (if you have one). A good way to make your face known is by showing up to grand rounds, M&M conferences, and journal clubs. Also, the residents will commonly know who writes great letters and who writes lukewarm template-based letters.
Interview Prep Matters
As interview season approaches, it is important to be intentional about how you present yourself. It may be helpful to reflect on “why ortho” ahead of time so you can answer that question confidently and with authenticity. One suggested strategy is journaling in the weeks leading up to interviews. It can help connect the dots in your path to medicine and articulate your passion for the field.
Personal Statements: Tell Your Story
Many personal statements focus on an orthopedic injury—either their own or a family member’s—which does little to set you apart from the masses of orthopedic applicants. To make your personal statement stand out, try focusing on what makes you highly unique and memorable. Tie it into truly caring about patients, and it is okay to connect it to your love of orthopedics. As Dr. David Bennett puts it, every orthopedic surgery applicant has a defining experience or “formative crucible” that shaped their pursuit of orthopedics². Lean into that and speak about what orthopedics means to you. Highlight how your ethics, character, and experience align with the field. You should string together parts of your CV to tell a story and tie it in some fashion to orthopedics. Some ideas are your unique contributions to an orthopedic team and what type of surgeon you aspire to be.
Bottom Line: Apply the 3 A’s
Availability, Affability, Ability. Be accessible to residents, fellows, and attendings when they need help with a project. Never ghost someone, this is very common to see medical students do when projects get difficult or medical school becomes overwhelming. Just communicate, overcome, and follow through on your word. If allowed to help out with research, execute the project well, promptly, and with minimal oversight.
Taking these steps seriously can help set you apart as a competitive applicant.
References
- National Resident Matching Program (NRMP). Charting Outcomes in the Match: U.S. MD Seniors – 2024. National Resident Matching Program; 2024. Accessed April 15, 2025. https://www.nrmp.org/wp-content/uploads/2024/08/Charting_Outcomes_MD_Seniors_2024-2.pdf
- Bennett D. Every orthopedic surgery applicant I’ve encountered who matched did something significantly better than their peers. LinkedIn. Published February 29, 2024. Accessed April 15, 2025. https://www.linkedin.com/posts/david-bennett-md-faaos-dabos-fposna-616b57269_every-orthopedic-surgery-applicant-ive-encountered-activity-7317207765200904194-AfEu
