ORTHOPAEDIC SURGERY AND IMGS

Bottom line : Orthopedics is tough for IMGs ! Tough enough to prompt advising Orthopedics aspirants to be ready for long periods of waiting and trying before finally getting into a program.

Orthopedics surgery remains extremely tough even for the best of American Medical graduates. The big reasons possibly being that number of residency positions are low and it remains one of the highest paid specialties in USA. In the year 2005, there were 152 Orthopaedic surgery residency programs offered a total of 3085 residency positions. Of these, 2999 positions (97.2%) were filled by American Medical Graduates, leaving a mere 86 slots for IMGs. Compare this with 21,332 positions offered in Internal Medicine of which the AMGs filled up 52.8 % positions.

Secondly, There is pretty much a fairly large 'waiting line' of people hoping for orthopedic surgery residencies - these include people currently involved in research, observerships, and even general surgery residency positions (both categorical and preliminary). Often, as I hear, even getting into a preliminary position in some places need a year or more of research work in the field. Combine this with the fact that America is currently seeing a Surplus of Orthopedic Surgeons which is supposed to increase atleast upto the year 2010, which means we will not be seeing an increase in sanctioned residency slots for a long time too.

Finally, a lot of highly trained orthopedic guys from United Kingdom are being forced to look at USA due to the visa rule crisis.

I am not being a pessimist and am not suggesting IMGs should not dream of orthopaedic surgery in US - but practicality must piggy-back with long-term dreams. It is a system that we are trying to break into and rather than cribbing about it, it is best to be patient, strategize and slowly work towards it without being foolish enough to bet and risk everything on it.

Take home points for IMGs planning on Orthopaedic Surgery in the United States:

- Besides Orthopedics, apply to BOTH prelimary and categorical positions in General surgery (Orthopedics needs a year of General Surgery Training before entering the categorical residency program)

- Take up General Surgery if you get it (match or prematch) and then work your way towards the bony brother - because, for tough branches like Orthopedics and Radiology, the unspoken rule is GET INTO THE SYSTEM FIRST rather than keep waiting for the right branch and let other opportunities slip by. There is a second important reason to this - Remember that when you apply for residencies, there's only one Common application Form that you can fill up and submit irrespective of what specialties you apply to. So if you slogged for 2-3 years for building a "orthopedic" resume doing all the right things like research, observerships, externships, etc. , the credibility of your application for other specialties like categorical general surgery may drop down.

- USMLE Scores need to be very high - 240 and above for many programs. If scores are low, then the waiting period will possibly be longer with a need for more US clinical experience and research along with solid US Letters of Recommendation.

- If no US Clinical experience, Post Graduate Training in your Country will certainly help rather than being totally fresh out of medical school with no Ortho experience




Shall post more as I get more enlightened...