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Hello everyone! I have recently passed the USMLE Step 1 and scored 248. And now I am wondering if it's worth continuing passing the other examinations. I'm a 5th year european medical student (of a total 6 curriculum) who has completed 3 months of clerkships at top german university hospitals (general surgery, vascular surgery, orthopedic surgery). I also have 1 month experience in UK, Cambridge - Orthopedic Surgery and 2 additonal months of clerkship at the Orthopedic University Hospital in Zurich, Switzerland (Balgrist). I have gathered 4 recommendation letters from world class faculty while working there.

I am not AOA member (Alpha Omega Alpha)
I have only 2 case reports under review, none published yet
I don't have green card

I just want to know if I am losing my time with USMLEs or if there is a real chance of getting matched in a good university program in US?
Should I consider to go for PGY-1 in General Surgery and then transfer to Ortho?
 

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I can tell you a bit about these competitive specialties in the US. I didn't apply to Ortho. I applied to neurosurgery this year but the two are very similar in terms of FMG matching trends. And matching strategy.

Your step 1 is fine, it won't make you or break you. It's not going to make you shine. It will, most likely, get you past filters at most places. That being said you will end up being filtered out at a LOT of places because you are an IMG. The number of FMGs is really low in ortho; take a look at last year's stats. 3 (!) non-US IMGs matched! These are your chances. The fact that you are thinking of giving up after getting a mediocre score on step 1 makes me think you haven't really decided to go for it. If you aren't 100% sure that this is what you want, ortho in the US period, then don't. It's a really long road full of uncertainties, lots of work, zero guarantees, it's far away from home (I have a feeling we are from the same country btw). If this IS what you want then here's what I think you should do from here on.

Try and do electives/subinternships. You are in a unique position: still in med school with step 1 done. Apply for electives in ortho in the months that are not competitive (AMGs do these subIs close to application season - June-October; try and find something in spring or beginning of next year). Do as many as you can, I would say do 3-4 if possible. Once you are there you gotta kill it. Impress. Get awesome LORs. These are the LORs that matter. Your European rotations are nice, but nobody cares. It's the cherry on top, nothing more. You need people here to vouch for you, it's a relatively small field so you need mentors here who see you in a clinical setting. Then try and find a research spot at one of these places. Work there for a couple of years, publish (a lot), finish your steps. Try and get a green card in the meantime (it's a long process). Find good mentors who are willing to go to bat for you. Once all this is in place, you can apply. Scores only get you this far.

It's a game, it may take years, it may never happen. If you want to go through this then go for it. First thing's first: apply for electives, start looking now.

Anyway hope this helps. Let me know if you have questions.
 
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