An Open Letter to Medical Students considering an application to Orthopaedic Surgery Residency for the 2022 Match

Kenneth Gundle, MD

7 min readAug 19, 2021

High Points

We remain committed to supporting residency applicants

Continue to focus on your clinical training

We will not ‘punish’ applicants who managed to do two away rotations

Whether virtual or in-person, interviews will happen and be great

Our rank list goes in finalized no latter than 2/14/2022. If COVID-19 control is good and you would find it useful to visit Portland after that date but before your deadline on 3/2/2022, that is okay with us. It won’t influence our decisions, but is an option for applicants.

This is OHSU

An update for the 2021–2022 application cycle

We are so excited for our new interns, who started clinically in July. Despite all the uncertainty and change of the last application cycle, we Matched a fantastic class. Likewise, I am so proud of our graduated residents who are primed for independent practice (though heading for some advanced training and fun in fellowships). Our rising chiefs also made it through their own virtual interviewing process, which seemed to at least have some advantages, and will be joining great fellowships after next year.

We have spun around the sun, and #OrthoMatch2022 is now about 7 months away. For this cycle, we are excited for the opportunity to host away rotators in orthopaedic surgery at OHSU. Our own students will be able to do an away rotation as well. General guidelines by COPA are for only one away rotation — a recommendation I disagree with. Visiting rotations are deeply educational and advantageous on multiple levels for students and for programs. I would have much preferred that two away rotations be allowed, and a third for those who lack home programs. Myself and other have advocated through the Council of Orthopaedic Residency Directors (CORD) and to COPA and in other forums. We discussed this at the CORD meeting this spring, and I support the CORD statement that was subsequently published.

While pushing for more opportunity, we also must adapt to the realities. We are happy to have away rotators for as many students as possible for as many months as possible. Not all interested students will be able to rotate with us, and that is totally fine. As with last year, our priority is to support medical student applicants and Match another great group of residents.

Similarly, the OHSU Orthopaedic Surgery Residency Program will not do virtual-only rotations, or have lots of general info online sessions with tracked attendance. I would encourage medical students to get medical training, hands on, spending time in the clinic and the ward and the OR and the ED. Taking time on a PM&R rotation, or with Infectious Diseases, or in the SICU would all help medical students be more prepared for orthoapedic surgery residency. More time on Zoom? I don’t see as much benefit. I recognize virtual rotations may be a way to signal interest in a program, but last year I think we were able to provide opportunities to get to know OHSU without them.

We are continuing our Resident Ambassador program. Interested medical students can reach out to Robin Sasaoka and be put in touch with residents, who can communicate by email/phone/video/etc, to answer questions and give a sense of our program from its most important members. We started matching people up with residents in July. We will continue sharing about our program on Twitter and Instagram, and participate in the AOA ORIN database. Our Grand Rounds are taped and put on YouTube and in our archive if you are interested. I wouldn’t want someone to miss an in-person education-promoting event (or sleep) just in order to show their face or name on an attendee list, so we don’t offer this as a live event. I hope all this access provides the information necessary for applicants to decide whether to apply with us. If you are keen to show your interest in our program, please include a few lines about Portland/Oregon/OHSU with your personal statement — as requested in ERAS.

For application review, we have and will continue taking a holistic approach. In addition to faculty reviews, program leadership also uses Thalamus Cortex to help review overall trends and work to mitigate any unconscious bias and support our DEI goals. Additionally, all faculty involved in application review undergo OHSU training on unconscious bias for hiring managers.

And for those applicants we invite to interview, we also open the door for conversations with our residents, our faculty, or any member of the OHSU community leading up to the interviews. We can help make connections with potential mentors/collaborators within or beyond our Department. This was a lot of fun last year, and helped connect applicants (both who matched with us and some who matched elsewhere) with people and organizations and start some great conversations — including with the Wy’east Pathway.

It remains a bit unclear whether interviews will be fully virtual, or a combination of in-person and virtual days. The COPA recommendations suggest they stay entirely virtual, and I do anticipate that at least some medical schools will not allow travel for interviews. We will support those applicants in doing virtual interviews. I thought that virtual interviews themselves went pretty well, and it is a time/hassle/carbon saving move. A potential disadvantage in that interview distribution gets thrown off, which is a risk. While the Thalamus data does not support this, clearly in any system there is the potential for issues. I can see why some programs are keen to return to in-person interviews, and we would love to show off our campus and city too! More to come on this issue — if possible, we will provide the opportunity for in-person interviews for those who are able to come and would find it helpful, and virtual interviews for others. While some may worry the two gets somehow different treatment, we ask for your trust for us to really not care either way. We managed to find amazing people during an entirely virtual year and can do it again.

One more thing…

As for an announcement — I’ve thought about this a lot. I have written to the NRMP to see if it is possible, and the response/implementation hasn’t been quick. But that is okay.

We will submit our final rank list no latter than 2/14/2022 — over two weeks before the due date of 3/2/2022. We will make no changes after Valentine’s Day. We will take daily screenshots to prove it. And if COVID-19 is under good control and anyone wants to visit Portland during that time, it is fine by us but totally optional. It won’t and cannot influence our decisions either way. We don’t need to know about travel plans, but if after 2/14/2022 you want to reach out and there is some way we can be helpful to your own decision-making process while in town, we are happy to do so within the confines of the Match rules. This is designed as to have no way to bear on our decision-making. Its purpose is to support applicants as big decisions are made, especially if interviews are all virtual again. Even if physical interviews are possible, some applicants may prefer to do them virtually for cost or logistical or other reasons. Then, closer to the rank list deadline, perhaps you want to visit a few cites to help with your final list. That makes more sense to me than flying all over the country for interviews, spending a minimum number of hours on the ground.

There would be no ability for applicants to feel pressured for this sort of ‘second-look-now-is-the-first-look’ opportunity, because the final rank list is already in. Even if applicants let us know they plan to visit… maybe those plans would then change at the last minute? After the residencies put in their final rank lists, of course? We would have little reason to take such communication seriously, and we won’t. I think this supports applicants and puts them first, as we should. It also has the advantage of being simple, and actually possible.

I’d love it if the NRMP made the Program Due Date earlier for all, or created a Final Answer button on the site. I can imagine a future where interviews are all virtual, and students then travel across the country (after final Program Lists are in ) for 7–10 days to help in making their final decisions. Whether or not this comes to pass, I think this is planning for the future. If we go through two years of virtual interviews, the arguments for going back seem to diminish further and that would be fine by me. If such a system were instituted more broadly, I could see this eliminating about 80% of travel (based on people optionally visiting 2–3 cities they don’t already know well, rather than going on ~10–12 trips for in-person interviews). And while it does not mitigate the problem of over-applications, or how the AAMC gets 40% of his revenue from ERAS applications, I think it is a step in support of applicants and am happy to make it happen for our program.

I have a lot of confidence in medical student applicants, and residency programs, to again adapt and respond to this Match cycle. If there is any way that I can help, please do not hesitate to reach out.

Stay safe, stay sane, and Good Hunting!

Kenny Gundle