Navigating Failure to Match in Orthopaedic Surgery

Orthopaedic surgery remains one of the most competitive specialties in the National Residency Matching Program. Despite the large number of medical students who do not match into orthopaedics, limited guidance exists for mentors to support these applicants. This review provides mentors with possible pathways and strategies to help ensure that applicants are best positioned to obtain a structured interim year that strengthens their research productivity, clinical experience, and faculty advocacy in preparation for reapplication. Mentors should also help applicants realistically assess their competitiveness and consider alternative specialties or parallel career pathways as part of early contingency planning. Although reapplicants face lower success rates in the orthopaedic surgery match, resilience, preparation, and mentorship can maximize their chances of a successful outcome.