A few questions from an M1

[Handinhand]

Hi all,

I am an M1 at a middle ranked private school in the midwest. I wanted to get a few questions answered from a wide range of people involved in EM instead of just the local opinion from a few people at my institution.

My first question is how competitive in the grand scheme of things is EM? What things could I start doing, besides focusing on doing well in my M1 classes to make myself a competitive student for EM?

So far I am getting involved in my school's wilderness medicine organization (I was recently elected to the position that will take over as president in my M2 year), which in cooperation with our global health program just had Dr. Auerbach of Stanford out to our campus to have multiple talks. This was a great opportunity and one I would love to continue as he was an amazing speaker and a contact I would like to keep up with over the next few years. I would also like to take on a leadership position in our global health organization.

I am also very interested in getting involved in global health research. Last week I met with a faculty member in our ER department who is involved with global health research, and was offered a possible research opportunity for this next summer. The project would be 10 weeks; 4 spent on campus, 6 spent in Vietnam doing traumatic brain injury prevention research through the Asia Injury Prevention Foundation (AIP). My next question has to deal with this. Although this sounds like a great opportunity, how is global health research viewed compared to more traditional research? If this research even leads to a publication, which might not happen, it's probably not going to be hugely influential in the grand scheme of things as it's only a 10 week project that could extend into my M2 year. I've also reached out to another faculty member about doing prehospital resuscitation research over the next few years during school, so hopefully something will come of that.

As far as career goals; I am fairly certain I will go into Emergency medicine, but I would also like go get my MPH with a global health emphasis or Masters in international health, as global health and wilderness medicine is something I would like to make a focus of mine long term. So far, the only schools I've seen that have EM programs and also have a good global health department seem to have fairly competitive programs (Harvard, Duke, Denver, UWash to name a few). What kind of accomplishments/ stats would an average resident of these EM programs have?

Thank you for any and all help you guys can give me. I know as an M1 this probably comes off as fairly neurotic; I don't mean it to, I would just like to start planning out what I need to start working on over the next 3 1/2 years.

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[KarlPilkington]

Here is my order of things to work on

1. Step I/II: Get a decent score and you'll interview anywhere you want.

2. Grades: Pre-clinicals are less important than clinicals, do better than half your class and you'll be fine. The goal is to do really well on your Medicine/Surgery rotations and avoid any red flag evaluations. Most folks can do this just by showing up, working hard, and not being a total oddball.

3. Research: This project sounds ideal, I'd do it in a heartbeat. Almost every applicant is loosely interested in wilderness and international medicine. Very few have any legit experience in regards to EM based research in these areas. I love both wilderness and International EM and have done a fair bit of both, but its VERY VERY hard to find any job that allows you to do these on anything other than a hobby/volunteer basis. I'd also talk to a lot of folks with MPH's before you took any time out of med school to add this degree. I know tons of folks with MPH's, I know zero folks who use them for anything. I can't remember the last time an applicant made a major move on the ranklist based on having an MPH. Not to say its worthless, but you don't need it to land a competitive residency slot, and you could easily get a wilderness or International fellowship where you get to work and get paid while getting your MPH.

Basically, focus on doing as well as you possibly can in med school, get involved with projects like this Vietnam thing. Don't piss people off 3rd and 4th year and you should be fine.



QUOTE=Diggidy;13364222]Hi all,

I am an M1 at a middle ranked private school in the midwest. I wanted to get a few questions answered from a wide range of people involved in EM instead of just the local opinion from a few people at my institution.

My first question is how competitive in the grand scheme of things is EM? What things could I start doing, besides focusing on doing well in my M1 classes to make myself a competitive student for EM?

So far I am getting involved in my school's wilderness medicine organization (I was recently elected to the position that will take over as president in my M2 year), which in cooperation with our global health program just had Dr. Auerbach of Stanford out to our campus to have multiple talks. This was a great opportunity and one I would love to continue as he was an amazing speaker and a contact I would like to keep up with over the next few years. I would also like to take on a leadership position in our global health organization.

I am also very interested in getting involved in global health research. Last week I met with a faculty member in our ER department who is involved with global health research, and was offered a possible research opportunity for this next summer. The project would be 10 weeks; 4 spent on campus, 6 spent in Vietnam doing traumatic brain injury prevention research through the Asia Injury Prevention Foundation (AIP). My next question has to deal with this. Although this sounds like a great opportunity, how is global health research viewed compared to more traditional research? If this research even leads to a publication, which might not happen, it's probably not going to be hugely influential in the grand scheme of things as it's only a 10 week project that could extend into my M2 year. I've also reached out to another faculty member about doing prehospital resuscitation research over the next few years during school, so hopefully something will come of that.

As far as career goals; I am fairly certain I will go into Emergency medicine, but I would also like go get my MPH with a global health emphasis or Masters in international health, as global health and wilderness medicine is something I would like to make a focus of mine long term. So far, the only schools I've seen that have EM programs and also have a good global health department seem to have fairly competitive programs (Harvard, Duke, Denver, UWash to name a few). What kind of accomplishments/ stats would an average resident of these EM programs have?

Thank you for any and all help you guys can give me. I know as an M1 this probably comes off as fairly neurotic; I don't mean it to, I would just like to start planning out what I need to start working on over the next 3 1/2 years.[/QUOTE]

 

[Laeno]

Your projects will probably help you regardless. A good rule of thumb is to stay involved, in things that interest you. You'll eventually have to talk about a lot of these things during interviews, so it'd be great if you actually liked them. I wouldn't get too caught up in the details of what exactly would be "perfect" for EM. You want tone unique, anyway.

It's pretty difficult to tease out stats for the "best" programs. Also, as many of the M4s here are realizing... The well known programs may not even fit you, or you it. You can get some general data with the charting outcomes (google that, a new set of data should come out this summer) data published by the NRMP. In general, though, you'll want scores and grades as high as possible--the field is getting more competitive.

You seem like a well read fellow, so I'll recommend this: http://www.amazon.com/The-Successful-Match-Succeed-Residency/dp/0972556176 . It's a bit hard core, but it covers everything, very well.

 

[Handinhand]

For Step 1, when you say get a good score and you'll interview wherever you want, what is a good score? Specifically a score you would need to most likely receive interviews at the more highly regarded programs? (I, like I'm sure a lot of people interested in EM, am very into the outdoors, and will be much more interested in residency out west compared to other regions. How competitive are programs in the bigger cities out west, like San Fran, Denver, Seattle, Salt Lake, and Portland, for example?)

As far as pre-clinical grades are concerned, will I need to be AOA? I'm most likely going to high pass or honors all of my first semester classes, but I doubt I will get AOA because I like to get out and have fun on the weekends, not spend them in the library like some people in my class do.

I fully intend to do the Vietnam research project because students that have worked on it in years past have said what an incredible experience it is; the fact that it will be viewed favorably is just a cherry on top. Would you think it to be necessary to try and get involved in the other CPR/Resuscitation research as well? From what I understand the PI is a fairly big name in EM research, and I thought it would be a good experience to work with him.

Thank you for all the help so far, and thank you for the book recommendation, I will have to check it out.

 

[FSU2013]

For Step 1, when you say get a good score and you'll interview wherever you want, what is a good score? Specifically a score you would need to most likely receive interviews at the more highly regarded programs? (I, like I'm sure a lot of people interested in EM, am very into the outdoors, and will be much more interested in residency out west compared to other regions. How competitive are programs in the bigger cities out west, like San Fran, Denver, Seattle, Salt Lake, and Portland, for example?)

As far as pre-clinical grades are concerned, will I need to be AOA? I'm most likely going to high pass or honors all of my first semester classes, but I doubt I will get AOA because I like to get out and have fun on the weekends, not spend them in the library like some people in my class do.

I fully intend to do the Vietnam research project because students that have worked on it in years past have said what an incredible experience it is; the fact that it will be viewed favorably is just a cherry on top. Would you think it to be necessary to try and get involved in the other CPR/Resuscitation research as well? From what I understand the PI is a fairly big name in EM research, and I thought it would be a good experience to work with him.

Thank you for all the help so far, and thank you for the book recommendation, I will have to check it out.

Be patient for a couple months. The NRMP publishes all of the match data every other year. For now, you can check the data on "Charting the Outcomes" from 2011. By all accounts, last year was somewhat more difficult to match than the year before and this year it is even more difficult. Some people are saying it's because more competitive applicants are applying to more places; others say there is increased interest by more competitive students. In all likelihood, it's a combination of both.

If you get a 240 on step1, I bet you can interview anywhere, although I doubt if you get a 230+ there would be any type of limitation based on test scores (this is purely speculation). Further, there has been increased interest in Step 2 CK over the past few years. You most certainly do NOT need to get AOA, but it wouldn't hurt. There are no specialties where you have to get AOA - think about it, it's only 15ish% of the class. There are a high percentage of AOA applicants in derm, radonc, ortho, etc, but even still I believe it's a sizable minority.

As far as location, I believe there is some regional bias. I have only gotten 2 rejections so far, but both of them were from programs in NYC and I'm applying from the SE without any externships in the area. May be completely random, but that seems to me like a regional bias.

Good luck! Relax. Try to enjoy med school.

 

[dally1025]

Be patient for a couple months. The NRMP publishes all of the match data every other year. For now, you can check the data on "Charting the Outcomes" from 2011. By all accounts, last year was somewhat more difficult to match than the year before and this year it is even more difficult. Some people are saying it's because more competitive applicants are applying to more places; others say there is increased interest by more competitive students. In all likelihood, it's a combination of both.

If you get a 240 on step1, I bet you can interview anywhere, although I doubt if you get a 230+ there would be any type of limitation based on test scores (this is purely speculation). Further, there has been increased interest in Step 2 CK over the past few years. You most certainly do NOT need to get AOA, but it wouldn't hurt. There are no specialties where you have to get AOA - think about it, it's only 15ish% of the class. There are a high percentage of AOA applicants in derm, radonc, ortho, etc, but even still I believe it's a sizable minority.

As far as location, I believe there is some regional bias. I have only gotten 2 rejections so far, but both of them were from programs in NYC and I'm applying from the SE without any externships in the area. May be completely random, but that seems to me like a regional bias.

As far as Step scores go, it is getting more competitive. My home program isn't a top name program by any means and their average Step 1 score last year was in the 230's. You can still match at a solid program with an average/below average step 1 score. I applied to some of the name brand programs with a Step 1 score in the 230's and I have only gotten 1 interview and a couple of waitlists from the more competitive programs. Could be they didn't like my personal statement or something besides my score but I'd wager you'd need a bit higher to get lots of interviews at the more competitive programs.

If you're not from the west but want to end up there you should do an away rotation out west. I was told EM is pretty regional before I applied and my interview offers have mostly been from my region (I did my away in my region).

As for the OP, relax, study hard and do your best, and don't worry about matching yet.

 

[my doc in a box]

If you get a 240 on step1, I bet you can interview anywhere, although I doubt if you get a 230+ there would be any type of limitation based on test scores (this is purely speculation). Further, there has been increased interest in Step 2 CK over the past few years. You most certainly do NOT need to get AOA, but it wouldn't hurt.

Good luck! Relax. Try to enjoy med school.

Not really.

I had a 245 step 1 (step 2 mid-250's but didn't come out till november) and senior AOA and only got 10 interviews out of 38 apps, a couple of which are "bottom of the barrel" type programs that I applied to as safeties. Only 2 of my interviews are at well-known good programs, I got no ivy league/hopkins-type invites, and the rest of my invites are middling. Some of my rejections were relatively crappy programs. I only got one invite at a program outside of my geographical region.

On the other hand, one of my interviewers told me I was a very competitive applicant and should match at the top 1 to 3 programs on my rank list.

This year's charting the outcomes will be very interesting, cause I'm bufuddled as hell.

My advice to you, MS1, is to have a look at that document when it comes out, and to have a very good faculty advisor/mentor. Also, don't be overconfident as I was, although I still believe my confidence was well-founded.

 

[Forthegood]

Not really.

I had a 245 step 1 (step 2 mid-250's but didn't come out till november) and senior AOA and only got 10 interviews out of 38 apps, a couple of which are "bottom of the barrel" type programs that I applied to as safeties. Only 2 of my interviews are at well-known good programs, I got no ivy league/hopkins-type invites, and the rest of my invites are middling. Some of my rejections were relatively crappy programs. I only got one invite at a program outside of my geographical region.

On the other hand, one of my interviewers told me I was a very competitive applicant and should match at the top 1 to 3 programs on my rank list.

This year's charting the outcomes will be very interesting, cause I'm bufuddled as hell.

My advice to you, MS1, is to have a look at that document when it comes out, and to have a very good faculty advisor/mentor. Also, don't be overconfident as I was, although I still believe my confidence was well-founded.

This was my experience to a tee. 38 programs, 14 invites, declined 2, waitlisted at like 5 or so. And I'm a solid applicant all the way around by the numbers and stuff on paper.

Truth is, I got the feeling a lot of these programs basically just reach in a hat and pull out a bunch of names and that's who they invite for an interview... so don't be stingy with your primary apps. APPLY BROADLY

 

[RustedFox]

"If you get a 240 on Step 1, I bet you can interview anywhere."


- Sorry, amigo. Not anymore. Things were getting smothery four years ago when I was an applicant. Since then... maaan.

 

[EMquest3]

"If you get a 240 on Step 1, I bet you can interview anywhere."


- Sorry, amigo. Not anymore. Things were getting smothery four years ago when I was an applicant. Since then... maaan.

Agreed, 250+ Step 1 here and currently batting 50% on interviews

 

[FSU2013]

Wow. Sorry to hear that....I had no idea it was that rough out there. My app is pretty similar to yours but I have been doing quite well. That's crazy.

 

[my doc in a box]

This was my experience to a tee. 38 programs, 14 invites, declined 2, waitlisted at like 5 or so. And I'm a solid applicant all the way around by the numbers and stuff on paper.

Truth is, I got the feeling a lot of these programs basically just reach in a hat and pull out a bunch of names and that's who they invite for an interview... so don't be stingy with your primary apps. APPLY BROADLY

I also look fab on paper and have a very well-rounded and interesting history/experiences, and was shocked at my results.

I sort of disagree with the bolded- this craziness is partly due to mass hysteria and overapplication particularly among the top tier applicants. I say apply broadly within your own geographical region, including the crappier programs, and limit apps to far-away programs to ones you are really really interested in. (in an ideal world). Rejections, even from out of region programs, will hurt your confidence.

The only invites I had which I can't reasonably drive to were from 2 programs that I personally emailed after meeting faculty at ACEP or having been born in the same city (so, "personal connection" made me a more attractive applicant, just like being from the same region would). There is a reason for the regionalism - I had to decline (my only interview decline of 10 invites) the offer from one of the out-of-region places due to travel time constraints.

 

[winkleweizen]

This is strange...I had no idea. Im competitive, but doesnt sound like im any more competitive then you guys (Good steps and decent grades but no AOA) and ive gotten interviews almost everywhere I applied.

Maybe stuff like SLORs really do make a big difference? Because ive been told mine are "Excellent" Or perhaps the reason ive gotten love on the other coast is becaues I did an away there? Hell, idk.


To the OP....Just do the best you can and try not to worry about "O I need a 250 or I wont match at Denver"

Good Steps, clinicals and SLORs=match success.

Get involved in **** you are interested in. And as far as solid programs with good MPH programs, check out UNC.

 

[EM2013woot]

I somewhat agree with what's being said here, though with a slightly different slant: my step 1 is south of 220 and I'm batting around 90% on interviews.

I somehow got all my reaches, but didn't get two more regional programs I'd liked to have interviewed at. I think what helped me big-time were my EM rotations and the marks/SLORs I got from those. I busted my rear to honor them and my letters (so I've been told) are outstanding.

Now I had looked at the NRMP program directors survey (google it) and saw that performance in EM rotations and SLORs are pretty much at the top of what PDs care about--but since all I've heard throughout med school is the paramount importance of step 1, I really couldn't believe that this was true. Well, now I sorta do. Regardless, I'm ridiculously shocked and feel insanely grateful with how things have gone since everybody and their mom is a crazy good applicant this year. I wish the OP and fellow applicants the best of luck.

 

[EM2013woot]

Good Steps, clinicals and SLORs=match success.

Awww shucks you just beat me to it. Congrats on your success hombre.

 

[dally1025]

I sort of disagree with the bolded- this craziness is partly due to mass hysteria and overapplication particularly among the top tier applicants.

Perhaps they overapplied but I think most people are sticking to 10-12 interviews. If overapplication from mass hysteria was the only cause of the 240+ step 1 crowd not getting the expected number of interviews they would have trickled down. Several of the programs I've interviewed at have said the number of med students at their program applying for EM has doubled and and in one place tripled from past years. Applying broadly doesn't hurt anyone as long as you don't hold onto interviews too tightly. Plus there are several less competitive programs that I thought I would get an interview at but haven't heard anything or been rejected. It's a crapshoot and you don't want to not match because you didn't apply broadly enough. However, it's not so competitive that someone with an average or even below average step 1 score won't match. I have a few friends with average or below average step 1 scores with 12+ interviews.

I've gotten a few interviews outside my region and if you're interested in moving to a different part of the country apply broadly. You never know if they may like you.

 

[dally1025]

I somewhat agree with what's being said here, though with a slightly different slant: my step 1 is south of 220 and I'm batting around 90% on interviews.

I somehow got all my reaches, but didn't get two more regional programs I'd liked to have interviewed at. I think what helped me big-time were my EM rotations and the marks/SLORs I got from those. I busted my rear to honor them and my letters (so I've been told) are outstanding.

Now I had looked at the NRMP program directors survey (google it) and saw that performance in EM rotations and SLORs are pretty much at the top of what PDs care about--but since all I've heard throughout med school is the paramount importance of step 1, I really couldn't believe that this was true. Well, now I sorta do. Regardless, I'm ridiculously shocked and feel insanely grateful with how things have gone since everybody and their mom is a crazy good applicant this year. I wish the OP and fellow applicants the best of luck.

I've been told that my SLORs and LORs are excellent (one PD said it is exactly what we want to see). At my last interview, the interviewer straight up told me I applied to way too many programs... It's probably a defensive mechanism but it seems like some of this is just a crapshoot.

 

[Forthegood]

I agree with just about everyone above on this. The reason I said and still think people should apply broadly (at least regionally) is I know several people who have been (what it seems to me) just downright unlucky and despite solid stats and stuff on paper, they haven't gotten many interviews.

I never would tell someone to send an app to a place they really couldn't ever imagine being. But really, most people don't have any idea what kind of programs they are applying to until they are there for the interview (or not even after).

Applying broadly can only hurt your pocket book, not your chances. And it's your future, so it's probably better to be safe and decline some than sorry and interview 5 times total. Just my 2 cents.

Us giving advice with people's futures based on our N=1 studies can be dangerous-- I guess I'd just rather be cautious.

 

[Handinhand]

Wow this thread exploded, thanks for all the advice guys and gals.

Why do you all think EM is becoming so competitive? What are some of the things you guys are seeing that applicants have or are doing to set them ahead of everybody else/ make them a unique applicant? I feel like anybody can get into a research project at most schools, get good grades and do well on Step 1, so what else do you think can set you apart specifically in EM?

Also, I didn't mean to make it sounds like I was shooting for a residency program in Denver, I just used it as an example for what I've read is a top EM program out west, which is the general area/type of program I believe I'd like to end up at. Will I be at a disadvantage coming from the midwest? I really don't enjoy it here (I love to backpack, rock climb and mountain bike and all three of those are pretty sparse/terrible out here) and look forward to leaving in 3 1/2 years if I can.

 

[EM2013woot]

Applying broadly can only hurt your pocket book, not your chances. And it's your future, so it's probably better to be safe and decline some than sorry and interview 5 times total. Just my 2 cents.

Agree 1000%. Don't go nuts applying to 50 programs, but I have a couple friends who were basically boasting about the "low" number of programs they applied to at the start of the season. I'm sure both will match, but both are kind of hurting for interviews right now, even though one is a solid applicant and the other is a freaking superstar on paper.

 

[EM2013woot]

I've been told that my SLORs and LORs are excellent (one PD said it is exactly what we want to see). At my last interview, the interviewer straight up told me I applied to way too many programs... It's probably a defensive mechanism but it seems like some of this is just a crapshoot.

Nah, you're correct that much of this is a crapshoot. Maybe it helped that all three of my EM rotations where in totally different parts of the country at very different, but well-regarded programs? I dunno.

 

[dally1025]

Wow this thread exploded, thanks for all the advice guys and gals.

Why do you all think EM is becoming so competitive? What are some of the things you guys are seeing that applicants have or are doing to set them ahead of everybody else/ make them a unique applicant? I feel like anybody can get into a research project at most schools, get good grades and do well on Step 1, so what else do you think can set you apart specifically in EM?

Also, I didn't mean to make it sounds like I was shooting for a residency program in Denver, I just used it as an example for what I've read is a top EM program out west, which is the general area/type of program I believe I'd like to end up at. Will I be at a disadvantage coming from the midwest? I really don't enjoy it here (I love to backpack, rock climb and mountain bike and all three of those are pretty sparse/terrible out here) and look forward to leaving in 3 1/2 years if I can.

EM is a relatively new specialty and it has a lot of advantages-shift work, pays very well for a 3 (or 4) year residency, and you can easily have a professional hobby. It's hard to say what really sets you apart. I don't think research will really mean that much (I have 3 papers including 1 first author paper-I have enough interviews but still wish I got some love from some other programs). If you're interested in it than by all means do it but don't do it unless you truly are interested. Do what you love most importantly. Give the people interviewing something to talk about. 90% of my interviews have been about my hobbies and interests.

You will be at a disadvantage coming from the midwest. I am interested in the west and only have 1 interview out there (with 3 waitlists). However, you can do your away out west which shows interest in the region which can drastically increase your number of interviews from that area. A guy in my class did just that and has several interviews. However, I have gotten several interviews in the Carolinas area-all have nice outdoorsy stuff. Wasn't what I was originally going for but after seeing the area it has what I'm looking for (just not so much the skiing).

 

[bad virus]

I'm going to take a slightly different slant than the others on here in terms of advice.

I was pretty much just like you, all bushy tailed, bright eyed and excited about EM. The only reason I wanted EM is because they did everything and it was one of the few fields that hasn't been developed academically over seas in 2nd world countries. I knew I wanted to die leavng behind a few newely developed training programs for people over seas so they could serve their populations long after my bones turned to dust.

I also took the advice of others who said you never know what you will be interested in at the end of the ride so just be all that you can be in med school. For the most part, this was true as I skirted around Ortho, Peds and Gen Surge. But just like the prodigal son, I returned to EM.

All I knew for sure is that I wanted to take the supreme advantage of medical school while I was there, and I did. I didn't even know what AOA was until they asked for my resume' 3/4 of the way through 3rd year. A month later they sent me a letter that said congratulations.

I will reiterate, what winkle said. Please focus on stuff you love. For me this was my local communty around where I lived and I continued developing programs and things I loved doing before med school for thar place. I am hoping to leave fourth year behind with a low income clinic that is running without my help at all. Just please focus on things you love or it will be a pain to do them instead of an exciting adventure. I remember one of my undergarad research projects being the bain of my existance because I hated it.

Anyway, you probably already know this, but focus on all you love and destroy your studies and you will be happy where you land. You will probably end up in EM (which is becoming the new ortho) but you never know what you will want to match into, so keep all doors open. Even if it is peds, CHOP and Hopkins only skim off the top 10%.

Good luck my friend.

 

[bad virus]

Agree 1000%. Don't go nuts applying to 50 programs, but I have a couple friends who were basically boasting about the "low" number of programs they applied to at the start of the season. I'm sure both will match, but both are kind of hurting for interviews right now, even though one is a solid applicant and the other is a freaking superstar on paper.

Not totally true. This process was a total crap shoot. my best friend and I are from different schools and were hoping to match at the same program but who knows. Anyway, we both got told to apply to 30+ programs, but think about it. Can you really think of 30+ places you would be happy to live in. We couldn't. We broke our backs finding 22. He is your standard 220+ applicant and I am more on par with the dudes that posted above. we are both batting 18/22 at the end of this and guess what; I got rejections from USC and Denver and he got invites. You never know what programs will see in your app that makes you look awesome to them.

 

[dally1025]

Nah, you're correct that much of this is a crapshoot. Maybe it helped that all three of my EM rotations where in totally different parts of the country at very different, but well-regarded programs? I dunno.

I only did 1 away but it was at a well-regarded program notorious for not inviting rotators back for an interview and I got an interview so they had to like me. Maybe I should have done another away? Or done my away in a different part of the country? Who knows. Maybe after all the stats are out next year we will have a better idea. I did the best I possibly could and have no regrets. At the end of the day, that's all anyone can ask for.

 

[EM2013woot]

Can you really think of 30+ places you would be happy to live in.

I guess we're coming at it from different points of view.

You really had trouble coming up with 20-30 places?? After going through frieda and the program websites, I had easily found 60 programs that looked great to me for varying reasons (and no, I applied to nowhere near that many). I've lived in tiny towns and major cities and in radically different parts of the country and have been happy everywhere. My modus operandi is to train at the best program for me. I'm obviously looking for a great "fit," but I'm also looking for some very specific things in a program and am happy to go to someplace new as long as I like the environment that's lit with fluorescents and 72 degrees year-round. I can live anywhere for 3-4 years.

Oh, and there are tons of places in the country with more than 1 EM program...so it's not really necessary to come up with 30 totally different places unless you have extremely specific requirements.

 

[bad virus]

I guess we're coming at it from different points of view.

You really had trouble coming up with 20-30 places?? After going through frieda and the program websites, I had easily found 60 programs that looked great to me for varying reasons (and no, I applied to nowhere near that many). I've lived in tiny towns and major cities and in radically different parts of the country and have been happy everywhere. My modus operandi is to train at the best program for me. I'm obviously looking for a great "fit," but I'm also looking for some very specific things in a program and am happy to go to someplace new as long as I like the environment that's lit with fluorescents and 72 degrees year-round. I can live anywhere for 3-4 years.

Oh, and there are tons of places in the country with more than 1 EM program...so it's not really necessary to come up with 30 totally different places unless you have extremely specific requirements.

Point taken, but can you really come up w/ 30 county/academic hybrid programs that you and your SO can see yourself living at? I was very picky on what I was looking for.

 

[Handinhand]

You will be at a disadvantage coming from the midwest. I am interested in the west and only have 1 interview out there (with 3 waitlists). However, you can do your away out west which shows interest in the region which can drastically increase your number of interviews from that area. A guy in my class did just that and has several interviews. However, I have gotten several interviews in the Carolinas area-all have nice outdoorsy stuff. Wasn't what I was originally going for but after seeing the area it has what I'm looking for (just not so much the skiing).

Did you do an away rotation out west? How many away rotations do people normally do? From what I understand they are usually weeks long and I'm assuming you need to do them early to get them on your application, so is 2-3 the normal number? How do away rotations work? Do you apply to a school in your third year to try and rotate there? How do away institutions decide who comes? I'm assuming top tier programs get more applicants for away than they can actually invite.

Anyway, you probably already know this, but focus on all you love and destroy your studies and you will be happy where you land. You will probably end up in EM (which is becoming the new ortho) but you never know what you will want to match into, so keep all doors open. Even if it is peds, CHOP and Hopkins only skim off the top 10%.

Good luck my friend.

Thanks for all your advice. I fully intend on doing what I'm passionate about. I am definitely going to do my Vietnam project next summer, and also want to get involved in local outreach clinics dealing with the fairly large immigrant & refugee population my city has.
Global health is definitely a huge career interest of mine, which is why on top of the reasons you listed, I'm drawn to EM, because it seems to lend itself well to working in developing countries.

You also sound like you're a competitive applicant. Have you been pretty happy with the application process so far (besides the rejections to Denver and USC, which I'm guessing can be attributed to the random crap shoot nature of the process)? Have any schools that declined to interview you given you any comments on why they chose not to, or any other feedback on your application? Are you also interested in moving out west, or are you already from there?

 

[dally1025]

Did you do an away rotation out west? How many away rotations do people normally do? From what I understand they are usually weeks long and I'm assuming you need to do them early to get them on your application, so is 2-3 the normal number? How do away rotations work? Do you apply to a school in your third year to try and rotate there? How do away institutions decide who comes? I'm assuming top tier programs get more applicants for away than they can actually invite.

I did my away rotation in the SE and I think I've been luckier than most (I at least have 1 interview out west). A guy in my class did his away out there and has had a little more luck than I have so if you're interested in that area by all means go out west for your away. Most people do 1 away, some do 2, and a few do 3 (if you don't have an EM program than you should probably do at least 2). They last 4 weeks (there might be a couple of tox rotations that last 2 weeks but I'm not sure) and usually done early in your 4th year. You apply during the winter/spring of your 3rd year. The key is just to apply early. Most aways are first come first serve while others actually select the candidates.

 

[Handinhand]

I did my away rotation in the SE and I think I've been luckier than most (I at least have 1 interview out west). A guy in my class did his away out there and has had a little more luck than I have so if you're interested in that area by all means go out west for your away. Most people do 1 away, some do 2, and a few do 3 (if you don't have an EM program than you should probably do at least 2). They last 4 weeks (there might be a couple of tox rotations that last 2 weeks but I'm not sure) and usually done early in your 4th year. You apply during the winter/spring of your 3rd year. The key is just to apply early. Most aways are first come first serve while others actually select the candidates.

Good to know. My school does have an EM program which I've read is regarded pretty well. I've also started to try and cultivate relationships with EM faculty here, including the department chair, as he's also big into global health (that's how I started talking with him, I only found out he was the department chair after I had already met with him). I figure having the chair know who I am should be a good thing when it comes time to get letters of recommendation and also to get advice from, yeah?

 

[my doc in a box]

Good Steps, clinicals and SLORs=match success.
.

I'll echo this. Because I had awesome pre-clinical and good step 1, and had largely burned myself out during years 1+2 as a result, and honors in 3/6 3rd year clinicals, I cruised through my home and away rotation with a high pass at both. Everyone had nice things to say about me but I don't think I had anybody really go to bat for me. Other than not going to a top 20 med school, and taking step 2 later in October, I think having good but not outstanding letters hurt me - deservedly so. I was overconfident - learn from my fail. Unfortunately you really can't hit cruise control until match day.

 

[raotattoo]

TIL that everyone has a theory about interview/match success and that these theories are frequently conflictual/contradictory. It's pretty safe to conclude that everyone is throwing around anecdotal evidence.

Obviously, getting the best grades/SLORs/CV you can is important. Going to a name brand medical school is useful. Going to a foreign medical school will hurt you. Applying strategically is important. Sending thank you notes is done by some, but I'm betting most people who match don't send them. There is really no single correct way to play this game; some people who play correctly are going to lose and a few dirt bags are going to win.

Do the best you can. If you're a decent human being along the way, there's a good chance that you'll succeed.

 

[mcworbust]

Thanks everyone for all the info/advice, very helpful (but scary how competitive it seems to be getting)!

I am a M1 in a similar situation to the OP and am hoping to stay at my institution if possible as my fiance is an M3 at the same place and will be trying to stay at our current school as well. Any advice for how to plan out M4 year? I was thinking multiple EM rotations (well, I guess an EM rotation and then another rotation heavy in EM) at my home institution and only 1 away, as opposed to 1 home and 2 away rotations.

I know its a few years out and I shouldn't worry about it now, but Devo is driving me crazy and I had to find something else to do for a bit

Any advice would be appreciated, thanks!

Do the best you can. If you're a decent human being along the way, there's a good chance that you'll succeed.

If I know the OP (and I think I do, 619 represent!), he's got that last part down - damn decent human being

 

[Handinhand]

Hey guys, just wanted to revive this thread and get some more recent info from everyone now that match day came and went.

Do you think EM got any more competitive compared to last year? To the M4s that just matched, first of all congrats for being done; I was wondering what you thought of the interview process/ how difficult it was compared to the perceptions you had before you started?

I wanted to ask about research again. I am definitely going to Vietnam now this summer for ~6 weeks for the same research project before (Research looking into increasing compliance in children for wearing their helmet to decrease TBI's related to motorcycle bicycle accidents). Doesn't seem to be a long term research project that I can really "hang my hat on", but I think it will be a great for getting some ER related global health work under my belt.

I am also planning on joining a clinic EM research lab at my school that does some pretty significant research that's affiliated with the NETT program at UMich. What I wanted to know though was do you think research is all that necessary for EM, especially with my Vietnam project? I still plan on doing both projects, but that lab is very big and I'm wondering if I should just sit back, help out where I can and learn as much as I can, or be more forward and try and get my own project? It doesn't sound like research is #1 for being competitive in EM, so what do you all think about being bull headed and trying to get a publication from the work?

Thanks again for any more help

 

[benzonase]

Incoming M1 here...dead set on EM but the tone of everyone towards the growing competitiveness of EM on this board over the last 3 years has me increasingly worried. I am also wondering what are the little things I could be doing besides getting good grades/steps.
what about shadowing an EP during 1st and 2nd year? would that be a worthwhile thing to do? I feel like it could help me prepare for my EM rotations

 

[The White Coat Investor]

A lot of paranoia on here about board scores. I know I'm a little older than most on here, but even with exceptional board scores (and no, I don't consider 240s exceptional) I didn't get to interview everywhere I applied. I got 28/30, which was about 18 more than I needed. But guess what? There were still two places that didn't even offer me an interview. What does that tell you? There's more to it than board scores.

Yea, if you got a 192 you're going to struggle. But a 240? Come on. Give me a break. I doubt anywhere uses a cut-off above 230 (someone correct me if I'm wrong). The average EM program probably doesn't use a cut-off at all. Just like getting into medical school, it's all about the whole package. People that get 250s on their boards (and 40s on their MCATs and 1500 on their SATs and 95s on their in-service exams) tend to have good grades, write well, interview well, and be involved in lots of cool stuff. It isn't just the scores folks.

 

[Akail]

I'll bite.

Yeah, EM is probably more competitive now than it was in the past. Realistically though, it's not at the point where matching is a foregone conclusion for the "average" (referencing the real average, not SDN derm) applicant. Try to do your best on boards. I think that if you're the 220s on both steps type with above average SLORs, you'll get enough interviews to match. You may not get a lot of love from the perennial high-tier residencies, and you may not exactly go where you want to, but you'll go somewhere and more than likely, it'll be a solid program. There's only so much you can do; it's better to be worried and use that for motivation on strengthening your app than being complacent and expecting interviews by default. Study hard, work harder and do your best. Research the programs that you're applying to/interviewing at. I feel like a lot of people put more attention towards what they think will be their top 1-3 programs. Focus on being one of the winners that can post a ROL on here and legitimately say "would be happy to match at any of these 13 programs".

 

[lek11]

M3 here with a very, very subpar Step 1. The increasing competitiveness concerns me, but the crapshootiness described in this thread is actually a little encouraging. I'm also very encouraged to hear that EM residencies generally value Step 2 more than other specialties. I'm a very capable student at a top school, but I ran into some medical problems that derailed me for awhile so I ended up with only a couple weeks to study for Step 1. Honestly, I'm lucky I passed. I should have taken time off, but I didn't, and I have to figure out how to move forward from here.

I know EM residencies tend to care less about research, but I'm considering taking a year off for EM-specific research. I could also use the time to rehab my medical issues and make sure I kill Step 2. I think a 50-60 pt improvement is a real possibility here. Multiple faculty members at my school have expressed their willingness to help me explain my situation to residency programs when the time comes. I've definitely dug myself into a hole, but I feel lucky that EM seems to more highly weigh Step 2, personality in interviews, etc. Fingers crossed.

 

[John Lannister]

M3 here with a very, very subpar Step 1. The increasing competitiveness concerns me, but the crapshootiness described in this thread is actually a little encouraging. I'm also very encouraged to hear that EM residencies generally value Step 2 more than other specialties. I'm a very capable student at a top school, but I ran into some medical problems that derailed me for awhile so I ended up with only a couple weeks to study for Step 1. Honestly, I'm lucky I passed. I should have taken time off, but I didn't, and I have to figure out how to move forward from here.

I know EM residencies tend to care less about research, but I'm considering taking a year off for EM-specific research. I could also use the time to rehab my medical issues and make sure I kill Step 2. I think a 50-60 pt improvement is a real possibility here. Multiple faculty members at my school have expressed their willingness to help me explain my situation to residency programs when the time comes. I've definitely dug myself into a hole, but I feel lucky that EM seems to more highly weigh Step 2, personality in interviews, etc. Fingers crossed.

A year off to research? Just do well on rotations and take step 2.

 

[Arcan57]

A year off to research? Just do well on rotations and take step 2.

A year off needs a good explanation. Some explain themselves (MPH/MBA/NIH fellowships). Outside of those, I don't think a random year in the lab helps except to try an build a relationship for getting into that particular program. Most programs aren't as enamored of researchers as the name-brand IM and surgery programs.

 

[fahimaz7]

Be patient for a couple months. The NRMP publishes all of the match data every other year. For now, you can check the data on "Charting the Outcomes" from 2011. By all accounts, last year was somewhat more difficult to match than the year before and this year it is even more difficult. Some people are saying it's because more competitive applicants are applying to more places; others say there is increased interest by more competitive students. In all likelihood, it's a combination of both.

If you get a 240 on step1, I bet you can interview anywhere, although I doubt if you get a 230+ there would be any type of limitation based on test scores (this is purely speculation). Further, there has been increased interest in Step 2 CK over the past few years. You most certainly do NOT need to get AOA, but it wouldn't hurt. There are no specialties where you have to get AOA - think about it, it's only 15ish% of the class. There are a high percentage of AOA applicants in derm, radonc, ortho, etc, but even still I believe it's a sizable minority.

As far as location, I believe there is some regional bias. I have only gotten 2 rejections so far, but both of them were from programs in NYC and I'm applying from the SE without any externships in the area. May be completely random, but that seems to me like a regional bias.

Good luck! Relax. Try to enjoy med school.

255+ here and I went 20/22 invites. Didn't hear back from UW or UCSF though. Did get OHSU and Davis and Stanford. A 240 doesn't buy you interviews "anywhere," but what it does do is almost guarantee you an acceptance somewhere.

With that said, getting a 240+ is a hard thing and is not guaranteed at all. Do the best you can in class to help you out when the time comes.

 

[fahimaz7]

M3 here with a very, very subpar Step 1. The increasing competitiveness concerns me, but the crapshootiness described in this thread is actually a little encouraging. I'm also very encouraged to hear that EM residencies generally value Step 2 more than other specialties. I'm a very capable student at a top school, but I ran into some medical problems that derailed me for awhile so I ended up with only a couple weeks to study for Step 1. Honestly, I'm lucky I passed. I should have taken time off, but I didn't, and I have to figure out how to move forward from here.

I know EM residencies tend to care less about research, but I'm considering taking a year off for EM-specific research. I could also use the time to rehab my medical issues and make sure I kill Step 2. I think a 50-60 pt improvement is a real possibility here. Multiple faculty members at my school have expressed their willingness to help me explain my situation to residency programs when the time comes. I've definitely dug myself into a hole, but I feel lucky that EM seems to more highly weigh Step 2, personality in interviews, etc. Fingers crossed.

60 points step 2 improvement? Not to be an ass, but I think you might be a little too optimistic there. I think it's realistic to hope for a 15-30 point improvement. Can't say I've ever heard of someone going from a 210 to a 270 between step 1 and step 2. Not even sure it's possible tbh. Either way, good luck in your future endeavors.

 

[Hercules]

A year off needs a good explanation. Some explain themselves (MPH/MBA/NIH fellowships). Outside of those, I don't think a random year in the lab helps except to try an build a relationship for getting into that particular program. Most programs aren't as enamored of researchers as the name-brand IM and surgery programs.

Completely agree and think this would be a poor use of your time unless you really need that time to recover medically.

 

[EM2013woot]

It isn't just the scores folks.

Spot on. The sky is not falling and here's another dose of anecdotal stuff: after just going through the match and talking with classmates throughout the process it seems that while board scores aren't unimportant, EM rotation grades and SLORs are far more important.

The guy with 220/230, all EM honors, and glowing letters is probably going to get more invites than the 240/260 guy with high passes and "fine" letters. Obviously the higher your board scores are the better, but doing well on your EM rotations can really make you stand out and can certainly make up for lower board scores.

My step 1 was below average (<220) and I got interviews at all but a couple places I applied. I got all my "reach" interviews and matched at my dream program. I am not special (my school isn't top 5, not AOA, bad dancer, etc). To future EM applicants: take a breath, work your butt off on your EM rotations, and remember that you are more than your board scores.

 

[Dane07MD]

255+ here and I went 20/22 invites. Didn't hear back from UW or UCSF though. Did get OHSU and Davis and Stanford.

To add to the crapshoot of it all.

I had below a 220 on step 1, and did get an interview at UCSF and Davis, but no love from Stanford, OHSU, or UW. I interviewed at some other great places, and got rejected from other places that surprised me. Was offered 23 interviews on 30 apps, and went to 14 (probably 1-2 too many).

It's a whole package thing, step scores alone can't ever predict where you'll interview, but even those of us with below average step 1 scores still match, and usually in a top choice even still.

 

[Akail]

To add to the crapshoot of it all.

I had below a 220 on step 1, and did get an interview at UCSF and Davis, but no love from Stanford, OHSU, or UW. I interviewed at some other great places, and got rejected from other places that surprised me. Was offered 23 interviews on 30 apps, and went to 14 (probably 1-2 too many).

It's a whole package thing, step scores alone can't ever predict where you'll interview, but even those of us with below average step 1 scores still match, and usually in a top choice even still.

What year did you apply in?

 

[Dane07MD]

I applied last year (ie I'm about to finish my intern year). It was the first year UW was on the ERAS app.

 

[Handinhand]

Hey guys, just wanted to update this and see if anymore people want to give experience/advice to myself and the loads of other kids that I'm sure are in a similar situation to me.

So I ended up going to Vietnam this summer and working on the research project I spoke of earlier. I was there for 6 weeks, and will be working on finishing up my literature review/research over this next semester. Seeing as I still have work to finish on this project, and my 2nd year is looking at being very busy school wise, I don't think I'm going to get involved in the large, clinical EM research I spoke of before. Do you all think the project in Vietnam will be sufficient research for competitive EM programs? I loved my experience there, and the work was on helmet use/ injury prevention education, so it's highly relevant to EM I feel. I just don't know how only having a 6 week project will look to some people.

I am now the president of my wilderness medicine society here at school. I'm not sure if that adds a terrible amount to any future application. It should be a nice connection to get involved with the docs at school that are involved in WMS though, and I've convinced the school to pay for rock climbing trips, so that's a bonus as well haha.

I don't know if I mentioned it before, but I worked as an EMT for a volunteer 911 service for 4-5 years throughout undergrad and during my year off before medical school. I recently made the decision to stop volunteering, as my old service is more than an hour away from school and it just wasn't going to happen 2nd year. I was wondering if this is something that I should mention as a past experience? The majority of my time EMTing was in undergrad so I was curious if that's still something that can be put down on applications.

Also, I've began reading through advice for Step 1 studying. I am trying to set a difficult but realistic goal of scoring in the 240-250 range. I understand that may not be possible, but it sounds like that's a very good score for applying to any EM program, and so I'm going to try my hardest over the next year to put myself in the position to achieve that score.

Besides all of that, is there anything else that you all suggest I start doing? It sounds like EM rotations and letters of rec are the most important things for EM residency applications, but I am almost 100% positive that I'd like to go into EM, so if there's anything more I could do now that could put me ahead I'd love to hear it.

 

[Handinhand]

Hey guys, sorry to be that annoying med student again. I was just hoping to get some answers to the above questions, as well as one about grades.

I was recently told by a EM faculty member at my home institution that pre-clinical grades are looked at pretty closely for the EM match these days. That went against much of what I've read in the past, but I was curious if this was changing?

Thanks!

 

[b-real]

Hey guys, sorry to be that annoying med student again. I was just hoping to get some answers to the above questions, as well as one about grades.

I was recently told by a EM faculty member at my home institution that pre-clinical grades are looked at pretty closely for the EM match these days. That went against much of what I've read in the past, but I was curious if this was changing?

Thanks!

With the myriad grading systems between schools, nobody is giving much weight to preclinical grades, assuming you haven't failed any courses. Step 1, step 2 (probably just as important as step 1) and clinical grades are where it counts.