EM match for someone with poor scores

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Smiths11

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Hi everyone,

Third year DO here, and have a big decision to make very soon. I've asked this in another part of the forum but I figured the EM forum would give better advice. I am interested in either EM or Gas. I love both of them for different reasons and honestly would be happy with either or. I have relatively low Step 1/COMLEX 1 scores and therefore need to choose strategically.

I've done a lot of research and have gathered that for EM programs, auditions, SLOEs and Step 2 scores carry more weight than they do for other programs, and this especially holds true for AOA residencies. ASSUMING that I improve on Step 2 and do very well in auditions, would it be smarter for me to rotate at/shoot for AOA programs? Should I just forget about going for Gas?

Or, is EM so competitive now that with my lower scores I should focus on Gas? Or, do the Step 2/auditions not carry as much as weight for EM as I think and, again, I should just go for Gas?

I wish there was a way for me to cross post this on the Anesthesia forum because I don't think I should repost yet again there.

Thanks in advance for all the advice.
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Smiths11 said:
Hi everyone,

Third year DO here, and have a big decision to make very soon. I've asked this in another part of the forum but I figured the EM forum would give better advice. I am interested in either EM or Gas. I love both of them for different reasons and honestly would be happy with either or. I have relatively low Step 1/COMLEX 1 scores and therefore need to choose strategically.

I've done a lot of research and have gathered that for EM programs, auditions, SLOEs and Step 2 scores carry more weight than they do for other programs, and this especially holds true for AOA residencies. ASSUMING that I improve on Step 2 and do very well in auditions, would it be smarter for me to rotate at/shoot for AOA programs? Should I just forget about going for Gas?

Or, is EM so competitive now that with my lower scores I should focus on Gas? Or, do the Step 2/auditions not carry as much as weight for EM as I think and, again, I should just go for Gas?

I wish there was a way for me to cross post this on the Anesthesia forum because I don't think I should repost yet again there.

Thanks in advance for all the advice.
Click to expand...

SLOE's and Auditions are extremely important. Also, you should probably post your scores. There's a difference between a 198 and a 220.
 
How low of a STEP1 score are we talking about? It's difficult to offer realistic advice without information that should have been included in the OP.
 
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Smiths11 said:
Hi everyone,

Third year DO here, and have a big decision to make very soon. I've asked this in another part of the forum but I figured the EM forum would give better advice. I am interested in either EM or Gas. I love both of them for different reasons and honestly would be happy with either or. I have relatively low Step 1/COMLEX 1 scores and therefore need to choose strategically.

I've done a lot of research and have gathered that for EM programs, auditions, SLOEs and Step 2 scores carry more weight than they do for other programs, and this especially holds true for AOA residencies. ASSUMING that I improve on Step 2 and do very well in auditions, would it be smarter for me to rotate at/shoot for AOA programs? Should I just forget about going for Gas?

Or, is EM so competitive now that with my lower scores I should focus on Gas? Or, do the Step 2/auditions not carry as much as weight for EM as I think and, again, I should just go for Gas?

I wish there was a way for me to cross post this on the Anesthesia forum because I don't think I should repost yet again there.

Thanks in advance for all the advice.
Click to expand...

What was your step 1 score? Low meaning 220? Low meaning 198? Completely different answer to your question.
 
Sorry, I am in the 210-220 range for Step 1. 420-430 for COMLEX 1
 
Smiths11 said:
Thanks, appreciate it.

I'm in the process of applying for auditions and time is critical, hence the quick bump.

But please, feel free to dig up past threads in order to put people down. You must live an interesting life.
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Why not just review previous posts that have similar scores as yours? Also bumping your own thread after a couples hours is just......


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Makati2008 said:
Why not just review previous posts that have similar scores as yours? Also bumping your own thread after a couples hours is just......


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Click to expand...

I've been doing that. I've read pretty much all of the EM vs Gas threads. But my situation is unique, hence the new thread - and probably why we have 20 threads on similar, but not exactly the same, topics.
 
Smiths11 said:
I've been doing that. I've read pretty much all of the EM vs Gas threads. But my situation is unique, hence the new thread - and probably why we have 20 threads on similar, but not exactly the same, topics.
Click to expand...

How is your situation unique.


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Makati2008 said:
I obviously did but do not see how it's different. People apply to multiple specialties every year.


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Click to expand...

Because I am asking which one from the two is better from a strategic perspective based on competitiveness, not which one is better fit for my personality/I'll enjoy more (like every other EMvsGas thread).
 
Smiths11 said:
Because I am asking which one from the two is better from a strategic perspective based on competitiveness, not which one is better fit for my personality/I'll enjoy more (like every other EMvsGas thread).
Click to expand...

So your question isn't different at all? Just compare scores for both specialties and go from there. With your AOA scores you aren't very competitive at the top tier of programs. Acgme would be better serve by someone else. I matched acgme but know the aoa world better


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Doctor4Life1769 said:
Your COMLEX scores suck but your USMLE is probably OK to get into an anesthesia program. Idk about EM programs. But I will say you should not pursue anesthesia.
Click to expand...

Why do you think I shouldn't pursue anesthesia?

And lets say Step 2 dramatically improves + great SLOEs, does that tip the hand in favor of EM?

Thanks again
 
Smiths11 said:
Why do you think I shouldn't pursue anesthesia?

And lets say Step 2 dramatically improves + great SLOEs, does that tip the hand in favor of EM?

Thanks again
Click to expand...
Your scores are not super competitive for either as both need similar scores to get in, but doesn't mean either speciality is out of reach. Getting a 240 on step 2 doesn't mean you will get an EM spot, nor does it mean you will get anesthesiology spot. Do the best you can on step 2, do anesthesiology and EM rotations, and make a decision for yourself. Apply broadly AOA and ACGME in either speciality and let the chips fall where they may.
 
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Your scores as they are aren't competitive for EM and I doubt they would be competitive for gas. Only by knocking step 2 out of the park will you have a chance at either. No one can realistically say which specialty you will have a better shot in but its fair to say if you become competitive for EM you will also be competitive for gas. Regardless of what you decide I would apply to either IM or FM programs as back up.
 
Smiths11 said:
Hi everyone,

Third year DO here, and have a big decision to make very soon. I've asked this in another part of the forum but I figured the EM forum would give better advice. I am interested in either EM or Gas. I love both of them for different reasons and honestly would be happy with either or. I have relatively low Step 1/COMLEX 1 scores and therefore need to choose strategically.

I've done a lot of research and have gathered that for EM programs, auditions, SLOEs and Step 2 scores carry more weight than they do for other programs, and this especially holds true for AOA residencies. ASSUMING that I improve on Step 2 and do very well in auditions, would it be smarter for me to rotate at/shoot for AOA programs? Should I just forget about going for Gas?

Or, is EM so competitive now that with my lower scores I should focus on Gas? Or, do the Step 2/auditions not carry as much as weight for EM as I think and, again, I should just go for Gas?

I wish there was a way for me to cross post this on the Anesthesia forum because I don't think I should repost yet again there.

Thanks in advance for all the advice.
Click to expand...

So, as others have pointed out, nothing is novel is about this situation, unless there is something else you're not sharing w/ us.

Anyhow, your research is correct. I don't think that SLOEs (which not all the AOA progams use), Step 2/Level 2, or auditions are more important for AOA vs ACGME; I think that they are equally important for both sides for different reasons. I know that my ACGME program would not interview or rank a DO applicant that did not interview, had poor SLOES, or poor board scores.

I had basically the exact same scores for both COMLEX and USMLE. I only applied ACGME and did not apply to other specialties, specifically to maximize my opportunities in the one thing I wanted. I would advise others in similar situations to do the same, but different people have different levels of risk tolerance. In my biased opinion, EM's emphasis on the SLOE makes it difficult for applicants to split their time.

First, you need to relax and pick a specialty.
 
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Damn you guys are dicks. This forum has become a snake pit lately.

I don't know who you pissed off to warrant the above responses but I have no idea who you are and will give you an honest assessment. First you need to pick a specialty, entertaining your options is cool as a med student but you are about to decide what you will do for the rest of your life, weigh the pros and cons and be decisive. I had the same scores as you but was set on EM. I knew step 2 would make or break my ACGME apps so I when I applied for auditions I hedged my bets and applied for 1 straight AOA place, a dual accreditation place, and two ACGME spots.

I applied AOA on July 15th and and later that month found out that I did well on step 2 with a 30+ point increase. I scheduled 15 AOA interviews as late as I could and waited to see what happened with my ACGME apps. The ACGME invites started rolling in during October and by the end of the month I cancelled all of the AOA interviews and put my money on ACGME, which is where I matched.

You could definitely apply to two specialties but they are both competitive so it would be cost and time prohibitive. You would literally need to apply to like 150+ programs and do 6+ auditions to give yourself a fair shot in each specialty, make that 200+ and 6+ if you are planning to apply AOA/ACGME EM and Anesthesia.

So best advice is pick a specialty, apply AOA when it opens, crush step 2, apply ACGME when it opens, revisit your strategy and commit based on step 2 score and program interest. If you bomb step 2 then consider IM/FM backups.
 
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Smiths11 said:
Sorry, I am in the 210-220 range for Step 1. 420-430 for COMLEX 1
Click to expand...

I received 210-215 range USMLE step 1 and got into an allopathic residency. However, I improved 20+ points on step 2. If I were you, I would decide between two choices. You can go all in AOA and rotate at 3-4 reasonable AOA programs. Or, if you really want ACGME, you can split your 4th year with 1-2 AOA auditions and 1-2 ACGME auditions. Regardless of the path you choose, you must do well in auditions, do well on step 2, and apply broadly. EM (both AOA and ACGME) is only getting more competitive each cycle,but it's not out of the question for you just yet.
 
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tbh, both your USMLE and COMLEX scores are probably too low for EM. You may be able to match ACGME but IMO those scores are too scary to go only ACGME. Though if EM is where your heart leads you, I would go AOA, get a bunch of aways, and work your a$$ off. That's probably your best bet. Can't comment on Anesthesia, but you might be ok for ACGME. Not enough experience to comment further.

Either way, you should CRUSH Step 2/Level 2. And try to take it early so it's on your apps.

Good luck
 
Smiths11 said:
Because I am asking which one from the two is better from a strategic perspective based on competitiveness, not which one is better fit for my personality/I'll enjoy more (like every other EMvsGas thread).
Click to expand...

Strategically? This is not House of Cards. You are thinking about this wrong. Pick a specialty you like best and apply to that one. End of story.

What strategic advantage is there to going to a slightly better/more competitive program if it's in the wrong specialty? Anesthesia and EM are two very different worlds. While there is some overlap, there is a world of difference in day to day practice. You may end up in the best EM program in the country, but if a couple of years later you realize that was the wrong choice and you would be much happier in anesthesia, or vice versa, your strategic advantage will not matter at all.
 
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gro2001 said:
Strategically? This is not House of Cards. You are thinking about this wrong. Pick a specialty you like best and apply to that one. End of story.

What strategic advantage is there to going to a slightly better/more competitive program if it's in the wrong specialty? Anesthesia and EM are two very different worlds. While there is some overlap, there is a world of difference in day to day practice. You may end up in the best EM program in the country, but if a couple of years later you realize that was the wrong choice and you would be much happier in anesthesia, or vice versa, your strategic advantage will not matter at all.
Click to expand...

What if I like both? Yes they're different but I appreciate different aspects of both. What was your #2 choice if you were not in the one you are now? What if you were applying, and you had a greater shot at #2 than #1, and bigger risk of ending up in FM/IM were you to go for your #1, wouldn't it bit reasonable to settle for the safer option that you still very much like?

Or let's say my absolute favorite specialty was Derm, would you still advise me to apply to it and end of story?

I can see myself being happy in either career. Hell, I can see myself happy in FM/IM - they're all doctors treating patients. But I have to give weight not just to my interests but to my chances of fulfilling those interests as well.
 
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pandadoc said:
tbh, both your USMLE and COMLEX scores are probably too low for EM. You may be able to match ACGME but IMO those scores are too scary to go only ACGME. Though if EM is where your heart leads you, I would go AOA, get a bunch of aways, and work your a$$ off. That's probably your best bet. Can't comment on Anesthesia, but you might be ok for ACGME. Not enough experience to comment further.

Either way, you should CRUSH Step 2/Level 2. And try to take it early so it's on your apps.

Good luck
Click to expand...

Thanks!

Yep I am planning on doing all AOA or dual programs if I do EM, although I feel a number of them might be ACGME only come next year. And yes taking my Step 2 in June.
 
DO2016EM said:
I received 210-215 range USMLE step 1 and got into an allopathic residency. However, I improved 20+ points on step 2. If I were you, I would decide between two choices. You can go all in AOA and rotate at 3-4 reasonable AOA programs. Or, if you really want ACGME, you can split your 4th year with 1-2 AOA auditions and 1-2 ACGME auditions. Regardless of the path you choose, you must do well in auditions, do well on step 2, and apply broadly. EM (both AOA and ACGME) is only getting more competitive each cycle,but it's not out of the question for you just yet.
Click to expand...

So here's my question, why not just do all AOA rotations 4th year? As long as you get good SLOEs, wouldn't that be enough to be competitive for ACGME? Or are ACGME auditions also important for EM just like AOA ones are?
 
Smiths11 said:
So here's my question, why not just do all AOA rotations 4th year? As long as you get good SLOEs, wouldn't that be enough to be competitive for ACGME? Or are ACGME auditions also important for EM just like AOA ones are?
Click to expand...

Most AOA programs are virtually unknown to most ACGME programs, especially outside of their respective regions. I would always recommend ACGME > AOA for SLOEs if you want to maximize their impact.

Or, you could just do whatever you want and apply to any and all specialties that you may remotely be interested in in both AOA and ACGME. :shrug:
 
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From a "strategic" perspective, this year it was probably easier to get into anesthesia than EM based on the number of unfilled spots in each.
 
If you truly like both, I'd probably apply to gas.

Maybe a little less competitive and it's a great field. I thought about applying gas, but i just didn't have the patience for long cases.
 
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