How competitive is EM really?

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J ROD

J ROD

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It appears to me that EM is becoming much more competitive. Is this the case or am I just seeing things wrong?

It seems like a 220-225 Step 1 is not good enough anymore with an overall solid app.

Would appreciate any info for those out there right now trying to get into residency......:)
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Just take a look at the NRMP data. Board scores are similar to years past but the trend will be in an increase as more people apply. If you look at # of applicants compared to # of spots you can see its more a function of more applicants than spots therefore more not matching and rising competition (higher score requirement).
 
Really? I thought it was just a slight increase in applicants but those applicants applying to more programs than in years past. It's gone from applying to half a dozen programs, to a dozen, to two dozen, to now 40-50. Am I mistaken?
 
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Again, the data is available. Google NRMP Charting Outcomes, they are published every other year I think (2012 just published). Page 11 gives you the info about # of applicants/spots and therefore how many people DIDN'T match. It was close to 600 (1668 spots, >2200 applied). Most of the unmatched are NOT "US Allopathic Seniors" aka D.O.'s/IMG's

If you look closer in the actual ED pages of data instead of summary you can see board scores etc.
 
Compare 2012 with the same statistic from 2011, spots:applicants were 1626/2025 in 2011...
 
Per4mer8 said:
Just take a look at the NRMP data. Board scores are similar to years past but the trend will be in an increase as more people apply. If you look at # of applicants compared to # of spots you can see its more a function of more applicants than spots therefore more not matching and rising competition (higher score requirement).
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Actually, the number of EM applicants decreased very slightly from 2011 to 2012. Whether there's been an increase this year remains to be seen.

See this recent article.
 
One assistant program director told me that her program saw a 30-40% increase in applications this year, which was similar to what other programs experienced. She said this was likely a reflection of advisors telling students to apply more broadly after last year's match filled all spots (an overreaction in her opinion), but not necessarily that more people were applying into EM.

So interviews are more competitive because applicants are going to more while programs haven't been able to offer an increase in interviews in proportion to the increase in applications, but not necessarily more competitive overall, just maybe a bit more difficult to get an interview.

[Same point the article made]
 
Unless you have some red flags, a 220-225 will get you enough interviews, granted you're a US allopathic student. For the DO's (myself included) and IMG's, the bar is set a little higher.

That all pends that you don't severely geographically limit yourself, have a bad SLOR, had to repeat multiple courses, or write some sort of awful personal statement.
 
Colbert said:
Unless you have some red flags, a 220-225 will get you enough interviews, granted you're a US allopathic student. For the DO's (myself included) and IMG's, the bar is set a little higher.

That all pends that you don't severely geographically limit yourself, have a bad SLOR, had to repeat multiple courses, or write some sort of awful personal statement.
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I personally have a sub-220 step 1, 230-240 step 2, applied to ~40 places and received 13 interviews all along the east coast (about 4-5 are newer, less competitive programs, but the others are well established). I think I had decent letters, but I don't have any stellar grades or extracurricular activities, so it's still possible for joe shmo applicant to do well in EM.
 
Croooz said:
Really? I thought it was just a slight increase in applicants but those applicants applying to more programs than in years past. It's gone from applying to half a dozen programs, to a dozen, to two dozen, to now 40-50. Am I mistaken?
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Apparently the national average is 35 this year.
 
J DUB said:
So, it is probably just a tad more competitive and more just spreading the wealth of apps around from the same pool.

Good to know.......what I have been reading in here has me a little worried.
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Yep. My Step 1 score is in that range and I have an otherwise average application, except for unusually good clinical grades and a vaguely interesting non-trad background. I got interviews at 9 of the 30 programs I applied to. I only applied to 30 because I want to stay in a specific geographic area. Otherwise I would have probably applied to another 10 or so.
 
Don't spend too much time worrying. If you're worried, fire off 10 more applications. I applied to too many and interviewed at too many.

It might be a little more competive, but 9+/10 US grads are still matching and a decent amount of those who don't made dumb mistakes like didn't apply to enough places, applied late, etc. Decent grads with decent scores and decent grades who applied to enough places are still going to match somewhere.

I had good grades and great scores and applied to 30. I went to 21 interviews and turned down 7 more. In retrospect, I should have applied to 20 and interviewed at 10. But the "back-up places" offer the interviews first, so you schedule them, then fit the "top places" in between them. No point in driving through the city and not interviewing, so you just go to the back-up places too. You usually get a couple of meals and a place to stay out of it anyway! It was a lot of fun to meet people in EM all over the country whose names I now see on papers and in journals and stuff.

I only met two applicants and one resident in all those interviews that I didn't like. Then I matched with one of them....who subsequently left the program due to a drug problem.....funny how that EM sixth sense works eh?
 
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If I go on another interview where they start off with "woah man we got record numbers of applicants this year" I'm gonna flip my ****. I actually had one PD say to us "so are you guys worried about not matching this year?" Wtf are you supposed to say in reply to that?

Especially since I'm in the couples match with someone going into EM, this whole process is just giving me an ulcer.

I think with all these applications, it's just coming down to board scores, and the glory days of EM caring more about personality than board scores are over.

Maybe I'm just too cynical now that I'm getting towards the end of the interview process.
 
engineeredout said:
If I go on another interview where they start off with "woah man we got record numbers of applicants this year" I'm gonna flip my ****. I actually had one PD say to us "so are you guys worried about not matching this year?" Wtf are you supposed to say in reply to that?

Especially since I'm in the couples match with someone going into EM, this whole process is just giving me an ulcer.

I think with all these applications, it's just coming down to board scores, and the glory days of EM caring more about personality than board scores are over.

Maybe I'm just too cynical now that I'm getting towards the end of the interview process.
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Haven't people been complaining over the past few months about how random it's been this year and that even with great step scores they didn't get as many interviews? Maybe the number of places people are applying to will actually help them look beyond board scores...
I do think there are going to be about 20 SOAP spots this year because the same 500 people were interviewed at 90% of the programs. Maybe it will help calm the growth of the crazy for next year.
 
woeiru said:
Haven't people been complaining over the past few months about how random it's been this year and that even with great step scores they didn't get as many interviews? Maybe the number of places people are applying to will actually help them look beyond board scores...
I do think there are going to be about 20 SOAP spots this year because the same 500 people were interviewed at 90% of the programs. Maybe it will help calm the growth of the crazy for next year.
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Haven't really heard too many people getting a lot of interviews with below avg steps is the thing. I think in the past (circa 2008) the match was much more in the applicants favor whereas now I feel like programs have a lot more and better applicants to chose from. I'd love to see 20+ spots for people to scramble in to but doubt well see more than 1-3.
 
I have a below 220 step 1 score, I'm middle third of the class, and I honored 1 EM rotation/passed the other one. I applied to 30 EM programs, and got 26 interview invitations. So, we're out there. Many of those programs I interviewed at were "top-tier" EM residencies. I will say that I had above average SLORs and a ton of EM/disaster experiences. I think they are probably looking more at personality and interests than step scores. So, my advice to future applicants is to perform well on rotations and develop your interests.
 
han14tra said:
I have a below 220 step 1 score, I'm middle third of the class, and I honored 1 EM rotation/passed the other one. I applied to 30 EM programs, and got 26 interview invitations. So, we're out there. Many of those programs I interviewed at were "top-tier" EM residencies. I will say that I had above average SLORs and a ton of EM/disaster experiences. I think they are probably looking more at personality and interests than step scores. So, my advice to future applicants is to perform well on rotations and develop your interests.
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Do you go to a top 20 NIH school? Seems like from the people I've been meeting you're the exception rather than the norm...I don't mean to be nitpicky, just curious. Regardless I think everyone applying to EM in the future should try to maximize every part of their app and apply broadly. This entire process is bonkers and everyone has a different take on the matter.
 
Nope, it's not a top 20 NIH school. I honestly think it was because of my LORs and my EM experiences. I think if you only apply with 1 EM rotation and no other EM experience (EMS, ED tech, disaster preparedness), you are at a disadvantage. I think they are looking for people who they know are 100% sold on EM and who they know will excel in EM.
 
han14tra said:
Nope, it's not a top 20 NIH school. I honestly think it was because of my LORs and my EM experiences. I think if you only apply with 1 EM rotation and no other EM experience (EMS, ED tech, disaster preparedness), you are at a disadvantage. I think they are looking for people who they know are 100% sold on EM and who they know will excel in EM.
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I've actually been thinking about this since I got accepted. I already have a few years of experience as an ED tech and a firefighter/EMT. I've been trying to decide if there would be a benefit to try and pull one shift a month at each during medical school. I do really enjoy both and I don't think it would be a problem time wise, I was just wondering what residencies would think about that. Did you work in those fields through med school han14tra, or was your previous experience enough?
 
I'm both a firefighter and EMT. I remained active in it throughout medical school. I felt like it worked in my favor for EM residencies. Being able to say, "I've been doing EMS for the past X years. I enjoy it and that's why I made time for it during medical school despite the busy workload." really shows more commitment to the field than "Well, I enjoyed my 4 week EM rotation."
 
Those were the exact same reasons why I wanted to stay in the field, thank you for that. To be honest, I was already leaning towards staying because I love it, your post just helped confirm my decision.
 
han14tra said:
Nope, it's not a top 20 NIH school. I honestly think it was because of my LORs and my EM experiences. I think if you only apply with 1 EM rotation and no other EM experience (EMS, ED tech, disaster preparedness), you are at a disadvantage. I think they are looking for people who they know are 100% sold on EM and who they know will excel in EM.
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Which "top tier" programs did you get an invite from and what was your step 2?
 
Lanolin said:
Which "top tier" programs did you get an invite from and what was your step 2?
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I'm similar to the above poster (step 1 under 220 and my school ain't top tier), and I think we're getting a little carried away...

Do programs prefer high board scores? Yes. Does a low board score alone prevent you from getting great interviews? No. All of the following will help your application/make up for a lower score:
strong clinical grades, previous/meaningful exposure to EM, meaningful research, significant volunteer work, saving the rainforest, etc. While having a higher board score will prevent you from being screened out, the two most important things (IMHO) to help you actually get interviews are EM rotation grades and the SLORs they yield. Not doing an away rotation or two will likely put you at a disadvantage. The whole application process is indeed random, but the idea that having more flair on you app will help you get more interviews isn't so far out there.

Oh, and here a few of my "top" invites: Denver, UNC, Michigan. Of course, I won't be at any of them next year--I cancelled all three. Everybody's definition of the "top" places is different, and for good reason (you know, different strokes for different folks). Two of my top programs right now are "lesser" name places that I think are amazing. Go wherever you think you'd be happiest. The end.
 
han14tra said:
I have a below 220 step 1 score, I'm middle third of the class, and I honored 1 EM rotation/passed the other one. I applied to 30 EM programs, and got 26 interview invitations. So, we're out there. Many of those programs I interviewed at were "top-tier" EM residencies. I will say that I had above average SLORs and a ton of EM/disaster experiences. I think they are probably looking more at personality and interests than step scores. So, my advice to future applicants is to perform well on rotations and develop your interests.
Click to expand...

Would you be willing to list the "top" programs you interviewed at?
 
EM2013woot said:
I'm similar to the above poster (step 1 under 220 and my school ain't top tier), and I think we're getting a little carried away...

Do programs prefer high board scores? Yes. Does a low board score alone prevent you from getting great interviews? No. All of the following will help your application/make up for a lower score:
strong clinical grades, previous/meaningful exposure to EM, meaningful research, significant volunteer work, saving the rainforest, etc. While having a higher board score will prevent you from being screened out, the two most important things (IMHO) to help you actually get interviews are EM rotation grades and the SLORs they yield. Not doing an away rotation or two will likely put you at a disadvantage. The whole application process is indeed random, but the idea that having more flair on you app will help you get more interviews isn't so far out there.

Oh, and here a few of my "top" invites: Denver, UNC, Michigan. Of course, I won't be at any of them next year--I cancelled all three. Everybody's definition of the "top" places is different, and for good reason (you know, different strokes for different folks). Two of my top programs right now are "lesser" name places that I think are amazing. Go wherever you think you'd be happiest. The end.
Click to expand...

Did you go <220/250 or 220/220? Most of the people at my program who have a ton of great interviews, with a step 1 score in the neighborhood of 220, did so by improving significantly on step 2 and having stellar SLORs.
 
Sure, it's probably getting a lot more competitive. I'm buying the hype a bit. However, it cannot be understated how subjective this process is. For instance, I have two classmates whom I know pretty well matching into EM. Applicant #1 is middle of road boards 220s-230s, middle of road grades throughout first 3 years (at best), lots of early EM interest, only home EM rotation (no Aways), no publications or anything else real special and has interviewed at Denver, OHSU, HCMC, Cincy, Carolinas and Vanderbilt. Applicant #2 is strong on boards 250s/260s, top 25% of class, Honored home EM and 2 Away rotations (3 H's for those keeping score), 2 publications in med school, a fair amount of community service, and was shut out at 3 of the 5 programs named above. I know both pretty well, They're both pretty likable and very personable. Can't explain it, we've all joked about it quite a bit as Applicant #1 will be the first person to state that Applicant #2 should be getting all the love. And I'm sure there are hundreds if not thousands of other stories like this....But it still all comes down to the person reading/deciding on your overall application, and honestly, it also might matter when in the application process they read your app (early vs. late).

Who knows?
 
I'm in a situation very similar to EM2013woot and han14tra in terms of school, scores and success of my application.

More importantly than applying to a ton of places next year, I think the key is to apply broadly and early. I sat down with an attending at my program and we came up with a list of 5 less competitive places, 15 we thought fit my application well, and 10 that were reach programs. While the yield from my reach group was far higher than I expected, I still would have been in a comfortable spot had I been rejected from all of them. Even if you have a stellar application, if you only apply to traditionally competitive places, you're far more likely to have a disappointing cycle. Not to mention, like many others, I ended up really enjoying many of the programs that were lower on my list at the beginning of the season.
 
FirefighterDoc said:
Those were the exact same reasons why I wanted to stay in the field, thank you for that. To be honest, I was already leaning towards staying because I love it, your post just helped confirm my decision.
Click to expand...

Just so everyone knows...if you had multiple years of EMS experience you don't necessarily have to continue working in EMS during med school. They will see your years of experience and not question your commitment to the specialty. I had ~6 years of EMS experience before med school and stopped once I started. Everyone has loved it on the interview trail, but staying active during med school I don't think will give you that much more of an edge. Focus on doing well in med school unless you really enjoy what you do.
 
fahimaz7 said:
Did you go <220/250 or 220/220? Most of the people at my program who have a ton of great interviews, with a step 1 score in the neighborhood of 220, did so by improving significantly on step 2 and having stellar SLORs.
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230s. I don't want to be too specific about my scores, the programs I applied to, etc because I don't want to be identified (especially by any PDs, who might be looking around on here).
 
I need help with more one thing. I hear first 2yrs grades dont matter that much overall.

Is anything over a 3.0 GPA good enough?

I can have a life with close to a 3.0..........getting over a 3.5 is really not worth the amount of extra time and work to me at this pt.

Please advise for those that have experience on this. Thanks in advance.
 
J DUB said:
I need help with more one thing. I hear first 2yrs grades dont matter that much overall.

Is anything over a 3.0 GPA good enough?

I can have a life with close to a 3.0..........getting over a 3.5 is really not worth the amount of extra time and work to me at this pt.

Please advise for those that have experience on this. Thanks in advance.
Click to expand...

3.5 or 2.5, doesn't matter. Focus on Step 1. I've had interviewer comment on some of the most randomest parts of my applications...but noone's every mentioned my pre-clinical grades.
 
Akail said:
3.5 or 2.5, doesn't matter. Focus on Step 1. I've had interviewer comment on some of the most randomest parts of my applications...but noone's every mentioned my pre-clinical grades.
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If they mention your pre-clinical grades, it's probably because they suck. With that said, you should concentrate on doing the best you can in every aspect.
 
Obviously the ideal is to do the best you can. The wisdom behind holding back in first and second year can be debated and that's before you even get into the argument about mastering the material for 1st and 2nd year exams translating to performance on Step 1.

That being said, MS1 and MS2 grades are low yield and I doubt many doors will be shut to you with a >3.0 GPA.

The biggest impact from them probably comes more from how they affect your class ranking and AOA status rather than the grades themselves. Also, this is more true for EM than for other specialties...
 
Will be around middle of class.......no AOA.

I just dont care to try and memorize all the small things that I will not remember anyway. That is what separates the top scores.

I will have greater than a 3.0........but probably not higher than a 3.5.
 
J DUB said:
Will be around middle of class.......no AOA.

I just dont care to try and memorize all the small things that I will not remember anyway. That is what separates the top scores.

I will have greater than a 3.0........but probably not higher than a 3.5.
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If your app pops as much as your SDN badges, you'll be fine. lol.
 
My experience is counter to some of the above posters. As I've said in a few threads, I consider myself a d*mn good applicant with 240+/250+, and a lot of other stuff to back it up, and no red flags. I applied to 38 mostly mid-range to upper-level schools, but 8 or so were west coast (I'm east coast) and 6 or so were hopkinsy/ivy types - none of which I got. Also didn't get denver, no emory, no UNC, no wake, no UVA, no Maine, no maryland. I didn't get interviews at a lot of places I thought would be a given. I ended up with 10 invites and went on 9. About 3 places I interviewed were traditionally less competitive (one was really bottom of the barrel). I had good responses and positive words at most/all of my interviews.

At this point I don't know what went wrong for me. I know I'll end up matching at a fine program, but the ole' pride took a beating.

My advice is to get a GOOD advisor, someone who is involved in the application/interview process, and start meeting with him/her early. My advisor is very hands-off, has only met face-to-face with me a few times. He answers specific questions if I ask, but he never got involved, never became much of a mentor. He isn't really involved with the application/interview process at our program and couldn't give me a heads up about what to expect. Don't fly alone.

Every time I post in one of these threads I get p!ssed again. Part of me suspects ERAS screwed me somehow - pretty much all of my invites, and ALL of the better programs, came really early with nothing after that.
 
I think this year really "reset" the bar for EM moving forward. I think that a lot of programs starting sending out mass invites to everyone with, for example, 240+ Step 1 scores, as this would typically be a pretty high benchmark. However, as applications kept rolling in or as programs kept reading through the piles I think they were a bit shocked at not only how many 240+ applicants there were this year, but how many 250+ and 260+ step 1 applicants there were. Hence, I think some people made it with an early invite if they were maybe an early review, but a 243 on step 1 become only "good" instead of "great" by the time October hit. Again, I'm only using Step 1 b/c it's probably the most agreed upon/referred to marker, not because I think it's a marker of IQ (it's a f*ckin 9 hour test, nothing more).

Then again, as I've said many times, there is a huuuge subjective component to this (see my earlier post above for one of a thousand examples of this). Be your best you, be true to yourself, let the chips fall where they may.
 
I got my step 1 tattooed on my lower back. I am very proud of it.
 
DreamingTheLive said:
I think this year really "reset" the bar for EM moving forward. I think that a lot of programs starting sending out mass invites to everyone with, for example, 240+ Step 1 scores, as this would typically be a pretty high benchmark. However, as applications kept rolling in or as programs kept reading through the piles I think they were a bit shocked at not only how many 240+ applicants there were this year, but how many 250+ and 260+ step 1 applicants there were. Hence, I think some people made it with an early invite if they were maybe an early review, but a 243 on step 1 become only "good" instead of "great" by the time October hit. Again, I'm only using Step 1 b/c it's probably the most agreed upon/referred to marker, not because I think it's a marker of IQ (it's a f*ckin 9 hour test, nothing more).

Then again, as I've said many times, there is a huuuge subjective component to this (see my earlier post above for one of a thousand examples of this). Be your best you, be true to yourself, let the chips fall where they may.
Click to expand...

I think that's a bit alarmist. We have to wait until the stats from this year are available to find out whether 243 on Step 1 is now a lackluster score for EM.
 
Whoa there. Not saying a 243 isn't a good score, far from it and certainly not "lackluster." But I do believe that the number of applicants applying to EM w/ board scores above 240+, just say over the last 3-4 years, has increased markedly.

Hopefully I'm wrong though.
 
DreamingTheLive said:
Whoa there. Not saying a 243 isn't a good score, far from it and certainly not "lackluster." But I do believe that the number of applicants applying to EM w/ board scores above 240+, just say over the last 3-4 years, has increased markedly.

Hopefully I'm wrong though.
Click to expand...

"240 is the new 230".

This, and there's the bizarre phenomenon that STEP scores seem to be on a treadmill. The "minimum passing score" keeps going up bit by by, as does the national average, as does the "recognized" competitive score for *whatever specialty*. Eventually, we gotta reset the bar, or in a couple years or so, 240 will be "on the low end of a decent score".
 
DreamingTheLive said:
Whoa there. Not saying a 243 isn't a good score, far from it and certainly not "lackluster." But I do believe that the number of applicants applying to EM w/ board scores above 240+, just say over the last 3-4 years, has increased markedly.

Hopefully I'm wrong though.
Click to expand...

Charting Outcomes in the Match doesn't give a full distribution, but the average Step 1 score of matched applicants went from 222 in 2009 to 223 in 2011 - not exactly a marked increase over those two years. Like I said, we'll have to wait for this year's results to see if there's been a more impressive increase in the past 2 years.
 
Just found this thread and was wondering if any applicants that have matched this year have anything to add, or if they feel anything has changed in the last year or so.
 
Diggidy said:
Just found this thread and was wondering if any applicants that have matched this year have anything to add, or if they feel anything has changed in the last year or so.
Click to expand...

I'd agree that EM is getting more and more competitive. I applied to 55 programs with a step 1 in the 250s. I only got 12 interviews and ranked them all. People in my class definitely didn't match EM, which to me seemed impossible. Though I echo the sentiments above that these people didn't apply widely or to a variety of programs (reach vs. "safety")
 
Diggidy said:
Just found this thread and was wondering if any applicants that have matched this year have anything to add, or if they feel anything has changed in the last year or so.
Click to expand...

Check out the Rank order lists threads, people post their stats and where they've ranked. You can get a glimpse of the SDN crowd and where they were competitive (just remember that for every 250+ on here there's a dozen 220s out in the real world who still matched).
I think a complete application early on was a big factor this year and I think EM is nice because it's not all scores that get you an interview. I was merely average (by national not SDN standards) in Step1 but got 20+ interview offers (applied to <40) at great schools including ones outside my region. I didn't cure cancer so I assume it was because I had leadership, research, a 30 point improvement on step 2 and a relatively well rounded app that was complete early on.
 
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