How competitive is EM really?

[mybubbles14]

***from a truly average applicant step 1 wise (not SDN average)***

Take what you read on SDN with a grain of (very small sample size) salt. Apply early, broadly and do as well as you can on step 2 and your clerkships. Try to identify a good advisor now who will be honest with you about your chances and who can help you create a good list of schools. It is not the end of the world if you don't honor every EM rotation. Don't be annoying or a weirdo on your interviews...and remember everything counts. Every correspondence etc. from now on with these programs could impact your application...don't piss anyone off!

I too did not cure cancer, although I am close to finding a cure for Rheumatoid Arthritis. I also improved on step 1 by >30 points and applied broadly. I got interviews from places I didn't expect, and radio silence for places I thought I'd get invites. I applied ~40 places, got 15 invites and attended 12. There were only 3 places I had hoped to get invited to which I didn't...2 ended up being wait lists and 1 rejection. Get your app AND at least 1, preferably 2 SLOEs in as early as possible. Some places will sit your app to the side until it is complete. Once all the interviews are handed out you are just waiting to get off the wait list (which does happen as people with too many interviews start to cancel).

Good luck!

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[scummie]

Looks like I may not need to hand over my firstborn and a small herd of goats for a sacrifice after all.

 

[Birdstrike]

Looks like I may not need to hand over my firstborn and a small herd of goats for a sacrifice after all.

Never hurts your chances, though.

 

[Handinhand]

Does anybody have any suggestion on how to improve your chances at a residency outside of your geographic region?

I was born and raised in the midwest, but would like to go out west for residency. I know this won't be easy, but I've looked at good programs out west (Denver, Utah, OHSU, etc..) and they all seem to have residents that aren't from, nor attended medical school, in the west, so it must not be impossible.

From all of the research I've done EM seems to be different when considering what makes you a competitive applicant, compared to the classical uber-competitive specialties like ortho, derm and plastics where you need research, sky high board scores, lots of honors, etc. What are some things you all think sets someone apart? I know there are going to be far more applicants with high board scores and good SLORs than there are residency spots, so there has to be something making those who are accepted pull away from the rest of the field.

 

[BoardingDoc]

Go do an away out there and kick ass. If you impress them in person, they'd certainly rather take you than some unknown candidate with a board score that's 15 pts higher than yours.

 

[QuackaDO]

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.

I know of at least one someone who got 18 interviews, was a DO, and had <210 Step 1. Work hard on your auditions and get good letters, be complete EARLY and apply broadly, and ABSOLUTELY follow up with emails to places you are absolutely interested in if you don't hear anything from them early on. That and increase on your Step two and it really goes a long way. Not everyone will like your app and there will be places you dream of hearing from that don't get in touch or even give you a rejection. Get past it cuz there are something like 167 other fish in the sea and if you get in touch with some of those others and tell them you are interested in THEM and why you are interested in THEM (not some randomly generated general cut and paste type email) then you can and likely will improve your odds. EM is not even close to impossible... if you put the time and effort into doing it. If you just want to drop your app in and sit back and wait you better be one of the SDN "normal" applicants or really like the idea of doing IM as a backup

 

[red10]

Does anybody have any suggestion on how to improve your chances at a residency outside of your geographic region?

I was born and raised in the midwest, but would like to go out west for residency. I know this won't be easy, but I've looked at good programs out west (Denver, Utah, OHSU, etc..) and they all seem to have residents that aren't from, nor attended medical school, in the west, so it must not be impossible.

From all of the research I've done EM seems to be different when considering what makes you a competitive applicant, compared to the classical uber-competitive specialties like ortho, derm and plastics where you need research, sky high board scores, lots of honors, etc. What are some things you all think sets someone apart? I know there are going to be far more applicants with high board scores and good SLORs than there are residency spots, so there has to be something making those who are accepted pull away from the rest of the field.

Being from the midwest myself, I feel like its a little difficult to get out of the region in general with west being more difficult than east or south (or at least thats the way it seemed with the n=8 in my class). Apply to lots of programs, follow up with love letters if you don't hear anything for a while. Also if you have one particular location you're wanting, do an away rotation around there. Seeing a SLOR from that geographic area may help some other programs give you a shot if the letter is a good one.
It's hard to know exactly what each program is looking for and even if you'd did, it can be a crapshoot. The school where I matched told my interview group that they specifically looked for leaders and so they invited us to interview because we all had strong leadership on our applications. Pretty much every program I interviewed at commented on how great my SLOR was from my away rotation. So the best thing you can do for yourself is check out charting outcomes and maximize as many areas as possible (volunteer, research, scores, etc) and then kick ass on your EM rotations so your letters speak for you. If your away rotation wants you bad, other people will too.

 

[DocEspana]

Should probably distinguish the northeast from the east. The dynamics in the NH, MA, NY, CT, North Jersey corridor are drastically different from what you'd find anywhere else along the seaboard. And thats not dissing the well respected and amazing programs to be found in other eastern seaboard states. But the entire mentality for applicants and program styles is pretty different.

 

[Handinhand]

Thanks for all the great advice guys! I'm just finishing up my M2 year and studying for boards so I have a little bit to go, but I like being prepared for things.

I am curious for the attending and residents reading this -- what kinds of things are you looking for in a medical student when you're evaluating them? Given that the field is so broad and requires knowledge of many different specialties, knowledge that takes more than the first three years of med school to learn, how exactly do you evaluate a student? What would an honors level student know/say/do for you to hold them in that regard?

 

[womp]

Percent of Unmatched US Seniors in 2014:

Neurosurg: 17.7%
ENT: 17.6%
Plastics: 17.3%
Ortho: 17.1%
Derm: 9.1%
Gen Surg: 8.7%
OBGYN: 7.1%
Rad Onc: 6.0%
Psych: 3.6%
EM: 3.4%
Family Med: 3.1%
Peds: 3.0%
Neurology: 2.6%
IM: 2.0%
Anesthesia: 2.0%
Radiology: 1.0%

 

[DocEspana]

Percent of Unmatched US Seniors in 2014:

Neurosurg: 17.7%
ENT: 17.6%
Plastics: 17.3%
Ortho: 17.1%
Derm: 9.1%
Gen Surg: 8.7%
OBGYN: 7.1%
Rad Onc: 6.0%
Psych: 3.6%
EM: 3.4%
Family Med: 3.1%
Peds: 3.0%
Neurology: 2.6%
IM: 2.0%
Anesthesia: 2.0%
Radiology: 1.0%

That list leaves out the big momma

Urology: 31%

 

[DocEspana]

Percent of Unmatched US Seniors in 2014:

Neurosurg: 17.7%
ENT: 17.6%
Plastics: 17.3%
Ortho: 17.1%
Derm: 9.1%
Gen Surg: 8.7%
OBGYN: 7.1%
Rad Onc: 6.0%
Psych: 3.6%
EM: 3.4%
Family Med: 3.1%
Peds: 3.0%
Neurology: 2.6%
IM: 2.0%
Anesthesia: 2.0%
Radiology: 1.0%

Also historically the EM demand (from US seniors) was much smaller than the supply of spots. That is still the case, even if the demand has met the supply finally. It hasnt overwhelmed it.

 

[womp]

That list leaves out the big momma

Urology: 31%

Yeah separate match. Never got the appeal of Urology though.

 

[@JackShephard]

Percent of Unmatched US Seniors in 2014:

Neurosurg: 17.7%
ENT: 17.6%
Plastics: 17.3%
Ortho: 17.1%
Derm: 9.1%
Gen Surg: 8.7%
OBGYN: 7.1%
Rad Onc: 6.0%
Psych: 3.6%
EM: 3.4%
Family Med: 3.1%
Peds: 3.0%
Neurology: 2.6%
IM: 2.0%
Anesthesia: 2.0%
Radiology: 1.0%

Where is this data from?

Btw, notable missing categories
Physical medicine and Rehab: 10.4%
Prelim IM: 8.7%

 

[womp]

Where is this data from?

Btw, notable missing categories
Physical medicine and Rehab: 10.4%
Prelim IM: 8.7%

Data from 2014 NRMP match data.

High unmatched rate for Prelim IM makes sense, given many people going into Ophtho, Rads, Neuro, Anesthesia, etc. only apply to 4-5 programs for the PGY1 year in addition to their Advanced spots and can get overly confident. It's not a backup plan for most.

PM&R is more popular than you think and is a growing field.

 

[@JackShephard]

PM&R is more popular than you think and is a growing field.

lol, how do you know what I think?

Apparently it's 3 times more popular than EM and slightly more popular than derm.

 

[Bojack Horseman]

lol, how do you know what I think?

Apparently it's 3 times more popular than EM and slightly more popular than derm.

I have a hard time understanding exactly what they do. Every description I've heard sounds really vague and esoteric.

 

[@JackShephard]

I have a hard time understanding exactly what they do. Every description I've heard sounds really vague and esoteric.

I think because each doctor can run a completely different practice / patient population.

 

[DocEspana]

I have a hard time understanding exactly what they do. Every description I've heard sounds really vague and esoteric.

Breakfast is monitoring PT/OT workers. Lunch? Distinguishing sub-acute vs acute placement vs home as far as inpatient dispo goes. Their dinner is composed of lower extremity traumatic injuries. But every waking moment between these "meals" is stroke patients. Stroke patients day in and day out.

I imagine a decent percent find themselves in pain management fellowships