In trouble, want ER but don't know how to get it

[Needhelprealposter]

First post and, unfortunately, I'm not a troll.

Situation: MS4 at a DO school applying for residency right now. Did poorly in medical school but survived; took a year off to try to get a good Step 1 score and for other reasons that may not be super relevant right now. PM me if you want to know.

Did poorly on Comlex 1 and 2; passed them on first try but got below-average. Passed step 2 PE on first try also.

Applied to many, many DO ER programs; almost all of them. Only got a few interviews. Based on evaluations and the vibes from the few that I got; it doesn't look good. Maxed out on ER audition rotations; most went poorly but that's neither here nor now.

Applied to about 7-14 DO FP programs (being vague to be more anonymous) as a backup. Got a few emails; about 50% interview rate.

Only eight interviews were done and one of them, an FP program that has trouble filling and is very undesirable told me that I wasn't going to match there. I can't get anything right now.

The good: I know what I want and that is ER.

The bad: I don't know how to get to my destination. I was reading up on rotating traditional internships and the idea I got was that it wasn't a great choice. Some program directors on the official DO websites said that it may actually hurt your application. I also am not sure what to do; do a year of another specialty and try to switch or whatnot. Any advice would be great, either via PM or on this thread.

Thank you for any guidance you can give me.

---

Members don't see this ad.

 

[GTP]

Why do you keep calling it ER

 

[Needhelprealposter]

Faster than writing ED? I don't know. Never knew it wasn't said this way.

Edit: I thought ER and ED were really synonyms. Not really that important; I'm sure you understand me.

 

[LaceyMD]

Faster than writing ED? I don't know. Never knew it wasn't said this way.

Edit: I thought ER and ED were really synonyms. Not really that important; I'm sure you understand me.

I believe @GTP's point is that...

ER = emergency room, which is a place within a hospital.

EM = emergency medicine, which is the specialty practiced by doctors who work in an ER.

 

[SoyMilk]

Why do u think the em rotations went poorly?

 

[SoyMilk]

If you've done poorly on multiple aways what makes you think you're wired for em? Are u just chasing the lifestyle opportunities.

 

[DeadCactus]

Careful, medical students get really worked up about EM vs ER thing: they need something to be condescending about.

To the OP, the unfortunate reality is that it doesn't sound like EM is going to happen for you. I would recommend paving forward with FM and tailor your efforts to the urgent care or rural ER career track. It may not be ideal, but I think you'll be able to find contentment through this route. I would be extremely wary of risking not being able to complete any residency by myopically chasing EM...

 

[Old_Mil]

To the OP, the unfortunate reality is that it doesn't sound like EM is going to happen for you. I would recommend paving forward with FM and tailor your efforts to the urgent care or rural ER career track. It may not be ideal, but I think you'll be able to find contentment through this route. I would be extremely wary of risking not being able to complete any residency by myopically chasing EM...

This is good advice...

 

[Needhelprealposter]

I believe @GTP's point is that...

ER = emergency room, which is a place within a hospital.

EM = emergency medicine, which is the specialty practiced by doctors who work in an ER.

You know, I went through 4 years of college and 3.75 years of medical school and didn't ever know that ER and EM stood for those things. Thank you very much.

 

[Needhelprealposter]

If you've done poorly on multiple aways what makes you think you're wired for em? Are u just chasing the lifestyle opportunities.

I've done "poorly" in the sense that I get nervous when presenting to attendings. It's just something that I still suck at. Like when I get interrupted after one sentence it's still hard for me to get my mind back on it. Or when I know the answer I don't have a lot of confidence so I don't say it.

In one rotation a select few residents hated me from the start and always looked for ways to berate me. I don't know why that happened; I had just met one of them for example. Another one went very well in my estimation. A third one was ok, not great. They weren't disasters but not as good as I expected. Sorry, one rotation just went bad. It was my first time in the ER and I got pimped on the science of suturing for like 6 minutes by a resident and it didn't go well. Like stuff that no other med students knew after I asked them the questions. On that same rotation I would be assigned to see a few patients and they would inevitably be in the bathroom for 5 minutes. So it seemed like I was a dolt because I wouldn't be finished when the resident came in. Murphy's law in effect for that month.

I'm not a great medical student but one fellow auditioning medical student was taking like 20 minutes to talk to a patient with stereotypical chest pain indicative of cardiac pathology. The nurse I was with to put in IVs asked me, "Don't you guys have to pass a practical exam before finishing medical school? That guy is taking forever for a simple thing." I mean I do have the sense to ask basic questions like, hx of HTN,↑ cholesterol, smoking, DM, Past Family Hx of cardiac events, stress test, etc to rule out MI.

The big issue is lack of confidence even though I know my stuff; people pick up on that lack of confidence and think that I'm stupid or incompetent.

I'm "wired" for *the* ER (yes, said purposely to spite that jerk recently accepted medical student) because I really do like the variety and like quick decisions and almost everything that it entails. If ER paid just the same as FP I still would like it more if that gives you an idea of my intentions.

EDIT: Things have been getting bad for the DO match for emergency medicine. One of my friends apparently did very, very well on both step 1 and step 2 and has a great application. Pretty nice person to boot and does well in rotations also. That person only has a few interviews after applying broadly. Crazy.

 

[dotcb]

It sounds like you won't be doing an EM residency. Based on on what I'm hearing, you may be thankful to match at all. Do what you can to try matching in EM, while making sure it doesn't keep you from matching into your back up plan. Maybe you can do rural EM shifts or urgent care.

 

[Arcan57]

OP,
Agree with other attendings that you're not going to match into EM. If you want to do the residency, kicking ass at an FM residency MAY help. It seems like there's something missing in terms of self-awareness that is going to make it hard for you to be successful in your aspirations. From reading your description of yourself, you have a below average fund of knowledge, ? below-average interpersonal skills, and are below average in terms of being rattled and ability to recover after being rattled. While the pathology and work environment may seem appealing to you, it doesn't sound like EM is a good fit for your abilities. The question you need to ask yourself is, "What do I need to do to correct these problems?" More time is clearly not the issue since you took a year off to do below average on COMLEX and you weren't superlative on your EM rotation after doing 50% more EM than average. Cognitive-behavioral therapy may help if there is a significant anxiety component to your struggles, but until you figure out what the problem is and find some work-around there are going to be doors that stay closed to you.

In regards to your example about the 20min CP interview, while that's horrendously long for an attending it's not horrible for a med student (or unfortunately even a rotating off-service intern). You say the pain was indicative of cardiac pathology, which makes me wonder if your differential is appropriately broad. Sure CP can be an MI, but if you're not asking questions related to r/o PE,PTX, pericarditis, aortic dissection or pneumonia then you're going to have a tough time when you're presenting and are asked for your differential. Premature diagnostic closure can be a tool to deal with an insufficient knowledge base (it's got to be X because X is the only thing on my differential) or to deal with the cognitive load that comes from trying to decide on whether to work up multiple low to moderate probability options (PROTIP: If you're in training, knowing how to work-up a disease always seems smarter than saying the patient doesn't have the disease).

 

[Needhelprealposter]

Thank you very much for your honest input. The real, real crux of the matter is that I have very low self-confidence. Went to a top...about 30 university, was all state in a major sport in HS, got an MCAT that was above the average MD matriculant score...but I still hate my perceived failings. That probably caused me to do poorly in medical school since I got depressed. Like we were being pimped by the resident in one rotation and I softly said almost every single answer but didn't speak up. So the person in front of me would get points. In our culture we're taught to be quiet and not speak up, if that helps explain it.

The DO board tests are terrible. For example, I got comfortably above-average scores on both DO question tanks and did crappy on the real test. My classmate did well on the test and when we were talking about diseases this friend couldn't converse about basic step 1 type questions. And it's not like I'm a bad standardized test taker per my SAT/ACT/MCAT scores.

My interpersonal skills are actually not that bad; not great but nothing like freaky weird.

I don't really get rattled actually; it's just that I mumble. It's a big problem I have.

I've actually gone through CBT and I don't have anxiety. Unfortunately, I have had a lot of personal tragedy in my short life which most likely contributes to my low self-confidence and depression.

In that rotation they specifically told us that we had like 10 minutes to do a very focused history and physical before presenting to the resident. The thing is that this medical student wasn't just being thorough, he was taking a rather long time to actually ask the questions. Like he wasn't used to asking them.He also wasn't going through the differential diagnosis of chest pain; he was just taking a long, long time to ask questions to rule out MI.

Thank you for your advice. It's a bad situation but it could be worse. I could have failed step 1, step 2, and/or the step 2 PE.

 

[Birdstrike]

Why do you keep calling it ER

I like "ER" better. "ED" always sounded dorky to me.

Plus, "Birdstrike, why do you call it an ER when it's an entire department?"

Me: "Dude. Cause where I work, it's literally just a room, still. Yeah, hard core and old school, I know, but yeah. No 'department' here. Just a room. All we got is ONE FRICKIN ROOM."

Plus, once upon a time, probably before you were born, there was a cool show named "ER." There was and never will be any cool show named "ED." Only Bob Dole's problem getting a ----- is named "ED."

So choose sides now.

"ER" vs A Problem Getting Your Junk Working


"ER"


The other just never sat well with me.

Just sayin'...

 

[Siggy]

[SNIP]

" There was and never will be any cool show named "ED." Only Bob Dole's problem getting a ----- is named "ED."

So choose sides now.

"ER" vs A Problem Getting Your Junk Working


"ER"


The other just never sat well with me.

Just sayin'...

I actually got asked by the office staff on an outpatient rotation to stop using the term "ED" because I was confusing them with the other ED.

 

[julie29524]

To OP,

I feel for you. Medicine is not easy, no one said it was, we all doubted ourselves at one point or another. Confidence takes time, knowledge and reinforcement, it doesn't come naturally to everyone. I was also taught to be soft-spoken growing up. I didn't have a lot of confidence at the beginning, the ED staff waits for you to prove yourself competent before respecting you at a teaching hospital because the RNs definitely know more than a new ED intern.

I remember I couldn't sleep before my very first trauma/resus shift as a PGY2, I was terrified when the SICU senior left and I was the only doc covering SICU night float, I was scared before my first attending shift, I didn't want to get out of my car before my first community ED single coverage shift. But I slowly tried to build up the confidence by gathering knowledge, when the surgeon commented on something I didn't know, I went home and read about it until I knew more than I needed to. When I fumbled through my 1st central line as an intern, I went home and watched 20 youtube videos on central lines and read about it until I didn't need any help again.

My advice:
- if you do have depression, you needs to be under a psychiatrist's care. Depression is a disease and it will mess up your career if you don't get it under control. I think you feel like you are not in control of your life, when you discuss other students, pt delaying your HPI, the tragedies in your life, the boards are terrible. But in reality, you ARE in control of your life, we all have obstacles, its up to you how you handle it.
- observe why there are medical students that are stellar, what are they doing different, and try to do it too. Is it because they speak up? then you should speak up too. So what if you are wrong, everyone is wrong as some point, thats why you are here to learn.
- be more confident, you got into medical school because the admission committee concluded that you are good enough. Medicine is 95% hardwork, dedication and attitude. Medicine is not your intelligence, not your scores, yours scores are not who you are and they do not define you.
- whatever you end up doing next year, be in FM, or a prelim spot, you need to kick-ass at it. You need to have good knowledge, you need to answer the pimp questions first, you need to ask your attendings for feedback on how to improve ( this is very important, I've known people who thought everything was peachy, until they get their evaluation and they were below average). You need to have a good attitude, you need to volunteer to do things, you need to be proactive at learning and participating. You need to have mentors that you can meet with frequently to talk, if you have someone like this at your current medical school, it would be beneficial, someone to be able to help you dissect your weaknesses and strengths and how to improve.

PS

- Do not think just because an attending cut you off during your presentations, its because they think you are doing poorly. We are just trying to manage 4 residents and 30 patients at the same time with some efficiency. Ask your attending how they like presentations. I always remind my students that: it needs to be 2-3 minutes of presentation, don't tell me stuff that I don't need to know ( I don't need to know surgical hx, family hx, heart and lung exam for a laceration repair.) its fine to only say the abnormal vitals and abnormal exam finding only. )
- I know plenty of FM physicians that working in big EDs in good size cities. They are probably not taking the level 1 trauma, CPR in progress patients, but they are doing good ED work. There are EM fellowships for FM and Peds residencies.

keep your chin up.

Thank you very much for your honest input. The real, real crux of the matter is that I have very low self-confidence. Went to a top...about 30 university, was all state in a major sport in HS, got an MCAT that was above the average MD matriculant score...but I still hate my perceived failings. That probably caused me to do poorly in medical school since I got depressed. Like we were being pimped by the resident in one rotation and I softly said almost every single answer but didn't speak up. So the person in front of me would get points. In our culture we're taught to be quiet and not speak up, if that helps explain it.

The DO board tests are terrible. For example, I got comfortably above-average scores on both DO question tanks and did crappy on the real test. My classmate did well on the test and when we were talking about diseases this friend couldn't converse about basic step 1 type questions. And it's not like I'm a bad standardized test taker per my SAT/ACT/MCAT scores.

My interpersonal skills are actually not that bad; not great but nothing like freaky weird.

I don't really get rattled actually; it's just that I mumble. It's a big problem I have.

I've actually gone through CBT and I don't have anxiety. Unfortunately, I have had a lot of personal tragedy in my short life which most likely contributes to my low self-confidence and depression.

In that rotation they specifically told us that we had like 10 minutes to do a very focused history and physical before presenting to the resident. The thing is that this medical student wasn't just being thorough, he was taking a rather long time to actually ask the questions. Like he wasn't used to asking them.He also wasn't going through the differential diagnosis of chest pain; he was just taking a long, long time to ask questions to rule out MI.

Thank you for your advice. It's a bad situation but it could be worse. I could have failed step 1, step 2, and/or the step 2 PE.

 

[Birdstrike]

Thank you very much for your honest input. The real, real crux of the matter is that I have very low self-confidence. Went to a top...about 30 university, was all state in a major sport in HS, got an MCAT that was above the average MD matriculant score...but I still hate my perceived failings. That probably caused me to do poorly in medical school since I got depressed. Like we were being pimped by the resident in one rotation and I softly said almost every single answer but didn't speak up. So the person in front of me would get points. In our culture we're taught to be quiet and not speak up, if that helps explain it.

The DO board tests are terrible. For example, I got comfortably above-average scores on both DO question tanks and did crappy on the real test. My classmate did well on the test and when we were talking about diseases this friend couldn't converse about basic step 1 type questions. And it's not like I'm a bad standardized test taker per my SAT/ACT/MCAT scores.

My interpersonal skills are actually not that bad; not great but nothing like freaky weird.

I don't really get rattled actually; it's just that I mumble. It's a big problem I have.

I've actually gone through CBT and I don't have anxiety. Unfortunately, I have had a lot of personal tragedy in my short life which most likely contributes to my low self-confidence and depression.

In that rotation they specifically told us that we had like 10 minutes to do a very focused history and physical before presenting to the resident. The thing is that this medical student wasn't just being thorough, he was taking a rather long time to actually ask the questions. Like he wasn't used to asking them.He also wasn't going through the differential diagnosis of chest pain; he was just taking a long, long time to ask questions to rule out MI.

Thank you for your advice. It's a bad situation but it could be worse. I could have failed step 1, step 2, and/or the step 2 PE.

All kidding about the ER/ED thing aside, here's my honest opinion.

You have strengths and weaknesses, like all of us. Despite this, you made it past pre-med, got into medical school and will (presumably) pass medical school. The long and short of it is that despite some very difficult challenges and uncertainty along the way, you've accomplished most of your goals. I cannot tell you whether or not you'll be accepted or where, without personally knowing or observing you. Perhaps your tendency is too assume the worst and you're painting a gloomier picture in this thread due to your personality and that your odds are better than you're presenting, I don't know.

But considering you've made some very substantial accomplishments along the way despite your personal obstacles, my gut feeling is that you'll continue to achieve your goals if you continue to move forward, maintain what confidence you have while building up more in the future and just simply keep working hard. The harder and longer you work, the luckier you just may find you'll get. Keep your spirits up, and things are likely to work out for the best. You've made some very real accomplishments so far (more than 99% of the general population) and there's no reason to think you won't continue to do so, if you remain committed to doing so.

 

[jw3600]

All kidding about the ER/ED thing aside, here's my honest opinion.

You have strengths and weaknesses, like all of us.

He/she did not do well at a DO school, did poorly on boards, is unable to present to an attending, unable to understand that social dynamics like saying "I'm 'wired' to practice ER!" may have caused him to be perceived poorly on audition rotations, and in general does not seem to understand the general trend in medical students learning to take a history. I hate to be the one to say it but I have yet to be made aware of the strengths. Hopefully OP can understand that honesty is what they need right now and the possibility they need to look within for improvement.

 

[Needhelprealposter]

He/she did not do well at a DO school, did poorly on boards, is unable to present to an attending, unable to understand that social dynamics like saying "I'm 'wired' to practice ER!" may have caused him to be perceived poorly on audition rotations, and in general does not seem to understand the general trend in medical students learning to take a history. I hate to be the one to say it but I have yet to be made aware of the strengths. Hopefully OP can understand that honesty is what they need right now and the possibility they need to look within for improvement.

HS was subelite, all of us 4.0+ people went to ivy league or to public ivies.

MCAT > average MD matriculant.

Science GPA was screwed by our very competitive university. See, the secret a lot of people like me didn't know was that it's better to go to an easier undergrad with less academically strong people to get a great GPA. Unless you went to an ivy college, I ain't impressed.

Took a year of science classes at a normal college to boost science GPA, which was only like 3.3 at our hard university, and got like a 3.9.

Don't feel so snug being an MD graduate; I didn't get into an MD school because I went to a very hard college and didn't apply to many MD schools. My colleagues did better than me in medical school even though my stats were WAY above theirs due to personal issues.

You also don't know me or haven't heard me present. Nor were you there with the other ms4 that was talking to the pt.

I do appreciate honesty but I'm not some bumbling dummy that doesn't know crap. I found your reply somewhat insulting.

 

[jw3600]

HS was subelite, all of us 4.0+ people went to ivy league or to public ivies.

MCAT > average MD matriculant.

Science GPA was screwed by our very competitive university. See, the secret a lot of people like me didn't know was that it's better to go to an easier undergrad with less academically strong people to get a great GPA. Unless you went to an ivy college, I ain't impressed.

Took a year of science classes at a normal college to boost science GPA, which was only like 3.3 at our hard university, and got like a 3.9.

Don't feel so snug being an MD graduate; I didn't get into an MD school because I went to a very hard college and didn't apply to many MD schools. My colleagues did better than me in medical school even though my stats were WAY above theirs due to personal issues.

You also don't know me or haven't heard me present. Nor were you there with the other ms4 that was talking to the pt.

I do appreciate honesty but I'm not some bumbling dummy that doesn't know crap. I found your reply somewhat insulting.

I am a DO student. I also had an MCAT above the average MD matriculant. I could care less where you want to high school or undergrad. Hearing you refer to your undergrad as "very hard" sounds unbelievably whiny and entitled. Especially considering ivies are known for grade inflation. Accomplishments before med school are pretty meaningless when it comes to residency placement.

The fact is that everyone starts at the same point in med school and your performance was ADMITTEDLY sub par against a group of students who are statistically less likely to excel in med school. The fact you are even bringing up your inferior performance to your classmates as mitigated by "your way higher stats" show how delusional you are. MCAT/UGPA are freaking predictors. No one uses the predictors of medical school performance when they have the actual RESULTS.

Obviously, I don't know you. What kind of preface is that? It is unfortunate that you had personal issues but that does not wholly absolve you of your, again self-admitted, poor performance. It is a additionally considered factor at most. And no **** I did not hear you present to the attending. YOU SAID "I've done "poorly" in the sense that I get nervous when presenting to attendings."

Honestly, your posts read like a facebook comment. Either you are a troll or seriously need to reevaluate how you perceive yourself. You have an excuse for everything. Life is not about what you might be able to do. It's about results. It can be merciless but that's the way it is. Good luck.

 

[Makati2008]

I am a DO student. I also had an MCAT above the average MD matriculant. I could care less where you want to high school or undergrad. Hearing you refer to your undergrad as "very hard" sounds unbelievably whiny and entitled. Especially considering ivies are known for grade inflation. Accomplishments before med school are pretty meaningless when it comes to residency placement.

The fact is that everyone starts at the same point in med school and your performance was ADMITTEDLY sub par against a group of students who are statistically less likely to excel in med school. The fact you are even bringing up your inferior performance to your classmates as mitigated by "your way higher stats" show how delusional you are. MCAT/UGPA are freaking predictors. No one uses the predictors of medical school performance when they have the actual RESULTS.

Obviously, I don't know you. What kind of preface is that? It is unfortunate that you had personal issues but that does not wholly absolve you of your, again self-admitted, poor performance. It is a additionally considered factor at most. And no **** I did not hear you present to the attending. YOU SAID "I've done "poorly" in the sense that I get nervous when presenting to attendings."

Honestly, your posts read like a facebook comment. Either you are a troll or seriously need to reevaluate how you perceive yourself. You have an excuse for everything. Life is not about what you might be able to do. It's about results. It can be merciless but that's the way it is. Good luck.

Agreed. I was initially feeling bad for the Op but all these excuses as well as the other issues mentioned by the above poster make me have no pity for her/him.

I definitely can relate to some of the issues he/she has(ie anxiety and not doing well on comlex) but that is when you suck it up, read more, present more, and ask for critiques of your weaknesses.

Nothing is handed to you, especially EM with it being so hot these days.

 

[The White Coat Investor]

EM = specialty
ED = Part of the hospital
ER = TV Show
EP = practitioner of the specialty; other acceptable names include emergency doctor and emergency physician but not ER physician, ER doctor, ED physician, ED doctor, EM doctor, EM physician, emergency medicine doctor, emergency medicine physician, or emergentologist.

Do I correct people in person? No. But it certainly looks bad to me when I see it on applications, CVs, and letters of interest. This question goes through my mind: "Does this person really not know the official, formal name of the specialty they're most interested in? What else do they not know? What other lapses in judgement will they make?" Judgmental? Perhaps. But remember I'm not the only one in the specialty that feels that way. No sense in closing doors that would otherwise be open to you due to a silly thing like this.

To the OP- best to try for the backdoor of EM- an FP residency with an emphasis in EM + a one year EM fellowship, then to a less competitive/rural ED if this is really your dream.

 

[Needhelprealposter]

I am a DO student. I also had an MCAT above the average MD matriculant. I could care less where you want to high school or undergrad. Hearing you refer to your undergrad as "very hard" sounds unbelievably whiny and entitled. Especially considering ivies are known for grade inflation. Accomplishments before med school are pretty meaningless when it comes to residency placement.

The fact is that everyone starts at the same point in med school and your performance was ADMITTEDLY sub par against a group of students who are statistically less likely to excel in med school. The fact you are even bringing up your inferior performance to your classmates as mitigated by "your way higher stats" show how delusional you are. MCAT/UGPA are freaking predictors. No one uses the predictors of medical school performance when they have the actual RESULTS.

Obviously, I don't know you. What kind of preface is that? It is unfortunate that you had personal issues but that does not wholly absolve you of your, again self-admitted, poor performance. It is a additionally considered factor at most. And no **** I did not hear you present to the attending. YOU SAID "I've done "poorly" in the sense that I get nervous when presenting to attendings."

Honestly, your posts read like a facebook comment. Either you are a troll or seriously need to reevaluate how you perceive yourself. You have an excuse for everything. Life is not about what you might be able to do. It's about results. It can be merciless but that's the way it is. Good luck.

I'm sorry for the rudeness of my post but I felt like I was being made fun of or "criticized" for attending a DO school. A lot of MD students I've met assume that you had a 3.3 GPA and a 24 MCAT from Bob's college. But there are exceptions. And the post was saying, "I don't know what strengths the person actually has." That seemed insulting to me.

MCAT/uGPA are very, very good predictors for med school performance. Partly because people that had good GPA/MCAT statistics are likely to continue doing well. I agree that previous performance is not a perfect basis for predicting future performance. I never said I went to an ivy, either. Actually, I only heard of Harvard inflating grades, not the other ones.

My poor performance is subjective; I have a very, very low opinion of myself and assume that the attending didn't like me. This is not an excuse, at least in my eyes. It is the problem and I'm trying to tackle it.

Good luck to you too.

 

[Needhelprealposter]

EM = specialty
ED = Part of the hospital
ER = TV Show
EP = practitioner of the specialty; other acceptable names include emergency doctor and emergency physician but not ER physician, ER doctor, ED physician, ED doctor, EM doctor, EM physician, emergency medicine doctor, emergency medicine physician, or emergentologist.

Do I correct people in person? No. But it certainly looks bad to me when I see it on applications, CVs, and letters of interest. This question goes through my mind: "Does this person really not know the official, formal name of the specialty they're most interested in? What else do they not know? What other lapses in judgement will they make?" Judgmental? Perhaps. But remember I'm not the only one in the specialty that feels that way. No sense in closing doors that would otherwise be open to you due to a silly thing like this.

To the OP- best to try for the backdoor of EM- an FP residency with an emphasis in EM + a one year EM fellowship, then to a less competitive/rural ED if this is really your dream.

Thank you. I'll try my best to just do well in residency.

 

[GTP]

This thread took an unexpected turn ...