Options if I don't match

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WarmFuzzies

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Hey guys,

I'm an osteopathic student trying to match into EM, but unfortunately my prospects aren't looking so hot this year. I didn't match into an AOA position and I only interviewed at one ACGME spot. Soo I'm basically assuming I'll have to scramble during the SOAP next week. Assuming that I am also unable to scramble into an EM spot, I am just trying to weigh my options as to what to do next - try to scramble into a prelim year and reapply to EM next year or bite the bullet and go for an IM spot. While my academic record is probably a bit below average for EM (see summary below), my main pitfall was probably sending in my applications late (2 weeks, and don't really have an excuse for that one). My question is what kind of effect would doing a prelim year have on my candidacy? Would it even improve my stock? If so, is it better to do a Surg-prelim or medical-prelim?

IM was always a strong second option for me and even though I've REALLY wanted to do EM all four years of med school, if I do start an IM residency, I don't know if I would have the stones to risk trying to transfer out into a different specialty.

COMLEX/USMLE 1: 485/195
COMLEX/USMLE 2: 564/235
Rank: Bottom half of class
Extracurric: Class council pres x2 years, did two EM electives during MS1 and MS2
Research: 2 neurosurgery publications while in undergrad
Work exp prior to MS: Ambulance EMT x1 year, ED Trauma Tech x1.5 years

Any advice would be greatly appreciated! Thanks guys!

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Hey guys,

I'm an osteopathic student trying to match into EM, but unfortunately my prospects aren't looking so hot this year. I didn't match into an AOA position and I only interviewed at one ACGME spot. Soo I'm basically assuming I'll have to scramble during the SOAP next week. Assuming that I am also unable to scramble into an EM spot, I am just trying to weigh my options as to what to do next - try to scramble into a prelim year and reapply to EM next year or bite the bullet and go for an IM spot. While my academic record is probably a bit below average for EM (see summary below), my main pitfall was probably sending in my applications late (2 weeks, and don't really have an excuse for that one). My question is what kind of effect would doing a prelim year have on my candidacy? Would it even improve my stock? If so, is it better to do a Surg-prelim or medical-prelim?

IM was always a strong second option for me and even though I've REALLY wanted to do EM all four years of med school, if I do start an IM residency, I don't know if I would have the stones to risk trying to transfer out into a different specialty.

COMLEX/USMLE 1: 485/195
COMLEX/USMLE 2: 564/235
Rank: Bottom half of class
Extracurric: Class council pres x2 years, did two EM electives during MS1 and MS2
Research: 2 neurosurgery publications while in undergrad
Work exp prior to MS: Ambulance EMT x1 year, ED Trauma Tech x1.5 years

Any advice would be greatly appreciated! Thanks guys!

If it was me I would wait until after the acgme match and then find an AOA tri/Ty. Your chances of matching in either side will be very slim(I was told by several PDs they don't look at reapplicants.) but I would assume you have a better shot at an AOA residency then acgme with it getting so much more competitive. Also did you have any sloe? I'm just wondering due to you having a decent step 2 score? So any red flags(minus step. 1)? Also I would go for broke next cycle and apply to as many programs that you can afford.
 
Did you apply pretty broad?

If you applied wide on the AOA side and didn't match I don't think you are going to fare much better on the allopathic side.

I hate saying you don't have a chance...but the odds are certainly stacked up against you.

If you really want to do EM you would want to apply to every program in the nation and do a prelim at a hospital with an EM program you realistically can "impress." Even if you don't rotate in the ED during prelim year, maybe your interactions with their off services residents will help you in next application cycle.
 
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Thanks for the tips!
Yes, I did have a decent SLOE and 3 good LOR's (but only 1 from an EM related specialty). I applied pretty broadly to both, but to be honest might as well have skipped AOA, I applied so late. Obviously, between that and the weak Step 1 I was kinda doomed. Hoping my chances will be better next year if I eliminate the lateness factor and have an additional year of residency under my belt.
 
Thanks for the tips!
Yes, I did have a decent SLOE and 3 good LOR's (but only 1 from an EM related specialty). I applied pretty broadly to both, but to be honest might as well have skipped AOA, I applied so late. Obviously, between that and the weak Step 1 I was kinda doomed. Hoping my chances will be better next year if I eliminate the lateness factor and have an additional year of residency under my belt.

I wouldn't think the lateness would be a factor(just 2 weeks). I applied a little late to the osteo match and still ended up at my number 1.

Also you said your sloe was decent was it high pass or honors at least? I think next year you need to find a way to get an additional quality sloe to help you.
 
Thanks for the tips!
Yes, I did have a decent SLOE and 3 good LOR's (but only 1 from an EM related specialty). I applied pretty broadly to both, but to be honest might as well have skipped AOA, I applied so late. Obviously, between that and the weak Step 1 I was kinda doomed. Hoping my chances will be better next year if I eliminate the lateness factor and have an additional year of residency under my belt.

You will also need to get all new rec letters for next year, preferably at least 2 EM SLOR's. Something else you could do is start a research project now---hopefully something that can be continued next year---and try to get a publication before the next round of interviews.
 
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I heard from people that people who do Surg Prelim feel more comfortable doing procedures during their intern year in EM. If you were to do prelim, do your elective early during audition rotation period in EM so you can get a SLOE.

Just to let you know if you do decide to do a TRI, AOA EM programs are highly biased toward those who auditioned at that program. If you really want to go to that one program, an option for you would be to do a TRI there and express great interest in the program. Please realize that as a reapplicant, you'll be at a disadvantage.
 
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