Osteopathic EM programs

[EMrdon]

Anyone have any experience or past posts that describe the process of re-applying? I, unfortunately, didn't match into EM this go around either but I'm not really ready to throw in the towel. I got my TRI spot with a PD that has some EM connections and currently my gameplan is to apply and rank EM and FM programs next go around.

Will the majority of FM programs accept my TRI at par, or will they make me repeat the intern year? Will AOA EM programs even consider a candidate that already has internship under their belt (and are therefore ineligible for govt funding)?

I can't really find any good resources on this honestly, just random threads on here and most of them are outdated to the point of irrelevance. If anyone has a good line on how this thing actually works I would love to hear about it.

For some perspective:

I'm pretty much in the middle of my class. Comlex 1: 510 Comlex 2: 580
My application was in a little late with some letters coming in particularly late, and I have some skeletons in the closet (a couple misdemeanors in college).

In other words, I don't feel like I'm too much of a reach to match at some EM program but now that I'll be coming off a TRI I think I might look like chopped liver. Anyone have any input? Should I resign myself to family practice?

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[Makati2008]

There had to have been something off. Did you only apply to the top DO programs? What about on the ACGME side? If you had 10 DO interviews and didn't match anywhere, that's just wrong. 550 to a 515 doesn't seem like a huge drop to be honest.

I agree acgme side you would have a few bites with your score. Even with my comlex I had 11 acgme invites.

 

[Makati2008]

Anyone have any experience or past posts that describe the process of re-applying? I, unfortunately, didn't match into EM this go around either but I'm not really ready to throw in the towel. I got my TRI spot with a PD that has some EM connections and currently my gameplan is to apply and rank EM and FM programs next go around.

Will the majority of FM programs accept my TRI at par, or will they make me repeat the intern year? Will AOA EM programs even consider a candidate that already has internship under their belt (and are therefore ineligible for govt funding)?

I can't really find any good resources on this honestly, just random threads on here and most of them are outdated to the point of irrelevance. If anyone has a good line on how this thing actually works I would love to hear about it.

I thought you were applying acgme? Also why did you avoid Ohio? How many interviews did you have?

As competitive as EM I would go any and everywhere I could afford unless you have super star stats and even then I would still have my backups in place.

 

[EMrdon]

I did apply ACGME, no interviews. I think probably because I didn't take Step 1 + the red flags.

I had 6 interviews on the AOA side, but they were primarily at bigger programs in the Northeast. I really thought I had a chance at these places following interviews and talking with PD's so I didn't necessarily feel the pressure. Obviously in retrospect I should have focused much more on these "less competitive" locations in Ohio and Michigan, but this doesn't really give me any traction now.

So, as much as I enjoy reliving my mistakes in this process, I'm trying to focus on the next step. TRI seems like a no-brainer at this point, given I can't do much else but match into FM/IM. So where from here? Re-apply much more broadly and perhaps focus on programs that I haven't applied to already?

 

[Makati2008]

I did apply ACGME, no interviews. I think probably because I didn't take Step 1 + the red flags.

I had 6 interviews on the AOA side, but they were primarily at bigger programs in the Northeast. I really thought I had a chance at these places following interviews and talking with PD's so I didn't necessarily feel the pressure. Obviously in retrospect I should have focused much more on these "less competitive" locations in Ohio and Michigan, but this doesn't really give me any traction now.

So, as much as I enjoy reliving my mistakes in this process, I'm trying to focus on the next step. TRI seems like a no-brainer at this point, given I can't do much else but match into FM/IM. So where from here? Re-apply much more broadly and perhaps focus on programs that I haven't applied to already?

I would follow the same path as siggy. Also the red flags(if they are big ones like failing a step or a repeating a year) I would think long and hard if you are going to be a viable candidate or would you be better served doing FM with an EM fellowship because as you correctly stated EM is getting more and more competitive. Also I would focus on killing level 3.

I know of a few programs that won't even touch your application being a reapplicant so I would think about that as well.

Also would contacting places to see where you ranked(if they can tell you ) will also be helpful?

 

[Siggy]

I would follow the same path as siggy. Also the red flags(if they are big ones like failing a step or a repeating a year) I would think long and hard if you are going to be a viable candidate or would you be better served doing FM with an EM fellowship because as you correctly stated EM is getting more and more competitive. Also I would focus on killing level 3.

I know of a few programs that won't even touch your application being a reapplicant so I would think about that as well.

Also would contacting places to see where you ranked(if they can tell you ) will also be helpful?

I think even with red flags, if there was an issue that could be solved next year that occurred this year (i.e. my first EM LOR came in late Sept, early August because my first EM rotation was Sept to August), then it's definitely worth reapplying. The big difference, however, is that you need a real backup specialty since you've already done a traditional year. So pick whether you want to apply to EM and IM or EM and FM, or any other essentially sure match specialty.

Also, if you can show your face at a program this year, do it (arguable getting a LOR at the same time, end of 4th year LORs should be stronger than the start of 4th year LORs), as well as scrambling into an intern year that offers away rotations.

Furthermore, the worst thing possible is to do nothing for a year. I know of one case (albeit rare) where an intern left an EM program for a FM program and one of the traditional years at that hospital was able to slide into the open spot as a PGY2. Similarly (same facility), I know of a NeuroSx resident who similarly decided to switch residencies and snagged a PGY1 spot.

Granted, these are exceptions and included exceptional people, but things do happen.

 

[NYEMMED]

Makati2008 Congratulations! I know you really wanted this. What region of the country did you match?

Congrats to all the rest as well.

 

[EMrdon]

Honestly I don't have any academic red flags. No board/rotation/class failures. Generally good clinical grades (mostly high pass or honors).

I have a couple misdemeanor charges from college, thats what i think really held me back. I was also rather late on a few letters.

So I think next year I'll have reasonable chance but I plan on ranking FM as well.

 

[Makati2008]

Makati2008 Congratulations! I know you really wanted this. What region of the country did you match?

Congrats to all the rest as well.

Check your inbox!

 

[just1man]

There had to have been something off. Did you only apply to the top DO programs? What about on the ACGME side? If you had 10 DO interviews and didn't match anywhere, that's just wrong. 550 to a 515 doesn't seem like a huge drop to be honest.

I did not apply acgme because my usmle 1 was only 213. I agree, it seems just wrong, but I don't What the answer could be other than bad luck with the lists filling above me. 1 thing is I had no SLOE s , they were all just letters.

My other thought was there must have been something in a letter, but I received many invites and had great feedback on my letters during interviews, I had two of my coordinators verify my letters were good and they stated they would have no hesitation using them.

I am not totally sure what you mean by top programs. I know the top 4 or so, but I would have trouble putting the rest in a meaningful order. A big issue on the DO side is that many programs have 5 or less residents so you could be relatively high on the list and still not match.

 

[gutonc]

I did not apply acgme because my usmle 1 was only 213. I agree, it seems just wrong, but I don't What the answer could be other than bad luck with the lists filling above me. 1 thing is I had no SLOE s , they were all just letters.

Not sure how it is on the DO side, but in the ACGME match, for all intents and purposes, no SLOE = no Match.

 

[NYEMMED]

Not sure how it is on the DO side, but in the ACGME match, for all intents and purposes, no SLOE = no Match.

I agree with this for the DO side. The SLOE is very important, Not an end all be all but probably takes 90-95% of the wind out of your sails.

 

[Makati2008]

I agree with this for the DO side. The SLOE is very important, Not an end all be all but probably takes 90-95% of the wind out of your sails.

Agreed. I had one program call me to tell me they were going from sloe instead of lor at the beginning of the cycle to explain the delay of the lor.

 

[ewokka]

Just1man- I agree with the others FM with EM fellowship seems like it might be a good choice for you. Good luck with everything though, I'm sure it will work out.

Is doing only two auditions at AOA programs safe? I plan on doing my other 3 at ACGME spots. I'd rather match in an ACGME program mainly for geographic reasons but I don't wanna make a fatal mistake and not show my face at all in the event that I don't skip the AOA match. Also, how many interviews in ACGME programs would I need to 'safely' skip the AOA match? My step 1 COMLEX is good at 600+ but USMLE a little less stellar at high 220s. I plan on taking USMLE step 2 also. I am trying to schedule my fourth year wisely. Any advice would be much appreciated.

 

[HarryPlopper]

Extremely down
550+ step 1
515 + step 2
Good preclinical grades, all rotations were honored or high passed.
3 auditions, EM research, solid letters, previous EMS experience.

10 interviews and no match. Kiss of death was only auditioning top programs, didn't match those and I was toast. I had 5 more invites but seriously doubt it would have made a difference. Auditions are king now.

Not doing a TRI because next year it will be even harder applying as a TRI and more and more picking EM. Not to mention that it makes for a 5 year residency as you are very unlikely to get advanced standing.

Don't kid yourself either, I had no red flags and even got a couple "ranking you highly" letters.

I'm very sorry to hear this and I wish you the best. But I would like to point out a few problems with your statement. Please understand I'm not trying to be an ass but I think you should know why you might be wrong with "no red flags":

"Ranking you highly" letters from programs are bullsh*t. Never trust what any program says until match day. Never.

Next is the drop in your COMLEX. COMLEX 2 and Step 2 weigh more than COMLEX 1 or step 1 for EM. What was your Step 2 score? Step 1 of 213 looks bad but you CAN make it up with a good Step 2. If your Step 2 was bad, then this spells trouble. One of the point of taking the Step in addition to COMLEX is prove consistency, whether it is good or bad. You don't want to show that you are consistently bad. On one of my ACGME interviews, my interviewer asked me why was my Step 2 only marginally higher than my Step 1 (which was high 230s) as they hoped for a ~10 point increase (Anyone else have trouble with this?). I didn't expect this to screw me and I didn't think it was fair IMO but this is to underscore the importance of a good Step and COMLEX 2 or at least a significant increase.

I do think those invites would have made a difference. I was interviewed and I matched at a program that many have told me that this program rarely interviews or match anyone who didn't do an audition. Audition is king but so are SLOEs.

Another thing you didn't mention on this post but on another post is that you didn't apply ACGME. I'm sorry to be abrasive but I have no idea why you would do this. Many ACGME programs are very EM friendly and since you already took the steps, for what reason would you not apply? True your chances may not be good but it's worth a shot.

However I think the biggest problem with your application is that you got letters of eval but none of them were SLOEs. In the distant past, not having a SLOE (SLOR back then) in EM wasn't good but wasn't a deal breaker for AOA back then but it is pretty much mandatory now. I suspect that you were interviewed at many places because of your strong application but they did expect a SLOE at one point or another.


From your application, it sounds you will be an excellent physician wherever you go. Again, I wish you the best in your endeavors.

 

[HarryPlopper]

Just1man- I agree with the others FM with EM fellowship seems like it might be a good choice for you. Good luck with everything though, I'm sure it will work out.

Is doing only two auditions at AOA programs safe? I plan on doing my other 3 at ACGME spots. I'd rather match in an ACGME program mainly for geographic reasons but I don't wanna make a fatal mistake and not show my face at all in the event that I don't skip the AOA match. Also, how many interviews in ACGME programs would I need to 'safely' skip the AOA match? My step 1 COMLEX is good at 600+ but USMLE a little less stellar at high 220s. I plan on taking USMLE step 2 also. I am trying to schedule my fourth year wisely. Any advice would be much appreciated.

Going to 10 interviews is reasonable for last year; can't say for this year until ACGME match results come out. Might change since EM is getting harder.

I would do at least one audition at an ACGME spot and I wouldn't do more than 3 EM rotations altogether. It seems overkill. I would recommend that one of those spots be out of state from where you are to prove to PDs during your interview that you are interested in education and not just location. I ignored this advice and I learned this the hard way.

EM is getting harder and although EM friendly, you can't always be sure you'll match. If your USMLE ends up being lower than Step 1 or if your SLOEs are mediocre (even a single one of them) then you aren't safe IMO.

Auditions are important. If you feel you can do more than 3 rotations then great. However if you do a rotation at one of the places that offer a SLOE and you do not get one and send it in because you felt that your performance was weak, then just be prepared to be asked this should it come up in an interview. I wasn't asked this personally but a friend of mine was and the response was not good. Some people say this is a red flag.

 

[MerickManual]

It was a tough year for EM... I know five peers right off the bat with great scores, LOR (they claim) and auditions with the "rank you highly" email that went unmatched and had to scramble... I wish all of you who didn't match in your specialty of choice the best of luck.

 

[ewokka]

Going to 10 interviews is reasonable for last year; can't say for this year until ACGME match results come out. Might change since EM is getting harder.

I would do at least one audition at an ACGME spot and I wouldn't do more than 3 EM rotations altogether. It seems overkill. I would recommend that one of those spots be out of state from where you are to prove to PDs during your interview that you are interested in education and not just location. I ignored this advice and I learned this the hard way.

EM is getting harder and although EM friendly, you can't always be sure you'll match. If your USMLE ends up being lower than Step 1 or if your SLOEs are mediocre (even a single one of them) then you aren't safe IMO.

Auditions are important. If you feel you can do more than 3 rotations then great. However if you do a rotation at one of the places that offer a SLOE and you do not get one and send it in because you felt that your performance was weak, then just be prepared to be asked this should it come up in an interview. I wasn't asked this personally but a friend of mine was and the response was not good. Some people say this is a red flag.

Improving on USMLE makes sense. What about COMLEX? With a 600+ would it look bad if I didn't improve upon that on Step 2? I assume that most do better on step 2 as it is less focused on meticulous basic medical science stuff...?

 

[HarryPlopper]

Improving on USMLE makes sense. What about COMLEX? With a 600+ would it look bad if I didn't improve upon that on Step 2? I assume that most do better on step 2 as it is less focused on meticulous basic medical science stuff...?

A 600+ looks good. It does look bad if your Step 2 isn't better than your Step 1 unless your Step 1 is already very high to begin with. If your Step 1 is low, you might be asked why you didn't take Step 2. IMO, I've never heard of a good response to that question. Ever. The good news is that Step 2 is easier for most people and if you study hard enough and continue the same trend as your COMLEX, you should be great.

 

[Makati2008]

A 600+ looks good. It does look bad if your Step 2 isn't better than your Step 1 unless your Step 1 is already very high to begin with. If your Step 1 is low, you might be asked why you didn't take Step 2. IMO, I've never heard of a good response to that question. Ever. The good news is that Step 2 is easier for most people and if you study hard enough and continue the same trend as your COMLEX, you should be great.

I think he will be ok with his scores as long as he doesn't drop from the 600s to the 500s. A score of 600 is still a very good score....

 

[Siggy]

It was a tough year for EM... I know five peers right off the bat with great scores, LOR (they claim) and auditions with the "rank you highly" email that went unmatched and had to scramble... I wish all of you who didn't match in your specialty of choice the best of luck.

Did any of them catch the 6 open EM spots (including the 1 EM/FM and 2 EM/IMs)? I'm starting to think that matching into a TRI was more of a Godsend than I felt on Match Day.

 

[MerickManual]

Did any of them catch the 6 open EM spots (including the 1 EM/FM and 2 EM/IMs)? I'm starting to think that matching into a TRI was more of a Godsend than I felt on Match Day.

No, they didn't.

 

[HarryPlopper]

Did any of them catch the 6 open EM spots (including the 1 EM/FM and 2 EM/IMs)? I'm starting to think that matching into a TRI was more of a Godsend than I felt on Match Day.

I'm surprised that there were any EM spots open after the match.

 

[Sparty12]

I'm surprised that there were any EM spots open after the match.

It might be because the EM programs themselves didn't rank enough applicants. Similar to the student, it's important for the program to rank enough quality candidates.

 

[Makati2008]

It might be because the EM programs themselves didn't rank enough applicants. Similar to the student, it's important for the program to rank enough quality candidates.

That is true. One of my top three didn't fill and it's a good program but they don't interview they just rank those that rotate there. If they would have given me any insight to my ranking I would have thought long and hard about changing my number one due to the other program being better for me from a financial standpoint.

 

[darthmicrobius]

So, 2/10/2014 will forever be remembered in my mind as the most disappointing day ever... Im a DO student and I was going for EM but failed to match. This came as a big surprise to me but I learned alot in the process and wanted to share my story for others who are gunning for EM to learn from...

I thought I was a shoe-in at my base hospital's EM program and thought I would have a good shot at the 4 other programs I ranked. My app, Ive been told by my home institution's PD, was very competitive. I had 615 and 670 Comlex scores, 220 USMLE, passed PE first try, no real red flags I can think of apart from an MIP I got in college. Passed almost all courses with high honors or honors. No research but many volunteer and international experiences. Had only 1 SLOE for the MD programs I applied to.

In hindsight, my problem was that I didnt audition at the right places, I didnt apply to enough programs, and I underestimated how competitive EM is

When applying, I couldnt decide between EM and rads and applied to 12 DO EM programs, 12 MD EM programs, and 10 rads (DO) programs. I rotated through my base hospitals (DO) EM program, 2 MD EM programs and 3 DO rads places (all 2 week rotations). I thought that because my board scores were so high, I would get interview invites to all the places I applied to... I was invited to interview at 4 DO programs, all the rads programs I applied to and only the 2 MD hospitals I applied to. All the interviews went well except for the MD hospitals I applied to. Around mid October I decided on EM and declined most of my rads interviews (I was even given 2 offers from PDs at the rads programs I rotated at, both of which I declined). I ranked all the DO places I interviewed at, was told by a few seniors at my base hospital that I was a shoe in for my home program, and even spent my free time putting in shifts at other local programs I interviewed with but didnt audition at.

On match day, I didnt match and after losing it for a few hours, I gained some composure and called up local hospitals (at 11 am, before the scramble list came out) to ask what programs failed to match. To make a long and complicated story very short, I was offered an IM spot at a local hospital (which I am very fond of) which I made a hasty decision to take. My chances in NRMP were poor and I didnt want to risk this IM spot (which was a time sensitive offer) by trying to scramble for one of the open EM spots...

I feel very fortunate ot have snagged the IM position I have and I want to give this a chance, as I used to be set on pursing IM. I plan on trying to be the best resident possible.... but, I still question my hasty decision and if I end up dreading it, I will have no choice other than to apply next cycle to an MD 3 year EM program.

So, to anyone who is thinking of applying to EM, decide EARLY so that you can make it known to your base hospital (if they have a program) that you are gunning to be an ER doc. Send your apps in on the first day that ERAS opens and apply to A TON of programs, even in places that may seem less desirable than others.... I think 20-30 programs would be a good number to shoot for. If you are applying to MD programs, be sure you have at least 2 SLOEs or else most programs wont even consider you.. Most importantly, Plan 2 or 3 auditions and rock your audition rotations by arriving early, staying late, reading, and getting in face time with the PDs and chief residents. The connections you have and the people you impress are far more important factors than board scores and class rank... I really underestimated this as there are a ton of politics involved in medicine and auditioning was similar to a popularity contest at times...

Sorry for the length of this message... good luck to all and congrats to those who ranked.. for those who failed to, it does get better...

 

[Makati2008]

So, 2/10/2014 will forever be remembered in my mind as the most disappointing day ever... Im a DO student and I was going for EM but failed to match. This came as a big surprise to me but I learned alot in the process and wanted to share my story for others who are gunning for EM to learn from...

I thought I was a shoe-in at my base hospital's EM program and thought I would have a good shot at the 4 other programs I ranked. My app, Ive been told by my home institution's PD, was very competitive. I had 615 and 670 Comlex scores, 220 USMLE, passed PE first try, no real red flags I can think of apart from an MIP I got in college. Passed almost all courses with high honors or honors. No research but many volunteer and international experiences. Had only 1 SLOE for the MD programs I applied to.

In hindsight, my problem was that I didnt audition at the right places, I didnt apply to enough programs, and I underestimated how competitive EM is

When applying, I couldnt decide between EM and rads and applied to 12 DO EM programs, 12 MD EM programs, and 10 rads (DO) programs. I rotated through my base hospitals (DO) EM program, 2 MD EM programs and 3 DO rads places (all 2 week rotations). I thought that because my board scores were so high, I would get interview invites to all the places I applied to... I was invited to interview at 4 DO programs, all the rads programs I applied to and only the 2 MD hospitals I applied to. All the interviews went well except for the MD hospitals I applied to. Around mid October I decided on EM and declined most of my rads interviews (I was even given 2 offers from PDs at the rads programs I rotated at, both of which I declined). I ranked all the DO places I interviewed at, was told by a few seniors at my base hospital that I was a shoe in for my home program, and even spent my free time putting in shifts at other local programs I interviewed with but didnt audition at.

On match day, I didnt match and after losing it for a few hours, I gained some composure and called up local hospitals (at 11 am, before the scramble list came out) to ask what programs failed to match. To make a long and complicated story very short, I was offered an IM spot at a local hospital (which I am very fond of) which I made a hasty decision to take. My chances in NRMP were poor and I didnt want to risk this IM spot (which was a time sensitive offer) by trying to scramble for one of the open EM spots...

I feel very fortunate ot have snagged the IM position I have and I want to give this a chance, as I used to be set on pursing IM. I plan on trying to be the best resident possible.... but, I still question my hasty decision and if I end up dreading it, I will have no choice other than to apply next cycle to an MD 3 year EM program.

So, to anyone who is thinking of applying to EM, decide EARLY so that you can make it known to your base hospital (if they have a program) that you are gunning to be an ER doc. Send your apps in on the first day that ERAS opens and apply to A TON of programs, even in places that may seem less desirable than others.... I think 20-30 programs would be a good number to shoot for. If you are applying to MD programs, be sure you have at least 2 SLOEs or else most programs wont even consider you.. Most importantly, Plan 2 or 3 auditions and rock your audition rotations by arriving early, staying late, reading, and getting in face time with the PDs and chief residents. The connections you have and the people you impress are far more important factors than board scores and class rank... I really underestimated this as there are a ton of politics involved in medicine and auditioning was similar to a popularity contest at times...

Sorry for the length of this message... good luck to all and congrats to those who ranked.. for those who failed to, it does get better...

I agree except I would apply to at least 30 places in the match especially with EM being so competitive. Also to the op what area are you in? I would recommend reapplying I'm the osteo match and pan apply acgme because the MD world seems to be even more competitive that ours. Several places I interviewed had greater than 1k apps for class sizes less than 7.

 

[discostu42]

.

 

[sylvanthus]

ACGME may be tough, but id still apply. Apply to both matches and see what interviews you are able to get and then make a decision if youll stay in the AOA match.

 

[discostu42]

Thanks for your feedback @sylvanthus.

 

[sylvanthus]

Your USMLE is likely fine, try to improve on step 2 as EM programs take step 2 very seriously, equal to or greater than step 1. The bigger issue is the LOA. Likely not a death sentence, but it will likely come up.

 

[discostu42]

Ok, thanks a lot for your feedback, I really appreciate it.

::end thread hijack::

 

[GTP]

Hey everyone. I've been reading this thread very religiously, and I appreciate everyone who has posted. Congrats to those who matched, and goodluck in the next round to those who didnt. Just to double check, SLOE cannot be filled out by DOs right? CORD is only for MDs? Also, can any attending you work with during an EM rotation fill out the SLOE or does it have to be the PD? Furthermore, would it be frowned upon to ONLY get an EM SLOE and an ultrasound SLOE from the same program? In other words, are they still counted as two separate SLOEs?

Thanks a lot everyone!

 

[Tiger10]

Hey everyone. I've been reading this thread very religiously, and I appreciate everyone who has posted. Congrats to those who matched, and goodluck in the next round to those who didnt. Just to double check, SLOE cannot be filled out by DOs right? CORD is only for MDs? Also, can any attending you work with during an EM rotation fill out the SLOE or does it have to be the PD? Furthermore, would it be frowned upon to ONLY get an EM SLOE and an ultrasound SLOE from the same program? In other words, are they still counted as two separate SLOEs?

Thanks a lot everyone!

The SLOE can be filled out by MD or DO. I believe you need to rotate at a place with a program to get it but I don't think it has to be an ACGME program. The best SLORs are filled out by the director of the rotation and are composites of the feedback from the staff +/- residents. A non-residency affiliated ED SLOE's, if they can do them, I'd consider useless. The reason SLOE's are valuable is they give feedback from people involved with residencies who see EM-aspiring med students and they compare you to other students you're competing with in terms of rotation grade and where they estimate you'd be on their rank list.

I'm not a PD/attending but I was involved in some interviews during the past 2 years. If I saw a letter from a well respected program that said you were a stand out, you were probably were vs. a letter from a random community doc who said you were the best student he's seen. They also help to compare applicant A with an honors from a place where 50% of people got honors but were ranked middle 1/3 of the list and applicant B had a high pass where 5% got honors but was ranked top 1/3 of the list.

I'd get 2 from different programs since it'd be 2 sets of opinions. Don't underestimate the importance of SLOEs... Aside from the actual interview, they carried the most weight in the feedback I gave our PD.

 

[GTP]

The SLOE can be filled out by MD or DO. I believe you need to rotate at a place with a program to get it but I don't think it has to be an ACGME program. The best SLORs are filled out by the director of the rotation and are composites of the feedback from the staff +/- residents. A non-residency affiliated ED SLOE's, if they can do them, I'd consider useless. The reason SLOE's are valuable is they give feedback from people involved with residencies who see EM-aspiring med students and they compare you to other students you're competing with in terms of rotation grade and where they estimate you'd be on their rank list.

I'm not a PD/attending but I was involved in some interviews during the past 2 years. If I saw a letter from a well respected program that said you were a stand out, you were probably were vs. a letter from a random community doc who said you were the best student he's seen. They also help to compare applicant A with an honors from a place where 50% of people got honors but were ranked middle 1/3 of the list and applicant B had a high pass where 5% got honors but was ranked top 1/3 of the list.

I'd get 2 from different programs since it'd be 2 sets of opinions. Don't underestimate the importance of SLOEs... Aside from the actual interview, they carried the most weight in the feedback I gave our PD.

Thank you. This is so helpful. I was starting to get nervous because I am in the process of applying for audition/away rotations, and the DO programs have been more aggressive about scheduling me now, but the MD programs are taking their time. I thought only ACGME programs could fill out SLOEs so I was worried about "using up" all my rotations at DO programs. This makes me feel much better. I'm happy going MD or DO. I'll just schedule things in the order I receive offers.

 

[DO3]

So...here's the deal about the SLOE from the DO perspective. Only faculty at a residency program can fill them out. Many DO programs don't care about them or require them for application. There are a few that do prefer at least one, but you'll have to research which ones yourself. If in doubt, ask the program coordinator. If you do an audition at a DO program, many are unfamiliar with filling them out. Some simply don't fill them out. Again, it's program dependent. For some reason, a lot of DO programs prefer the more personal letters. And, nowadays, a lot of DO programs won't rank you without an audition. So that matters more than your letters.

Now, if you are applying to an MD program, the SLOE's definitely matter. Most require a minimum of two, and some want all of your letters to be in that format. However, on the MD side, it's not enough to simply get the letters. Where the letters are from is very important. If you get 3 SLOE's from DO auditions, many MD programs aren't going to really care about them. It's not going to help your application. If applying to competitive MD EM programs, you need to rotate and get strong SLOE's from well-respected and well-established MD EM residency programs. MD program directors and faculty know one another and respect their peers' opinion.

Another thing about SLOE's....be or prepared to wait upwards of two months before they are completed. Several of my classmates got SLOE's from MD programs, however, by the time they were turned in, it was too late in the application cycle for them to be of use. Put them in a really bad spot.

I just went thorough the EM application cycle, this was my experience.

 

[HarryPlopper]

So...here's the deal about the SLOE from the DO perspective. Only faculty at a residency program can fill them out. Many DO programs don't care about them or require them for application. There are a few that do prefer at least one, but you'll have to research which ones yourself. If in doubt, ask the program coordinator. If you do an audition at a DO program, many are unfamiliar with filling them out. Some simply don't fill them out. Again, it's program dependent. For some reason, a lot of DO programs prefer the more personal letters. And, nowadays, a lot of DO programs won't rank you without an audition. So that matters more than your letters.

Where are you getting the info that DO programs don't care about SLOEs? PDs? Instead of looking up which programs do/do not care about SLOEs, it would be better to play on the safe side and send in a SLOE regardless. There have been people with stellar apps not get in possibly because of lack of SLOEs. Also doing a rotation at a place that offers SLOE and not getting one can raise questions. I wouldn't say it's a red flag, but it will raise brows and even come up in an interview. I do agree that personal letters are important but in general, it should be assumed that SLOEs are the way to go, especially now that EM is getting more competitive.

If you get 3 SLOE's from DO auditions, many MD programs aren't going to really care about them.....It's not going to help your application.

I disagree. The NE is very friendly towards DOs and some take DO SLOEs seriously. If it were say in the west, they may not take it seriously but then again they don't accept DOs either.

Another thing about SLOE's....be or prepared to wait upwards of two months before they are completed. Several of my classmates got SLOE's from MD programs, however, by the time they were turned in, it was too late in the application cycle for them to be of use. Put them in a really bad spot.

You can make it easier on yourself by expressing your interest in getting a SLOE early on so the writer will begin compiling information. It may help expedite the process for some people.

You should generally get at least 1 SLOE in by the time you send in your application, which should be soon after programs begin accepting apps.

 

[DO3]

Actually, yes, that info was from some PDs. SLOEs are definitely not required on the DO side for many programs. Had multiple friends match into DO programs without a single one. Best advice is to check with the program coordinator despite what the above poster states. My experience during the interview process was that a SLOE from a dually accredited DO program would carry some weight with MD programs, but that a letter from a DO only program wasn't as desirsble.

 

[Beth_W737]

Depends, I matched AOA but interviewed at allo and dual programs and all mentioned my positive SLOEs from my DO program. So it all depends

 

[GTP]

I see. Thanks everyone for your comments. DO3 you mentioned the importance of getting an SLOE from an ACGME program that is well recognized because PDs know and trust each other's opinions. My first rotation is set up at Newark Beth Isreal. But I am also trying to set up an ultrasound rotation with the PD (hopefully two SLOEs from 1.5 rotations?). Is this considered a well recognized program? I've only heard positives about it, except for the fact that it is a level 2 center. However, with the location, level 1 trauma cases walk in all the time. I'm also considering St Loius medical program, Emory, Medical college of wisconsin, Case western reserve, Texas (austin), Akron, Healthpartners, St Lukes, PCOM Einstein, WashU, and John H stroger for rotations. I know Emory and PCOM are highly regarded but I am not sure about the rest.

 

[HarryPlopper]

Actually, yes, that info was from some PDs. SLOEs are definitely not required on the DO side for many programs. Had multiple friends match into DO programs without a single one. Best advice is to check with the program coordinator despite what the above poster states. My experience during the interview process was that a SLOE from a dually accredited DO program would carry some weight with MD programs, but that a letter from a DO only program wasn't as desirsble.

Thank you for your reply.

I see. Thanks everyone for your comments. DO3 you mentioned the importance of getting an SLOE from an ACGME program that is well recognized because PDs know and trust each other's opinions. My first rotation is set up at Newark Beth Isreal. But I am also trying to set up an ultrasound rotation with the PD (hopefully two SLOEs from 1.5 rotations?). Is this considered a well recognized program? I've only heard positives about it, except for the fact that it is a level 2 center. However, with the location, level 1 trauma cases walk in all the time. I'm also considering St Loius medical program, Emory, Medical college of wisconsin, Case western reserve, Texas (austin), Akron, Healthpartners, St Lukes, PCOM Einstein, WashU, and John H stroger for rotations. I know Emory and PCOM are highly regarded but I am not sure about the rest.

I don't think you get two SLOEs from the same program, even if they are they are different rotations. NBI is a well-recognized, dual-accredited program in the area.

 

[Beth_W737]

I got 2 SLOEs from my first audition because I couldn't do it until Aug, and my next rotation didn't finish until end of Oct which was too late. We don't get 3rd year electives.

 

[jkmph]

I got 2 SLOEs from my first audition because I couldn't do it until Aug, and my next rotation didn't finish until end of Oct which was too late. We don't get 3rd year electives.

For what it's worth, it doesn't make sense to get 2 SLOE's from the same program/rotation. It's a composite evaluation of your performance based on the input of all the clinicians / residents you worked with (in theory, at least). Getting two is at best redundant. At worst, you can hurt yourself if they say different things or one is good and one is bad.

 

[Beth_W737]

All mine were good and there was no possible way for me to get any from any other ER faculty before Oct except at our home program, I got one from the program director, one from the head of the ED. I'm not sure a new letter in Nov would have done any good though in hindsight maybe I should have.

 

[DO3]

2 SLOE's from two different places, if both are strong, are definitely better than 2 SLOE's from the same program. 2 SLOE's from the same program will contain the same information except for the extra comments that the authors might add.

 

[scummie]

Take this with a grain of salt, but I have talked to multiple PDs who say that anything more than 2 aways is considered excessive. But this is SDN.

 

[JJohnsonDO]

Can anyone discuss their experience/provide some information about Mount Sinai/Miami Beach?

 

[ewokka]

Need some advice here. Have 4 elective ERs set up 4th year (working on it at least). I primarily want to apply acgme so should I do acgme programs first to get acgme SLORs, or will it not matter if my SLORs are from AOA programs? My ACGME rotations aren't until early October and November. Should I schedule at least 1 earlier if possible to ensure I'll have their slor before application time?

 

[jkmph]

Need some advice here. Have 4 elective ERs set up 4th year (working on it at least). I primarily want to apply acgme so should I do acgme programs first to get acgme SLORs, or will it not matter if my SLORs are from AOA programs? My ACGME rotations aren't until early October and November. Should I schedule at least 1 earlier if possible to ensure I'll have their slor before application time?

If you want to go ACGME, it would be wise to get letters from ACGME programs.

 

[dav86]

Need some advice here. Have 4 elective ERs set up 4th year (working on it at least). I primarily want to apply acgme so should I do acgme programs first to get acgme SLORs, or will it not matter if my SLORs are from AOA programs? My ACGME rotations aren't until early October and November. Should I schedule at least 1 earlier if possible to ensure I'll have their slor before application time?

If you want to go ACGME you will need ACGME SLOEs. Oct and Nov rotation are probably too late to give you the best chance to have letters in on time. Oct might work depending on how long it will take the program to write you the letter. Many ACGME programs will start handing out invites in Sept, Oct, Nov. If you don't have a SLOE in by that time many programs will overlook you. Not trying to scare you just giving you an honest response. I had one SLOR in by the time my app was complete and I got some interviews but my second SLOR was in late and I think it decreased the numbers of interviews I received.