How competitive is EM?

As someone invovlved in the application process now I'm not sure I am the best person to rank EM's competitiveness, but I'll tell you what I think. In my opinion EM is in the top middle third of competitiveness, and probably reached the peak of it's competitiveness 2-3 years ago. With new programs opening every year and established programs increasing the number of spots they offer there has been a bit more capacity to accept the numbers of students who want to do EM. It is considerably less competitive than Derm, Ortho, or ENT. Much more competitive than run of the mill IM, Peds or FP. The top tier IM, Peds, and FP are probably just as competitive as the bulk of EM residency spots.

Applicants generaly beat the mean on USMLE step 1 and 2. Most have HP or Honors clinical grades. THe key is great letters of recommendation from EM rotations. Most students who get interviews end up getting a spot in one of their top 3 choices. EM tends to be a bit more difficult for DO students to match into Allo spots but many including many posters here have done so. IMG's may find it very difficult to match into EM judging from posts here.

The military has 3 EM residencies including 1 that is mixed military/civilian. I am told that the military really wants EM physicians since their skills are the most useful in combat situations prior to surgery. I have no idea how competitive they are but I would guess they're probably a bit more than Civ residencies. I didn't do military because I didn't want them telling me what specialty to go into or when I could do residency. Apollyon could do a better job fleshing out this section I think.

Hope that helps.

Casey

Originally posted by cg1155

The military has 3 EM residencies including 1 that is mixed military/civilian.

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Which one is military/civilian?

For a non-surgical specialty, EM is moderately to highly competitive. Less so than Derm and Rads but more so than IM, FP, Peds, gas, and some GS. You will find exceptions to all these on an individual basis but in general I think this holds true.

For most applicants, I think the key to matching EM is all about numbers. Of course I mean grades and boards to a certain extent, but more so with the number of applications submitted. For most students, even those with below average numbers, EM is attainable assuming you apply to enough programs.

I think EM program directors do a good job of evaluating candidates as individuals rather than as a set of scores and grades. There is more of a "front line" mentality in EM where a person's adaptability and work-ethic often times is valued more than great scores. Ultimately, programs want a person they think they can work well with in a pinch and who have a "low maintenance" personality. They want someone who can play well with others and won't fold at 3 a.m. They aren't always looking for the smartest, but they are all looking for the sharpest. Do you see the difference? (I hope my point is clear).

It has been said here a time or two in the past but I'll say it again for those who are new to the process. The large majority of US grads seeking to match EM do so. Most that don't either applied to/ranked too few programs or just had too many red-flags in their apps or interviews. (repeated courses/years, questions about professional conduct, etc.).

I can't speak too intelligently about FMG's because I'm not one and don't really know many, but what I have seen is that they often times are successful matching. The hard truth for FMGs is that many programs just won't consider them to begin with while there are a few others (mainly in the northeast) who embrace them and match quality FMGs every year. DOs often times experience the same problems as well, but usually to a lesser extent. In fact, it doesn't look like my program has ever had a DO resident to my knowledge. I don't know if that is a regional variation or some unspoken bias on the part of someone in the program. If so, the bias has been unspoken as far as I can tell. I've never heard a negative word uttered about DO's here. I personally don't have a bias since I have worked with many and realize we are all essentially from the same mold.

Originally posted by DrMom
Which one is military/civilian?

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Madigan Army Medical Center/University of Washington - Seattle

Dr. Mom, I can only guess he/she is speaking of Wright State U. EM program, which has 8 civ and 4 military per class.
We are, of course, affiliated with Wright Patterson AFB...the other air force EM residency is San Antonio.

thanks, guys

I'm in the process of checking out different programs.

a question like the one in this thread has been posted many times in the past, and the same answers have been given. Why dont we look at the opposite end of the spectrum and ask " how uncompetitive can EM get?"

what I mean is, are there programs out there whose competition level would be that of some primary care specialties? ( a board score below the mean avg preclinical grades and just decent clinicals etc.) of course one should have all the personal qualities that other posters listed above.

bump.

realruby-
i don't think there's a program out there known for being uncompetitive. EM is EM, and EM will probably stay hot for a while... people will go anywhere for a program so I don't think one program is much easier than the other. Howeve,r I can say the opposite, there are programs that are HARD to get into.

Q, DO

so does that mean that there are only a handful of programs that are "hard core" competitive while everything else is the same? Im not an M4 in the application process so I dont know much about all the programs, but I have a hard time believing that a program in Oklahoma would be near the same competition level than on in Florida, or Chicago, NY etc.

Originally posted by realruby2000
so does that mean that there are only a handful of programs that are "hard core" competitive while everything else is the same? Im not an M4 in the application process so I dont know much about all the programs, but I have a hard time believing that a program in Oklahoma would be near the same competition level than on in Florida, or Chicago, NY etc.

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When looking at first Aid for the Match or Iberson's-I do not remember which, EM is in the top 10 most competitive residencies (6 or 7? can't remember)

What that means is that if you have good numbers-you can apply and interview at fewer programs (10), middle of the road you will interview at 10-15, and things can go up from there.

Very few people who apply to only EM programs do not match (this is NOT true for more competitive specialties like Derm or Optho). Some years EM programs do not completely fill either, and there are spots in the scramble.

Like any specialty there are the "Really Good" programs (search the posts if you are interested in seeing what they are). Then there are the ones in the middle. Then there are newer, untested programs that are not as well known therefore may not fill or be as competitive. Also-the "competitive-ness" of a program does not simply rely on Geography or size of city.

Hope this helps-
B

Sorry to jump in, I'm an American who will graduate from a good foreign school. I have many years of experience as a paramedic and er tech. My scores are passing, Step 1 so far, but nothing to write home about. I am doing well in my rotations and seem to get along with all of my superiors. I have even been hinted to about getting a prematch for IM if I wanted it. However I really want to do EM. It's what I've always dreamed of doing. What do you think my chances are of matching in EM? Can you help me as far as what strategies to use keeping in mind I'll be applying to places I have never been to. I thank you in advance for any help.

blueghost said:

Sorry to jump in, I'm an American who will graduate from a good foreign school. I have many years of experience as a paramedic and er tech. My scores are passing, Step 1 so far, but nothing to write home about. I am doing well in my rotations and seem to get along with all of my superiors. I have even been hinted to about getting a prematch for IM if I wanted it. However I really want to do EM. It's what I've always dreamed of doing. What do you think my chances are of matching in EM? Can you help me as far as what strategies to use keeping in mind I'll be applying to places I have never been to. I thank you in advance for any help.

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I just wanted to go ahead and welcome this thread back from the dead. Where did you drag this out of?

Here's your strategy...apply early and apply often. You have two big strikes against you already, a foreign med school and poopy board scores. Doesn't mean you can't do it, just that you need to apply to more places. Acing an away rotation at the program of your choice would go a long way to assisting your application.

AND...take step II CK early, and do VERY well on it. By doing well on it, it can do nothing but help you. If you don't do so hot, or even worse than on step I...yikes.

Again, do a couple of away rotations and get stellar SLOR's!! These will help you a ton, and not to be negative, you will need it.

I too am from a foreign medical school (caribbean); US born and raised, worked as an ED tech for 2 years prior to medical school.

I did well on step I, better on step II, got great SLOR's, and still had a tough time getting as many interviews as I would have liked. Let's put it this way...I didn't have 'the pick of the litter'...but still enough to hopefully do well in the match.

Any specific questions...PM me.

Good luck...

can anyone comment on the competativeness among EM programs based on the length of the residency (1+3, 3, 2,3,4)? i realize the straight 3 year programs are the most common and probably the most seeked, but what about a 4 yr program? less competative as more people want a 3 yr residency??? thanks...

Any EM DOs or EM-bound DOs have any advice for a pre-DO student. I have two years of ED tech experience and I am about 98% certain I'll be trying for EM residencies. I'm in the interview process right now and would like some advice on what to look for in a school to help improve my chance of matching. Are new schools a really bad idea or do Board scores and LOR's conquer all?

GreenShirt said:

Any EM DOs or EM-bound DOs have any advice for a pre-DO student. I have two years of ED tech experience and I am about 98% certain I'll be trying for EM residencies. I'm in the interview process right now and would like some advice on what to look for in a school to help improve my chance of matching. Are new schools a really bad idea or do Board scores and LOR's conquer all?

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I don't think the name of the school matters that much. Pick at place that you like and where you think you'll get the best education. I personally would probably avoid the newer schools just because I don't want to be in the "guinea pig" class but others may disagree. Medical school is hard enough without mid-semester curriculum changes. I interviewed for the first class at a school and declined the acceptance to go to a school that was established (and part of a University). No regrets.

Do well in school. Study hard and prepare well for the boards then kill them. I strongly recommend taking the USMLE as well. Involve yourself in some EM activities. Do away rotations at places that have residency programs (including some you want to go to). You'll be golden.

In the end, residency programs just want good people to train and who will work hard. I really didn't get the feeling that the school you went to (MD or DO) really mattered as much as the total package.

Hope that helps. Good luck on the interviews!

polygonal said:

I don't think the name of the school matters that much....

Do well in school. Study hard and prepare well for the boards then kill them. I strongly recommend taking the USMLE as well. Involve yourself in some EM activities. Do away rotations at places that have residency programs (including some you want to go to). You'll be golden.

In the end, residency programs just want good people to train and who will work hard. I really didn't get the feeling that the school you went to (MD or DO) really mattered as much as the total package.

Hope that helps. Good luck on the interviews!

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Amen. Really. Letters of rec matter, too. Especially if they come from someone familiar or well-known to program administration. Residency is definitely more about quality of life than quality on paper.

-Push

Waiting for Monday to find out if I have to scramble-no nails left-circles under my eyes

Great stuff in my app-good lors-good interviews-good clinical grades-bunch of honors and HP's BUT: failed boards, lousey scores, trouble testing

Worrisome because I was not asked about this at most interviews. DO YOU THINK I MATCHED?????????????????????????????????????????????????????

ziffy 850 said:

Waiting for Monday to find out if I have to scramble-no nails left-circles under my eyes

Great stuff in my app-good lors-good interviews-good clinical grades-bunch of honors and HP's BUT: failed boards, lousey scores, trouble testing

Worrisome because I was not asked about this at most interviews. DO YOU THINK I MATCHED?????????????????????????????????????????????????????

Click to expand...

If you interviewed at a good number of places, i'd say your chances aren't as bad as you may think. 10 is the magic number to match. Good luck!

polygonal said:

I don't think the name of the school matters that much. Pick at place that you like and where you think you'll get the best education. I personally would probably avoid the newer schools just because I don't want to be in the "guinea pig" class but others may disagree. Medical school is hard enough without mid-semester curriculum changes. I interviewed for the first class at a school and declined the acceptance to go to a school that was established (and part of a University). No regrets.

Do well in school. Study hard and prepare well for the boards then kill them. I strongly recommend taking the USMLE as well. Involve yourself in some EM activities. Do away rotations at places that have residency programs (including some you want to go to). You'll be golden.

In the end, residency programs just want good people to train and who will work hard. I really didn't get the feeling that the school you went to (MD or DO) really mattered as much as the total package.

Hope that helps. Good luck on the interviews!

Click to expand...

Sorry to bring this thread back after a few years, but I'm also a pre med student. My stats as of now are on the lower side of the MD but the higher side of DO, so I'll probably apply to both. I would like to do EM and reading from this, it's reassuring to know that programs would like the whole package. However, I was wondering if it is any harder for a DO student to rotate at an MD program?

LastPolarBear said:

Sorry to bring this thread back after a few years, but I'm also a pre med student. My stats as of now are on the lower side of the MD but the higher side of DO, so I'll probably apply to both. I would like to do EM and reading from this, it's reassuring to know that programs would like the whole package. However, I was wondering if it is any harder for a DO student to rotate at an MD program?

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You should do your best to go to an Allo program with an EM department, or a DO school with a good EM department. Longstanding interest in EM will serve you well (EMS experience, etc).

The bottom line is that there are more EM spots than there are allo applicants. So there are definitely spots up for grabs. Moreover, there are plenty of DO's doing EM.

From personal experience, DO's are often the best residents at my allo hospital. This is probably b/c the DO's that make it into our Allo programs were probably at the top of their DO classes. Cream rises to the top.

YOOOUK09 said:

...Cream rises to the top.

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Well said, but that metaphor can't be understood out of context. Unfortunately, some EM residencies are quite particular about where they shop for dairy products. Being on the 'other side' of the interview experience is quite revealing; there's a good degree of subjectivity intrinsic to the entire process. Its sort of unfortunate that applicants can't control which faculty members interview. Clearly, an excellent interview can turn an otherwise mediocre candidate into a superstar. That said, a fair amount of emphasis placed on the usual battery of board scores, GPA, letters, etc. Certain aspects of the interview process are forever out of control, but candidates can nevertheless do their research. This thread does resurface, but its definitely an important one... relevance doesn't seem to fade with time. Here's just a couple of observations:

1. GIT YER INFO!
-Talk to residents. They have a vested interest in their program and tend to tell the good and bad truths. An honest opinion is better than feedback from a website, and it never hurts to talk to current residents and faculty directly. As a DO applicant, I didn't want to waste my time applying to programs that would not consider the COMLEX. I spoke to PDs/residency coordinators to confirm that they ranked DO applicants that didn't take the USMLE.

2. USMLE vs COMLEX:
-This questions comes up quite a bit and much data is available after even a brief search of these forums. Some PDs simply find it easier to compare apples to apples. I used to think this question represented the proverbial beaten and dead horse. However, I now feel (in my own very humble opinion) that taking the USMLE is worth the extra time and effort. COMLEX for whatever reason hasn't achieved parity with USMLE in the minds of many residency PDs. Though the reasons for this may not be logical, its smart for applicants, especially osteopathic physicians, to ask about how COMLEX scores are utilized.

3. SCORES AND LORs
-Its frustrating, but its clear that GPAs and other numbers help residency coordinators pick out the interview group. Simply put, some applications are sorted by board scores while others place more emphasis on EM involvement and prior experience. Having great, "numbers" will make it more likely that you'll be invited to interview.

4. THE NAME GAME
-The realities of reputation stink, but names DO matter. When letters of recc are solicited from other PDs or medical student coordinators, the impact on an applicant's ranking can be astronomical. Academic EM is a small community and word spreads fast. Its important to get recc letters from designated faculty. When on an EM rotation, meet with the student coordinator / PD and let them know you'll be asking for a SLOR. I've seen several applicants slide down the rank order list due to letters from well respected PDs. Similarly, applicants from less prestigious schools (i.e. newer DO schools, caribbean institutions) may have a more difficult time in the application process. Their app may rely more heavily on "numbers" in order to stand out amongst the crowd.

5. THE INTERVIEW
-This is, without question, the great equalizer. Being selected for an interview places you on a semi-level playing field. EM faculty want people who they can (1) work a night shift with and (2) tolerate. Even if your USMLEs are 240+ and your class rank is in the clouds, you risk a "DNR/do not rank" designation if you manage to alienate everyone during the interview process. Not thanking residency coordinators can have disasterous consequences. Little things DO matter. Don't dominate the interview process or ask about the possibilities of having weekends and holidays off during your intern year.... One recent applicant actually was proud of the fact of his selecting EM for its, "superior lifestyle." That may be true, but few program directors want to hear about how you're looking forward to three+ years of fun in the sun without any call.


Best of luck to everyone in the match! EM has a large tent, and I'm sure there's room for more than a few circus acts. (This coming from someone who was almost axed after doodling during a pre-interview welcome session...)

-P

This may be an elementary question, but I've been reading on how "away" rotations at the program where you want residency in will help. I really don't know how this works, so please correct me if I assume anything that is wrong, but I was wondering if it would be harder for an osteopathic student to be able to rotate at an allopathic program.

LastPolarBear said:

This may be an elementary question, but I've been reading on how "away" rotations at the program where you want residency in will help. I really don't know how this works, so please correct me if I assume anything that is wrong, but I was wondering if it would be harder for an osteopathic student to be able to rotate at an allopathic program.

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Polar-

This is actually an excellent question. My answer is based on interaction with current interviewees and from experience at my own institution. In general, away rotations are an excellent idea and are HIGHLY recommended. They give you a chance to not only "shine," but to meet and interact with future mentors and colleagues. Programs anticipate an influx of students during the interview months, and its well known that students doing away rotations in Emergency Medicine during the fall/winter are usually serious about their future career choice. In additon to obtaining the necessary LORs, the "away" elective affords you valuable insight into a program's strengths and weaknesses. For example, I hope that students rotating with us at UMd appreciate the emphasis on bedside teaching and resident education. Some students find the separation between the adult ED and the Shock Trauma Center a bit unusual, but these are things that factor into an individual's rank order list decision process.

I've actually addressed the issue of visiting osteopathic medical students on a different thread. This issue is of particular importance to me, but its difficult to talk about because I respectfully disagree with those who employ me and review my record for promotion and tenure. For whatever reason, the Office of Student Affairs (OSA) does not currently permit DO or foreign medical students to rotate at the University of Maryland. Despite the fact that osteopathic physicians hold leadership posts in many academic departments, the OSA continually cites existing policy as the reason for exclusion. People with far more pull than my own have attempted to address this issue, but the Dean's stance has been firm. Only students from LCME (allopathic) schools can rotate within the UMD-SOM system. I see this as a policy that stands without logical merit since a large proportion of my time as a "Faculty Development Fellow" and Chief resident is dedicated to (allopathic) student education! Interested students have contacted the office of student affairs and have met with similar, negative responses.

The good news is that our department (EM) has remained staunchly DO friendly. I didn't rotate at UMd and managed to secure a spot. Our program director is an amazing advocate for residents with leadership potential- this applies to MDs and DOs alike. Both of the current chiefs of the UMD residency in Pediatrics are osteopathic physicians. Consequently, don't consider the inability to rotate at UMd as a contraindication to application. We accomodate shadowing shifts but regret the fact that we cannot offer DOs a slot in the medical student elective.

Also worthy of note is that policies are by no means consistent. Both UF programs are extremely DO friendly, and DOs are encouraged to rotate and apply to education programs at the Jacksonville and Gainesville clinical sites. Rich Stair is the PD over at Shands-UF and he was an amazing mentor for me during my years as a PM/FF with Alachua County Fire Rescue. Even before UF had official ACGME approval, he helped me worked out a couple of "observational" shifts in the Shands ED.

In summary, away rotations are an excellent idea- for both DO and MD applicants. For DO students considering an away rotation at an allopathic medical school, its imperative to talk with that institutions office of student affairs. For many medical schools with EM programs, DO vs MD isn't even an issue. Again, best wishes!

-P

pushinepi2 said:

Polar-

This is actually an excellent question. My answer is based on interaction with current interviewees and from experience at my own institution. In general, away rotations are an excellent idea and are HIGHLY recommended. They give you a chance to not only "shine," but to meet and interact with future mentors and colleagues. Programs anticipate an influx of students during the interview months, and its well known that students doing away rotations in Emergency Medicine during the fall/winter are usually serious about their future career choice. In additon to obtaining the necessary LORs, the "away" elective affords you valuable insight into a program's strengths and weaknesses. For example, I hope that students rotating with us at UMd appreciate the emphasis on bedside teaching and resident education. Some students find the separation between the adult ED and the Shock Trauma Center a bit unusual, but these are things that factor into an individual's rank order list decision process.

I've actually addressed the issue of visiting osteopathic medical students on a different thread. This issue is of particular importance to me, but its difficult to talk about because I respectfully disagree with those who employ me and review my record for promotion and tenure. For whatever reason, the Office of Student Affairs (OSA) does not currently permit DO or foreign medical students to rotate at the University of Maryland. Despite the fact that osteopathic physicians hold leadership posts in many academic departments, the OSA continually cites existing policy as the reason for exclusion. People with far more pull than my own have attempted to address this issue, but the Dean's stance has been firm. Only students from LCME (allopathic) schools can rotate within the UMD-SOM system. I see this as a policy that stands without logical merit since a large proportion of my time as a "Faculty Development Fellow" and Chief resident is dedicated to (allopathic) student education! Interested students have contacted the office of student affairs and have met with similar, negative responses.

The good news is that our department (EM) has remained staunchly DO friendly. I didn't rotate at UMd and managed to secure a spot. Our program director is an amazing advocate for residents with leadership potential- this applies to MDs and DOs alike. Both of the current chiefs of the UMD residency in Pediatrics are osteopathic physicians. Consequently, don't consider the inability to rotate at UMd as a contraindication to application. We accomodate shadowing shifts but regret the fact that we cannot offer DOs a slot in the medical student elective.

Also worthy of note is that policies are by no means consistent. Both UF programs are extremely DO friendly, and DOs are encouraged to rotate and apply to education programs at the Jacksonville and Gainesville clinical sites. Rich Stair is the PD over at Shands-UF and he was an amazing mentor for me during my years as a PM/FF with Alachua County Fire Rescue. Even before UF had official ACGME approval, he helped me worked out a couple of "observational" shifts in the Shands ED.

In summary, away rotations are an excellent idea- for both DO and MD applicants. For DO students considering an away rotation at an allopathic medical school, its imperative to talk with that institutions office of student affairs. For many medical schools with EM programs, DO vs MD isn't even an issue. Again, best wishes!

-P

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Thanks for the reply! It's good to hear that EM is very friendly for both MD and DO. This will definitely make my decision applying to med schools a little easier.

I never ran into a problem scheduling rotations affiliated with allo schools as a DO, so I think the UMD situation is definitely not the norm.

EM seems very DO-friendly in the Northeast, too, with the exception of a few of the "old guard" places in Manhattan. There are some DO program directors (PD = person in charge of the residency) and associate/assistant PDs and other faculty.

I do get the sense that there may be unofficial DO (and FMG/IMG) quotas in allo programs, though -- they don't mind having one or two of us, but get nervous about their perceived status if they have too many of us. So while you're competing against the total pool of applicants, I think you're also competing even more directly against the other DOs to be the winning DO for that year. I could be wrong, and maybe one of the PDs here has a different view, but that's the sense I have of how it goes.

LadyGrey said:

I never ran into a problem scheduling rotations affiliated with allo schools as a DO, so I think the UMD situation is definitely not the norm.

EM seems very DO-friendly in the Northeast, too, with the exception of a few of the "old guard" places in Manhattan. There are some DO program directors (PD = person in charge of the residency) and associate/assistant PDs and other faculty.

I do get the sense that there may be unofficial DO (and FMG/IMG) quotas in allo programs, though -- they don't mind having one or two of us, but get nervous about their perceived status if they have too many of us. So while you're competing against the total pool of applicants, I think you're also competing even more directly against the other DOs to be the winning DO for that year. I could be wrong, and maybe one of the PDs here has a different view, but that's the sense I have of how it goes.

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So far I read that the east coast and midwest are pretty DO friendly. Now, is this still true for west coast programs?

So, I spoke with my PD today, and he said that the buzz on the CORD website (where all the PDs chat?) is that this year EM is much more competitive than it has been - according to him, the number and "quality" of applicants has increased even more than expected. I'm not sure what that amounts to concretely, but... scary??

quideam said:

So, I spoke with my PD today, and he said that the buzz on the CORD website (where all the PDs chat?) is that this year EM is much more competitive than it has been - according to him, the number and "quality" of applicants has increased even more than expected. I'm not sure what that amounts to concretely, but... scary??

Click to expand...

All I can say is that I'm glad I got in under the wire.

DrMom said:

Which one is military/civilian?

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Wright State University Boonshoft School of Medicine

Dayton, Ohio

United States Airforce

I'm an FMG hoping to match 09. Just to give you a feel of the hell I went through...here are my stats:
School: ROss
GPA: 3.95 (top 5 of my class)
STEP 1: 233/94
STEP 2: 226/93
EM residency applied: 80s
EM residency interview invites: 10

It's a tough road...but eventually itll end up where you want it if you work at it.

Captainwada said:

I'm an FMG hoping to match 09. Just to give you a feel of the hell I went through...here are my stats:
School: ROss
GPA: 3.95 (top 5 of my class)
STEP 1: 233/94
STEP 2: 226/93
EM residency applied: 80s
EM residency interview invites: 10

It's a tough road...but eventually itll end up where you want it if you work at it.

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Rank em all bro. I literally feel your pain.

So what would you guy say now? Is EM as it was back in 2003: "Much more competitive than run of the mill IM, Peds or FP. The top tier IM, Peds, and FP are probably just as competitive as the bulk of EM residency spots" Or have things drastically changed? Does an average student (average step 1 scores, average grades, loads of ECs (like they count but I got scholarships so I like em') and a dual degree (MPH)) have any chance if he applies widely? Any advice? I guess I am getting nervous with what...less than a year to go...

surebreC said:

Well, I am just an M3 so make of this what you will... but if you look at the Charting Outcomes in the Match you will see that the average STEP I board score for an accepted applicant in 2007 was 220, which is actually a few points below IM (which surprised me). On top of that, if you look at US grads that matched, you will see the match rate is 92% which is pretty good! So I wouldn't stress out too much about matching "somewhere".

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I know. My dream is EM but I am a piss ass standardized test taker. Do great on all my rotations. Got some amazing letters and all that. I guess with just a year to go I look back realizing there isn't much I can change now if I wanted to. Guess I just gotta hope for the rest and apply broadly.

As long as there are no minimums, anyone can have a chance at matching. EM isn't super competitive. Yes, it's competitive, but not so much that those with low test scores should be discouraged from applying. You may have a harder time matching, but you still have a shot.

Apply for what you love. The worst thing that can happen is you don't match. If your scores are that low, you should have a backup plan just in case (other specialty, research year, etc.).

Since this thread is sort of a free-for-all question/answer on applying to EM and Jamers mentioned letters of rec, I had a quick question.

PDs are looking at 4th year letters primarily (most importantly EM SLORs), correct? I have no 3rd year letters as of yet, but I was hoping to get one after my 3rd year EM rotation coming up.

Good luck to everyone finalizing their Rank Lists - I know a year from now I'll be freaking out, checking the EM Forum like a fiend.

It'sElectric said:

Since this thread is sort of a free-for-all question/answer on applying to EM and Jamers mentioned letters of rec, I had a quick question.

PDs are looking at 4th year letters primarily (most importantly EM SLORs), correct? I have no 3rd year letters as of yet, but I was hoping to get one after my 3rd year EM rotation coming up.

Good luck to everyone finalizing their Rank Lists - I know a year from now I'll be freaking out, checking the EM Forum like a fiend.

Click to expand...

correct - it's the fourth year letters that programs want to see. You can have some extra letters beyond the SLOR (e.g. many programs only need 1 or 2 SLORS but need 3 or 4 letters) - but these shouldn't be based solely on a third year rotation

It'sElectric said:

Since this thread is sort of a free-for-all question/answer on applying to EM and Jamers mentioned letters of rec, I had a quick question.

PDs are looking at 4th year letters primarily (most importantly EM SLORs), correct? I have no 3rd year letters as of yet, but I was hoping to get one after my 3rd year EM rotation coming up.

Good luck to everyone finalizing their Rank Lists - I know a year from now I'll be freaking out, checking the EM Forum like a fiend.

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I actually used a medicine LOR as my third LOR. Some PDs don't care about anything but EM letters, but I already had an EM letter from the med student coordinator or PD at each place I'd rotated so I figured it would be good to show that I play nice on other services too. An EM LOR arrived kind of late, but I did use that one as well - giving me 4 total LORs, 3 SLORs.

It'sElectric said:

PDs are looking at 4th year letters primarily (most importantly EM SLORs), correct? I have no 3rd year letters as of yet, but I was hoping to get one after my 3rd year EM rotation coming up.

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I'm sure eventually a program director will come along and provide the definitive answer to this question but until then...
The way it was explained to me, back when I was gathering LORs, is that there is a hierarchy to the letters, with the higher ones carrying more weight during the application process.

1. Letters from program directors in the specialty you are applying to
2. Letters from faculty of residency programs in the specialty you are applying
3. Letters from faculty at academic institutions in the specialty you want
4. Letters from practitioners of the specialty you are applying to
5. Letters from practitioners in another field but are also faculty of a residency program
6. Letters from practitioners in another field, non academically affiliated
7. Letters from administrators at your school
8. Letters from residents/interns you worked with
9. Letters from your mom saying how smart you are

Additionally, letters obtained during 4th year are better than those obtained during 3rd year because they can better speak to your expanding knowledge base.

This is by no means a hard and fast rule... I'm sure there are some PDs who prefer to hear what your psych attending thought of you, and so on and so forth. But generally speaking... which is all we can do here, that's a fairly standard hierarchy.

This isn't to say you should dissuade your mom from writing a letter...