[2016-2017] Emergency Medicine Application Thread

Started by doggydog
Apply Smarter with MyERAS
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Get help with your application

Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.

Browse articles Compare schools My application plan Read Interview Feedback
Practice for interviews Ask an Advisor
Advertisement - Members don't see this ad
mega_colon said:
Question about letters. Its supposedly frowned about to not submit a SLOE from a rotation but if you have 4 letters up already you really can't submit another. Anyone else not submitting a SLOE because of this situation?
Click to expand...

#1 Ask the coordinator from the additional rotation if they would be willing to email your SLOE to other programs if requested.
#2 Let the PD and coordinator at your interviews know that you have a SLOE available from another rotation but couldn't upload it due to space constraints, and give them the contact info for the coordinator at that program. They'll reach out and ask for it if they want to.
 
jessk2015 said:
Is there any disadvantage to interviewing at a program towards the end of the interview season? We're obviously not dealing with a rolling admissions situation here, but I'm wondering if I should be concerned that (a) programs will have already made up their minds about their faves by the time I get in there for an interview, or (b) programs may think I'm less excited about them because I've scheduled them so late in the process.

Reality is that I'm going to be stuck with a lot of Jan interviews due to personal scheduling constraints earlier in the season.
Click to expand...

I interviewed with my residency program in the first week of February, it is a widely known, widely applied to program, and it replaced my #1 choice.. so no, its not too late.
 
Advertisement - Members don't see this ad
jessk2015 said:
I'm really sorry, I did not mean to be insensitive! It's too easy to get wrapped up in my own situation, so thank you for the reality check. I hope things are looking up for you, or at least start to pick up soon. It sounds like this week sucked for a lot of people regardless of how things have been going overall, so fingers crossed next week is better.
Click to expand...

Nah. You don't need to feel sorry at all. You applied to 100 programs... it's not like you are doing much better or worse in the app trail than other applicants who have applied to 30-40. No offense at all but just saying that people are pissy for no reason. You'll do great champ!
 
DetectiveAlonzo said:
Nah. You don't need to feel sorry at all. You applied to 100 programs... it's not like you are doing much better or worse in the app trail than other applicants who have applied to 30-40. No offense at all but just saying that people are pissy for no reason. You'll do great champ!
Click to expand...

Thanks, no offense taken! I fully embrace that I have the number of interviews that I have because I applied to a ridiculous amount of places. I feel lucky that I was in a position to do that, from a financial standpoint. And it goes without saying that there has been an embarrassing amount of attrition, and the interviews I've received are not the most glamorous [emoji1] Number one priority is to be employed next year.

Thanks for the vote of confidence!


Sent from my iPhone using SDN mobile
 
mega_colon said:
Question about letters. Its supposedly frowned about to not submit a SLOE from a rotation but if you have 4 letters up already you really can't submit another. Anyone else not submitting a SLOE because of this situation?
Click to expand...
I've been wondering the same thing. I was leaning towards not- do programs really need a fourth SLOE??
 
I really thought I was a strong applicant. Good EC, 250+ steps, good grades. 2 SLOES wit another comIng.
Idk what my sloes say but they can't be that bad
I'm not getting any love at all...... it's been very quiet
 
docqb said:
I really thought I was a strong applicant. Good EC, 250+ steps, good grades. 2 SLOES wit another comIng.
Idk what my sloes say but they can't be that bad
I'm not getting any love at all...... it's been very quiet
Click to expand...
Define not getting any love. Also, did you apply only to top programs?
 
Advertisement - Members don't see this ad
somebody should check last year's thread and see if the market was just as bad this time last year. i have a hunch it wasn't
 
NYCEM2017 said:
Mainly just nervous as well as conflicting information from varying school advisors. One said "apply very broadly" and another said apply to 30. Suffice to say, mixed signals made me worry and err on side of caution.
Click to expand...
Interesting. Some advisors appear to be so concerned about their applicants not matching they encourage people to shotgun it, hard. Certainly I'm inexperienced in this process, but looking at the most recent Charting Outcomes, it's tough for me to understand this advice.
 
SpacemanSpifff said:
Interesting. Some advisors appear to be so concerned about their applicants not matching they encourage people to shotgun it, hard. Certainly I'm inexperienced in this process, but looking at the most recent Charting Outcomes, it's tough for me to understand this advice.
Click to expand...
Why is it tough to understand? There are multiple people who post on this board daily with <5 invites with 240+s on step exams and HP or H on their EM rotations. Charting the Outcomes isn't doing them any favors right now.
 
doggydog said:
Why is it tough to understand? There are multiple people who post on this board daily with <5 invites with 240+s on step exams and HP or H on their EM rotations. Charting the Outcomes isn't doing them any favors right now.
Click to expand...

It's tough to understand because those with Step 1 >240 had a >95% chance of matching in EM in 2016. I doubt things have changed that much in a year.
 
SpacemanSpifff said:
It's tough to understand because those with Step 1 >240 had a >95% chance of matching in EM in 2016. I doubt things have changed that much in a year.
Click to expand...
I agree, I don't think things have changed that much in a year. That leaves only three options:

- people are hoarding interviews
- people that are having trouble getting interviews had a lukewarm SLOE or some sort of red flag (I'm hesitant to say this because there are just so many people that have <5 interviews)
- everyone applied to the same 30-40 programs on the coasts

Either way, they don't have enough interviews and probably should have applied to more/different programs even if the charting the outcomes told them they didn't have to apply super broadly..
 
Advertisement - Members don't see this ad
doggydog said:
Why is it tough to understand? There are multiple people who post on this board daily with <5 invites with 240+s on step exams and HP or H on their EM rotations. Charting the Outcomes isn't doing them any favors right now.
Click to expand...

I agree with this. I think advisers are changing their normal recommendations because according to my home school, EM apps went up "significantly" this year and (now the overall administration is checking on EM folks trying to make sure we have interviews which is atypical for them) since our advisers are likely seeing an unusual rise in number of apps to their departments, they are trying to adjust. I assume this is also the cause for the delay in timing of invitations, as schools have more applications to sort through than normal. I doubt there are enough extra applicants to really alter the match rate though, since the same freak out stuff happened with VSAS when so many more people were applying than usual, but I don't know anyone who didn't end up getting an away rotation.
 
chemjunkie said:
I agree with this. I think advisers are changing their normal recommendations because according to my home school, EM apps went up "significantly" this year and (now the overall administration is checking on EM folks trying to make sure we have interviews which is atypical for them) since our advisers are likely seeing an unusual rise in number of apps to their departments, they are trying to adjust. I assume this is also the cause for the delay in timing of invitations, as schools have more applications to sort through than normal. I doubt there are enough extra applicants to really alter the match rate though, since the same freak out stuff happened with VSAS when so many more people were applying than usual, but I don't know anyone who didn't end up getting an away rotation.
Click to expand...
I actually know a lot of people who couldn't get aways. But that's sort fb the limiting factor here, you can't really apply without them.
 
doggydog said:
I agree, I don't think things have changed that much in a year. That leaves only three options:

- people are hoarding interviews
- people that are having trouble getting interviews had a lukewarm SLOE or some sort of red flag (I'm hesitant to say this because there are just so many people that have <5 interviews)
- everyone applied to the same 30-40 programs on the coasts

Either way, they don't have enough interviews and probably should have applied to more/different programs even if the charting the outcomes told them they didn't have to apply super broadly..
Click to expand...
idk....even if everybody applied to the same 30 programs, that's at least 3000 interview spots for 1600 US seniors

actually nvm. 3000/12 = 250
 
I am sorry if this has some rant elements to it but just my 0.02$:
There is definitely a good number of people with solid stats who are having a hard time (myself included). Its easy to say in hindsight that someone should've applied to more or less programs by the number of invites they have but that's not something we can know going in.
Its possible that some people got burned on SLOEs but I think this just shows how subjective the current system is (and yes I get that life is subjective and unfair but it doesn't mean it SHOULD be this way).
This all drives the system into a bear market where fear and paranoia rule and people apply to more and more programs and hold on to way too many interviews. I doubt the total number of applicants is going up by that much but the total number of apps is which means that even a lukewarm SLOE can be a death sentence even though it wasn't the intention of whoever wrote it.
I would argue that we need a better system with more transparency but unfortunately this doesn't help any of us right now so panic on my friends, I'm right there with you
 
knrob said:
I am sorry if this has some rant elements to it but just my 0.02$:
This all drives the system into a bear market where fear and paranoia rule and people apply to more and more programs and hold on to way too many interviews. I doubt the total number of applicants is going up by that much but the total number of apps is which means that even a lukewarm SLOE can be a death sentence even though it wasn't the intention of whoever wrote it. I would argue that we need a better system with more transparency but unfortunately this doesn't help any of us right now so panic on my friends, I'm right there with you
Click to expand...
I feel like this is a huge driving force behind the present situation. Not matching is such a terrible outcome that, however unlikely, people will go to great lengths to minimize that risk (understandably). However, the lengths they go to in order to do this are probably way over the top in a lot of cases, which is where I think our advisors are letting us down a bit. More apps, more numbers for programs to sift through, fewer early interview invites to those with solid numbers.
It's definitely a frustrating situation. Looking at last year's thread I'm still confident that things will be just fine for the vast majority of folks when March rolls around.
 
SpacemanSpifff said:
I feel like this is a huge driving force behind the present situation. Not matching is such a terrible outcome that, however unlikely, people will go to great lengths to minimize that risk (understandably). However, the lengths they go to in order to do this are probably way over the top in a lot of cases, which is where I think our advisors are letting us down a bit. More apps, more numbers for programs to sift through, fewer early interview invites to those with solid numbers.
It's definitely a frustrating situation. Looking at last year's thread I'm still confident that things will be just fine for the vast majority of folks when March rolls around.
Click to expand...

I think the problem is inherent to the system though. People will respond to incentives and there is no incentive not to overapply or to hold on to too many spots. While I am certainly pissed at those people who have 15+ interviews and aren't canceling, I also understand them. They do take on a small risk by canceling even though the benefit I'd get from those cancellations is way more than the risk they would assume.
 
knrob said:
I think the problem is inherent to the system though. People will respond to incentives and there is no incentive not to overapply or to hold on to too many spots. While I am certainly pissed at those people who have 15+ interviews and aren't canceling, I also understand them. They do take on a small risk by canceling even though the benefit I'd get from those cancellations is way more than the risk they would assume.
Click to expand...
Yeah, it's tough.
 
knrob said:
Its possible that some people got burned on SLOEs but I think this just shows how subjective the current system is (and yes I get that life is subjective and unfair but it doesn't mean it SHOULD be this way).
Click to expand...
I think this is the main problem. We were all told how important SLOEs were, more important than Step scores even. We all knew how important they are, we just have no idea how our SLOEs ended up. So much weight is placed on these SLOEs and we have no idea what they say. My rotations were very bad about getting back timely feedback and a lot of the time it ended up being completely different than what was said during the end of shift feedback.

This forum loves to say that all you have to do is show up and act interested. No, this isn't the case at all. You have to work harder than you ever have before, you have to call consults, you have to admit patients, you have to connect with the attending, you have to know everything about the patient before the attending/resident does, and even still...you might get a HP for the shift. SLOEs are more based on luck than anyone will care to admit. Luck determines what attending you work with, if they decide to fill out an evaluation or not, if they only give straight 3s or straight 4s, if they even write any comments about your performance, if your clerkship director sticks to the <10% honor the rotation, etc. So much luck is involved in these for something that essentially determines how competitive we are as applicants. High passing two rotations v. honoring two rotations is the difference between paying for 30 applications v. 60-80 applications. It's a huge deal and we don't know where we stand. Leads to people sending out more apps and an artificial increase in competitiveness.
 
NYCEM2017 said:
Mainly just nervous as well as conflicting information from varying school advisors. One said "apply very broadly" and another said apply to 30. Suffice to say, mixed signals made me worry and err on side of caution.
Click to expand...
"Apply very broadly" and "Apply to a metric buttload" are not the same thing.

You can apply very broadly to only 15 or 20 programs. And you can apply to 30+ programs but if they're all in California plus Denver, Hennepin, etc., then you haven't applied broadly at all.

You're doing fine, but perhaps this is one of the reasons that others are having issues with getting invites.
 
doggydog said:
I think this is the main problem. We were all told how important SLOEs were, more important than Step scores even. We all knew how important they are, we just have no idea how our SLOEs ended up. So much weight is placed on these SLOEs and we have no idea what they say. My rotations were very bad about getting back timely feedback and a lot of the time it ended up being completely different than what was said during the end of shift feedback.

This forum loves to say that all you have to do is show up and act interested. No, this isn't the case at all. You have to work harder than you ever have before, you have to call consults, you have to admit patients, you have to connect with the attending, you have to know everything about the patient before the attending/resident does
Click to expand...
or worse...you go to a rotation where you dont get to do any of that...and then get criticized for your "energy" or "enthusiasm" :///
 
I got about 9 interviews thus far, Step 1 mid 230s, Step 2 low 220s (I was doing an away rotation while taking boards- bad idea), 1st SLOE uploaded right after submitting application, 2nd SLOE uploaded couple of days ago, both HP. I applied to 70 programs, but realistic ones maybe 5-6 reaches. I'm waitlisted on 2 programs on top of the 9 interviews.
 
I have 5 invites and that's only from places I rotated at. Also 5 rejections.
I agree with the whole SLOE argument. I have worked with attendings who say "great job" at the end of the shift and wrote nothing in the comments.
I have worked with attendings who ignored me the whole shift and don't pay any mind to what I do for my patients and then say "you seem uninterested"

It's completely subjective! Having to change my personality from shift to shift to try and click with people who you will only work with for 8+ hours is hard.
Unlike other specialities where you can pick who writes your letter, we don't have that choice.

In any case we are all in the same boat. Hopefully things turn around
 
I have to assume that it's either

1) Poor diversity in programs (all big name academic programs or all in one competitive region).

2) Lackluster SLOEs

As somebody who is turning away multiple interviews but has a Step 1 <215, this is really all I can point to. I've gotten plenty of interview offers from less competitive programs, but I also have a good mix of programs in the mid-range of competitiveness based on previous years. That said, I don't want M3s to think that the people getting interviews are people who are AOA and that the average Step scores must be through the roof.

The SLOE process is definitely a game - and there's definitely a component of luck to the game. But I would agree that you need to go to them on your A-game every single shift, and strong SLOEs can absolutely make up for a lackluster Step 1 performance.
 
Away rotation process needs to become standardized at all programs across the nation if the same programs are mandating they need SLOES's. All three of my rotations were P/F meaning none of my SLOE's have H/HP etc. There was almost no way for me to know this beforehand nor did I know it would impact my application later on. Make all rotations on the same grading scale, same evaluation after every shift and board exam +/- at all rotations so that all SLOE's are also standardized and mean much more. At this point I feel like they mean as much as our MSPE's with all the variation you can have in the rotation you do.
 
Advertisement - Members don't see this ad
To the people replying with stories of average or below stats and doing well, I think you're missing the point of what we are trying to say.
We aren't saying you have to have great stats to do well. If anything, we're saying that how well you do is more up chance than skill.
Yes, you need to work your ass off, but that doesn't guarantee good SLOEs.
And when your odds of success have more to do with luck than objective measures, thats a broken system.
Sure, some people still work hard and do well. But that doesn't mean the system works. That's like having a debate about the safety of a new medication where some people died as after taking it but then the defense pulls up the files of all the people who didn't die and says "see, its safe".
As for applying broadly, anyone who applied to over 50 programs applied broadly. There just aren't that many uber competitive programs out there.
 
ant12 said:
Away rotation process needs to become standardized at all programs across the nation if the same programs are mandating they need SLOES's. All three of my rotations were P/F meaning none of my SLOE's have H/HP etc. There was almost no way for me to know this beforehand nor did I know it would impact my application later on. Make all rotations on the same grading scale, same evaluation after every shift and board exam +/- at all rotations so that all SLOE's are also standardized and mean much more. At this point I feel like they mean as much as our MSPE's with all the variation you can have in the rotation you do.
Click to expand...

I understand your complaints - the process definitely should not hold so much variability across sites.

However, all my rotations were also P/F and I feel this is irrelevant. The form also asks what percent of people receive what grade, so a Pass at an institution where nobody gets High pass or Honors cannot be interpreted the same way as if those distinctions did exist. Nobody looks at our Pass grade in a vacuum. More importantly, the SLOE also asks to rate students relative to their peers in a variety of different categories, culminating in a final determination of where the program anticipates ranking the applicant on their match list. THIS is much more important than whether somebody got a High Pass or Pass or whatever.
 
CliveStaples said:
I understand your complaints - the process definitely should not hold so much variability across sites.

However, all my rotations were also P/F and I feel this is irrelevant. The form also asks what percent of people receive what grade, so a Pass at an institution where nobody gets High pass or Honors cannot be interpreted the same way as if those distinctions did exist. Nobody looks at our Pass grade in a vacuum. More importantly, the SLOE also asks to rate students relative to their peers in a variety of different categories, culminating in a final determination of where the program anticipates ranking the applicant on their match list. THIS is much more important than whether somebody got a High Pass or Pass or whatever.
Click to expand...

While its true that people should look at this in context, I doubt most reviewers take the time to really delve into the specifics of each SLOE and work out the percentages. Not to mention the automatic bias looking at H or P can give even if a program is P/F or alternatively gives out H to everyone. In addition, the massive amount of apps means that its easy to set filters to HP or H.
Finally, the SLOE is still subjective, so the standardization process you describe still wouldn't account for the randomness involved in how students are ranked in the SLOE or how they are graded. This is a problem in med school in general but its worse for us since we don't pick our letter writers.
 
knrob said:
While its true that people should look at this in context, I doubt most reviewers take the time to really delve into the specifics of each SLOE and work out the percentages. Not to mention the automatic bias looking at H or P can give even if a program is P/F or alternatively gives out H to everyone. In addition, the massive amount of apps means that its easy to set filters to HP or H.
Finally, the SLOE is still subjective, so the standardization process you describe still wouldn't account for the randomness involved in how students are ranked in the SLOE or how they are graded. This is a problem in med school in general but its worse for us since we don't pick our letter writers.
Click to expand...

I don't want to come across as argumentative because I agree that the way things are, there is so much variability that exists in the SLOEs based on institutions and I agree that these are things that need to be worked on.

That said, the strength of the SLOE comes from the fact that we do not get to pick who writes them. It means that unlike most LORs which get thrown into the trash because they are universally positive (no discriminating features) these actually carry weight.

These letters aren't like the rest of the ERAS application where you can use a computer program to screen - you have to open these letters up and look at them. No way to throw one away because it doesn't have honors without seeing on the same page what percent of people got honors. And so far, despite the fact that my SLOEs do not say honors, every interview I've been in has commented on my "strong" SLOEs. They're strong because they objectively rank me against my peers and that's the part that they pay the most attention to, though you have no reason to believe me if you don't want to.

Yes, a lot of the things that contribute to the SLOEs are subjective, but ultimately their strength is in their ability to objectively compare applicants - and PDs believe that this determines an applicants aptitude as a resident even more strongly than the other objective portions of the application, and probably rightfully so.

The hard part is trying to compare applicants with SLOEs from different institutions. This is why they ask for us to go to multiple places and get multiple letters. If you have lackluster letters from multiple places, it's less likely to be due to the luck of where you rotated and vice versa.

At the end of the day, I think that unless there are vastly more people applying to EM this year, we need to remember that historically there have been enough seats for US MDs (and plenty that DOs get too) and as a result, even a "this student is in the middle third of applicants" isn't a bad grade on the SLOE by any means.
 
CliveStaples said:
I don't want to come across as argumentative because I agree that the way things are, there is so much variability that exists in the SLOEs based on institutions and I agree that these are things that need to be worked on.

That said, the strength of the SLOE comes from the fact that we do not get to pick who writes them. It means that unlike most LORs which get thrown into the trash because they are universally positive (no discriminating features) these actually carry weight.

These letters aren't like the rest of the ERAS application where you can use a computer program to screen - you have to open these letters up and look at them. No way to throw one away because it doesn't have honors without seeing on the same page what percent of people got honors. And so far, despite the fact that my SLOEs do not say honors, every interview I've been in has commented on my "strong" SLOEs. They're strong because they objectively rank me against my peers and that's the part that they pay the most attention to, though you have no reason to believe me if you don't want to.

Yes, a lot of the things that contribute to the SLOEs are subjective, but ultimately their strength is in their ability to objectively compare applicants - and PDs believe that this determines an applicants aptitude as a resident even more strongly than the other objective portions of the application, and probably rightfully so.

The hard part is trying to compare applicants with SLOEs from different institutions. This is why they ask for us to go to multiple places and get multiple letters. If you have lackluster letters from multiple places, it's less likely to be due to the luck of where you rotated and vice versa.

At the end of the day, I think that unless there are vastly more people applying to EM this year, we need to remember that historically there have been enough seats for US MDs (and plenty that DOs get too) and as a result, even a "this student is in the middle third of applicants" isn't a bad grade on the SLOE by any means.
Click to expand...

I disagree with the "objective" part.
Its standardized but not objective because its still mostly about the subjective opinions of others.
You can put subjective opinions through many "objective parameters" (ie MSPE) but its still not objective.
We can argue about the efficacy and fairness of that but the truth remains that its not at all objective.
This is exactly why applications are up. If programs don't rely on true objective measures, no one can know they're safe, so everyone overapplies.
 
You must log in or register to reply here.

Similar threads

YeeHawWooHoo
Emergency Medicine Schedule
2
Replies
64
Views
9K
Major
Major
E
Advice for EM residencies
2
Replies
61
Views
11K
EctopicFetus
EctopicFetus
H
VA emergency medicine
Replies
10
Views
4K
Old_Mil
Old_Mil
WildWing
FAQ - Emergency Medicine
Replies
15
Views
5K
The Knife & Gun Club
The Knife & Gun Club
D
ABEM Certifying Exam 2026+ New Oral Exam (Prep/Study/Resources/Feedback)
Replies
10
Views
6K
Brigade4Radiant
Brigade4Radiant