[2016-2017] Emergency Medicine Application Thread

[ant12]

I was not saying to standardize SLOE's. I was saying to standardize all AI EM rotations.
Edit: and the VSAS application process while you're at it

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[racerwad]

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.

I can't speak for all reviewers, but I know I look really closely at the content of the SLOE and I am aware if X is P/F or an Honors kind of place. Our PD gives us pretty clear guidelines of where and what to look at, how to interpret things, etc. I definitely consider what the breakdown is when looking at someone's grade from the program.

Our program is not uber competitive, but we have no trouble getting enough folks to interview. That said we do not use any filters AFAIK as I see plenty of passes on SLOEs to review.

Honestly, I think it is a strength of our system that we aren't able to choose our reviewers. I think it makes for more honest appraisals.

There was the same anxiety the year I applied, the years before, and the years after. Obviously, Charting Outcomes isn't helping anyone right at this moment since it doesn't predict performance at the beginning of the interview season. The overwhelming majority of you guys will match and the majority of you guys who match will match at one of your top choices. I promise it will work out. It always does, year after year.

 

[CliveStaples]

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.

I completely agree that these are objective scores being applied to a subjective decision. But this is what the entire residency match process is - we get ranked by programs, based on their subjective evaluations. In this regard, the SLOE is more like the residency match than any other measure, which is why PDs are going to give them so much weight. I think the SLOE is much stronger than the MSPE because it uses specific scoring metrics (top 10%, top 1/3, middle 1/3, bottom 1/3) as opposed to the MSPE's vague language.

These SLOEs aren't going to go away and I think the problems really lie in the limited sample size that encompasses them. This is only harmed further by places that don't have good responses on shift evaluations and things like that. I expect there will be a push towards standardized shift evaluation forms in the future, which may help this problem. That said, a student's performance will always be subjective - there's no way to make "how well did the student perform" an objective measure across all institutions.

As to the problem of increased applications, I do think the lack of transparency is going to be the ultimate driving force in this problem. Maybe making SLOEs open to students to view after they've been uploaded would help students understand their competitiveness better.

 

[Goose Egg]

I can't speak for all reviewers, but I know I look really closely at the content of the SLOE and I am aware if X is P/F or an Honors kind of place. Our PD gives us pretty clear guidelines of where and what to look at, how to interpret things, etc. I definitely consider what the breakdown is when looking at someone's grade from the program.

Our program is not uber competitive, but we have no trouble getting enough folks to interview. That said we do not use any filters AFAIK as I see plenty of passes on SLOEs to review.

Honestly, I think it is a strength of our system that we aren't able to choose our reviewers. I think it makes for more honest appraisals.

There was the same anxiety the year I applied, the years before, and the years after. Obviously, Charting Outcomes isn't helping anyone right at this moment since it doesn't predict performance at the beginning of the interview season. The overwhelming majority of you guys will match and the majority of you guys who match will match at one of your top choices. I promise it will work out. It always does, year after year.

just out of curiosity, around what time does your program feel like it's mostly finished the work of filling interview spots?

 

[racerwad]

just out of curiosity, around what time does your program feel like it's mostly finished the work of filling interview spots?

This is a good question that I don't have a good answer to. Subjectively, it feels like we have not yet sent out all invites, but I do not know for sure. The first round is certainly out, but I am not sure if we have sent out the total # of invites we planned on.

 

[EMhopeful*]

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.

I didn't get an away rotation, and I've gotten >30 interview invitations out of 70 applications. I also honored most of M3 (HP in surgery), and my Step scores are slightly above average at 240s/250s. Not AOA. No publications.

So what gives? I think my saving grace is that my one SLOE is strong and from a well-reputed and well-connected institution in EM. My point is that EM does the best job at attempting to objectively evaluate and stratify applicants using standardized letters, but there is still some sheer luck, subjectivity, and bias inherent to the process.

 

[knrob]

My original intention wasn't to start a debate about the pros and cons of SLOES but looks like it got a little out of hand...
There were 2 things I wanted to highlight:
1)There is a large amount of affirmation bias in some posts. Those who have done well assume they deserve it (which I'm not arguing against) and then assume that those who aren't doing well must not be doing well for a good reason/have done something to deserve it. Any assertion that the system is problematic or luck based is met with some internal resistance since the system put them on top so it must be right.
2)People seem to complain a lot about how everyone overapplied and is holding onto invites but also defending the current system. I think there's a major contradiction there since the current system is what drives this process and its unrealistic to expect anything else under the current rules. Chastising those who overapplied or are hoarding interviews is missing the point.

 

[bjjmd]

Thank you for all of the feedback here. I hope that as we move through the remainder of october those holding interviews will start canceling them so that the average applicants can have more opportunities

 

[DocBeardface]

So I strongly believe the problem lies in the advice many of us are getting from our schools, who are petrified of having unmatched students and so urge even strong applicants to apply broadly to 40+ programs. I don't like to post stats, but I'm a strong enough candidate to be sitting on 15+ interviews at the moment -- many in areas I'd prefer not to match. I'm not at all convinced I needed to apply so broadly in the first place, but even now with the invitations I have, when I asked a school advisor if I could drop one that I'm not interested in I was advised against doing so because it is a less competitive program and there seems to be concern that there will be too many competitive programs on my final rank list. Not sure what to make of that at all, but I'm fairly certain this approach is harmful to other applicants and clogs the system.

In any case, I think if we all just applied to programs we were actually interested in attending, it would ultimately benefit both the programs and the applicants. Instead of inviting me to interview (perhaps I'm strong but very low likelyhood of ranking program x because it doesn't meet the criteria I'm looking for) a program could invite a perhaps slightly less competitive applicant who would be extremely happy for the spot.

All this brings to mind an option for 'swapping'. Perhaps programs could introduce a feature where if you are holding an interview somewhere you could elect to 'swap' interviews with someone holding a spot at a more desirable program for them. I.e I have an interview at x but want one at y, where I'm on the waitlist. If I could somehow enter in the eras system that I want Y, then perhaps someone waitlisted at and wanting X but holding Y could result in a swap. Both of us end up with an interview at a place we desire and free up a waitlist spot, and increase the chance that the interviewed applicant will rank the program. In such a system, which facilitates securing the interviews you care most about, people may be less inclined to hoard interviews. Unless of course your school is advising you otherwise..

Okay that was long winded, but just because I think there is room for improvement!

 

[EMhopeful17]

On another note, I sent out three emails of interest last week, and still haven't heard anything back via email or via invites/rejections. Part of me thinks it went straight to junk mail. My IM friends say phone calls have been working out, but I kinda feel that comes off as desperate. Anyone else have any luck?

 

[EM17ThrowAway]

On another note, I sent out three emails of interest last week, and still haven't heard anything back via email or via invites/rejections. Part of me thinks it went straight to junk mail. My IM friends say phone calls have been working out, but I kinda feel that comes off as desperate. Anyone else have any luck?

Think of a program as your grandma. Would she prefer a phone call or an email?

 

[LilKangaroo]

I'm not at all convinced I needed to apply so broadly in the first place, but even now with the invitations I have, when I asked a school advisor if I could drop one that I'm not interested in I was advised against doing so because it is a less competitive program and there seems to be concern that there will be too many competitive programs on my final rank list. Not sure what to make of that at all, but I'm fairly certain this approach is harmful to other applicants and clogs the system.

That is the exact opposite of what my advisor told me. He recommended canceling the interviews and withdrawing from programs that I haven't heard from and am no longer interested in going to after getting interviews at places I was more interested in.

In his words:

"Yes, please withdraw from programs at which you would not accept an interview even if offered or would not rank post-interview. This will free up these valuable slots for your peers."

 

[TheSchnugg]

Trying to let go of a couple of my interviews so you guys can get them but I'm having a hard time deciding how many I should actually go on (and no, I'm not sitting on 40 interviews ). I know 12 is the magical number but I can't help but think that this is dependent on the competitiveness of said programs. I'm trying to match in the west (yes Cali), and this being a competitive region, I wonder if I may need to go one more interviews if my rank list will be made up of mostly programs from out there. Any thoughts on this?

 

[mesmerazopam]

Think of a program as your grandma. Would she prefer a phone call or an email?

I guess it depends on how busy your grandma is. If my grandma was reviewing 1000+ residency applications, she’d probably prefer email.

All jokes aside, I don’t think there is a rule of thumb in this regard. How do people even make this phone call? Do you just call and say, “I’d really like an interview with your program because I’m really, really interested?” Are you calling the very busy coordinator? The even busier program director? Email seems preferable to me because A) It’s less time consuming and can be easily referenced and B) The only thing that a program director or selection committee probably cares about is that you took the extra time to express interest, of any kind. I highly doubt anyone looks over these emails for Shakespearian prose. It probably gets noted: “Applicant expressed interest” and maybe your app gets moved up the list. If you had something truly interesting and unique, maybe it gets noted.

I made a lot of calls in a previous career, and I can’t even imagine how I would go about making that phone call not awkward or desperate sounding. Asking about your status as a conversation starter is a waste of time and we should know better. Randomly giving a spiel about how much you really love the place is, to me, equally presumptuous when you consider how busy the administrative staff are at these programs. The only advantage to making any contact is to distinguish your application as serious among the many hundreds of qualified candidates. An email does that. Anyone who has ever worked in an administrative capacity knows how disruptive phone calls are to work flow and I imagine these program coordinators are taking many, many calls per day. But, I admit that this is likely super variable program to program. Knowing what I know about medicine, I can easily see how some programs would prefer a phone call if only because of some sense of extra-special seriousness.

I don’t know. It seems early to be reaching out as I’ve generally been giving programs the benefit of the doubt and have assumed that they’re still filtering through the deluge of applications.

 

[WildcatS11]

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.

Of course they do. You might not think so, but reviewers take this pretty seriously.

 

[WildcatS11]

Think of a program as your grandma. Would she prefer a phone call or an email?

I would never call the admissions office trying to get an interview. They read your emails.

 

[Goose Egg]

christ last year's thread is bumming me out. seems like the rich stay rich and the poor stay poor. one guy posted in the soap thread and most everybody else just disappeared. somebody please take away my internet

 

[EM17ThrowAway]

How do people even make this phone call? Do you just call and say, “I’d really like an interview with your program because I’m really, really interested?” Are you calling the very busy coordinator?

Important point of clarification. If you have no special reason to be interested in them beyond "seems like a nice place to do residency" then there's no point in contacting them to begin with. If, however, you have a special and/or extenuating circumstance driving your interest in that program, then yes, a call is absolutely better. A call was, is, and always will be far more genuine.

I would never call the admissions office trying to get an interview. They read your emails.

You do you. N= a couple, but it works (not just for me).

 

[EMpty2017]

christ last year's thread is bumming me out. seems like the rich stay rich and the poor stay poor. one guy posted in the soap thread and most everybody else just disappeared. somebody please take away my internet

I'm doing the same thing too. Hopefully they all matched somewhere.

 

[Yraqi]

Important point of clarification. If you have no special reason to be interested in them beyond "seems like a nice place to do residency" then there's no point in contacting them to begin with. If, however, you have a special and/or extenuating circumstance driving your interest in that program, then yes, a call is absolutely better. A call was, is, and always will be far more genuine.


You do you. N= a couple, but it works (not just for me).

Do you mind telling us how you went about doing that?

 

[RainbowOtterz]

I'm doing the same thing too. Hopefully they all matched somewhere.

Not all of us did and some of us are reapplying. I know and have lived the pain of many people on this thread.

 

[WildcatS11]

You do you. N= a couple, but it works (not just for me).

I am not applying,. I can tell you with certainty that our admissions folks at a large, academic, well respected urban program would be confused if you called just to tell them you are interested. If you have something compelling, I guess you could try it.

 

[EM17ThrowAway]

Do you mind telling us how you went about doing that?

Hello Mr/Ms X, my name is EM17ThrowAway and I'm an applicant to your program this year. [pause for banter] I just wanted to follow up and let you know about something that may not be well reflected in my application and I feel is important for your program to know. [insert reason here] [some back and forth concerning your reason] Oh yes, thank you for your time and you have a great day. [ill be sure to pass this along to the committee thank you!]

 

[alexalex]

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.

Doubt this is that important but sure they should be more standard, maybe a more clear scoring or what not. I'm sure they are very aware a lot of programs are P/F only. I had H / P / HP, and I don't think it hurt me. I have heard a SLOE has to be really bad to really hurt you or really good to bump you up (given on average most are positive). I think having a complete application is more important so that they consider you right away instead of placing you in the "maybe pile", - by that I mean 2 SLOEs and step2 in by oct 15. Couples matching is also very rough so probably none of this applies to them : / ,... my heart goes out to you.

 

[doggydog]

Doubt this is that important but sure they should be more standard, maybe a more clear scoring or what not. I'm sure they are very aware a lot of programs are P/F only. I had H / P / HP, and I don't think it hurt me. I have heard a SLOE has to be really bad to really hurt you or really good to bump you up (given on average most are positive). I think having a complete application is more important so that they consider you right away instead of placing you in the "maybe pile", - by that I mean 2 SLOEs and step2 in by oct 15. Couples matching is also very rough so probably none of this applies to them : / ,... my heart goes out to you.

I heard the opposite. That even a lukewarm SLOE can cause you to go from competitive to not competitive.

 

[alexalex]

I heard the opposite. That even a lukewarm SLOE can cause you to go from competitive to not competitive.

I hope that is not the case, nothing in the app should be that damning for anyone. I'm pretty sure one of my SLOEs was very mediocre given I saw the eval sent to my school, but my other two SLOEs must be good, so that it didn't matter as much. I guess either having one really bad one or 3 that show a negative pattern is what hurts. I do believe we should at least know if we have a bad SLOE so we can choose to not send it out, but doubt this will ever be the case.

 

[doggydog]

I hope that is not the case, nothing in the app should be that damning for anyone. I'm pretty sure one of my SLOEs was very mediocre given I saw the eval sent to my school, but my other two SLOEs must be good, so that it didn't matter as much. I guess either having one really bad one or 3 that show a negative pattern is what hurts. I do believe we should at least know if we have a bad SLOE so we can choose to not send it out, but doubt this will ever be the case.

I agree, we should know, but a lot of the times we don't. There were two notable posters on this board last cycle who had some bad comments written on a sloe that got in after they had received a lot of interviews. I know at least one fell pretty far down his rank list. After two other great SLOEs and step scores, a few bad comments on a late SLOE caused that.

 

[mega_colon]

The big thing is that this is not a part of the application you know about and can adjust for. Maybe keep a few more of your safety interviews. But since you don't know we have good candidates getting torpedoed and not even knowing they were less competitive. At least in other fields applicants generally know how competitive they are.

 

[medmedman]

Is it wishful thinking to assume that they haven't sent out all interview invites yet? Currently sitting at 5 and I don't exactly like those odds as my final number...

 

[doggydog]

Is it wishful thinking to assume that they haven't sent out all interview invites yet? Currently sitting at 5 and I don't exactly like those odds as my final number...

No one can tell you if you are going to get more interviews.
There is a 100% chance that more interviews will be sent out by almost every program in the country.

 

[medmedman]

No one can tell you if you are going to get more interviews.
There is a 100% chance that more interviews will be sent out by almost every program in the country.

....Um yea, which is why I asked generally

 

[smallcitybigtown2]

Got 2 interviews, 1 rejection and don't have a SLOE. Applied to 35 programs. After reading this discussion, I'm guessing I should be evaluating different options. My worry is that my 4 LoR's and PS are specific for EM. What should I do??

 

[EM17ThrowAway]

Got 2 interviews, 1 rejection and don't have a SLOE. Applied to 35 programs. After reading this discussion, I'm guessing I should be evaluating different options. My worry is that my 4 LoR's and PS are specific for EM. What should I do??

Why don't you have a SLOE?

 

[smallcitybigtown2]

Why don't you have a SLOE?

Did my first 2 EM rotations at locations without a residency program. Will be at an academic institution starting mid Nov. Got bad advice from a new advisor.

 

[NYCEM2017]

Got 2 interviews, 1 rejection and don't have a SLOE. Applied to 35 programs. After reading this discussion, I'm guessing I should be evaluating different options. My worry is that my 4 LoR's and PS are specific for EM. What should I do??

The lack of a SLOE is a huge issue. Many programs expressly state that they require a minimum of 1 SLOE to consider your application. You should check with every program which you applied to - usually the info is on their website. Otherwise, consider applying to programs which do not specifically require a SLOE.




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[smallcitybigtown2]

The lack of a SLOE is a huge issue. Many programs expressly state that they require a minimum of 1 SLOE to consider your application. You should check with every program which you applied to - usually the info is on their website. Otherwise, consider applying to programs which do not specifically require a SLOE.




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Ya I made sure to check all of their websites, and applied to programs that don't require it. However, I feel like it's still an issue as I have only received communication from 3 programs. I'm just trying to figure out where to go from here.

 

[jessk2015]

Sent 2 emails of interest last night. Received 2 personalized rejection responses today. Perhaps I should have called

On the bright side, I sent 3 emails of interest the night before, and none of them have responded at all yet. SO YOU'RE SAYING THERE'S A CHANCE!

 

[RoyalMule]

Did my first 2 EM rotations at locations without a residency program. Will be at an academic institution starting mid Nov. Got bad advice from a new advisor.

I'm afraid I'll be in a similar situation. I am sure they don't hold as much weight as one coming from a program director at a residency, but would it still be worthwhile to get a SLOE from a EM physician from my rotation?

 

[Frazier]

Where did all the interview invites go? Why has it been silence for over a week?
Are people actually going on all their interviews this cycle too?

Earlier this week, applicants at my school got an email from one of EM admins saying that basically ish hit the fan this cycle.

 

[EMpty2017]

Did my first 2 EM rotations at locations without a residency program. Will be at an academic institution starting mid Nov. Got bad advice from a new advisor.

Whoever your advisor is should be fired. Not having a SLOE definitely limits your option and potentially a spot at a good program. It just makes me angry that an advisor wouldn't do the proper research to help students, it's irresponsible. Are you attending a DO or MD program?

 

[doggydog]

Applicants at my school got an email from one of EM admins saying that basically ish hit the fan this cycle.

Details? In what way?

 

[medmedman]

Where did all the interview invites go? Why has it been silence for over a week?
Are people actually going on all their interviews this cycle too?

Earlier this week, applicants at my school got an email from one of EM admins saying that basically ish hit the fan this cycle.

Hm so I just spoke with the PD at my institute and he told me to be more patient. He said that as the cycle continues, people will start cancelling their interviews and that there should be a good amount of movement fairly soon. He actually said wait a week or two before contacting schools. I know that's not super helpful but trying to stay positive haha

 

[Frazier]

Details? In what way?

It was a group email to like 10 students, so no feelings were hurt -- but he noted that many of us have too few interviews at this point in the season, application numbers are through the roof this cycle, and recommended that drastic actions be taken (i.e. start cold calling).

 

[medmedman]

Got 2 interviews, 1 rejection and don't have a SLOE. Applied to 35 programs. After reading this discussion, I'm guessing I should be evaluating different options. My worry is that my 4 LoR's and PS are specific for EM. What should I do??

Your advisor told you you don't need a SLOE? Honestly I'm not sure how great your chances are at this point. Awesome job on getting the 2 interviews - I thought all schools required at least one SLOE. I'd talk to your program director at your institution and tell him about your situation. He might be able to help out since your advisor really screwed you over with that advice

 

[doggydog]

It was a group email to like 10 students, so no feelings were hurt -- but he noted that many of us have too few interviews at this point in the season, application numbers are through the roof this cycle, and recommended that drastic actions be taken (i.e. start cold calling).

And the panic ensues. What a wonderful cycle we are having.

 

[Frazier]

And the panic ensues. What a wonderful cycle we are having.

Word. We applied just in the nick of time!

 

[SarahBellum1]

I got an invite from a school on Monday and another just yesterday from places that first sent out invites a month ago. So there's some movement! Just be patient! We'll all be okay

Where did all the interview invites go? Why has it been silence for over a week?
Are people actually going on all their interviews this cycle too?

Earlier this week, applicants at my school got an email from one of EM admins saying that basically ish hit the fan this cycle.

 

[Goose Egg]

It was a group email to like 10 students, so no feelings were hurt -- but he noted that many of us have too few interviews at this point in the season, application numbers are through the roof this cycle, and recommended that drastic actions be taken (i.e. start cold calling).

Did he say what constitutes "too few interviews" at this point? I feel like this is ridiculous. I have friends going derm, rad onc with similar step scores who are not struggling nearly as much. EM alone feels like it has that premed atmosphere. Cold-call programs? come on....

 

[FrozenCoke2k51]

Did he say what constitutes "too few interviews" at this point? I feel like this is ridiculous. I have friends going derm, rad onc with similar step scores who are not struggling nearly as much. EM alone feels like it has that premed atmosphere. Cold-call programs? come on....

Another glimmer of hope, heard from a PD on a recent interview that they are getting 1-3 cancellations a day this last week, I expect a second wave will start rolling in the next week or 2.

 

[Girly X]

How do we know if a program accepts 4 letters? Or is everyone just assigning 4 to all?


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