[2018-2019] Emergency Medicine Application Thread

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anon6134 said:
For those of us joining EM late, anyone have any advice on how in the world to get rotations in a reasonable time frame for a SLOE? I have one set up pre-ERAS but getting a second is near impossible prior to January. At this point I am going to have to apply with one SLOE but I am starting to get concerned about even getting a second during the year. VSAS is either straight rejection or radio silence, emails to individual programs are either ignored or all rotations are full. Not sure how PD's are expecting every applicant to apply for away rotations mid 3rd year if we are on the fence.
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Send me a PM. I'm not certain, but I think we may have openings before January if interested.
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Newyawk said:
But surely its a plus. I imagine bc most people dont have perfect grades and most have prob an average of HP in EM then its not considered an important factor bc you cant use it to differentiate most applicants. But if you had a straight honors student apply EM youre telling me it wouldnt impress people?
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The people that get straight honors are pretty unlikely to just all of a sudden become middle of the road or worse in EM and get poor SLOEs. I mean, if they have a major personality flaw or are bad students, they wouldn't have gotten straight honors. Could it happen where someone with straight honors got two bad sloes? Sure, but I would say its extremely unlikely and personally haven't seen it happen.
 
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Quick SLOE question as I wrap up my first audition. I did an EM elective rotation at the end of 3rd year with a preceptor at a community hospital (basically shadowing with an occasional H&P sprinkled in). Since the SLOE asks if this is our 1st, 2nd, 3rd etc. rotation, am I supposed to tell the clerkship director about that rotation? I don't want her to check off "2nd rotation" and then have programs wonder if I'm hiding a letter. Or do I just not say anything so that she checks off "1st rotation"? Thanks!
 
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TheOne13 said:
Quick SLOE question as I wrap up my first audition. I did an EM elective rotation at the end of 3rd year with a preceptor at a community hospital (basically shadowing with an occasional H&P sprinkled in). Since the SLOE asks if this is our 1st, 2nd, 3rd etc. rotation, am I supposed to tell the clerkship director about that rotation? I don't want her to check off "2nd rotation" and then have programs wonder if I'm hiding a letter. Or do I just not say anything so that she checks off "1st rotation"? Thanks!
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I wouldn't say anything.
 
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TheOne13 said:
Quick SLOE question as I wrap up my first audition. I did an EM elective rotation at the end of 3rd year with a preceptor at a community hospital (basically shadowing with an occasional H&P sprinkled in). Since the SLOE asks if this is our 1st, 2nd, 3rd etc. rotation, am I supposed to tell the clerkship director about that rotation? I don't want her to check off "2nd rotation" and then have programs wonder if I'm hiding a letter. Or do I just not say anything so that she checks off "1st rotation"? Thanks!
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That question is answered incorrectly a lot. My guess is, the intent is that it means which AI it is. I would consider your first AI/sloe rotation to be your first rotation, but its obviously a subjective interpretation. I think its fine to consider it that way.
 
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SpacemanSpifff said:
True to an extent. The only data we have suggest that they all matter (see the 2016 PD survey results). Especially when you start getting into the pool of applicants that all have glowing SLOE's, you gotta differentiate somehow.
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Yep. I think the other stuff becomes more the tie breakers. Two people with equally great SLOEs, who are both good interviews and seem like they'd fit at your program; then you look at their board performance and grades to differentiate.
 
Hi!

Wondering if anyone has any details on NYU away rotation - shifts? tests? bad/good SLOEs? Or any tips.

Thanks!
 
Just received 2 offers for away rotations, both really late (10/22 block and 11/19 block). Is it feasible to do these rotations and still go on interviews?
 
TheOne13 said:
Just received 2 offers for away rotations, both really late (10/22 block and 11/19 block). Is it feasible to do these rotations and still go on interviews?
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Yes. Most places understand that you will have interviews during this time. You should be able to knock out 2-3 each month. But also, most places interview in Dec and January as well. So don't get too worried if for some reason the scheduling demands in Oct-Nov limit you to only a handful.
 
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Thank for the response! As a follow-up question, would it be better to hold LOR spots open for these rotations or should I go ahead and be complete ASAP and get an attending I rotated with to write me a LOR? I already have 1 SLOE, and I believe my next rotation will provide me with a 2nd.
 
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PowerfulDRE said:
Whens the applicant excel sheet gunna get goin?
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Its a work in progress but ill touch base with Surely. I dont know how much use it will have right now while we wait on SVI and STEP 2 CK scores. I was thinking about adding an SVI column this year to see if PDs use it differently now that we are year #2.
 
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ZX10R said:
Its a work in progress but ill touch base with Surely. I dont know how much use it will have right now while we wait on SVI and STEP 2 CK scores. I was thinking about adding an SVI column this year to see if PDs use it differently now that we are year #2.
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Add it if you have the chance. I’m curious to see if it has any real affect



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ZX10R said:
Its a work in progress but ill touch base with Surely. I dont know how much use it will have right now while we wait on SVI and STEP 2 CK scores. I was thinking about adding an SVI column this year to see if PDs use it differently now that we are year #2.
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Wasn't there an SVI column last year on the applicant info tab? Hard to check from mobile. Strongly suspect PDs are wiser than to use it this year, though.
 
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ZX10R said:
Its a work in progress but ill touch base with Surely. I dont know how much use it will have right now while we wait on SVI and STEP 2 CK scores. I was thinking about adding an SVI column this year to see if PDs use it differently now that we are year #2.
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surely said:
Wasn't there an SVI column last year on the applicant info tab? Hard to check from mobile. Strongly suspect PDs are wiser than to use it this year, though.
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There was indeed an SVI column on last year's document :)
 
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lepen86 said:
Hi!

Wondering if anyone has any details on NYU away rotation - shifts? tests? bad/good SLOEs? Or any tips.

Thanks!
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Rotated there back in the day (about 5 years ago). Was pretty discouraged by the experience, especially coming off the high I felt after my home audition rotation - actually questioned my decision to go into EM as a result of it. Very difficult patient population, faculty/residents I thought were meh, absolutely no feedback given during any point of the rotation so I had no idea how I was doing, required attendance every day at morning report even if you didn't have a shift that day. In retrospect, a poor experience.

Maybe it has changed?

The SLOE must have been good enough as I matched to a competitive program.
 
gamerEMdoc said:
Much like residency admin when looking at the applications, I doubt any students looked at the SVI column.
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Glad to hear it! Not saying it was a very useful metric, mostly just that it exists. Always made me feel good to hear how much residency admin dislike the piece o' crap that is the SVI.
 
gamerEMdoc said:
Much like residency admin when looking at the applications, I doubt any students looked at the SVI column.
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Do you think more program directors are going to look into the SVI this year? Do you think if someone gets a low score (between 6-11) that it'll prevent that candidate from getting interviews/ranked highly?
 
runthiscity said:
Glad to hear it! Not saying it was a very useful metric, mostly just that it exists. Always made me feel good to hear how much residency admin dislike the piece o' crap that is the SVI.
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I don't know that its disliked, more that its just unproven and unlikely to carry a lot of weight or be utilized by many programs.

Waterlover said:
Do you think more program directors are going to look into the SVI this year? Do you think if someone gets a low score (between 6-11) that it'll prevent that candidate from getting interviews/ranked highly?
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Who knows. I think the SVI right now is kind of a tie breaker. If two candidates both have the same SLOEs and similar boards, maybe the SVI can help determine which to interview? Sounds good theoretically, but in reality, if both students had good SLOEs you'd probably offer both interviews anyways. Maybe the REALLY low scores may hurt, maybe the REALLY high scores may help, but I doubt even the extremes will make a huge difference, and most people fall somewhere in the middle and the score won't make a difference one way or another.
 
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If I take my Step 2 CS in mid-November and expect to get results back like a week before rank lists are due (mid-Feb.), will that be a problem?
 
mymembernames said:
If I take my Step 2 CS in mid-November and expect to get results back like a week before rank lists are due (mid-Feb.), will that be a problem?
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Only if you fail. More & more programs are requiring a passing CS to even have you on their rank list.


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mymembernames said:
So do PDs wait till the 20th of Feb to do their rank list?
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I don’t know the answer to that. I received my score at the beginning of February and had a program ask after that for it. It’s similar to us certifying our rank list and can change it anytime after that as long as it’s within the timeframe.


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southerndoc said:
Usually last week of January the core faculty will meet to go over all the applicants again. The final rank list is submitted shortly thereafter. Not sure of exact date.
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So if I don't have my CS score back by then I wouldn't be ranked by your program?
 
mymembernames said:
So if I don't have my CS score back by then I wouldn't be ranked by your program?
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This is very program dependent. My CS score didn't come back until after rank order lists (bad advice + bad decisions on my part) but I still ended up matching towards the top of my list. Would I have gotten my #1 with a CS pass? Maybe but I doubt it. Only one school contacted me pre-due date to ask about it.
 
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mymembernames said:
So if I don't have my CS score back by then I wouldn't be ranked by your program?
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Never said that. We look at a lot of things when we rank applicants. Many programs have cutoffs, but we do not have strict cutoffs. Thankfully we view applicants as more than just numbers.
 
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The dates that the programs have to certify their lists are basically the same as the dates the students have to certify. Either party can certify earlier. Most programs finish up their list around the beginning of February I'd imagine.
 
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Is there any way to find out which new programs that are on the agenda for the September ACGME EM accreditation meeting?


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Can anyone who did an away at UMass or UConn speak to their EM programs? And in general how they liked the rotation/residents/fascilities/etc. Unless I missed it here, I haven’t been able to find any recent threads about them
 
I apologize if this question has been asked before but currently on my first EM sub I and intend to get a sloe but the program hasn't given us a clear idea of how/when sloes are uploaded. how do I go about in requesting one through eras? When I click add new LOR on Eras it gives me the option of one from a PD vs department chair. Do I need to submit a request first?
 
Anxietyfreak said:
I apologize if this question has been asked before but currently on my first EM sub I and intend to get a sloe but the program hasn't given us a clear idea of how/when sloes are uploaded. how do I go about in requesting one through eras? When I click add new LOR on Eras it gives me the option of one from a PD vs department chair. Do I need to submit a request first?
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Request one from the PD via ERAS. It'll generate a PDF form you can then email to the person writing your SLOE. Often the course director oversees this process, with the PD signing the SLOE along with the other faculty, so I'd start by emailing the PDF to the course director, and Cc the course coordinator. Hope that helps!
 
surely said:
Request one from the PD via ERAS. It'll generate a PDF form you can then email to the person writing your SLOE. Often the course director oversees this process, with the PD signing the SLOE along with the other faculty, so I'd start by emailing the PDF to the course director, and Cc the course coordinator. Hope that helps!
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Asking for next year. What do i do if the only EM aways I can get are in Jan feb mar etc. Is there anyway I can get an early SLOE, and not wait till match season with a probability of them forgetting about how i was during the rotation?
 
I wouldn’t recommend that. Rotating in the middle of 1/3 year is not going to make you look as good as a 4th year student in Sept or October. Especially if it’s one of your first EM rotations. And many places may not write SLOEs unless it’s during the SLOE AI season (June-Oct). They will meet and compare all the candidates during that time as a whole to decide how to rank them against eachother. So if you rotated as a third year back in January, and its now the middle of September and they are trying to remember you, and also are comparing you versus a 4th year with multiple EM months under their belt, you will be at a disadvantage.
 
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Anybody start the Google excel sheet? I’m curious to see students impressions of different programs.


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Yeah Step 2 matters more so than Step 1 in EM. SLOE's are often what differentiates candidates enough to get an interview. Once you've gotten the interview, it's a level playing field. Doesn't matter if you have a higher score or lower score at that point so much as the main decision factors will be SLOE's and how you interviewed.
 
Also rarely on SDN here but just wanted to throw out a word to the wise.

If any of you are in a pinch either in getting an away rotation, or interview later on, remember that the coordinators, these gals (most often gals) often have immense power. The program director/APD's/Chairs are super busy and get a billion emails in addition to clinical duties.

But I know of multiple coordinators who were able to help someone who was in a pinch, and got them slipped in an away rotation slot or tacked them on to an interview day. This is not to say to circumvent the system, but if things didn't work out like you'd hoped, sometimes a phone call to the coordinator to explain the situation may be worth a shot.

And best of luck from a Texas PGY1. There's a lot of stress in this, but there's also a lot of spots--more than ever. You've made it this far, be proud.
 
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:)) said:
After browsing initial spreadsheet responses was wondering why people are applying to so many programs- especially the strongest applicants, especially given this data - Apply smart in emergency medicine: New data to consider - Careers In Medicine

For step score > 235, returns diminish at 19 programs (peak at 30)
For step score 219-234, returns diminish at 24 (peak at 35)
For step score < 218, returns diminish at 29 (peak at 40)

I see numbers in the 40s, 50s, 60s even for super strong applicants- why?
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Diminishing returns is not the same as worsening results! I made a post before about how misleading it is for them to talk about diminishing returns as if that's a meaningful thing. Plus, the data this was based on was from the 2011-2015 matches...pretty out of date.

The average EM applicant applied to over 50 programs last year. This is driven by neuroticism and lack of transparency into the SLOE. If you feel like there's any chance one of your SLOEs might be a torpedo (SLorpedOE, trademark @surely), it's hard to resist the urge to spend another couple hundred bucks adding another 10 programs. Remember, each program you apply to after the first 30 is only an additional $26. That's cheap insurance against a very expensive bad outcome.

Edit: link to previous discussion of this data: AAMC Applications Data -
 
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Fear of not matching. Even though the advice is apply to 30-40 and interview at 12-15 (assuming no red flags or couples match), I'd bet that most students don't want to take the chance and would rather be overcautious. There's too much at risk, and humans are frequently risk averse. Logically, there's no reason to apply to 100 programs and go on 20 interviews, but sometimes the irrational or emotional side cannot be convinced.

As discussed endlessly, SLOEs are probably the biggest factor. Although we've been given some insight on how the SLOE is generated (thanks to a fantastic aPD), not every program may operate the same way. From my own experience and talking with friends, I know some rotations only have you turn in 2-4 shift cards while others have you turn in 14. If you're only turning in 3 shift cards (blinded), that seems like there's very limited information to even write a SLOE from. Sure, residents and attendings may be discussing students privately outside of the shift cards, but as students, we don't get that feedback. We're also at the point where we may be too cynical. We've all heard about students receiving excellent feedback in person and on school evaluations only to end up with a sub-par or outright damning SLOE. We've heard about students who were told they would be ranked to match or at the top of the list only to not match at that program or even worse, fail to match completely. We've been advised to take everything anyone says (good or bad) with a grain of salt.

Furthermore, some programs may heavily weigh where the SLOE is from. Not all students were able to obtain rotations at well-known/established programs. If I got an excellent SLOE from a lesser known program that recently switched to ACGME, would it still be weighed as positively if I were to get one from someplace like Indiana or LAC-USC? Maybe, maybe not. At the same time, if I received a poor SLOE from that same lesser known program, my application is down the drain. What if my SLOE writer doesn't have much experience with them? Might I possibly end up with a poorer SLOE? We've been told repeatedly that SLOEs are the number 1 factor in the EM application. Unfortunately for students, it is the one thing we are (mostly) blinded to in terms of how it is generated, what evaluation we received, and how much the reputation of the program that writes the SLOE really matters.

The bottom line is that many applicants are deciding to be risk averse due to fear and uncertainty. Students have spent 4 years and hundreds of thousands of dollars getting to this point. We'd rather drop a couple grand more to make sure that we match in our specialty of choice especially if you're a DO, have average scores and have an uneasy feeling about the SLOE.
 
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TheOne13 said:
The bottom line is that many applicants are deciding to be risk averse due to fear and uncertainty. Students have spent 4 years and hundreds of thousands of dollars getting to this point. We'd rather drop a couple grand more to make sure that we match in our specialty of choice especially if you're a DO, have average scores and have an uneasy feeling about the SLOE.
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This is understandable. The thing that gets me is these step 1/2 250+, SLOE H's applying to 50+ programs (or even 30+ for that matter). These applicants have a lot in their favor, even without knowing their "would rank ____" position on the SLOE. Pure neuroticism takes hold and the AAMC makes bookoo bucks.
 
SpacemanSpifff said:
This is understandable. The thing that gets me is these step 1/2 250+, SLOE H's applying to 50+ programs (or even 30+ for that matter). These applicants have a lot in their favor, even without knowing their "would rank ____" position on the SLOE. Pure neuroticism takes hold and the AAMC makes bookoo bucks.
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Med school is probably one of the most underrated business out there. Its a seller's market to desperate people aka us
 
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I haven't decided for sure but I would certainly prefer to go minimal in regards to number of programs. Somewhere in the 20s. I'm a competitive applicant stats/grades wise. Not applying to crazy competitive programs/locations exclusively (though a couple programs are). The anxiety provoking part is just not knowing with SLOEs. I can't think of any reason they would be poor, but hard to know the difference between solid and great. Another thing I'm thinking about is there is definitely a top 12-15 programs for me (mainly due to location) so anything past that is just kind of stretching to protect against not matching. People who are more open I can understand how they would get sucked into applying to 50 programs.

Side note: Am I reading it correctly that NBME charges $80 dollars to send your score to ERAS? The audacity with some of this money grubbing never ceases to amaze.
 
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Garferies said:
Just wondering, but what makes someones SLOEs competitive to PDs? Is it the applicant's ranking (top 1/3, middle 1/3), or the number of "above peers" check-marks that the applicant has? Or is it the comments being written? If all of them, which one has the most impact?
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This is probably variable from one program to the next, but as a generalization, I'd say that the sections, in order of most important to least:

1. The SLOE rank (top 10, top 1/3, mid 1/3, etc) , taking into consideration the percentages that program puts into each category
2. The comments, if there is anything actually important in their pertaining to the student (as opposed to some very generic statements)
3. The EM grade of the rotation taking into consideration the percentages
4. The section with the check boxes of above peers, level of peers, below peers.

It's not that section 4 isn't important, its just that if someone is checked off above peers or below their peers, its usually reflected in the comments. So 2/4 pretty much go hand in hand really, so section 4 doesn't usually add much once you read the comments.
 
can’t seem to get a clear consensus on this, so hoping someone can help.

my school makes it so my first EM rotation is in August, so my aways aren’t until September and October. should i submit ERAS on 9/15 with only 1 regular LOR and my 1 SLOE that will be in at that time, then my second SLOE shortly after (probably early October) in order to leave room for my third SLOE much later, or just submit with 2 regular LORs and the 1 SLOE so i’m complete right away, then just second SLOE early October? Only issue is then my last SLOE won’t have any room to get submitted, so it’d have to be sent to programs directly if anything at all. Not sure if a November SLOE will be all that helpful anyway. Please advise!
 
AthleteDoc7 said:
can’t seem to get a clear consensus on this, so hoping someone can help.

my school makes it so my first EM rotation is in August, so my aways aren’t until September and October. should i submit ERAS on 9/15 with only 1 regular LOR and my 1 SLOE that will be in at that time, then my second SLOE shortly after (probably early October) in order to leave room for my third SLOE much later, or just submit with 2 regular LORs and the 1 SLOE so i’m complete right away, then just second SLOE early October? Only issue is then my last SLOE won’t have any room to get submitted, so it’d have to be sent to programs directly if anything at all. Not sure if a November SLOE will be all that helpful anyway. Please advise!
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When you say "complete right away" I'm not sure what you are referring to. Having 2 regular LORs doesn't make your application complete. Submit with one SLOE, one regular LOR, and then add the other two SLOEs as they come in.
 
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