[2018-2019] Emergency Medicine Rank Order List Thread

[deleted547339]

I don't know how that could possibly happen if the ED volume to resident ratio isn't completely out of whack. (Too many residents/too little volume). Residencies aren't at urgent cares. Who are intubating the patients that come in if residents are getting the bare minimum? Either the place has anesthesia coming down to the ED to intubate (if so that's unbelievably bad), they have too many EM residents for their volume, or its an anomaly with one resident who is shying away and hiding from procedures and the residency isn't calling them out.

Without getting into specifics, I can tell you it wasn’t a one off resident situation. As above, intubation is an easy procedure, but the things that it represents are a lot more important in the resuscitations.

FWIW, I’ve never drained a PTA, that being said my understanding is that they’re almost always ok for rx and outpt ENT follow up, but I can reduce a shoulder with the best of em. I’m probably average with kids - I got great Peds training in residency but did a CCM fellowship. I feel like when you do CCM, you accept that you won’t be the fastest, the best with Peds, the best with ortho, etc. Still glad I did it.

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[TrashPanda13]

RANK LISTS ONLY!!!!

I'm just kidding . Remember the good ol' days when people would police that? Not much in the way of rank lists this year anyway.

Anyway, great discussion going on here. What do you all recommend future EM residents do so that they "make the best of residency" and become a badass EM doc regardless of where they train whether it be a "legendary", academic powerhouse, county, HCA, small community hospital etc.?

 

[TrashPanda13]

And now, back to our regularly scheduled programming....

Applicant Summary
Board scores: 250s/250s
EM rotation grades: Honors/Honors/Honors
AOA: Yes
Medical school region: East coast
Anything that made you more competitive: AOA, GHHS, 3 Top 10% SLOEs (mentioned on interviews), all honors 3rd year, previous ED job, plenty of interesting ECs, pretty down to earth outgoing dude

Main considerations in creating this ROL: Preferred more academic places, 3 > 4 years (slightly), geography played a small role, but SO happiness with location trumped most things (we had to agree)

1) TN -- Vanderbilt University

Pros: 3+1, Flat out loved this place, best in the country as far as what I'm looking for I think. Vibed with the faculty so so so much, residents were great people. Slovis was truly the man (didn't get it until I met him, but its true), loved Dr. McCoin and others too. Great SO support. Education focus vibed with me. Excellent clinical training and anyone who says otherwise is crazy. Great benefits, amazing peds, great food in hospital, great trauma. Nashville is awesome with plenty of sports to cheer for and my SO loved it too. Would be a dream come true! Legendary program that has earned the reputation

Cons: NONE (other than kind of far from home which is not ideal, but i'd survive)

2) MA -- Harvard Affiliated Emergency Medicine Residency at Beth Israel Deaconess

Pros: 3+1, really enjoyed this place a lot too, would be happy here. Was fighting for number 1 for a bit, but ultimately decided I liked Nashville better and the COL/faculty at Vandy was better too. Otherwise was fairly similar. Residents were cool and I liked all the sushi going around. Fenway + Sox games would be cool.

Cons: PD very stoic, but was ok with that. COL very high, lots of commuting to far sites, didnt love home grown EMR, Peds seemed kind of weak, weekly M&Ms have reputation of being formal

3) NC -- Carolinas Medical Center

Pros: 3 yrs, another place I enjoyed. best pre-interview dinner. loved residents. family feel. great benefits and respect in hospital. great reputation in EM. badass clinically.

Cons: off services seemed too "reliant" on EM, weird vacation schedule, heavy work schedule, peds floors?, not as warm and fuzzy

4) OH -- University of Cincinnati College of Medicine

Pros: should have been higher maybe, loved this place too, EM powerhouse. place oozes excellence and clinical badassery. loved PD. residents were super strong. can do anything coming from here. spoiled us with lots of money and gifts

Cons: 4 yrs, Cinci sucked as a city, residents were nice but not my people, tough sell to SO, seemed to work a ton and wouldnt say exactly how much

5) RI -- Brown University

Pros: Place gets so much troll hate on here that is just not deserved. REALLY liked this place a lot and would be happy here. Was a sleeper for me for sure. PD very nice and got along with her. Residents were nice. Providence was actually not bad though cold. Amazing clinical training and lots of academic resources for niche development. 9 hr shifts

Cons: 4 yrs, had some weird faculty interactions that held me back, residents nice but not my people exactly, otherwise would be happy here

6) PA -- Temple University School of Medicine

Pros: amazing program, great trauma and high acuity training, really got along well with all faculty and residents, amazing reputation, would be thrilled here too

Cons: did not love schedule, philly one of my least favorite NE cities, crap area around hospital and did not get the feeling they had many resources, otherwise excellent

7) PA -- University of Pittsburgh Medical Center

Pros: another I liked a lot, vibed with residents at dinner a lot, one of my fav dinners on trail, facilities were beautiful, liked Pitt as a city and thought I could live there fine, EMS excellent, sports med opps, amazing crit care, got along great with PD

Cons: apparently they work a TON and residents seemed tired, not really into EMS so not a big plus for me, far from home

8) CT -- Yale New Haven Medical Center

Pros: had a great interview day here as well. Gut feeling told me I'd be happy at this program, but just could not put above the others. Great academic and community experience. tons of money. faculty were nice, got along with PD. amazing benefits and salary

Cons: did not vibe with residents all that much besides a few, New Haven pretty dumpy and not the best place to live, 4 yrs, but would be happy here if i end up here

9) NY -- Mount Sinai School of Medicine - New York

Pros: Fav of NYC programs, Elmhurst seemed to be an amazing experience, residents were cool

Cons: realized NYC not for me, war zone EDs, nursing horrible, high COL, 4 yrs

10) NY -- NYU/Bellevue Medical Center

Pros: History of Bellevue had me enticed, but otherwise this place kind of let me down a little. I'm sure training is fine, but no one really made me feel that way during the visit and residents kept saying how weak the acuity and trauma can be which was not confidence inspiring. Very strong academically though and can go anywhere from here after im sure. plenty of money and opportunities in anything

Cons: same as above, with some added pretentious vibes?

11) MD -- Johns Hopkins Hospital

Pros: Actually loved this place, it should have been above the NYC places. Got along great with all of my interviewers and the chair. their 4th year actually seems cool though I'd prefer just doing a real fellowship. liked the residents a lot, got the sense the training was strong and having strong everything else wasnt a huge issue. Hopkins name can take you places outside of medicine, oozing with history

Cons: not super impressed by resident job placement, Baltimore just didnt seem like a safe place to have my family live, 4 yrs, not as strong in EM as basically anything else they do unfortunately, though this may be changing who knows

12) NC -- University of North Carolina

Pros: Another that could have been much higher, loved it here. PD is amazing, one of my favs on the trial. got the sense the training is strong with Wake Med and UNC site, got along great with residents, 3 yrs, liked NC a lot, awesome sports place to live. Legendary faculty still there.

Cons: not as strong as the higher ones, nothing really stood out clinically or academically that blew me away, benefits pretty poor compared to others with expensive parking etc, long commute to Wake

13) MA -- Boston Medical Center

Pros: liked the social mission, got sense residents were very strong and trauma was great here, high acuity, do a lot of community, got along with everyone fairly well

Cons: dang that interview day was long, 4 yrs for no reason, got cold vibe from some faculty, Boston COL, didnt vibe with PD too much, not academic enough for my goals, but a very good program just not for me

Anything else to add? Declined many amazing interviews due to SO veto power after the fact which kind of sucks but I'm at peace with it because I know my top 5 probably would not have changed regardless. Very happy with the interview season turn out and with my list. Happy to answer any questions to the right of this list on the spreadsheet lol.

Applied: Too many (got interviews at almost every one I applied to)
Declined: USC/LAC, Harbor UCLA, Denver, Cook, Maryland, U of Chicago, Northwestern, Michigan, Montefiore, Kings County, Georgetown, George Washington, Christiana, Presbyterian Cornell, Hennepin
Interviewed: See List
Rejected: UPenn (lol), HAEMR Mass Gen (stung)

 

[TrashPanda13]

Applicant summary
Board scores: 240s/???
AOA: No
Medical school region: Pennsylvania
Anything that made you more competitive: previous experience as EMPA

Main considerations in creating this ROL: feel' of location including city life preferred, single looking to mingle, sucker for reputation

1) IN -- Indiana University School of Medicine
Closest to home for me, downtown atmosphere is huge plus for me, loved the staff and residents. Can feel bro-y at times, but more supportive overall that other places

2) VA -- Eastern Virginia Medical School
Liked Norfolk for location (airport and at least there some things to do), residents

3) NC -- Wake Forest University
Good rep, wished city was bigger but had a good feel overall despite smaller surrounding area

4) SC -- Palmetto Health Richland
5) NC -- East Carolina University/Vidant Medical Center
6) OH -- Case Western Reserve University/University Hospital Cleveland Medical Center
7) SC -- Grand Strand Medical Center

 

[namethatsmell]

Without getting into specifics, I can tell you it wasn’t a one off resident situation. As above, intubation is an easy procedure, but the things that it represents are a lot more important in the resuscitations.

FWIW, I’ve never drained a PTA, that being said my understanding is that they’re almost always ok for rx and outpt ENT follow up, but I can reduce a shoulder with the best of em. I’m probably average with kids - I got great Peds training in residency but did a CCM fellowship. I feel like when you do CCM, you accept that you won’t be the fastest, the best with Peds, the best with ortho, etc. Still glad I did it.

To clarify, I wasn't trying to pick on people who are good at critical care or who've done fellowships. I was commenting on the potential setbacks of training at places that can hyper-focus on certain aspects of EM while not giving due diligence to other aspects of our field.

 

[deleted547339]

To clarify, I wasn't trying to pick on people who are good at critical care or who've done fellowships. I was commenting on the potential setbacks of training at places that can hyper-focus on certain aspects of EM while not giving due diligence to other aspects of our field.

I’m aware. We’re cool.

 

[deleted547339]

RANK LISTS ONLY!!!!

I'm just kidding . Remember the good ol' days when people would police that? Not much in the way of rank lists this year anyway.

Anyway, great discussion going on here. What do you all recommend future EM residents do so that they "make the best of residency" and become a badass EM doc regardless of where they train whether it be a "legendary", academic powerhouse, county, HCA, small community hospital etc.?

Don’t you back in the day me. Back in the day I put the rank lists up, lol.

But id avoid hca. I’d ask very pointed questions on interview days. What number of pph do your seniors see? How many lines and tubes as an intern. Etc.

 

[doggydog]

Don’t you back in the day me. Back in the day I put the rank lists up, lol.

Who even are you bro.

 

[alpinism]

I don't know how that could possibly happen if the ED volume to resident ratio isn't completely out of whack. (Too many residents/too little volume). Residencies aren't at urgent cares. Who are intubating the patients that come in if residents are getting the bare minimum? Either the place has anesthesia coming down to the ED to intubate (if so that's unbelievably bad), they have too many EM residents for their volume, or its an anomaly with one resident who is shying away and hiding from procedures and the residency isn't calling them out.

I've give you an example. I'm not trying to call out the program but I do feel its helpful to be open and honest about these things as it helps future applicants.

I did med school at Wisconsin. Their ER sees about 50K/ year and has 12 residents per class. I'm pretty familiar with the program as I did a ton shadowing and spend 2 months in the ER during 3rd and 4th years. If you're not familiar with UW its in Madison which is basically a big college town which also has the state capitol. The city is widely regarded as having one of the healthiest and most educated populations in the country. During my M4 subI rotation I saw a grand total of 1 intubation the whole month. There's many reasons for this besides the city population mentioned above but in addition most of the sick patients came in as transfers from outside hospitals to the mothership and were already resuscitated prior to arrival. Now if you interview there the leadership will tell you that they see tons of sick patients and have a 30% admission rate which is true but of course that doesn't tell the whole story or translate into good training for residents.

If you crunch the numbers the residents do 24 ER months and with an average of 1 intubation per month that comes out to 24 ER tubes during all of residency. Now they also do an anesthesia rotation and have the option to do HEMS shifts which means most residents graduate with over 50 tubes total. But the fact remains that their residents usually graduate with less than 30 ER tubes. Personally I think you need more than 30 to be competent so as a result they weren't at the top of my rank list.

 

[ski89]

I've give you an example. I'm not trying to call out the program but I do feel its helpful to be open and honest about these things as it helps future applicants.

I did med school at Wisconsin. Their ER sees about 50K/ year and has 12 residents per class. I'm pretty familiar with the program as I did a ton shadowing and spend 2 months in the ER during 3rd and 4th years. If you're not familiar with UW its in Madison which is basically a big college town which also has the state capitol. The city is widely regarded as having one of the healthiest and most educated populations in the country. During my M4 subI rotation I saw a grand total of 1 intubation the whole month. There's many reasons for this besides the city population mentioned above but in addition most of the sick patients came in as transfers from outside hospitals to the mothership and were already resuscitated prior to arrival. Now if you interview there the leadership will tell you that they see tons of sick patients and have a 30% admission rate which is true but of course that doesn't tell the whole story or translate into good training for residents.

If you crunch the numbers the residents do 24 ER months and with an average of 1 intubation per month that comes out to 24 ER tubes during all of residency. Now they also do an anesthesia rotation and have the option to do HEMS shifts which means most residents graduate with over 50 tubes total. But the fact remains that their residents usually graduate with less than 30 ER tubes. Personally I think you need more than 30 to be competent so as a result they weren't at the top of my rank list.

Just to play devils advocate from someone who knows nothing about that program, just because your n=1 month saw 1 intubation doesn’t mean that that’s the average. Just bumping up that average to 2/month makes a significant difference in the total number of tubes a resident might expect to get... again you might be right on, I don’t know, but your logic here seems off to me.

 

[doggydog]

Just to play devils advocate from someone who knows nothing about that program, just because your n=1 month saw 1 intubation doesn’t mean that that’s the average. Just bumping up that average to 2/month makes a significant difference in the total number of tubes a resident might expect to get... again you might be right on, I don’t know, but your logic here seems off to me.

Even residents at that program only have an n=1 residency duration.

 

[Spagett!]

Even residents at that program only have an n=1 residency duration.

What does this even mean, I feel like this is some ancient riddle I'm supposed to solve

 

[homebaseddad112818]

Applicant summary
Board scores: 210s/250s
EM rotation grades: Honors/Honors/High Pass
AOA: No
Medical school region: Northeast
Anything that made you more competitive: Had a couple of leadership positions, above average third year grades, top 30 med school(if that’s important idfk), I think my SLOEs were top 1/3, middle 1/3, middle 1/3 from what I read upside down across the table in really ****ty hand writing(still unsure). Got one or two comments saying they said nice things about me in my SLOEs. Everyone really seemed to like my personal statement. I think I am normal.

Main considerations in creating this ROL: Gut feeling, LOCATION, tried not to look too hard into 3 vs 4 year programs but I secretly prefer 3, tried to keep perceived prestige out of my decision making process but im sure theres some subconscious influence. Part of me thinks I want to do academics, but I also realize that soo many of us think we want to do academics when in reality we won’t.

1) TX -- UT Southwestern Medical Center - Dallas
I was at the pre interview dinner with the margarita machine and it was fantastic. The residents were cool seemed to be quite happy. On interview day, most of the interviews went smoothly-There was one with a lot of behavioral questions and then the PD interview was super brief and it was a lil weird but she was also post overnight. In terms of the program itself I liked that they rotate a good amount at Dallas Children’s ED and in their third year they spend a lot of time at different community sites to really get a flavor of how EM is practiced in different settings. They also kind of split their adult ED time between Parkland and Clements with Clements being the university hospital with strange pathology and parkland having a more county feel. I also stayed a couple of days after in dallas and really liked the city-its pretty cheap relative to where I am coming from, a lot of young people and **** to do in free time. **** winter.

Cons: 1) trauma surgery is king here and 2) felt like there was a lot of consulting. At parkland they literally have a separate OBGYN ED basically which was ****ing weird. Clear to me there this wasn’t a place where you finish all of your procedure requirements after intern year, but honestly I don’t know how important that is at the end of the day.

2) TX -- University of Texas Houston
Rotated here, and coming from a four year program I was really impressed to see what the PGY 2 and 3s were capable of here. I got the sense that they work hard but the faculty all seemed damn supportive and they all seemed like a close knit group of people. Good Peds exposure through their main hospital and texas childrens, they also get a super county experience at LBJ and more of a tertiary care feel at Memorial Hermann. I especially liked that there were a good chunk of younger residents here even though that’s probably coincidence. Also have a lot of young faculty doing cool things ie deputy editor of wikiem. Houston has plenty to do and yeah its humid but it wasn’t intolerable. Also, **** winter. Honestly this and Southwestern flipped flopped a lot in my mind for number 1

Cons: sounds like they have had problems with trauma surgery in past but no longer, residents’ main complaint was ortho is weak but again I don’t know how much that’s really gonna affect my training.

3) MA -- Boston Medical Center
Great group of residents and faculty and it would probably be my number 1 if it were in a warmer city. EM does pretty much everything in trauma situations and the ED here is just…wild. This is honestly a fan ****ingtastic program and anyone who ends up matching here will be really happy like the faculty and coresidents really care about each other. I’m really just not as big of a fan of boston for winter reasons.

4) ME -- Maine Medical Center
I reallllyyy like what this program has to offer. Its tertiary care level stuff without the competition of services like ortho, optho, ent. The residents were all nice and very happy with their choice. For those interested in academics, they match their residents into very competitive fellowships. Portland maine is a small city but its really cool-incredible food and beer. Faculty all seemed really nice and interviews were mainly conversational, they all warned us the PD is a really nice normal dude but comes off weird in the interview. This was true.

Cons- winter. Portland maine is a great city for beer and food and outdoorsy stuff. I don’t think it’s a great place to be 25 and single. The residents were pretty much all in very commited long term relationships/married with kids. There’s absolutely nothing wrong with that, I just feel like we might have different interests of what to do in our free time. Looking at their alumni list a lot were in the northeast and I think I want to go back to socal. Winter also sucks. Despite this, the people and the cool clinical opportunities this program has to offer made this program high on my list.

5) MD -- Johns Hopkins Hospital
They actually have a real reason for having a fourth year. Residents were normal people for sure and the program director seemed like a really nice person. The residents here didn’t really feel like they were overshadowed by other services and really said the residents on other services were keen on teaching ED residents. Lots of fellowships which I feel helps with teaching. Interviews were by in large normal, one person was kind of on the spectrum but hey its luck of the draw.

Cons-Baltimore isn’t the best city but it could be worse I suppose. They had a mandatory QI project every year(residents said was no big deal) and their emphasis really is on making academicians. Again, im probably going to end up in the community just like everyone else, and they still send around 60% of their grads into the community so im sure itll be fine.

6) CA -- Riverside Community Hospital / University of California Riverside
Program director here, as everyone else has mentioned ,seems like the real deal on wellness… like he used to be a clinical psychologist prior to going to med school. While it is a newer program they have a lot of the old loma linda faculty and I feel like they know what they are doing. Great procedure volume, despite being a level 2 they see a lot of tertiary care level stuff and both penetrating and blunt trauma. Free food from cafeteria(not playing a role in my decision but hey it doesn’t hurt). mommy and daddy live 30 mins from here and im sure this place would be great for finding a job in socal.

Cons-newer program. HCA association (which I think people need to calm the **** down over) but it really didn’t seem like they had a move the meat mentality. They seemed to be more focused on training physicians for the community but there still seemed to be academic opportunities available. The biggest con for me was riverside itself-kind of the armpit of Socal and the city kind of depresses me. You can still get to the beach, mountains or desert in an hour but yeah riverside blows.

7) MA -- University of Massachusetts
Well established program and they know what they are doing. Residents were all pretty nice at the interview dinner. I actually really enjoyed most of my interviews especially with the APD. There was one lady who was kind of off putting but she was post night shift and you cant let one odd duck sway your entire decision. Program director is a good dude-also heard the story about how someone was going through personal **** and the PD literally worked his shifts. I think this is a solid program that is well established with good opportunities for any sort of interest.

Cons-Worcester. Worcester sucks and that’s the main reason why this is lower. The residents seemed like they worked hard but they didn’t seem like they were suffocating from the workload.

8) MA -- Baystate Medical Center
Program director seemed like a really really good dude. Came out to the interview dinenr but kept just enough distance from the applicants. They look like they have really solid training and don’t have competition from optho ent ortho. A lot of newer in hosue fellowships which is nice from an educational perspective. Residents were all funny and fun to be around and were definitely happy. They all really loved the program leadership an They seemed to place residents all over the nation so I think I could find my way back to California after being a resident here. While not a pro for me- they are super family friendly.

Cons-location. If you translocated these people to a different location it would be quite high on my list. Im sure some people would find this location to be a pro in terms of outdoors access.

9) NY -- New York Methodist Hospital
Residents at the dinner were cool seemed like they ahd fun outside of work but I will say it felt like they were a little overworked. Interview day was fine and the interviews were pretty solid and residents were able to get solid fellowships. They placed a big emphasis on the strength of their ultrasound program. Park slope is a really cool area and NYC is an incredible place to be young. My one qualm with this program is the trauma-they rotate for trauma stuff at brookdale which now has its own EM residency and there was mumblings of the situation staying the same for now but that it might change. Also thought it was weird how they were bragging about how their sim guy is great with low fidelity sim…like a beautiful sim center isn’t going to make or break an educational experience but if you have ****ty sim don’t brag about it

10) TX -- Texas Tech Health Science Center/Paul L Foster School of Medicine
Rotated here and really liked most of the faculty and residents. Weird pathology and interesting patient population who are coming from Juarez with absolute dog**** medical care. Not too much competition from off service. Two reasons why this isn’t ranked any higher. Lot of inbreeding amongst faculty and on some of the shifts I felt like there were some attendings who weren’t exactly using evidence based medicine. Also do not like el paso. However I know they have a lot of alumni working in socal so good job network I suppose.


11) GA -- Wellstar Kennerstone
new program residents were cool, locaton’s not bad considering pretty damn close to Atlanta. They were transparent about not having a lot of penetrating trauma(again im not sure how huge of deal this is) but they were definitely getting a lot of blunt and this was definitely a good place for procedures. The program director used to be an APD at Emory and was there for a long time and he seemed like he knew what he was doing. That being said I kind of had a negative interview with the program director. FL -- Florida Atlantic University Florida Atlantic- definitely least workload 15, 12 hour shifts a month. Faculty all seemed like nice people and I actually really liked talking to the program director. Hard to explain why im ranking this lower than other new programs on my list but I just didn’t feel like they had the pathology, volume, or their general **** as together as other places. nice people and great location though.

12) PA -- Albert Einstein Medical Center
Program has been around for a while but this was the place I felt like the residents were just plain overworked. Multiple times throught the day residents seemed to think they really work a lot, they were all super nice though. On the tour even a resident from another service thought they worked a lot. They have a ****ton of ICU time in their curriculum. I hated philly idk why I just really did. The hospital is a real county hospital and seemed run down on the outside but that didn’t play too much into my decision making. I will say that I stayed after to observe in the ED and it seemed like my kind of patient population.

Anything else to add? applied pretty broadly to 89 programs, because of a weak step 1 score and I interviewed at every place I was offered. I will echo that its impossible to tell which programs will interview you if you have something like a weak step 1 score and(apparently) ok but not great sloes. Id be happy if I ended up in my top 6, medium happy from 7-9, and after that I’d be a little upset. To people who are third years with weak step 1 scores applying into EM-this sheet should tell you that step 2 can make up for a weak step 1 and SLOEs are the most important thing. You don’t have to go to some big name program-if you can find a place that you know doesnt bone its rotators with ****ty SLOEs. I know I wrote a lot but I remember lurking on last year’s ROL a lot so maybe thoughts will help someone.

Declined: none
Withdrew: none
Rejected: muchos

Appreciate the writeup. If I understand correctly, your EM rotation grades were Honors/Honors/High Pass, but you think your SLOEs were top 1/3, middle 1/3, and middle 1/3? How does that work? Why wouldn't the SLOE's be top 1/3 for all of them? I apologize for my confusion - I just didn't understand the relationship between these two.

 

[r-e-l-a-x]

There ISN'T necessarily a relationship between the two. One is the grade your school assigns based on your reported performance as well as whatever "extra" things they require like did do your orientation module on time or whatever. The other is your SLOE, a standardized form based directly on your clinical performance as seen by the faculty where you rotated (if you're unsure how the SLOE works you can google the form). Some programs may suggest almost everyone get honors for the rotation yet in the SLOE they have to be more objective (i.e. not everyone is top 1/3 or better).

If someone honors a rotation yes it is more likely they received either a top 1/3rd or top 10% SLOE, but not necessarily. Students are then blind to their actual SLOE's, which is problematic as they are in effect blind to the most critical component of their application and thus often over/under apply. A way to fix this would be to require the rotation grade to correlate to the SLOE grade so you know where you stand, or to provide some sort of SLOE "GPA" where you remain blind to your comments but understand in general where you fall.

 

[John Red]

There ISN'T necessarily a relationship between the two. One is the grade your school assigns based on your reported performance as well as whatever "extra" things they require like did do your orientation module on time or whatever. The other is your SLOE, a standardized form based directly on your clinical performance as seen by the faculty where you rotated (if you're unsure how the SLOE works you can google the form). Some programs may suggest almost everyone get honors for the rotation yet in the SLOE they have to be more objective (i.e. not everyone is top 1/3 or better).

If someone honors a rotation yes it is more likely they received either a top 1/3rd or top 10% SLOE, but not necessarily. Students are then blind to their actual SLOE's, which is problematic as they are in effect blind to the most critical component of their application and thus often over/under apply. A way to fix this would be to require the rotation grade to correlate to the SLOE grade so you know where you stand, or to provide some sort of SLOE "GPA" where you remain blind to your comments but understand in general where you fall.

Amen.

 

[anon6134]

I apologize for my confusion - I just didn't understand the relationship between these two.

Welcome

 

[gamerEMdoc]

One of the problem is, rotation sites don't control how schools end up assigning a final grade. I may think that a student is a middle 1/3 candidate, but based on how a school grades, they may earn a HP based on their individual scoring structure. Or a B. Or an 86%. Schools use different grades. They have different grading distributions (i've seen schools with almost 90% honors for their clinical years). The grades are all over the place, and therefore have become almost meaningless. The SLOE is a much more standardized across the board evaluation. But I do agree, some form of transparency, to an extent, would be beneficial.

 

[TrashPanda13]

Applicant Summary
Board scores: 230s/260s
EM rotation grades: Honors/Honors/Honors
AOA: No
Medical school region: Midwest
Anything that made you more competitive: Lots of leadership and unique volunteer experience that was discussed in most interviews. Never saw my 3/3 SLOEs but lots of mention to them on the interview trail and I think at least 2/3 were Top 10%.

If you're a future applicant reading this, here are some key things I think helped out on my away rotations.
-If you do one thing, start listening to EM Clerkship Podcast now from the beginning. I listened to it before/during my rotations while driving and the quick high yield episodes really made a difference in my performance on my rotations. It provided quick overview of presentation, diagnosis, and workup and I think it's part of the reason I was considered a strong rotator and knew the answer to a lot of EM specific questions I otherwise wouldn't have!
-Follow his advice and the 5 min EM presentation outline, from what I saw on aways a good, succinct presentation (which includes quick assessment/ddx and PLAN!) can also make or break you. Originally I made myself a worksheet to jot things down when interviewing patients to make sure I followed the format when presenting and it was great/helped with ddx and plan formation. When you get back and the attending asks if you're ready to present immediately, don't be afraid to say "I'll be ready in 2 minutes, I'd just like to organize my thoughts and plan." They'd much prefer this to a jumbled presentation, and you can take 2 minutes to reference your pocket book or wikem.org to nail your presentation. For ex, use your extra minute to fine tune; instead of I'd like to stitch up his lip, say I'm going to get some 5.0 nylon to stitch up his lip
-And finally, follow up on your patients without being reminded. It sounds small but its a huge part of EM. If you can tell your resident, "Our lady with the virus in room 10 is almost finished with her liter bolus and her heart rate is now below 100. I think when it's finished she'll be ok to discharge home." It's simple things like that which make you seem to function more independently and the infamous follow-up that people talk about, not just constantly refreshing the labs button.

Main considerations in creating this ROL:
1. Location. I realized the importance of this during one of my away rotations. I loved their program and acuity but didn't have much to do for my enjoyment outside the hospital (coffee shops, hiking, festivals, just anything to get out of the house) and realized how much this affected my happiness for just one month. Also wanted to be able to fly home to family and SO easily.
2. Fit. Didn't' really know what this meant before interviewing but after a few interviews you start to get a sense of whether or not the program vibes with your style. Wellness and happiness are key for me.
3. Originally I thought 3>>4, but fit and location ended up trumping this
4. Not sure about my ultimate career goals, so liked the idea of places rotating in multiple settings (academics/community/county mixes)
5. Shift schedule. I dont like 12s and I want to have a life outside the hospital.
6. I was initially concerned about acuity. While not all places are created equal, there's a reason ACGME standards are in place and you'll get good training anywhere, it just depends on what training you're looking for in training. I realized I'm probably not going to work in the busiest knife and gun club/underserved ER where everyone is dying all time when I'm done with residency, so I didn't give this as much weight as I had anticipated prior to interview season.

1) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros - I wasn't expecting to love this as much as I did. Mix of academic/county/community (although I wish the time was more evenly distributed). If you have a vision, there are people and resources to make it happen and I felt inspired by that to find a niche. Best use of 4 years with elective time and tracts. I like the area. Close to SO. Institution wide focus on wellness.

Cons - Cost of living!! This part terrifies me if I match here, but it's just something to figure out. I wish they spent more time at county, I'm sure the population in Palo Alto isn't as acutely ill as some other shops. Worried about consult culture at main hospital.

2) AZ -- Maricopa Medical Center
Struggled a lot with putting this at #1/#2. I'd be thrilled either way.

Pros - Loved this program & the residents. I felt like the third years were confident to take on whatever patient walked through the door in a county hospital. Multiple rotation sites, including academic exposure with mayo. Month of nights seems ideal (why doesn't everyone do this?). Loved Phoenix, much more affordable COL. PD seemed like a catalyst for change when advocating for the residency.

Cons - Scared of Phoenix summers. I would need to learn some basic Spanish quickly. Maricopa is not a stroke or STEMI center, so you have to go other places to get exposure to those complaints. Off service rotations can be weak.

3) SC -- Medical University of South Carolina

Pros - The residents seemed like they were truly happy and performed well. At the end of the day, I realized that's all I really need out of a residency and wellness is really a high priority for me. They expanded the size of their program, faculty were approachable, and great location. Hello beach & good food.

Cons- Sometimes the acuity seemed lower here. Working on getting another contract with a community hospital for their residents, so right now just single site. Flooding/hurricanes. Far from SO.

4) UT -- University of Utah Hospital & Clinics

Pros - Great location with happy residents. Multiple sites, seems like they get lots of exposure to ortho. Affordable COL. Attended their didactics and I was impressed.

Cons - acuity of U of U rumored to be lower, but sort of same situation as before. I'd rather be happy than slammed with super sick patients in a place I'm unhappy.

5) TN -- Vanderbilt University

Pros - Loved how involved their faculty were on interview day and how part of their pay was determined by teaching scores. Liked education model and chief year with attending pay. Now a catch all hospital so lots of different patient populations. 3 year reputable program.

Cons- Residents seemed cool but many older and married. I don't love Nashville. Hoping to get out of the midwest.

6) TN -- University of Tennessee - Nashville

Pros - Major surprise for me on the trail. Pure community and not a trauma center, but the residents see plenty of stop and drop SICK patients. PD from a well established program and definitely has a great vision for program. Good fit with the residents.

Cons- not sure I wanted a purely community experience. Also have to go 4 hours away for two blocks, and while they provide housing that wasn't appealing to me. Hoping to leave the midwest. It's dumb but less prestigious.

7) MO -- Washington University St. Louis/Barnes-Jewish Hospital

Pros: Super high acuity, mix of county/academics in a powerhouse hospital. I love the knife/gun club in EM, even if it's not the setting where I ultimately see myself practicing. I think this program is on its way up in the ranks. I actually like St. Louis.

Cons: Don't think they utilized the fourth year as well as some other programs, lots of off service that the residents didn't seem to love, didn't like scripted interview questions. Fit with the residents was meh.

8) IL -- Advocate Christ Medical Center

Pros - Loved the residents here, seemed to be very close because of single site. High acuity and well known program in the midwest.

Cons - cold Chicago winters. pure community and would like more variety since ultimate career goals are unclear. longer commutes from the city. PD didn't interview us, and honestly found that kind of insulting given how much people pay/time people spend to make it there

9) MA -- Harvard Affiliated Emergency Medicine Residency at Beth Israel Deaconess

Pros - actually my favorite program model on the trail, loved the idea of the 3+1 model. Also was really impressed by the leadership role third years took on in the department, and how second years were pushed with the trigger resident role. Residents and social were so fun

Cons - i love boston for a few days, but decided I couldn't live there. Cold, expensive, hard to have a car but you need one. But mostly no guaranteed golden weekends which just didn't work for SO or seeing family.

10) WA -- University of Washington Emergency Medicine Residency Program

Pros - Only level 1 trauma center in the WWAMI. The part of me who wants to be a badass EM trauma doc loved this aspect of the program. The PD can be controversial and while I liked her I saw this as a bit of a red flag. You want the face of your program to play nicely with others but also be able to hold their own. Loved their variety of sites, prob the best mix of county/academics/community I saw on the trail.

Cons - 4 years and they work really hard as interns. Mixed feelings about Seattle - love the outdoor possibilities but might have been depressed with the months of rainy drizzle. Residents had to unionize for fair living wages and contract up for renewal and I wish the hospital system took more pride in them so this wouldn't have even been an issue. Controversial program leadership. One interviewer purposefully tried to make me squirm and it turned me off.

11) SC -- Palmetto Health Richland

Pros - The acuity here is unreal. The residents can handle just about anything, saw them handling multiple near coding patients at once while remaining pretty calm. COL is dirt cheap. Great benefits and food money.

Cons - Old, white male leadership and few female attending set a tone to this program. Couldn't get on board with Columbia SC (hot and 2 hours from anything cool). 12 hour shifts.

12) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center

Pros - Loved this program in general. Thought their residents were strong and got good experience with the variety of location sites. The residents were fun. I loved the IDEA of living in LA and was super stoked to get this interview. Doing amazing stuff with Med Ed. Felt my conversations during interviews with the faculty were tailored and insightful, which wasn't true everywhere.

Cons - I really tried to love the LA lifestyle but I realized I just can't do it, and I didn't fully realize this until after visiting for interview day. Couldn't do the daily traffic, life with a pet there who needs some green space. 12 hour shifts + time to wrap up + driving time = too long of days for me.

13) OR -- Oregon Health and Science University

Pros - strong program in PNW, 3 years, love Portland as a city

Cons - this was almost a DNR for me. Residents stay 3-4hours after shift because basically a non-existent sign out culture. PD confirmed this was true but then said she doesn't see a problem with it. That spoke volumes to me in terms of how this program culture and got the impression they may be very resistant to change if problems arise (ie I'm sure the residents have tried to change this in the past).

14) HOME INSTITUTION
-Hospital culture less than ideal
-Need to experience something different

Rejected: Carolinas, USCF, USCD, UCLA Harbor, UCLA USC

 

[TrashPanda13]

Applicant summary
Board scores: 220s/220s
EM rotation grades: Honors/Honors/Honors
AOA: No
Medical school region: Midwest
Anything that made you more competitive: Unique leadership positions in undergrad + med school

Main considerations in creating this ROL: Fit, clinical prowess, location

1) IL -- John H. Stroger, Jr. Hospital of Cook County
Placed this #1 at the end of the day because of the true diversity of the program (faculty/residents, patient population, etc) - it is real & tangible. Already knew the clinical training was exemplary, loved my shadow shift, and wanted to be in Chicago. I had reservations about a strictly graduated curriculum, but chose to "trust the process". How the trauma team was set up/how many learners there were also worried me, but it is longitudinal over the 4 years, and once again, I trust the institutional reputation. Knew some of the residents & they were very honest about the +/-'s of the program - I liked the honesty.

2) IL -- Advocate Christ Medical Center
Rotated here and absolutely loved it. Into-the-fire mentality was super cool and I really enjoyed working with the residents & faculty (fit = check!). Good pace, pathology, and camaraderie within the dept. I had a really hard time putting this #2, and honestly wished I could do a 50-50 rank with Cook & Christ (don't hate me for saying that lol). Would be ecstatic to end up at either.

3) NY -- NYU/Bellevue Medical Center
The mission of this program really got me. Unlike many other applicants, my interview with Goldfrank was actually pleasant and it was kind of like talking to Father Time (I was just in awe the whole time lol). Wasn't sold on Manhattan due to the lack of penetrating trauma, but since they acquired the Brooklyn site, I'm hoping that area will be addressed. Enjoyed Manhattan living, but can see how the rat race could wear you down. Still, location & reputation got me on this one.

4) MI -- Wayne State University Detroit Receiving Hospital
Rotated here, home program, absolutely phenomenal site/training/teachers/patients/pathology/everything under the sun. Fit = check with the residents & faculty. I was a little concerned about the declining census, but know firsthand that the clinical training is badass, and that's important to me.

5) MI -- Sinai-Grace Hospital
Clinical badassery, high volume, penetrating trauma, pathology. Didn't experience it firsthand, but I know I'd come out of here as an amazing doc. The name isn't as widely recognized, hence it ended up here on my list, but that didn't really dissuade me. Was a little surprised at how defensively the PD speaks about his program (literally, at every opportunity, this is brought up), but maybe this is more strategic than anything. He honestly seems like an amazing advocate for his residents and great teacher.

6) NY -- Jacobi/Montefiore - Albert Einstein College of Medicine
Clinical badassery, penetrating trauma, name. Enjoyed my shadow shift. Was a little concerned about how huge each class is, and think I'd thrive more with less residents (get to know them better).

7) IL -- University of Illinois Hospital - Chicago
Rotated here, loved the people. Not a huge fan of the multiple, low-volume ish sites. Residents were nice, but didn't think they were as clinically strong as others (or, at least, not outwardly projected as such - which is all I had to really rely on apart from pt discussions/management).

8) MI -- Henry Ford Hospital
Rotated here, loved the training, would come out a badass doc. Not a fan of the culture, people here are not as chill as I'd like, and I think I'd burn out fast from lack of true appreciation for what wellness is (at least from the program leadership & some of the residents whom I interacted with). It is a stellar institution, but just wasn't my cup of tea from the happiness dept.

9) PA -- Albert Einstein Medical Center
Liked Philly, would be cool to live here, assume there's good trauma/pathology with North Philly patient population.

10) MI -- St John Hospital & Medical Center
Good mix of patient population (Grosse Pointe + Detroit), high volume, etc. The interview day was kinda meh, one of the APD's tried to "talk down" my application and then ended with "but you'd be a great fit here". Just wasn't my jam.

11) NY -- New York Presbyterian Hospital
Great location, high volume, didn't like the shift structure & the long commute hospital-to-hospital. Not my people.

12) DE -- Christiana Care Health Services
Great program and clinical training. EM seems to run the hospital, more or less. Didn't like the location ultimately, and that placed it this far down. Also, one month of nights seemed weird to me. Residents were cool af though.

13) NY -- Hofstra Northwell SOM at North Shore / LIJ
Some weird people at the dinner that I didn't vibe with, some cool people that I did vibe with. Interview day focused more on the perks/benefits of the program than the actual clinical training. PD was awesome, his calming voice can soothe your deepest fears lmao.

14) MI -- William Beaumont Hospital
Seemed like too cush of a program for me. Don't want to purely work with a suburban population.

15) OR -- Oregon Health and Science University
Awesome location & PD - she was truly unique, positive, and offered some cool advice/questions during the interview day. Loved that. Ultimately, don't want to move that far away, but Portland was cool af.

16) FL -- University of South Florida
Just not my cup of tea.

17) MI -- Central Michigan University College of Medicine Affiliated with Covenant Healthcare and Saint Mary's of Michigan
PD read me my SLOE, which was cool. Don't want to be in Saginaw after being in Detroit for so long, and that decided it for me ultimately.

18) NY -- Hofstra Northwell School of Medicine at Staten Island University Hospital
Don't want to be in Staten Island. Great clinical training at the program adn great PD thoguh.

Anything else to add? My comments shortened as I went down the list, which is probably reflective of some of my enthusiasm as well. I'd be happy to end up at any of the places ranked, though. I really value the utility my SLOE's brought to my application, and I *HUSTLED* for interviews during the season. I would not underestimate the value of getting your name out there, never giving up, and willing your reality into existence. I took +2 additional years during med school (no course failures, but definitely bumps along the road) and had somewhat meh-average/below-average board scores, so my sole focus during my 4 SLOE months were to be my best everyday & have a good attitude. It was trying, but I think many mini-milestones were reached and hopefully, success to be had at the end of this long trail. Don't take any of my comments negatively, I mean no malice - all blunt, stream-of-consciousness babble.

Applied to: Too many to list (116)
Declined: (9) UIC-Peoria, Genesys, St. Mary Mercy, Lakeland, ProMedica Monroe, UCF/HCA, Mercy Health Muskegon, MetroHealth, Kings County
Interviewed: All ranked programs
Rejected: Innumerable rejections (applied to 116 total), UMich (waitlisted)

 

[John Red]

One of the problem is, rotation sites don't control how schools end up assigning a final grade. I may think that a student is a middle 1/3 candidate, but based on how a school grades, they may earn a HP based on their individual scoring structure. Or a B. Or an 86%. Schools use different grades. They have different grading distributions (i've seen schools with almost 90% honors for their clinical years). The grades are all over the place, and therefore have become almost meaningless. The SLOE is a much more standardized across the board evaluation. But I do agree, some form of transparency, to an extent, would be beneficial.

What, if anything, do you think CORD would be receptive to? As another student mentioned, the idea of a SLOE gpa seems great. Or maybe once at least 2 SLOEs are submitted students can receive information showing which 1/3 their sloes pertain too, without identifying which institution gave each grade?

 

[gamerEMdoc]

What, if anything, do you think CORD would be receptive to? As another student mentioned, the idea of a SLOE gpa seems great. Or maybe once at least 2 SLOEs are submitted students can receive information showing which 1/3 their sloes pertain too, without identifying which institution gave each grade?

Idk, Im not sure how it would even work to be honest. I had the idea of a sloe gpa awhile back, but I have no clue how it could work the more I thought about it. All the esloe system does is generate a pdf. It would have to be much more robust to track each students different sloe ranks and generate an average. Eras would have no reason to generate any such data, they arent affiliated with the sloe in anyway. And some students dont submit all the sloes they get, Im not sure how that would be handled.

And honestly I have no idea how receptive cord would be to something like this. I’m also not even certain it would be allowed by the AAMC with students waiving the rights to see the content of their letters.

I’ll create a post on the cord list serve to see if any of the sloe people have any insight, But the skeptic in me says there will be little reason to change the system from their end.

 

[planedude86]

Applicant summary
Board scores: COMLEX 460s/480s, No USMLE
EM rotation grades: Honors/Pass/Pass/Pass/High Pass/Honors
AOA: No
Medical school region: Southeast
Anything that made you more competitive: N/A
Special considerations: Failed COMLEX 1 initially. Former longtime paramedic. Re-applicant from transitional year, spent 5 months in EM during my intern year

Main considerations in creating this ROL: Spouse location

1) PA - Geisinger Medical Center

2) NY - Orange Regional Medical Center

Anything else to add? I matched today, somehow. Never ever ever give up, if this is what you truly want. Keep hustling and get great SLOEs. The transitional year was truly a great opportunity for a second chance at showcasing myself and pursuing the dream. As other posters have said, make your name known, make a ton of connections, and hustle hard.

Applied to: 47 this year, 110+ last year
Declined: None
Interviewed: All ranked programs
Rejected: 45 rejections this year, 100+ rejections last year

 

[TrashPanda13]

Applicant Summary
Board scores: 210s/220s
EM rotation grades: Pass (P/F only) X 2
AOA: No
Medical school region: Southeast
Anything that made you more competitive: Non-traditional, prior EM experience Location, fit

1) LA -- Louisiana State University - Shreveport
I fit here. I like the people, the area, everything.

2) LA -- Louisiana State University - Shreveport
I’m listing this again because their 5 year EM/FM program is my #2
This would have been my #1 if I wasn’t in my late 30’s. My kids are older too so I want to be able to enjoy the post-residency lifestyle before my oldest graduate high school. I’ll be equally happy matching at either program.

3) FL -- Orange Park Medical Center
New program, yes it’s HCA but the location (Jacksonville metro) fits my family.

Level 2 trauma center that sees quite a bit from the rural areas between Jax & Gainesville. The PD was very honest about the pros/cons of the program and he knows he has some work cut out for him.

4) AR -- Unity Health

The volume is a little low but I think it would be a good place to train. Virtually unopposed, newer program.

Anything else to add? Reapplicant. Non-clinical Research year. Only 4 chances for EM. Also applied Family Medicine. 9 ranks total but only applied to my specific region for FM.

My CS failure hurt me this year, I think. I wish there was a way for programs to filter out specific Step exams for failures rather than the blanket any failures. Most people don’t care about CS but they don’t have time to look deeper than filtering for all failures.

Applied to: 54 programs across the Southeast and Midwest.
Declined: None
Interviewed: All listed
Withdrew prior to hearing from: None
Rejected: Many

 

[TrashPanda13]

Applicant summary
Board scores: 230s/250s
EM rotation grades: High Pass/High Pass High Pass High Pass
AOA: No
Medical school region: Northeast
Anything that made you more competitive: DO applicant (less competitive I guess)

Main considerations in creating this ROL: Location, Program strengths

1) NY -- New York Methodist Hospital
Rotated there. Loved the location, the people were great. Every shift I had an amazing time.

2) NY -- New York-Presbyterian - Queens
Pros: Loved the PD, they do a lot of stuff as a program. Scribes. Queens is good.
Cons: Weird ED set up and you probably will need an interpreter phone every single hour.

3) NY -- State University of New York - Upstate (Syracuse)
Pros: Super passionate PD. Program is really good, good sim, good didactics, no night shifts as a PGY1. Upstate has a huge pathology catchment.
Cons: Location

4) NJ -- St. Joseph's Regional Medical Center/New York Medical College
Pros: Strong program. Great trauma. Great pathology.
Cons: Wear white coats like all the time. Jersey isn't NY

5) NJ -- Morristown Memorial Hospital
Pros: Rich hospital, lot of ancillary staff. Residents can ask for whatever they want.
Cons: Older residents/faculty. Not the greatest path. Not the greatest trauma. Jersey

6) NY -- New York Medical College/Metropolitan
Pros: Super passionate PD, Location
Cons: 3 hospitals where you have to work. Working at the main site doesnt give you any interesting path, mainly social cases, the cool path is seen in the other two places.

7) NY - Hofstra/Norththwell Southside Hospital
Pros: Access to hofstra facilities. ED is brand new, and really nice. Good trauma, main Hofstra program sends people to southside for trauma
Cons: New program, will be first year class. PD was weird.

8) NY -- Brookdale University Hospital and Medical Center
Pros: Passionate PD, Great path (gonna learn in a warzone), Location
Cons: Young program (1 graduated class), city hospital so no ancillary staff, Location

9) NY - St. John's Riverside Hospital
Pros: Cool APD
Cons: Young program. Bad PD. Poor path. Location is Meh

Applied to: 76
Declined: None
Interviewed: All Ranked
Withdrew prior to hearing from: None
Rejected: Too Many

 

[TrashPanda13]

Applicant summary
Board scores: 200s/220s
EM rotation grades: Pass (P/F only)/Pass/High Pass/Honors
AOA: No
Medical school region: Southeast
Anything else that made you more competitive: National leadership positions, some research at larger institutions although unpublished
Less competitive: DO applicant, 5 auditions, comlex 1&2 550-600, did not release USMLE scores.

Main considerations in creating this ROL: Potential for CC fellowship, strong trauma, SO job market, housing market with potential to rent out after residency.

1) FL -- FSU-Sarasota
Sold by the new program. Great lifestyle, fun town that is super outdoorsy. Like the faculty, enjoyed interview day. Felt like the hospital had resources. >90k visits/year, solid trauma, great PICU and nearby all childrens. Entirely unopposed. $$$

CONS: has been said that the population is skewed toward elderly which is fine for me since I want to do CC, this will likely increase # of acute patients. New program. Little elective time.

2) FL -- Mount Sinai Medical Center/Miami
Strong leadership, best didactic that I encountered on the trail, which I felt is extremely important in being well rounded in training. Interesting moonlighting opportunities. Connections galore. Grads get jobs where they want to be. New ED, Miami Beach. ED director is CC trained and works in the field. Happy residents $$$$$

CONS: Some heterogeneity around the confidence and skill level of the residents. No in-house trauma, trauma is opposed at Ryder. Possible concern 2/2 lack of procedures, although there was solid acuity on the tour alone.

3) FL -- Kendall Regional Medical Center
International medicine fellowship in a residency. Very sick cubans. Procedures for DAYS. Huge ED, learn the business of medicine. "The real Miami". Generally strong faculty. Loads of CC. Level 1 trauma and burn center. Would become fluent in español. $$$$

CONS:
Opposed by gen surg, altho it seems that everyone plays nice with each other. HCA oversight, but seniors had no problems getting jobs. Easily the best HCA EM residency. Transitioning PD, little research. Meditech. NO MOONLIGHTING

4) MI -- Beaumont Trenton/Dearborn
4 year program (traditionally DO) that gives ample time to moonlight and make up lost attending salary, more time to consider fellowship opportunities. Learn basics of EM at a community ED, then spend last three years at at a more acute hospital on the border of inner city Detroit. Good PICU exposure, felt like a hidden gem. Very organized interview day, happy residents. Busy, high acuity ED on tour. I like Detroit, seems to be a burgeoning housing market, with low cost of living. Visits >100k combined. Strong EMS footprint. Felt a "good fit" here. $

CONS: 4 year program, relatively unknown, little brand recognition outside MI.

5) PA -- Reading Health System
Really impressed with this interview. Enormous hospital, well-funded, with bling. Very personable PD, interviews with people who actually read your application. Residents were very enthusiastic about new program. Largest ED that I have ever been in. Incredibly stories of interesting cases at interview dinner. Totally unopposed. Strong trauma, CC opportunities. $

CONS: Reading PA, could be looked at as a pro with a developing housing market but still a truly boring town with PHL being just a little too far away to be a regular attraction. Would be my number one if location was improved.

6) PA -- Albert Einstein Medical Center
Old, established program that takes pride in training go-anywhere, do-anything EM docs. Strong leadership, good didactic, hugely underserved population. Lots of critical care. Peds at CHOP. NICU rotation. Lots of exposure to the fringes of the field. Great schedule of 11s, 3d, 3n, 3off. Big ED that is well equipped. <3 Philly. Fantastic faculty for the most part. Lots of visits. $$

CONS: graduated responsibility blows. Interns not allowed in trauma bay. Split procedures with surgery. Tired residents. 4 year program with a largely wasted intern year ended up dropping this lower than expected on my list.

7) NC -- Campbell/Cape Fear
Super underrated program at one of the busiest EDs in the country (135K at a single site). Critical access hospital with strong CC and EMS footprint. All rotations in house. Cheap housing market, lots of outdoor activities. Southern charm. Nice residents. $

CONS: VERY similar to the Reading program, you have to get over the location. No reason to stop at Fayetteville off of 95. Opposed by gen surg and OB but there is clearly enough procedures to go around. Faculty seemed less invested than Reading.

8) RI -- UNECOM - Kent Hospital
Strong faculty. Great externships (Boston Childrens/Harvard Tox, Shock trauma, Women and Infants for OB, Hasbro for PICU). Happy residents that seem to get along for each other and have good lives. Providence is a wonderful place to live. Unopposed.

CONS: Low acuity, NO trauma, little CC. Got an elitist vibe from some of the residents and faculty. Very homogenous population of older nursing home pts. Little Peds exposure outside of externships. 4 year program that would do little to prepare you for CC fellowship.


9) NY -- St. John's Riverside Hospital
Three year program with faculty hailing from big name schools/programs looking to make a name for themselves in NYC. Rotate a three area hospitals. Incredible view of the Hudson river. Yonkers is cool, can commute from city but very expensive to live. Externships at good area hospitals for core rotations. $$$$$$

CONS: Froo-froo. Strange interview day, strange PD. Residents seemed on edge. Reminded me of the "Get Out" movie. NYC tough sell for SO.

10) MI -- Henry Ford Wyandotte Hospital
3 year program that rotates at one of the largest ICUs in country at Henry Ford main with a lot of the big names in critical care. Wyandotte is a nice suburb of Detroit with enough going on to keep you interested. Great interview day that was super efficient. Nice residents that seem to get along. Cheerful PD. $$

CONS: only 65K visits, ship out to shock/trauma for trauma rotations and Flint (!) for PICU. Just doesn't seem to support the volume to produce well-rounded go-anywhere EPs.

11) NJ -- Inspira Hospital
Best feature is externships at Christiana/Cooper for trauma and Nemours for Peds. Could live near Philly and have a long commute. $$$

CONS: Weird vibes, seemingly bored residents. PD didn't exude a sense of control or director for his program. Very boring area around the hospital.

12) NJ -- RowanSOM Stratford
Essentially Inspira but closer to Philly without the cool externships. Faculty at interview were clearly interested in your application. No selling points from the program, just given a flyer about it (no powerpoint, no talk from PD) felt very impersonal because of that. Residents who were facilitating were taking "notes" on applicants eating lunch. Strange vibes again. $$$

13) PA -- Jefferson Health NE (Formerly Aria)
Nice faculty, nice facilities, solid old program with a ton of visits but nothing really to make it stand out amongst Philly programs. 4 years without a real justification. 8hr shifts are a dealbreaker as stupid as that sounds but I would rather stay longer on shift that to work 6 day weeks. $$$

14) NY -- St Barnabas Hospital
EM "as seen on TV", no really. Complete chaos. I love the idea and was super excited about the program until I saw the emotional and physical toll it took on the residents who were palpably burned out. Hospital has little funding, much of the equipment doesn't work. If you graduate from this place without it breaking you, you are clearly a superstar of EM. Seemed like a gamble. Terrible didactic that included OMM lectures. Bronx is a tough sell to live. $$$$$$$$$$$

15) FL -- UCF North Florida Regional Medical Center
Great interview day, nice faculty. Residents were chill. Good facility with high acuity in CC. SO doesn't like Gainesville. Lot of the interesting pathology is sent to nearby UF. Not sure if high admission rate is due to HCA just literally admitting anyone who wants to come in. Run by "the Man". Was never a college football person and you have to be if you live in this town. $

16) FL -- Brandon Regional Hospital
Another HCA EM residency popping up. This one has the elements it needs for success save for trauma and opposition, but it hasn't fully matured yet. First class taken outside of match last year an a resident at the interview day was SO incredibly off putting that It fell at least 5 spots lower on my list than it would have. Interesting things go to nearby Tampa General. Should get better in a few years. Tampa is a nice place to live. $$

17) MI -- Saint Mary Mercy Hospital
More interesting detriot programs already ranked higher. Lowest volume (only 52K), ships out to Shock/Trauma. Didactic was lackluster. Hospital has bling. PD is very nice. Just did not engage me personally in any way. $$

Applied to: 65
Declined: Geisinger, Lehigh
Other interviews attended: NUMC (DO match only)

 

[TrashPanda13]

Applicant summary
Board scores: 230s/230s
EM rotation grades: Honors/High Pass/High Pass
AOA: No
Medical school region: Northeast
Anything that made you more competitive: GHHS, Volunteer leadership positions throughout medical school, EM volunteering and research as a pre-med, decent “why medicine” story, 2 Top ⅓ (one came after Dean’s letter submission)

Main considerations in creating this ROL: Gut feel was pretty big for me, wanting to be in a program and city that I would be happy with, found out along the trail that I’d prefer to leave NY. Would like to end up in academic leadership

1) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Pros: Loved my time here, vibe with almost every resident I met, felt that the ED ran super well so you could focus on the clinical aspects of EM medicine, felt that the 4th year gives you the ability to experience different niches through electives. Faculty and residents knew their stuff, and the weekly lectures Great mix between an academic and county patient population, plus Antelope valley where you’ll be doing a bunch of procedures during each shift. Originally from Los Angeles and would prefer to go back after 4 yrs out east. Would provide me excellent job placement out west especially in academic leadership

Cons: Olive view is technically not a level 1, but level 1 pathology still comes there and you need to stabilize it so it’s a +/-, fair amount of 12s but they are incorporating 8s, I suppose the commute can be rough but I enjoy driving and for me, it’s not that bad

2) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros: Thought there ability for you to pursue whatever niche within academic medicine was the best out of the programs I interviewed at. The mentorship you receive along with the exposure you are provided sets you up well for fellowships out of residency. Residents were nice, didn’t mess with them as well as other groups I met on the trail. Lectures were amazing, actually maintained my focus, the number of resources you have at your exposure are endless makes shifts relaxed (but potentially too much of a crutch). Loved Palo Alto, and the ability to hike on off days. Would have great CA placement out of residency.

Cons: The Kaiser system is nice but the real world doesn’t run like Kaiser, and with that being ½ of the training that concerns me. Kaiser is a well-oiled machine and expects you to move patients. The lack of county exposure which has been mentioned. Not vibing with all of the residents, although a few were great. Did notice a little bit of hand-holding from the attendings while there.

3) CA -- University of California Irvine Medical Center
Pros: Loved the PD, she was very energetic, passionate and sarcastic, was a person who I could tell would go to bat for her residents. Sold the fact that even though their volume is low, each resident still see’s a bunch of patients, also sold the 3yrs well. The area of Orange it is in allows for a diverse patient population, so I don’t think i’ll lack any exposure. Thought the resident camaraderie was strong and that they were able to find time here and there to do stuff with each other. Have a lot of opportunities to teach medical students, strong in US, and the produce their own journals. Decent academic opportunities out of residency via mentorship. LA adjacent which is good enough for me. This program bumped from 5 to 3, simply due to location.

Cons: Small program, when I’m off most everyone will be on. The ED surprised me by how small it was. They do this thing were attending triages all the patient’s with an PGY1, not sure if this impacts your ability to think through patient work up, or is just more convenient/helpful

4) MD -- Johns Hopkins Hospital
Pros: Probably one of the best interview days I had on the trail. The school did a great job of providing a list of available residents as host, and the resident I stayed with was a great host, fun to talk to, made sure I had coffee in the morning, all of which was a solid sign of who the program brings in. During the day I felt like all the residents were extremely bright, but not cocky about it, we were invited to chairman rounds where a case was presented and all the residents added their opinions, literally thought some of the residents were attendings. I think they do a great job creating a functional 4th year and pitching it. Dr. Regan seemed like an excellent PD to have to advocate for you. Decent amount of responsibilities, not graduated, seem to be well supported and not overworked. The camaraderie was solid. Ton of money and resources. If this wasn’t in Baltimore (prefer more of the West Coast), and had somewhat stronger residency placements this would have been my #1.

Cons: Unsure of how I feel about Baltimore (although the tour they give of the city definitely reassured me), and I basically want to get out of the cold in general. The Alumni placement didn’t significantly impress me which was weird to me because I basically thought it was an East Coast Stanford.

5) PA -- University of Pittsburgh Medical Center
Pros: Solid name in EM, probably one of the best 3 yr EM programs in the country when it comes to a community or academic placement. The residents were great to speak with, definitely more of a midwest vibe, which would be something I would just need to get used to. But sat at the social with a PGY 1, 2, & 3 and they all were speaking with one another freely about life, which showed me that classes aren’t isolated. I appreciated how the program has it’s niche’s within CC, Tox, and EMS, definitely will be learning from leaders. Dr. Dorfsman gave me the best pitch during the trail on how I’d be successful in Academic EM if I went there. Great variety with respects to all the sites within the UPMC system. Enjoyed Pittsburgh since visiting it before, and continue to like the little towns within it.

Cons: Didn’t vibe as well with the residents as I did with my top 4, and Didn’t feel as comfortable here as I did at Hopkins although I know I might be trading better job placement, the resident who gave us the tour really didn’t want to be doing it and left a sour note to the end of the day.

6) CA -- University of California Davis
Pros: California 3 year program with an established alumni base, good variety of clinical sites. Residents seemed to enjoy one another, Sacramento actually impressed me more than I was expecting, enjoyed my interviews with the program leadership

Cons: Residents seemed to be at the stage in life of having kids and buying houses, which I’m not currently at. Although Sacramento impressed me, I didn’t get as great a vibe here as I did when I was at Hopkins or Pitt, which are the two it would have jump purely because it’s in California

7) NY -- Mount Sinai St. Luke's Roosevelt Hospital Center
Pros:Felt that there was a true sense of community amongst the residents, and found it awesome that most of them lived in the same building. Young program leadership that are becoming leaders in the field of academic EM, Beck-Esmay would be a great person to work with. They seem to be big on wellness with mandatory lunch breaks during shifts. All my friends who rotated here loved their experience. Best 3-year option in NY by far.

Cons: Potentially too bro-y a vibe for me, heard that some of the 3 rd years were potentially not as proficient with leading codes or traumas simply due to lack of exposure or potentially training, although less of the headaches of NY EM it still has some of those struggles. I’d prefer to leave NY but the camaraderie at SLR would make up for an extra 3 years

8) CA -- Loma Linda University School of Medicine
Pros: The residents were great, know of a current resident who went to my med school who loves it there. Crazy amount of international opportunities not just in your 3rd year, but year 3 as well with funding provided, Peds experience was probably strongest on the trail (or they just hyped it up the most), Los Angeles adjacent living

Cons: I’ve lived in the inland empire before so I wanted a little bit more variety in terms of location. An interaction via email after my interview with the coordinator made this place drop a couple of spots.

Note: I also don’t feel the religious thing was that big, interview tour guide had the same concerns coming in as us applicants do which she put to rest. Coffee is avaliable or you can bring it in, yes no meat but you can bring your own food, and you can give plan B in the ED

9) DC -- Georgetown University Hospital/Washington Hospital Center
Pros: Loved the fact that the did 1-on-1 shifts where you receive direct teaching from the attending. One of the top PDs I met on the trail super attentive and nice, seemed like he’d go to bat for you, thought the residents really enjoyed spending time with one another which made for a fun social. 3 years which made it go above GW. Have never lived in DC but seemed like a solid place to live

Cons: I remember traumas being run strangely here but don’t have the exact stats. I think this program dropped because I interviewed there early in the cycle and would just put newer places above it. So nothing major on the negative side, guess I just didn’t love it enough to keep it high when I interviewed at a new program.

10) NY -- Mount Sinai School of Medicine - New York
Pros: Great academic program within the New York area, would be near a lot of my friends who will likely end up in NY, larger class so when I have time off there will be others with free time as well, enjoyed my time with the PD although he is leaving (hopefully they’ll find someone as good as him, everyone seemed to like him). Would give me an opportunity out of residency via the program’s connections

Cons: Interviewed on the last day, social was not planned (I place weight in my experience during the social), the whole interview day felt like an afterthought, as a person going into academics the presentation was super academic heavy almost a detractor which was odd, would prefer to be out of NY, not the same vibe with these resident compared to SLR but then again no social

11) DC -- George Washington University
Decent vibe with the residents, seems like a place that will help you carve out whatever path you desire, the PD created a nice icebreaker to start the interview day off. More academic than Georgetown so I feel opportunities would be better. However thought Mount Sinai was more established a solid post residency placement better, and Georgetown ended up being higher due to interactions with the PD and residents

12) NY -- SUNY Downstate/Kings County Hospital
Jacobi in Brooklyn as my interviewer told me, and I’d rather live in Brooklyn than the Bronx personally. I’d end up becoming a clinical badass, and know how to handle a complex variety of cases, but I can only imagine what their EDs look like when it’s not 10 am (and it was already crowded like most NYC EDs). Abrasive interviews, and this weird scoring template that is half filled out before you’re in the rooms, and tilted just in the right direction for you to be staring at it. As you can tell I’m no longer being helpful. Better job placement (or just better advertisement) of places I’d want to go to post-residency (Harbor, USC, etc)

13) NY -- Jacobi/Montefiore - Albert Einstein College of Medicine
Yes you’ll do your own blood draws, and wheeling patients, and finding patient’s because rooms don’t exist, but once graduation comes you’ll have dealt with everything if you’re not burnt out. Conferences are very meh, on shift clinical teaching is scarce, resources are strapped. Montefiore is not your classic academic hospital, thus, in my opinion, Jacobi is purely county. I’ll take a Jacobi 3rd year over a couple of 3rd years from programs I have above, but I’m worried that all the nonsense of NY EM would wear me down

14) NY -- Hofstra Northwell School of Medicine at Staten Island University Hospital
I was surprised by how much I enjoyed the faculty here. But when I spoke to the residents it seemed like they were people who wanted to get their check and go home and have a cush community job in 3 years. Which for many people is a great gig. Nothing really impressive stood out from this program.

15) NY -- New York Presbyterian Hospital
Big name that will be amazing in 5 years with all the faculty they are bringing on board. My meeting with the outgoing PD was one of a kind, he basically talked about himself for the full 20 minutes and tested my ability to focus. I knew of a lot of people who rotated here and none of them seemed to enjoy their time here which was a big red flag

Anything else to add? As people have said SLOEs are big, but that being said a middle SLOE does not equal failure I read it on one of my sheets that I got one from my first away, but I still interviewed a decent places. Still SLOEs can wipe away a mediocore or poor Step1 or bring you down from your 260/270 perch. If you're not getting interviews around Nov 1, start emailing programs and make each email personal to the PD and CC the coordinator. Call a program after 1-2 weeks if nothing happens, ended up getting an interview from one of my Top 5 programs after doing this

Applied to: 37
Declined: UCSD-Still regret turning this one down, was exhausted at the time
Interviewed: All listed
Official Rejection: USC, Highland, Denver, OHSU, MGH, BI, Penn, UC, Brown, Maryland----Silent Rejection Post Waitlist: NW, UCSF, Harbor (via email, not silent)
Ghosted: Cook, Jefferson, Temple, Yale, BMC, Washington, UCSF-Fresno, NYU

 

[takeurmeds02]

Thought it might be helpful to bump this just to get an idea of what to expect/look for any purported changes as we start on the interview trail

 

[Rekt]

Thought it might be helpful to bump this just to get an idea of what to expect/look for any purported changes as we start on the interview trail

Yeah but honestly this years thread was probably the worst by far. Better off looking at the earlier years.

 

[takeurmeds02]

Yeah but honestly this years thread was probably the worst by far. Better off looking at the earlier years.

Really? In what way? I feel like it would have the most up-to-date info even if for a few programs?

 

[bball4]

Applicant summary:
Board scores: 230s/240s
COMLEX: 560's/520's/Pass PE first try
EM rotation grades: High pass/Honors
AOA: No
Med school region: Midwest
Anything that made you more competitive: No not really


Main considerations in making this ROL: Location/being close to family is the most important thing to me. Prefer a county feel vs an academic feel.


1) OH – Case Western/MetroHealth
Pros: Good location since most of my family is from the Cleveland area. Excellent trauma exposure, longitudinal peds, good ultrasound training, tons of flight medicine opportunities, high acuity, no floor months, residents were super chill and fun to hang out with. Cleveland is a relatively cheap place to live and has a decent night life. I get the feeling you would come out of this place extremely well trained


Cons: Residents seemed tired and burnt out. They also seemed unsure about if they like the shifts they have to do at the Cleveland Clinic. Minimal food allowance.



2) OH – Akron General
Pros: Close to Cleveland. Residents were all extremely close and very friendly. Program director was very laid back and funny. Loved the atmosphere here- all residents and attendings are on first name basis. Residents seemed very happy overall

Cons: Have to drive to Metro for trauma month (might be changing in the future). Would not want to live in Akron. Residents spend a lot of time doing US guided PIV’s when nurses can’t get access- good skill to have but would get annoying after a while.

3) OH – St. Vincent Mercy Toledo
Pros: Established program. EM residents really run the show here and are highly respected in the hospital. Dr. King seems like a wonderful PD and has tons of connections everywhere. Good flight medicine if you’re into that.
Cons: Living in Toledo… Ultrasound training was mediocre in the past, but they are working to change that and have hired excellent US faculty.

4) OH -- Doctors
Pros: Love Columbus- great city with tons of bars and restaurants, and good night life/music scenes as well (definitely a great city to be 23-30 in- tons of young professional and recent college grads). The residents were some of the sharpest I've encountered (not just saying that because I'm a DO). Great faculty that were willing to teach (lots of OSU grads). Family in the Columbus area.
Cons: Too community for me. Also, a very small hospital with almost every residency you can imagine- felt very congested. For the life of me I can’t figure out why the residency isn’t based out of Grant which is Ohio Health’s level one trauma center. Doctors does not have a trauma designation. Small residency class and didn’t mesh well with some of the residents. Hospital is located on the west side of Columbus and attracts an “interesting” patient population.

5) TX -- JPS
Pros: Solid county program. Not a lot of competing residences so you really get to do a lot- one resident said he did a lateral canthotomy during one of his first shifts as an intern. Good ultrasound with training in regional nerve blocks. Liked the residents and PD.
Cons: Have to travel to Dallas for peds. Far from my family in Ohio. Fort Worth seemed like a really cool city, but not as cool as Dallas.


6) TX – UT Health San Antonio
Pros: Liked this program more than I thought I would. Interview dinner was probably the most fun one I had. Program director was very laid back and seemed like a great guy. San Antonio is cheap and doesn't have terrible traffic.


Cons: No longitudinal peds. Seemed like they were very into global health- this is not really something I care for... Feel like I would have to learn Spanish if I matched here. San Antonio just doesn't do it for me for some reason. Don't like Mexican food.... Far from home

7) GA -- WellStar
Pros: High volume ED with not a lot of other competing residencies. Building a massive new ED across the street. Great program director- former APD at Emory. Tons of money for meals.
Cons: New program. Atlanta traffic is awful. Residents were slightly quirky. Lots of floor months. They have had some issues scheduling rotations such as OB.

8) NC – ECU/Vidant
Pros: Huge catchment area- you will see a ton here. High volume. Seemed like they get good training
Cons: By far my least favorite PD on the trail- all the other applicants that day felt the same way. The residents were very quirky and socially awkward and admitted this was not on the top of their lists. Greenville was downright depressing- need a bigger city. Considered not ranking, but didn't want to risk it.


Anything to add: As a DO I would encourage other DO’s to take both USMLE’s and to apply broadly.
Applied to: MetroHealth, Akron General, University Hospital/Case Western, St. Vincent Mercy, Doctors Hospital, University of Kentucky, University of Louisville, Detroit Medical Center/Wayne State, Detroit Medical Center/Cedars Sinai, William Beaumont, Spectrum Health, Presence Resurrection, Advocate Christ, University of Illinois, Rush University, Medical College of Wisconsin, Drexel University, Greenville Health, Palmetto Health, Wellstar Kennestone, University of South Florida, University of Florida Gainesville, University of Florida Jacksonville, McGovern, John Peter Smith, University of Texas Southwestern, University of Arkansas, Maricopa Medical Center, University of Nevada Las Vegas, Virginia Commonwealth University, SUNY Buffalo, Kansas City Truman Medical Center, Ohio State University, Cook County Medical Center, University of Michigan, Medical University of South Carolina, Indiana University School of Medicine, Jackson Memorial Hospital, Louisiana State University, University of Alabama, Orlando Regional Medical Center, Carolinas Medical Center, Allegheny, University of Maryland, UT Chattanooga, Emory, Boston University, University of Texas Austin, Baylor, Henry Ford Hospital, University of Tennessee- Murfreesboro, East Carolina School of Medicine, Carillion Clinic/Virginia Tech, Wake Forest University, University of Iowa, St. John Medical Center, Eastern Virginia Medical School, Grand Strand, Kendall Regional Medical Center, Atlantic Health

Applied to these in mid-October: Wright State, UT San Antonio, Florida Atlantic, Albert Einstein, Loyola, Brandon Regional/HCA, St. Elizabeth Boardman, University of Central Florida Ocala,

Declined interview invite: None
Attended interview at: All
Withdrew prior to hearing back from: None
True Rejections: Allegheny, Virginia Tech Carilion, Maryland, Boston University, Carolinas, UT Murfreesboro, UT Chattanooga, Emory, UT Austin, Henry Ford, University of Alabama, University of Cincinnati, UNLV, University of Arkansas, University of Michigan, University of Indiana, University of Wisconsin.

Ghosted or sent a “thanks for applying, we have concluded our interview season” by the rest.

Fellow DO student w/ similar scores and interested in similar programs. Curious to hear where you auditioned/matched if you're able to share? Feel free to PM as well.