[2019-2020] Emergency Medicine Application Thread

[MedDoctor92]

You have 12 interviews. You don't need any more. There is still plenty of time to get more interviews, but you don't need any more. If your dream programs come through, and allow you to drop one of your others great. Otherwise, you are just fine where you are.

Here's the thing, many programs get annoyed by LOIs. That's a risk you run by emailing them. It may backfire on you, and if you have an app that they were waiting on inviting you for, and you annoy them by emailing and hounding them, it may have the opposite effect you want. LOIs won't help everywhere, and may only help at some places. So why do some people get advised to send them? Well, if you are sitting on say 4 interviews right now, and LOIs do help at SOME programs, what's to lose at that point. But if you are already in a good position, chances are you still may get an interview at those dream places. Personally, I wouldn't risk annoying them at this point. If you want to email in December if you haven't heard from them, then great, at that point there's little to lose.

Got it! Thank you for your advice!

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[gamerEMdoc]

Just a quick word on LOIs in general for everyone. Don't kill the messenger, just relaying the sentiment I saw on a recent topic on this:

There is a thread on CORD about this right now, programs are not pleased about all the LOIs coming way too early. Some PDs are complaining of getting 20-30 emails a day all October "updating them about another SLOE" or asking for an interview. Spamming programs with LOIs too early absolutely can backfire. I get the wait is excruciating. But LOIs really only should be sent as a last ditch effort for people on the bubble of not matching and with nothing else to lose because they aren't getting many invites. They aren't for the "I only have 8 interviews and its already October 1st!!!!" students. They are for students sitting on 3-4 interviews in late October. Or students with 6 interviews in mid-November.

I'd also guess that LOIs are also probably less likely to work on more competitive places though I can't prove that. I would suspect that less competitive places that get a believable email from someone who really wants to come to their program are more likely to take that email seriously. Emailing a top tier program to tell them you really want to come to their program is silly because everyone that applied to their program likely really wants to end up there.

I'd just encourage people to save the LOIs for the people that really need them. And don't email the PD directly and clutter up their email inbox, just email (or call) the program coordinator.

 

[CyrilFiggis]

thanks thats good to hear

I take ownership of not getting the SLOE... but the program was unprofessional as fawk, still haven't sent out IVs.

One of my forms was given to the cheif and then lost, others failed to do them/turn them in

played catch up trying to get them all in with the coordinator telling me tough titties

Does this program happen to be located in the smallest state in the union? One of classmates rotated at Brown and as of last Saturday had not gotten a SLOE from an August rotation. Our Associate Dean told us that they as a program have been really slow to send out IVs to anyone who wasn't a rotator, home student or AOA-type applicant. And a student from there I met on the trail told me that only 2 of the 12 M4s from there got home interviews.

 

[CyrilFiggis]

But LOIs really only should be sent as a last ditch effort for people on the bubble of not matching and with nothing else to lose because they aren't getting many invites.

Can you talk about the efficacy of LOIs for addressing why you want to be in an area? I have a classmate at my program who is not from New England, but is at a NE program and only got aways from NE programs. They want to be Chicago because their partner just got a job offer there, but feel like they aren't getting any love from those programs because of geographic bias.

 

[The Knife & Gun Club]

Just a quick word on LOIs in general for everyone. Don't kill the messenger, just relaying the sentiment I saw on a recent topic on this:

There is a thread on CORD about this right now, programs are not pleased about all the LOIs coming way too early. Some PDs are complaining of getting 20-30 emails a day all October "updating them about another SLOE" or asking for an interview. Spamming programs with LOIs too early absolutely can backfire. I get the wait is excruciating. But LOIs really only should be sent as a last ditch effort for people on the bubble of not matching and with nothing else to lose because they aren't getting many invites. They aren't for the "I only have 8 interviews and its already October 1st!!!!" students. They are for students sitting on 3-4 interviews in late October. Or students with 6 interviews in mid-November.

I'd also guess that LOIs are also probably less likely to work on more competitive places though I can't prove that. I would suspect that less competitive places that get a believable email from someone who really wants to come to their program are more likely to take that email seriously. Emailing a top tier program to tell them you really want to come to their program is silly because everyone that applied to their program likely really wants to end up there.

I'd just encourage people to save the LOIs for the people that really need them. And don't email the PD directly and clutter up their email inbox, just email (or call) the program coordinator.

I LOVE hearing the inside scoop from your guys side of the process. I’m working as an adcom for our med school right now and have NO idea how you alll read so many virtually identical apps so fast.

What are your thoughts on the “Couples match LOI” where you reach out to a program and let them know your significant other got an interview and you’re interest in the program because XYZ? Still annoying this early in the season or no?

as always, gamer, you’re doing the lords work.

 

[Listen2Savage]

I LOVE hearing the inside scoop from your guys side of the process. I’m working as an adcom for our med school right now and have NO idea how you alll read so many virtually identical apps so fast.

What are your thoughts on the “Couples match LOI” where you reach out to a program and let them know your significant other got an interview and you’re interest in the program because XYZ? Still annoying this early in the season or no?

as always, gamer, you’re doing the lords work.

 

[Listen2Savage]

Does this program happen to be located in the smallest state in the union? One of classmates rotated at Brown and as of last Saturday had not gotten a SLOE from an August rotation. Our Associate Dean told us that they as a program have been really slow to send out IVs to anyone who wasn't a rotator, home student or AOA-type applicant. And a student from there I met on the trail told me that only 2 of the 12 M4s from there got home interviews.

nope, that sucks though, will name and shame after the match but its in NY

 

[gamerEMdoc]

Can you talk about the efficacy of LOIs for addressing why you want to be in an area? I have a classmate at my program who is not from New England, but is at a NE program and only got aways from NE programs. They want to be Chicago because their partner just got a job offer there, but feel like they aren't getting any love from those programs because of geographic bias.

That is, in general, the LOIs that do work, if its a program that takes them into consideration. Mass emailing a copy and paste email isnt that effective, but if I see one that seems to imply genuine interest for whatever reason, Im more apt to take it seriously.

 

[gamerEMdoc]

I LOVE hearing the inside scoop from your guys side of the process. I’m working as an adcom for our med school right now and have NO idea how you alll read so many virtually identical apps so fast.

What are your thoughts on the “Couples match LOI” where you reach out to a program and let them know your significant other got an interview and you’re interest in the program because XYZ? Still annoying this early in the season or no?

as always, gamer, you’re doing the lords work.

IDK that it hurts in that situation, but it may not be necessary. We personally at least try to coordinate our couples match interviews. If one of our other programs like a candidate, we try to get their SO in on our end. And vice versa. All our programs coordinators communicate back and forth re: couples match candidates.

Sometimes it just doesnt all work out. But we at least try.

 

[STEMI_voy]

Would you consider alternating airway with anesthesia a concerning sign for an established program? Are there any good/acceptable explanations for this practice?

 

[gamerEMdoc]

Would you consider alternating airway with anesthesia a concerning sign for an established program? Are there any good/acceptable explanations for this practice?

I'm assuming you mean in the trauma bay? I would hope its not ED airways. I did see this at a University place with an anesthesia residency; the justification was that anesthesia needed emergent airways as well. I think its silly to be honest. We are the specialty of the emergent airway. Those are the cases we need, because those are the cases we see on a daily basis as a specialty, not them. Anesthesia can cancel a case if there is even a hint of a difficult airway and plan for an alternative. If we have a drunk vomiting 300 lb patient who face planted and is aspirating we don't have that option to just cancel the case. Anesthesia and EM airways are two completely different things IMO.

That's not to say anesthesia may not want some emergent airway cases, and if it was something like they wanted to do an EM rotation, or they took trauma airway call once a week or something, I don't think that would be that unreasonable. We do a month of anesthesia. Why don't they come do a month of EM? They'd never let an EM resident come up every other day for 3 years and tube all of their OR patients. I just don't think rotating every other day really makes much sense, that's way too many airways being clipped off.

The reason I say this is, the number of actual truly hellish airways you'll get as a resident is limited. You may intubate 100 or so patients, but statistically, the first pass success of EM airways is over 90%. When you combine first and second try its like 98%. So statistically, you may get like 2-4 truly bad airways that you are throwing the kitchen sink at to Macguyver, if that. So giving up opportunities every other day just seems like a bad idea to me. With all my time in residency and 10 years as an attending, I can think of less than 10 cases of airways that I was like "wtf am I going to do now". There certainly are more challenging airways all the time, but the true "scareway" where you really struggle and are thinking of prepping for a cric as all hell breaks loose is just not that common.

 

[125MGCoffeePRN]

Is it true EM programs are, this year, only interviewing a capped amount of applicants from certain schools?

 

[gamerEMdoc]

Is it true EM programs are, this year, only interviewing a capped amount of applicants from certain schools?

I haven't heard anything about that in general, I mean most programs do their own thing when it comes to how they select people for interviews. I'm not sure how anyone would know if any given program(s) were doing this.

 

[Stephanopolous]

Can anyone tell me when most residency programs start? I've heard mid June or beginning of July. Currently planning a wedding and having issues with dates.

mid june to early july is what i've been seeing too. In the same boat but it's for my sister's wedding next year

 

[Rekt]

You can essentially guarantee two weeks before July 1st. A couple were three weeks before where I interviewed. I honestly just wouldn't plan anything for June.

 

[deleted725838]

Curious about your thoughts. 5, or 10 years from now is it really going to matter which program we end up at? Is the clinician I want to become dependent on the residency program? I assume it is like med schools, they are more similar than they are different. Some small differences that seem important at the time. By the end of four years we learn the same stuff, get some debt, some letters behind our name, and a coat with coffee stains.

 

[The Knife & Gun Club]

Curious about your thoughts. 5, or 10 years from now is it really going to matter which program we end up at? Is the clinician I want to become dependent on the residency program? I assume it is like med schools, they are more similar than they are different. Some small differences that seem important at the time. By the end of four years we learn the same stuff, get some debt, some letters behind our name, and a coat with coffee stains.

that’s why culture and fit end up being so important. Most residencies will make you agood doctor, but you want to enjoy the time and enjoy the people you work with.

I love a lot of the people from my med school and can say from experience our culture is different from others. Same goes for that gut feeling for residencies I’d imagine.

 

[Listen2Savage]

 

[The Knife & Gun Club]

View attachment 285332

Is there really another wave this late? I thought it was more of a slow trickle into december

 

[Tanishalanko34]

In a bit of a pickle, DO student here applying EM (obviously). Trying to decide if I should/can take Step 2 and do well. Your average applicant, Step 1 230s and Level 1/2 high 500s. Trying to stay regionally, done Sub-Is at all the programs I want to get into and have expressed my interest in staying in the area due to geographic ties. Did relatively well, think I have a good shot.

Currently sitting 14 interviews to EM programs. Have not heard from several programs I am interested in. At this moment studying for Step 2, test in 9 days and not feeling like I can score competitively (240s+). Any advice?

 

[Tanishalanko34]

In a bit of a pickle, DO student here applying EM (obviously). Trying to decide if I should/can take Step 2 and do well. Your average applicant, Step 1 230s and Level 1/2 high 500s. Trying to stay regionally, done Sub-Is at all the programs I want to get into and have expressed my interest in staying in the area due to geographic ties. Did relatively well, think I have a good shot.

Currently sitting 14 interviews to EM programs. Have not heard from several programs I am interested in. At this moment studying for Step 2, test in 9 days and not feeling like I can score competitively (240s+). Any advice?

Ideally I would fight through these next 9 days and score in the 240s but I don't know if I have it in me.

 

[mancub]

Ideally I would fight through these next 9 days and score in the 240s but I don't know if I have it in me.

One of the programs I rotated said they won’t rank students without a step2 score. I think you need to find out specifics from the regional programs you mentioned.

 

[PrayForUs]

Is there really another wave this late? I thought it was more of a slow trickle into december

I've kinda had a wave, a few invites for me is a wave lol. Definitely has eased my mind.

 

[boomshaketheroom]

One of the programs I rotated said they won’t rank students without a step2 score. I think you need to find out specifics from the regional programs you mentioned.

Yeah I think a few programs said that. Unless things have changed in the last couple years, though, you can just not release your Step 2 score until the last second. I dont think it gets sent out automatically? Or just not release it until after the match if they dont need it to rank.

 

[CyrilFiggis]

Is there really another wave this late? I thought it was more of a slow trickle into december

Wave of waitlists for me today.

 

[Forever_Blessed]

Yeah I’m honestly getting a bit worried over here. Only sitting at 5 IVs. I know I have 1 Honors for my SLOE, 2nd SLOE still pending.
STEP 2 ck score comes out this week (low step 1), so I’m thinking about sending update emails this week after my score comes out.

 

[4thyeartoss]

Wave of waitlists for me today.

I’d take that over the wave of rejections I got this afternoon.

 

[The Knife & Gun Club]

I’d take that over the wave of rejections I got this afternoon.

Yea my plane landed today and I turned my phone on to 3 Reject emails from programs I was quite fond of. Def a little bummed.

 

[TTPpentad]

Silence for several weeks, then rejections, then invites to waitlists (that they warned aren’t moving), and now more rejections. This is fun

 

[motatoes94]

Yea the November wave has definitely begun. I got a good batch of rejections yesterday. That means the second wave of interview peristalsis has begun right?

 

[doggydog]

Every year:
10/15: AW YEAH SECOND WAVE HAS BEGUN
11/1: Has the second wave started yet?
11/15: Anyone hear anything about a second wave?
12/1: When is the second wave coming?
1/1: The second wave has to be starting soon
2/1: Okay we are basically out of time for this second wave.
Day before Match day: okay I still need to hear from ten programs I’m interested in, maybe today is the day!

 

[blah12346497]

I'm still sitting at 6-7. Id be okay with 3-4 more. This process is so emotionally taxing. It is so difficult to focus on anything.

 

[WasALurkerButNotAnymore]

I'm in the same boat! 6-7 interviews and just waiting... Where are all these 2nd wave invites and waitlists that are supposed to appear around now?

 

[TTPpentad]

I'm in the same boat! 6-7 interviews and just waiting... Where are all these 2nd wave invites and waitlists that are supposed to appear around now?

I think it will be a slow, random trickle of invites rather than a wave. I just got off a waitlist this morning at one place and in turn, dropped an IV at another place. I'm guessing similar tiny movement will be occurring as the season continues. I sure wish another "wave" was coming instead though.

 

[bombay2pac]

Same here 6-7 interviews, bunch of waitlist and rejection emails recently. Just need a few more IVs and I’d be a happy camper.

 

[bombay2pac]

Same here 6-7 interviews, bunch of waitlist and rejection emails recently. Just need a few more IVs and I’d be a happy camper.

And here I thought I applied to too many schools (65)

 

[Listen2Savage]

I'm still sitting at 6-7. Id be okay with 3-4 more. This process is so emotionally taxing. It is so difficult to focus on anything.

same

 

[4thyeartoss]

Same here 6-7 interviews, bunch of waitlist and rejection emails recently. Just need a few more IVs and I’d be a happy camper.

Sounds like we’re all relatively in the same place. I’m only at 5, so I’m a little stressed out.

 

[WasALurkerButNotAnymore]

Well, just got a few more rejections... Good luck everyone

 

[gamerEMdoc]

Curious about your thoughts. 5, or 10 years from now is it really going to matter which program we end up at? Is the clinician I want to become dependent on the residency program? I assume it is like med schools, they are more similar than they are different. Some small differences that seem important at the time. By the end of four years we learn the same stuff, get some debt, some letters behind our name, and a coat with coffee stains.

I dont think it makes a difference for the most part to be honest. If a place has a focus in something you are really interested for your career, like big time research, then maybe. But clinical medicine, its not going to matter. You are going to still be learning new things for your entire career, residency is just the basis for a lifetime of learning and adapting to change in practice.

 

[gamerEMdoc]

A few things:

- expect interviews from mid-nov on to come in more of a trickle here and there
- most people arent cancelling in Oct/Nov. dec and Jan are a cancellation bloodbath. If your schedules are flexible, you should be able to pick up waitlist interviews
- 6-7 interviews still means you are very likely going to match statistically. I have people near the top of my list who have 6 interviews or so. They are going to match 100%.

Everything is going to be just fine. This is normal anxiety this time of year. If you have 6 interviews now, and can pick up 2 more interviews between now and Jan, you are going to match 9 times out of ten. Theres still 2.5 months to go.

 

[4thyeartoss]

A few things:

- expect interviews from mid-nov on to come in more of a trickle here and there
- most people arent cancelling in Oct/Nov. dec and Jan are a cancellation bloodbath. If your schedules are flexible, you should be able to pick up waitlist interviews
- 6-7 interviews still means you are very likely going to match statistically. I have people near the top of my list who have 6 interviews or so. They are going to match 100%.

Everything is going to be just fine. This is normal anxiety this time of year. If you have 6 interviews now, and can pick up 2 more interviews between now and Jan, you are going to match 9 times out of ten. Theres still 2.5 months to go.

Couple random questions and these may be totally naive, so I apologize in advance. As an APD or PD how do you know how many interviews candidates have? Also, half of my interviews are from audition rotations, are these interviews more of a courtesy because I spent a month there or are places genuinely interested in their rotators for residency?

 

[Rekt]

A few things:

- expect interviews from mid-nov on to come in more of a trickle here and there
- most people arent cancelling in Oct/Nov. dec and Jan are a cancellation bloodbath. If your schedules are flexible, you should be able to pick up waitlist interviews
- 6-7 interviews still means you are very likely going to match statistically. I have people near the top of my list who have 6 interviews or so. They are going to match 100%.

Everything is going to be just fine. This is normal anxiety this time of year. If you have 6 interviews now, and can pick up 2 more interviews between now and Jan, you are going to match 9 times out of ten. Theres still 2.5 months to go.

I dropped ~10 interviews last year early/mid December. Interview fatigue is very real and everyone thinks they're immune to it. I think the trickle is real, but really depends on what places you applied to. If you're waiting on Denver, Cinci, LAC, etc, then you're very unlikely to hear anything, but mid/low tier places are where the most movement will be.

 

[gamerEMdoc]

Couple random questions and these may be totally naive, so I apologize in advance. As an APD or PD how do you know how many interviews candidates have? Also, half of my interviews are from audition rotations, are these interviews more of a courtesy because I spent a month there or are places genuinely interested in their rotators for residency?

I know how many people have sometimes only because students that rotate with me often times seek out my advice regarding applying to EM. I offer to give as much or as little application advise as any rotator wants, read personal statements, and answer emails about applications months after the rotation if people hit me up for advice. So often people will email me that rotated earier in the summer and say "I'm stuck on 5-6 interviews, should I wait, apply to a backup, etc". Same questions I get here.

Interviews netted from auditions are not courtesy interviews. If anything, they are your best chance of matching for a middle to below average candidate. If you are in the middle tier of a few programs lists that you rotate at, they are more likely to rank you higher than other middle/low 1/3 type candidates they interview strictly because they know you.

 

[imascrubMD]

Hi everyone, I have a couple questions:
1) Do academic programs prefer academic SLOEs when sending out invites / ranking applicants? I currently have 2 SLOEs uploaded (1 non-EM residency, 1 community) that I feel are pretty solid, and a 3rd SLOE from a renown academic institution that was just uploaded this week. Is sending it specifically to academic programs (some sent me an invite already, others I'm still waiting on) worth the risk without knowing what's on it?

2) Regarding interviews, how much does competitiveness factor into deciding what programs to keep vs drop, and should I go to at least 2-3 programs that I'm very competitive for but only sort of interested in at the expense of several "dream" programs that I may not have a great shot at? Put another way, is it a bad idea to only interview at / rank "high-tier" programs that I'm truly excited about rather than having a good mix of low/mid/high tier programs?

Thanks in advance. Regardless, I will be dropping some invites soon so I hope it benefits some of you!

 

[gamerEMdoc]

1) Do academic programs prefer academic SLOEs when sending out invites / ranking applicants? I currently have 2 SLOEs uploaded (1 non-EM residency, 1 community) that I feel are pretty solid, and a 3rd SLOE from a renown academic institution that was just uploaded this week. Is sending it specifically to academic programs (some sent me an invite already, others I'm still waiting on) worth the risk without knowing what's on it?

First and foremost, residency sloes >>>> non-residency sloes. After that, Im sure prestige of the program factors in some for some places that are prestige programs themselves. But for the average program, Id rather see a top 1/3 sloe from a reputable community EM program than a low 1/3 at a big name program.

2) Regarding interviews, how much does competitiveness factor into deciding what programs to keep vs drop, and should I go to at least 2-3 programs that I'm very competitive for but only sort of interested in at the expense of several "dream" programs that I may not have a great shot at? Put another way, is it a bad idea to only interview at / rank "high-tier" programs that I'm truly excited about rather than having a good mix of low/mid/high tier programs?

I think that it matters how competitive of an applicant you are since some candidates wont need a safety program, and others aren't going to have the luxury of cutting any interviews. But for many candidates I don't think its a bad idea to have 1-2 safety programs.

 

[Smurf4halp]

Is it normal for programs to extend an interview invite, only for you to find out that it's completely filled up with no spots open on Thalamus or Interview Broker? This has happened to me on multiple fronts the past few months, and it's extremely frustrating considering I jump on it within the minute of the email invitation, and had no other choice but to waitlist myself. This system is extremely inefficient and emotionally draining in an unnecessary way. Combined with the lack of transparency of SLOEs (the MOST IMPACTFUL aspect of their app), it's no wonder applicants apply to a program number way beyond their means and deluge PDs with annoying emails as if it's the Hunger Games level of scarcity

 

[DESTINEDyHOPEFUL]

Is it normal for programs to extend an interview invite, only for you to find out that it's completely filled up with no spots open on Thalamus or Interview Broker? This has happened to me on multiple fronts the past few months, and it's extremely frustrating considering I jump on it within the minute of the email invitation, and had no other choice but to waitlist myself. This system is extremely inefficient and emotionally draining in an unnecessary way. Combined with the lack of transparency of SLOEs (the MOST IMPACTFUL aspect of their app), it's no wonder applicants apply to a program number way beyond their means and deluge the coordinator and PD emails with LOIs. Until these things get fixed, it's not gonna stop.

unfortunately, yea. i think it is pretty common. I will say however, I've seen s l o w movement from my waitlist spots. especially if you sign up for those late dec/jan spots.

 

[imascrubMD]

First and foremost, residency sloes >>>> non-residency sloes. After that, Im sure prestige of the program factors in some for some places that are prestige programs themselves. But for the average program, Id rather see a top 1/3 sloe from a reputable community EM program than a low 1/3 at a big name program.

Thanks for the response! On that note, since one of my SLOEs is a non-EM residency, would you suggest that I upload a third [even though its late and I have enough interviews at this point] just to have two official EM-residency SLOEs for ranking purposes?

 

[gamerEMdoc]

Thanks for the response! On that note, since one of my SLOEs is a non-EM residency, would you suggest that I upload a third [even though its late and I have enough interviews at this point] just to have two official EM-residency SLOEs for ranking purposes?

I would, unless you think its a SLOE that could hurt you.