A Little Advice

[It'sElectric]

I know how much everyone loves these advice threads....

To sum it up, my 4th year doesn't officially begin until the last 2 weeks of July. As a result, I'm currently scheduled to do 2 away EM rotations at programs from mid-August to mid-September and October 1st to 31st.

My problem, I will not have a 4th year SLOR from an ACGME program the first day we're able to submit our ERAS applications. If I'm fortunate enough, I'll have my first one after my first away rotation around mid-September (fingers crossed, another one after my 2nd away at the end of October). I will have two 3rd year SLORs (one from a faculty member at an ACGME program, but I got it while doing a rotation at a community ED) already in place.

Should I try and bump both of my away rotations up, with one from the end of July to mid-August, and the other from September to October? Or will I be just fine with where they are at?

Any advice would be much appreciated, because I probably need to jump on this right away, if I want to change them up.

Thanks in advance.

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[dlung]

You don't need all your SLORs done on the first day ERAS opens! Good grief. Most programs don't even bother looking at applications until October... at the earliest.

I guess, ideally, your EM rotations would be earlier, but you've already got more SLORs than 99% of your peers!

Here's my advice. If you want to play it by the book, or you think you're gonna really blow it on your first EM rotation, move up your rotations. If you want relax for a second and save yourself the pain of rearranging your rotations and living arrangements, leave things as is and have a scotch.

 

[It'sElectric]

You don't need all your SLORs done on the first day ERAS opens! Good grief. Most programs don't even bother looking at applications until October... at the earliest.

I guess, ideally, your EM rotations would be earlier, but you've already got more SLORs than 99% of your peers!

Here's my advice. If you want to play it by the book, or you think you're gonna really blow it on your first EM rotation, move up your rotations. If you want relax for a second and save yourself the pain of rearranging your rotations and living arrangements, leave things as is and have a scotch.

Much appreciated. I apologize for coming off so anal retentive. I think I just got a bit of the jitters thinking about the next 6-9 months. It seems like LORs are a huge part of the EM app, so I got a bit paranoid.

 

[SoCuteMD]

If you look back at past SLOR threads, you'll see that a) third year SLORs don't matter much and b) a SLOR written by someone who is not faculty at an ACGME program (as it sounds like one of yours is) is not a true SLOR (read the directions on the SLOR form for clarification).

You will get a SLOR from the first program in plenty of time. The second program is a bit iffy, since many programs make decisions in October, and the rest make them in that first week of November.

 

[It'sElectric]

If you look back at past SLOR threads, you'll see that a) third year SLORs don't matter much and b) a SLOR written by someone who is not faculty at an ACGME program (as it sounds like one of yours is) is not a true SLOR (read the directions on the SLOR form for clarification).

You will get a SLOR from the first program in plenty of time. The second program is a bit iffy, since many programs make decisions in October, and the rest make them in that first week of November.

Thanks SoCute. You addressed my primary concern - the fact they are 3rd year letters and I will likely have one 4th year slor in time.

I think I read through the thread you're referring to at least 5 times awhile back, and I'm not sure a consensus was ever reached. It says Emergency Medicine faculty (no mention of ACGME). There was a lot of debate as to whether that simply meant a board certified EM doc, or what.

Grrr...self-doubt is rampant.

 

[SoCuteMD]

Thanks SoCute. You addressed my primary concern - the fact they are 3rd year letters and I will likely have one 4th year slor in time.

I think I read through the thread you're referring to at least 5 times awhile back, and I'm not sure a consensus was ever reached. It says Emergency Medicine faculty (no mention of ACGME). There was a lot of debate as to whether that simply meant a board certified EM doc, or what.

Grrr...self-doubt is rampant.

Given the comparisons and statements they ask for, I think it's pretty clear they are asking this of faculty at an ACGME program. First, it references the Program Director as one of the ideal people to fill it out. Unless it's a residency program, there's no program director. Your average EM grad isn't going to have much idea "how much guidance this candidate will need during residency?" and "Given the necessary guidance, what is your prediction of success for the applicant?"

I went back to try to find the thread, but couldn't. If I were you I'd go back and look and see what BKN had to say. AFAIK he was the only PD who posted on that thread.

You can (obviously) do whatever you want, but lots was said about my letters on the trail, and it all concerned WHO they were from. The stellar letter I had from a lesser-known (but excellent) residency program didn't have nearly the impact.

This was all I could find: http://forums.studentdoctor.net/showthread.php?p=5403461#post5403461 but I know it wasn't the post either of us was talking about.

 

[dlung]

context context context...

I disagree with the SLOR being less useful as a 3rd year. Our medical students who are set on EM often rotate as 3rd year students in the 2nd half of the year--we don't waste their time by having them come back a couple months later to see if they've learned anything new.

As for WHO is writing your letters, I agree it matters, but determining their credentials is something else. The community ERs affiliated and not affiliated with residency programs in our area are littered with former residency chiefs, program directors, etc. Don't poo-poo your recommendations just 'cause it's "community."

 

[SoCuteMD]

context context context...

I disagree with the SLOR being less useful as a 3rd year. Our medical students who are set on EM often rotate as 3rd year students in the 2nd half of the year--we don't waste their time by having them come back a couple months later to see if they've learned anything new.

As for WHO is writing your letters, I agree it matters, but determining their credentials is something else. The community ERs affiliated and not affiliated with residency programs in our area are littered with former residency chiefs, program directors, etc. Don't poo-poo your recommendations just 'cause it's "community."

It sounds like your community sites are a unique place. Most aren't littered with former program directors. IME, there's a lot of credence given to letters from high profile academicians. Part of the problem with letters coming from community sites is that there's no way for the reader of the letter to verify the writer's credentials. Maybe the writer was an outstanding chief resident (which I'm not actually convinced qualifies them to speak with the same authority as faculty at a residency program), there's no way for the reader of the letter to know that piece of information. If the letter comes from a program director or a medical student director then even if that's not stated on the SLOR the reader could hop on the residency's website and SEE for themselves what position the writer holds.