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I imagine doing away rotations as soon as possible in 4th year to get SLORs will be important. Anything else I'm not thinking of?
Any recommendations for students at a program with no EM residency?
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deleted109597
That's pretty much it. Do a couple aways and rock them. Don't do 3 or more though, because at that point you get tired of being in the spotlight for that long.
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I came from a medical school without an EM program.
Above post is correct; its pretty much mandatory you do at least one away rotation and possibly two... more than that is a waste of time and money.
The other biggest hitch to me was the lack of guidance/mentoring. Where I was a resident, our PD and chief residents and other residents were very involved with the EM Interest Group. That connection and guidance may help get the foot in the door at the home program, but certainly can help you at other places too.
I wish I had a good recommendation on how to make up for the above.... Obviously places like SDN is a great resource and dont be afraid to randomly PM some of the folks you see on here if there is a burning question you have. Your hospital should at least have an ED... ask around down there who the newest graduate is and see if they would be willing to sit down and talk with you. I am back at my same medical school now and have been meeting with students one on one and discussing EM applications/etc...this has been well recieved since our students like you just did not have someone to give much advice. The bad thing is that my advice will probably be good for a few years, but the farther I get away from residency/academics, the worst my advice will become...
Above post is correct; its pretty much mandatory you do at least one away rotation and possibly two... more than that is a waste of time and money.
The other biggest hitch to me was the lack of guidance/mentoring. Where I was a resident, our PD and chief residents and other residents were very involved with the EM Interest Group. That connection and guidance may help get the foot in the door at the home program, but certainly can help you at other places too.
I wish I had a good recommendation on how to make up for the above.... Obviously places like SDN is a great resource and dont be afraid to randomly PM some of the folks you see on here if there is a burning question you have. Your hospital should at least have an ED... ask around down there who the newest graduate is and see if they would be willing to sit down and talk with you. I am back at my same medical school now and have been meeting with students one on one and discussing EM applications/etc...this has been well recieved since our students like you just did not have someone to give much advice. The bad thing is that my advice will probably be good for a few years, but the farther I get away from residency/academics, the worst my advice will become...
Does your above opinion (or anyone else's) change in the case of a US IMG looking to match in EM?
Am I wrong in thinking that programs want to see 3 SLORs + 1 non-EM LOR?
If only 2 are needed, would it still be beneficial to do a third, non-ACGME ER elective prior to doing the "audition" rotations (a bit of a lower pressure warm up)?
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OP - Do you have an EM rotation at your own school that is mandatory?
If so, do that first and then do two aways.
You can't get a SLOR unless the place has a residency program.
You pretty much need 2-3 of these letters.
Other letters don't really help all that much (although I used one this year).
If there are EM programs in your area, I'd seek out the PD or clerkship director and get some specific advising. Talk to someone at your school, they should have a connection they can hook you up with.
It's good to get advice directly from people who evaluate candidates every year.
If so, do that first and then do two aways.
You can't get a SLOR unless the place has a residency program.
You pretty much need 2-3 of these letters.
Other letters don't really help all that much (although I used one this year).
If there are EM programs in your area, I'd seek out the PD or clerkship director and get some specific advising. Talk to someone at your school, they should have a connection they can hook you up with.
It's good to get advice directly from people who evaluate candidates every year.
Do a rotation at your home place if there is one. Seek guidance from the EPs there. There is an online guidance feature through EMRA I believe so take advantage of that. Like other people have said, then at at least one and I would recommend 2 visiting rotations. You want to be ending your second rotation by late October ideally so that your second SLOR is in by Novemeber. If you have one good SLOR in and a good LOR (even if not a SLOR) from your home rotation and good grades/USMLE scores then you will get interviews. The faculty from your earlier visiting rotation (do it in July - September) can provide you some guidance as well.
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As a side, try and get your VSAS stuff squared away early and try and do you EM rotation as early in the spring/summer as possible so you'll have time to get your letters uploaded by the time your submit your ERAS in September. Your schedule might not accommodate it, but if it does, I'd shoot for doing a month or two of EM in the summer.
Also, it's sometimes hard to grab a spot as a visiting student either because the slots fill or the scheduling of the other institution doesn't match up with yours. But obviously try and go to a place you think you'd want to match at. It's basically a one month job interview.
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Thanks all. A few more specific questions popped into my mind while reading responses:
1) We do not have a mandatory EM rotation, but we have the option of doing 3 weeks in the ED as part of one of our other core rotations. I'll obviously be doing that, but should I rotate through my home ED a second time as a 4th year?
2) I was planning to take 2-4 weeks off to get Step 2 out of the way right after 3rd year. Do I have time for that or should I spend my time getting away rotations in early?
3) In terms of options for away rotations, I believe there are a few new programs opening in the next year or two. Can the faculty at those programs right SLORs once the residency is approved or not until the first class officially enters? Also, can Attendings at military EM programs write SLORs?
1) We do not have a mandatory EM rotation, but we have the option of doing 3 weeks in the ED as part of one of our other core rotations. I'll obviously be doing that, but should I rotate through my home ED a second time as a 4th year?
2) I was planning to take 2-4 weeks off to get Step 2 out of the way right after 3rd year. Do I have time for that or should I spend my time getting away rotations in early?
3) In terms of options for away rotations, I believe there are a few new programs opening in the next year or two. Can the faculty at those programs right SLORs once the residency is approved or not until the first class officially enters? Also, can Attendings at military EM programs write SLORs?
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deleted109597
Earliest most aways will let you do is August. They've got their own new residents and students, so many wouldn't let people rotate (back when I did it).
Taking Step II won't help you unless you did mediocre to bad on Step I. If you got above average, a higher Step II won't do anything.
I can't answer number 3.
Taking Step II won't help you unless you did mediocre to bad on Step I. If you got above average, a higher Step II won't do anything.
I can't answer number 3.
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I also am coming from a school with no program. So here is my 2 cents
1) Take the course and if you have an EP that is RT/BC have them write a SLOR. I have it on good authority that it will not HURT your app. I got one, I don't think I have not gotten offers because of it.
2) I also thought about taking step 2 between 3rd and 4th year. DON'T. Instead, settle down with some EM reading so that you can be up to speed when you get on your aways.
3) Any EP can write a SLOR, not only those associated with a residency program to the best of my knowledge.
Also, many places will let you rotate in July. I did.
Here is some advice in contrast to the one above mine.
I took Step 2 immediately following 3rd year before any 4th year rotations. I did this because I had a very average Step 1 score. I wanted to prove to programs that my step 1 was a fluke score and my clinical knowledge was above that of the average 4th year medical student. I also finished my 3rd year on internal medicine, which I believe made studying for the exam much easier and less time consuming. The emergency medicine exam during my first rotation (the SAEM one that many people take, in fact) was certainly not difficult, as much of it's content was covered in the step 2 study process.
Down sides to it include not being able to "prep" for emergency medicine as mentioned above, and also having the first clerkship SLOR coming in around the 1st of October (and even later for rotations following the first one). If you are concerned about a step 1 score, it's up to you, though a decent step 1 and I'd say step 2 can wait. I stand firmly by my decision to take it early, but again it's completely dependent on the rest of your application/step 1 score.
Listen to Sepulveda though, he is like you (no home EM clerkship).
I took Step 2 immediately following 3rd year before any 4th year rotations. I did this because I had a very average Step 1 score. I wanted to prove to programs that my step 1 was a fluke score and my clinical knowledge was above that of the average 4th year medical student. I also finished my 3rd year on internal medicine, which I believe made studying for the exam much easier and less time consuming. The emergency medicine exam during my first rotation (the SAEM one that many people take, in fact) was certainly not difficult, as much of it's content was covered in the step 2 study process.
Down sides to it include not being able to "prep" for emergency medicine as mentioned above, and also having the first clerkship SLOR coming in around the 1st of October (and even later for rotations following the first one). If you are concerned about a step 1 score, it's up to you, though a decent step 1 and I'd say step 2 can wait. I stand firmly by my decision to take it early, but again it's completely dependent on the rest of your application/step 1 score.
Listen to Sepulveda though, he is like you (no home EM clerkship).
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Not true...SLORs can only be written by faculty of accredited residency programs.
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From the CORD website SLOR section:
"ONLY Emergency Medicine Faculty are to complete the SLOR. Most programs with student clerkships are encouraged to have the Student Clerkship Director and/or the Program Director do a SLOR. You can get a start now by having the Clerkship Secretary pull the grades from LAST YEAR'S clerkship. This information is needed to complete item #4 of Section A on the first page."
Now, I make no promise to how much weight a SLOR from a non-program affiliated EP will carry, but I was advised by a program director to obtain it just the same.
Also, I should have mentioned that my step 1 score is better than average for EM. However, I still wanted to get step 2 out of the way since I planned to do three aways and wanted tO have the scores in my file by the deans letter. That's not how things worked out. I did one away in July, took step 2 at the end of August and did another away after that.
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Agree with taking Step 2 early if your Step 1 is average or below and you think you can perform better. From the rumor mill and NBME publications Step 2 is looked at as just as important as Step 1 for EM.
I came from a school with no EM residency and I would say its most important to do two aways at places with EM residencies so you can get letters from faculty there. Agree that three is probably too much. Even better if they are the PD, Med Student Coordinator, or a member of the Selection Committee that way they can pull for you at their program and make calls to their counterparts at other programs.
Inevitably there is a blowhard or two at your institution who fancies him or herself as the expert of getting a EM residency even though they have been out of residency for years and are not faculty at a residency program so they see no real trends till Charting Outcomes comes out which makes them as knowledgeable as Google and your willingness to read yourself. My advice is to ignore them and get a mentor at a neighboring institution with a residency. If you are confident in your clinical abilities I would not even bother doing a rotation at your school since its a waste of an early month that could be used for another away. The first few months of 4th year are improtant.
Lastly, I do believe you can get a SLOR from any EM faculty member at an academic institution but I agree that its useless. How can you compare an applicant to all the candidates you have seen if you do not evaluate candidates?
I came from a school with no EM residency and I would say its most important to do two aways at places with EM residencies so you can get letters from faculty there. Agree that three is probably too much. Even better if they are the PD, Med Student Coordinator, or a member of the Selection Committee that way they can pull for you at their program and make calls to their counterparts at other programs.
Inevitably there is a blowhard or two at your institution who fancies him or herself as the expert of getting a EM residency even though they have been out of residency for years and are not faculty at a residency program so they see no real trends till Charting Outcomes comes out which makes them as knowledgeable as Google and your willingness to read yourself. My advice is to ignore them and get a mentor at a neighboring institution with a residency. If you are confident in your clinical abilities I would not even bother doing a rotation at your school since its a waste of an early month that could be used for another away. The first few months of 4th year are improtant.
Lastly, I do believe you can get a SLOR from any EM faculty member at an academic institution but I agree that its useless. How can you compare an applicant to all the candidates you have seen if you do not evaluate candidates?
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My school did not have an EM program, this is what I did.
1. Involved myself with EMIG and got to know the chairman of the ED. I did some research and this got me to get an SLOR without having to do a rotation in-house. However, I did use my 1 month elective rotation in my MS3 year to do the research... I could've used that to rotate in the ER to get the same SLOR. My thinking is that if you've gone through the ER once (even as an MS3), you really don't need to rotate through as a 4th year student.
Ask your chairman to see if he/she can write you an SLOR without having to do an MS4 rotation. They should know that you NEED away rotations more than in-house rotations.
2. Rotate twice at outside rotations, get SLOR from them as well and ROCK them.
3. Take the step 2 late... probably around September or October of your MS4 year.
1. Involved myself with EMIG and got to know the chairman of the ED. I did some research and this got me to get an SLOR without having to do a rotation in-house. However, I did use my 1 month elective rotation in my MS3 year to do the research... I could've used that to rotate in the ER to get the same SLOR. My thinking is that if you've gone through the ER once (even as an MS3), you really don't need to rotate through as a 4th year student.
Ask your chairman to see if he/she can write you an SLOR without having to do an MS4 rotation. They should know that you NEED away rotations more than in-house rotations.
2. Rotate twice at outside rotations, get SLOR from them as well and ROCK them.
3. Take the step 2 late... probably around September or October of your MS4 year.
