Chances at ivory tower type academic programs

[joelawyer]

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4th year about to apply. Doing EM, hopeful for CCM fellowship. Please don’t hate me but I’m a fan of research, have about 9 first author EM papers and 15 “publications” total. want to keep doing a lot of research particularly in global health. Looking for a research heavy academic program that will support my interests while also teaching me to be a good doctor basically.

Based on what I want, my working signals list is Harvard, NYP, UCLA, UCSF, Stanford… obviously full of very competitive programs that are super selective.

Here’s my profile. I know it’s a “strong” med student profile but I’m wondering is it strong enough for those type of programs? Specifically, do I need to be less aggressive with my signals and mix in some community type programs or lower “tier” academic programs?

Top 10-20 USMD (who knows anymore but traditionally an “ivory tower”)
Step 2: 262
Honors in all clerkships
No idea how I’ll end up doing on SLOEs, I hope well??

 

[skougess]

4th year about to apply. Doing EM, hopeful for CCM fellowship. Please don’t hate me but I’m a fan of research, have about 9 first author EM papers and 15 “publications” total. want to keep doing a lot of research particularly in global health. Looking for a research heavy academic program that will support my interests while also teaching me to be a good doctor basically.

Based on what I want, my working signals list is Harvard, NYP, UCLA, UCSF, Stanford… obviously full of very competitive programs that are super selective.

Here’s my profile. I know it’s a “strong” med student profile but I’m wondering is it strong enough for those type of programs? Specifically, do I need to be less aggressive with my signals and mix in some community type programs or lower “tier” academic programs?

Top 10-20 USMD (who knows anymore but traditionally an “ivory tower”)
Step 2: 262
Honors in all clerkships
No idea how I’ll end up doing on SLOEs, I hope well??

I’m not sure any of those programs are competitive. Most people doing EM don’t want the “ivory tower” patient population for learning. It’s not like IM where the interesting cases will get sent to you if you work at Hopkins. You see what walks through the door.

Nothing wrong with trying to carve a research/academic career out for yourself. It’s one of the best ways to achieve EM longevity if you can stomach it. I’d rather gouge my eyes out than do research, so I’m jealous of you.

 

[Janders]

(1) sure you sound like a great candidate by those numbers
(2) EM is odd in that our classic “best” programs aren’t necessarily the classic “best” famous huge med schools/hospitals. But there is some overlap especially in the direction deep academic research if that is truly your passion.
(3) which Harvard do you speak of… we have multiple Harvards 😉

 

[joelawyer]

(1) sure you sound like a great candidate by those numbers
(2) EM is odd in that our classic “best” programs aren’t necessarily the classic “best” famous huge med schools/hospitals. But there is some overlap especially in the direction deep academic research if that is truly your passion.
(3) which Harvard do you speak of… we have multiple Harvards 😉

Yeah a lot of my mentors have told me to try for MGH. I do research in a really niche area and it would be the one place where there are faculty who are spot on for it. A few people have told me specifically there it helps to have a connection and I’ve really neglected networking in any way unfortunately so I don’t have that. But I hear what you say about selectivity from a lot of people— I guess we will see!

 

[Janders]

Ah my arch nemesis, the OTHER Harvard!

The combined BWH/MGH program is, of course, good. 4 years. Has some fellowships too. Lots of grads go into diverse academic and industry and varied jobs from my understanding.

 

[alpinism]

4th year about to apply. Doing EM, hopeful for CCM fellowship. Please don’t hate me but I’m a fan of research, have about 9 first author EM papers and 15 “publications” total. want to keep doing a lot of research particularly in global health. Looking for a research heavy academic program that will support my interests while also teaching me to be a good doctor basically.

Based on what I want, my working signals list is Harvard, NYP, UCLA, UCSF, Stanford… obviously full of very competitive programs that are super selective.

Here’s my profile. I know it’s a “strong” med student profile but I’m wondering is it strong enough for those type of programs? Specifically, do I need to be less aggressive with my signals and mix in some community type programs or lower “tier” academic programs?

Top 10-20 USMD (who knows anymore but traditionally an “ivory tower”)
Step 2: 262
Honors in all clerkships
No idea how I’ll end up doing on SLOEs, I hope well??

You'll be fine as long as you remember to apply broadly and not all Ivy League research schools.

I'm in Global Health and have worked as faculty at multiple of the above residencies and its a solid list.

Personally would recommend against NYP since its gone way downhill since COVID and most of us have left for other universities. There's a reddit thread about the numerous issues with the ED but its not known for currently providing good training nor is there a lot of support for doing research for the EM residents. I'd recommend looking at places known for both like Yale, Brown, Vanderbilt, Duke, etc... if you really want that kind of career in academics.

 

[joelawyer]

You'll be fine as long as you remember to apply broadly and not all Ivy League research schools.

I'm in Global Health and have worked as faculty at multiple of the above residencies and its a solid list.

Personally would recommend against NYP since it’s gone way downhill since COVID and most of us have left for other universities. There's a reddit thread about the numerous issues with the ED but it’s not known for currently providing good training nor is there a lot of support for doing research for the EM residents. I'd recommend looking at places known for both like Yale, Brown, Vanderbilt, Duke, etc... if you really want that kind of career in academics.

Thanks so much. Anywhere in NYC, SF, Southern California or Chicago you’d suggest? I’d love to be in a big city but def have Yale and Brown on the list and will add the other two. UChicago and Northwestern?

 

[Bittersteel]

Thanks so much. Anywhere in NYC, SF, Southern California or Chicago you’d suggest? I’d love to be in a big city but def have Yale and Brown on the list and will add the other two. UChicago and Northwestern?

NYC programs suck.

I remember wanting so bad to like them and being so disappointed on my interview days.

I did a sub I at Bellevue NYU and it almost made me abandon EM completely.

 

[JacobMcCandles]

Thanks so much. Anywhere in NYC, SF, Southern California or Chicago you’d suggest? I’d love to be in a big city but def have Yale and Brown on the list and will add the other two. UChicago and Northwestern?

Yes, any of them that are 3 year programs.

 

[alpinism]

Thanks so much. Anywhere in NYC, SF, Southern California or Chicago you’d suggest? I’d love to be in a big city but def have Yale and Brown on the list and will add the other two. UChicago and Northwestern?

So I'd personally suggest Mt Sinai Elmhurst of all the NYC EM residency programs but its still a hot mess with a bad commute between the sites.

That being said I know faculty there who are pretty happy and its good training with lots of critical care on all of the shifts.

 

[alpinism]

Thanks so much. Anywhere in NYC, SF, Southern California or Chicago you’d suggest? I’d love to be in a big city but def have Yale and Brown on the list and will add the other two. UChicago and Northwestern?

Loma Linda has wonderful Global Health fellowship programs but not much research so you would have to be willing to do your own projects.

 

[Janders]

NYC programs suck.

I remember wanting so bad to like them and being so disappointed on my interview days.

I had zero knowledge of NYC and zero home faculty who knew anything about them, so I chose 3 to go to based on SDN and their websites.

2 of them were rapidly my bottom two rank list spots. Woof.

 

[trackrunner321]

Matching into EM is now a joke, so I have no doubt you will match into one of your top 3 programs at the end of the day. UPMC also has numerous faculty involved in EM and critical care research. The clinical training is also top-notch. Would add that to your list.

 

[Apollyon]

So I'd personally suggest Mt Sinai Elmhurst of all the NYC EM residency programs but its still a hot mess with a bad commute between the sites.

That being said I know faculty there who are pretty happy and its good training with lots of critical care on all of the shifts.

Did Elmhurst spin off Mt Sinai proper? In my day, MSH was the core, but the MSH residents staffed Elmhurst primarily. (North Shore sent their residents there for 2 months of trauma.) The Sinai EM also did MICU at Elmhurst; I was an IM prelim intern at Elmhurst 2002-03, and, one day there was a floor code. I tubed the pt, and we had ACLS going by the time the resident from the ICU got there. And who was that resident? Scott Weingart, who said, "I could work with you every day" to me.

But, Shelly Jacobsen blacklisted me - interviewed me, but didn't rank me, therefore wasting my time - because I was from a Carib school.

 

[cyanide12345678]

4th year about to apply. Doing EM, hopeful for CCM fellowship. Please don’t hate me but I’m a fan of research, have about 9 first author EM papers and 15 “publications” total. want to keep doing a lot of research particularly in global health. Looking for a research heavy academic program that will support my interests while also teaching me to be a good doctor basically.

Based on what I want, my working signals list is Harvard, NYP, UCLA, UCSF, Stanford… obviously full of very competitive programs that are super selective.

Here’s my profile. I know it’s a “strong” med student profile but I’m wondering is it strong enough for those type of programs? Specifically, do I need to be less aggressive with my signals and mix in some community type programs or lower “tier” academic programs?

Top 10-20 USMD (who knows anymore but traditionally an “ivory tower”)
Step 2: 262
Honors in all clerkships
No idea how I’ll end up doing on SLOEs, I hope well??

Why do EM with intention of going into CCM.

Most people wanting CCM should go the IM route. It’s the path of least resistance and the most accepted pathway.

 

[Brigade4Radiant]

If you want to go into academic medicine I don’t see why you would go into EM then critical care. If you are doing academics most of your research will be in critical care if you get more grant money doing pulm.

Em doesn’t own the critical care fellowship in any of these prestigious programs

You are competitive however, because the leadership in academic emergency medicine is foolish you really only have five signals.

You only have 5 signals for EM that you can use in non away and home programs vs IM you can do 15 which gives you a far better shot at ranking a lot of competitive places.

 

[Bittersteel]

If your goal is CCM fellowship, do IM.

1) IM is a better foundation for the medium term management of ICU patients.

EM is stubbed toes, low risk chest pain workups and occasional intubations. When you intubate you won't do any elegant vent management. You'll slap on a basic mode and get them out as fast as possible.

2) pulm/ccm will give you an out to pulm clinic if you want it later.

3) if you decide not to do ccm you have whatever other fellowship you want from IM. If youre in EM and dont want CCM, now you're fooked.

 

[cyanide12345678]

If your goal is CCM fellowship, do IM.

1) IM is a better foundation for the medium term management of ICU patients.

EM is stubbed toes, low risk chest pain workups and occasional intubations. When you intubate you won't do any elegant vent management. You'll slap on a basic mode and get them out as fast as possible.

2) pulm/ccm will give you an out to pulm clinic if you want it later.

3) if you decide not to do ccm you have whatever other fellowship you want from IM. If youre in EM and dont want CCM, now you're fooked.

Yeah a 4th year med student shouldn’t be set on a particular fellowship yet. They haven’t had any real exposure.

If they don’t like CCM, EM has literally nothing else. Other than pain or palliative. But pain is an uphill battle.

If the plan is to do a fellowship, EM makes no sense.

In fact, CCM is probably not the most research heavy opportunity, the real latest research and advancement happening right now is oncology and rheumatology with the world of biologics.

Also other than EM being no. 1 in expected surplus, no. 2 on that list is CCM for surplus of doctors expected in 2030 i think.

 

[sloh]

Yeah a 4th year med student shouldn’t be set on a particular fellowship yet. They haven’t had any real exposure.

If they don’t like CCM, EM has literally nothing else. Other than pain or palliative. But pain is an uphill battle.

If the plan is to do a fellowship, EM makes no sense.

In fact, CCM is probably not the most research heavy opportunity, the real latest research and advancement happening right now is oncology and rheumatology with the world of biologics.

Also other than EM being no. 1 in expected surplus, no. 2 on that list is CCM for surplus of doctors expected in 2030 i think.

340b loophole under significant threat though

 

[Brigade4Radiant]

How do you know you don't like Cardiac Critical care? You could also go into critical care after cardiology. Research is into IM specialties and labs have an established Anesthesia or CC Pulm hierarchy. You rarely see an EM/CC be a high priority at these programs which will affect research grants.

It honestly better to do research in a well funded area than an niche interest since you will struggle to get grants and the more grant money the more you can decide how to do your research and making an impact. Publish or Perish. Money is in drug development so cardio, pulm, liver etc. You may not even be credentialed to do bronchs which may cause issues in coverage since they would have to get an extra pulm guy when your on.

I've never seen a pulm/cc do hospitalist work its so rare they are always in the ICU. You really want to do spare EM shifts when you can just as easily cover ICU shifts with less nights? With the nature of how EM is you have to move the meat so much and especialy in these academic areas its expected to get specialists on board after a few hours in the ED.

 

[EctopicFetus]

Why do EM with intention of going into CCM.

Most people wanting CCM should go the IM route. It’s the path of least resistance and the most accepted pathway.

And gets you into pulm which is another exit if you choose. I agree doing EM with the plan of CCM seems like a bad choice. unsure if you all saw the latest workforce data but CCM had the 2nd largest over supply behind….. EM. At least having Pulm with it gives you an out. Straight CCM/EM is a career where you are stuck.

 

[CopaceticOne]

And gets you into pulm which is another exit if you choose. I agree doing EM with the plan of CCM seems like a bad choice. unsure if you all saw the latest workforce data but CCM had the 2nd largest over supply behind….. EM. At least having Pulm with it gives you an out. Straight CCM/EM is a career where you are stuck.

And if there is a change in desires, there are waaaaaay more fellowship options from IM that are procedural, or plain chill, & high paying.

 

[Apollyon]

And gets you into pulm which is another exit if you choose. I agree doing EM with the plan of CCM seems like a bad choice. unsure if you all saw the latest workforce data but CCM had the 2nd largest over supply behind….. EM. At least having Pulm with it gives you an out. Straight CCM/EM is a career where you are stuck.

That's what I was going to say, and not even an exit. Pulm makes CCM rich.