Dead set on EM, any benefit to...

[FirefighterDoc]

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Any benefit to continue to work as an ED Tech when I start medical school this fall? I know that everyone says to keep your options open until 3rd year, but for someone who has worked for years in the ED as well as Fire/medic I am dead set on EM. Despite its flaws and ugly sides, I can't see myself any happier than working in an ED.

That being said, would there be any benefit to working in the ED while in medical school? I know boards will help first and foremost, but would residencies favor working over any other extracurriculars? Would that show them my commitment to EM? Would it help balance out the monotony of the preclinical years? I love it, but would my time be better spent on studying? All through undergrad I worked full time in the ED as well as part time with the Fire Dept and still had a life, so time management isn't an issue for me.

tl;dr
Will Emergency medicine residencies give two ****s whether or not I continued to pull a couple of shifts in the ED through medical school?

 

[DreamingTheLive]

I'll start this fastbreak...

M4

I don't think pulling a couple shifts in the ED throughout your first couple years really provides that much of a benefit to your application specifically. If you want some extra cash, or just really enjoy the work, then by all means go for it. However, I'd ensure that you're excelling in your studies first and foremost for those first 2 years. If you're honoring your courses and crushing exams, then if you still want to, sure. Given the increasing competitiveness of EM, you may also want to consider strengthening other areas of your application such as research, community service, leadership, mentoring, etc..

 

[gro2001]

Any benefit to continue to work as an ED Tech when I start medical school this fall? I know that everyone says to keep your options open until 3rd year, but for someone who has worked for years in the ED as well as Fire/medic I am dead set on EM. Despite its flaws and ugly sides, I can't see myself any happier than working in an ED.

That being said, would there be any benefit to working in the ED while in medical school? I know boards will help first and foremost, but would residencies favor working over any other extracurriculars? Would that show them my commitment to EM? Would it help balance out the monotony of the preclinical years? I love it, but would my time be better spent on studying? All through undergrad I worked full time in the ED as well as part time with the Fire Dept and still had a life, so time management isn't an issue for me.

tl;dr
Will Emergency medicine residencies give two ****s whether or not I continued to pull a couple of shifts in the ED through medical school?

It probably will not help much, if at all. Any benefit will be more than offset if you do worse in class/on boards than you could have otherwise. While the time management skills learned in college will help you, and while it is possible to do other things in addition to school work in med school, don't make the mistake of extrapolating what you can juggle based of your college performance. It's a whole different ball game.

 

[dotcb]

No - it won't help you match into EM.

 

[FirefighterDoc]

All I needed to hear, thanks guys.

 

[fahimaz7]

It'll help you meet all the EM faculty and get started on acquiring good letters of recommendation in the future. A letter from someone who knows you for 4 years is much better than the one written after 5 shifts during your 4th year rotation. I have a buddy in my class who was a paramedic and then EMS coordinator for the hospital during medical school. He got fantastic letters and was the highest ranked student from our school during our EM match. He didn't decide to stay, but if he would have wanted to the option was there!

 

[alpinism]

It'll help you meet all the EM faculty and get started on acquiring good letters of recommendation in the future. A letter from someone who knows you for 4 years is much better than the one written after 5 shifts during your 4th year rotation. I have a buddy in my class who was a paramedic and then EMS coordinator for the hospital during medical school. He got fantastic letters and was the highest ranked student from our school during our EM match. He didn't decide to stay, but if he would have wanted to the option was there!

Agreed. Wait to see if you can handle med school first. Then, if you have a few extra hrs available per week after allowing time for family/friends/hobbies, it's certainly possible to work a few shifts per month.

If you love working in the ED and have supportive faculty mentors available to learn from and build relationships with, it may help you to get stronger SLORs and network.

It won't directly boost your application however.

 

[Hercules]

As said above, do it if you love it but realize there are much better things you could probably invest that time in if looking to boost your application.

 

[FirefighterDoc]

Thanks guys
I do love it and love the people I work with, however knowing that it wont help for residency makes me feel better about leaving. Like you guys said, maybe after I start i'll see if I can work it in PRN if need be. That being said, I will for sure be staying with the fire department because it's a lot more flexible. As little as 0 and at most 4-5 shifts a month I can pull where im at. Plus I can definitely see myself still doing that on the side as an attending.

 

[FirefighterDoc]

It'll help you meet all the EM faculty and get started on acquiring good letters of recommendation in the future. A letter from someone who knows you for 4 years is much better than the one written after 5 shifts during your 4th year rotation. I have a buddy in my class who was a paramedic and then EMS coordinator for the hospital during medical school. He got fantastic letters and was the highest ranked student from our school during our EM match. He didn't decide to stay, but if he would have wanted to the option was there!

Would letters from EMPs from a non-teaching hospital be of any benifit? I thought that I would only be able to use letters from EM rotations I go on. Perhaps they might help for a particular program? At least half of the docs here came from Cook County.

 

[jbar]

If you have extra time first and second year and want to improve your chances of matching in EM you could

1: Start/be involved in an EMIG (emergency medicine interest group
2: Be involved in a wilderness medicine interest group
3: Get involved in EM research
4: Go to EM related conferences (SAEM/ACEP, regional or national), EM related medical student symposoiums
5: Shadow in the ER associated with your medical school (more learning than working as a tech, and you get to know faculty you will be working with as a 3rd and 4th year)

or 6: study

I'm sure your time management skills are fine, and being in the ER is fun. But there is so much to learn so quickly in medical school that there is always more to study. It's better to start strong and say "I have more time off than I thought, I'm picking up a hobby" than to say "I wish I hadn't committed to 2 shift as a tech in the ER a week, I'm falling behind."

 

[fahimaz7]

Would letters from EMPs from a non-teaching hospital be of any benifit? I thought that I would only be able to use letters from EM rotations I go on. Perhaps they might help for a particular program? At least half of the docs here came from Cook County.

A super strong letter from a EM doc that you've worked with for the last 1/2 decade means a lot more than some random faculty guy that you spent 3 shifts with. I'm sure the Cook County guys know quite a few people around the area as well.

 

[deleted109597]

A super strong letter from a EM doc that you've worked with for the last 1/2 decade means a lot more than some random faculty guy that you spent 3 shifts with. I'm sure the Cook County guys know quite a few people around the area as well.

Not necessarily. If they don't know the guy, or they don't respect him, it's worthless. If the sLOR he gets damns him with faint praise (or worse), the community letter won't help.

 

[FirefighterDoc]

A super strong letter from a EM doc that you've worked with for the last 1/2 decade means a lot more than some random faculty guy that you spent 3 shifts with. I'm sure the Cook County guys know quite a few people around the area as well.

So if I dont end up going back, should I just try and keep in close contact with one of the docs? The one I know real well wrote me a LOR for medical school and Ill be attending his alma mater in the fall. If the rest of my application is strong, would a letter from them help me in any way?

 

[fahimaz7]

Not necessarily. If they don't know the guy, or they don't respect him, it's worthless. If the sLOR he gets damns him with faint praise (or worse), the community letter won't help.

The same thing can be said for anyone at an academic center. If that person writes 15 letters/year that say "This guy is in the top 10%, would love to have him stay, I asked him to father children with my wife" type of comments then it will be a useless letter as well.

I doubt the Cook Co squad that this guy is talking about are boon-dock docs that don't know anyone in academic medicine.

 

[fahimaz7]

So if I dont end up going back, should I just try and keep in close contact with one of the docs? The one I know real well wrote me a LOR for medical school and Ill be attending his alma mater in the fall. If the rest of my application is strong, would a letter from them help me in any way?

I'd say do whatever makes you happy and ignore most of SDN. If you read this forum long enough you will become jaded and you will begin to think that there's only one way to skin a cat. The most important components of your application are the things that you can control, such as grades and step scores, as without these it won't matter what SLORs you have. 🙂

 

[deleted109597]

The same thing can be said for anyone at an academic center. If that person writes 15 letters/year that say "This guy is in the top 10%, would love to have him stay, I asked him to father children with my wife" type of comments then it will be a useless letter as well.

I doubt the Cook Co squad that this guy is talking about are boon-dock docs that don't know anyone in academic medicine.

And this is where I tell people to stop listening to your advice.
sLORs are written by PDs and aPDs. They don't write letters like the one you mentioned. The sLOR specifically asks what percent of people get honors, etc.
Second, a sLOR from anywhere will hold more merit than a non-sLOR. If he has a good letter from guys he works with, and they know guys at Cook, it might help him at Cook. Maybe. He still will need sLORs from faculty, and those will always get higher standing than any letter. Often, the community letters aren't read if the sLORs aren't good.

 

[Hercules]

The most important components of your application are the things that you can control, such as grades and step scores, as without these it won't matter what SLORs you have. 🙂

This is absolutely true. We are all unique snowflakes, but bad grades and/or a rough step score will get you screened out of a lot of residency interviews.

 

[fahimaz7]

And this is where I tell people to stop listening to your advice.
sLORs are written by PDs and aPDs. They don't write letters like the one you mentioned. The sLOR specifically asks what percent of people get honors, etc.
Second, a sLOR from anywhere will hold more merit than a non-sLOR. If he has a good letter from guys he works with, and they know guys at Cook, it might help him at Cook. Maybe. He still will need sLORs from faculty, and those will always get higher standing than any letter. Often, the community letters aren't read if the sLORs aren't good.

I was under the impression that ANY EM boarded faculty member (assuming these Cook guys have some affiliation with a medical school) can use the standardized form. Is that not the case? I know that two of my SLORs did not come from PD/aPD's.

 

[sylvanthus]

Aye one of mine did not come from a PD or aPD. I know that is likely the intent of the form, but it states on there "only emergency medicine faculty." Which quite frankly is a broad term. My core EM rotation had no residency affiliated with it and is a small community program. However, my preceptor was "adjunct faculty" so fit the definition even without a residency program.

Again, I am sure the intent was for the form to be used by PDs and aPDs at residency programs, but they need to do a better job of spelling that out clearly.

 

[Hercules]

It doesn't have to be a PD or aPD but without affiliation to a residency program it doesn't count as a SLOR (unless they have changed the rules since I went through it 8 years ago-- quite possible).

 

[deleted109597]

I was under the impression that ANY EM boarded faculty member (assuming these Cook guys have some affiliation with a medical school) can use the standardized form. Is that not the case? I know that two of my SLORs did not come from PD/aPD's.

Instructions are here.
And yes, you can have others do them, but again, the people that go to CORD are a)a little boring, but b)know each other pretty well. They've got a listserv that they communicate via as well. If you've got a letter from someone outside the club, it doesn't carry the same weight. Think of it as taking COMLEX instead of USMLE. You can argue until you're blue in the face that they test the same knowledge, but what residencies want is a way to compare people based on data they're comfortable with. Residencies cut applications by 75-90% before the interview process. You want your best shot.

Also, while not a red flag, if the only sLOR you get from an away is from one of the clinical faculty and not, say, the clerkship director or above, it gives people pause. Just being honest.

 

[zinjanthropus]

If you have extra time first and second year and want to improve your chances of matching in EM you could

1: Start/be involved in an EMIG (emergency medicine interest group
2: Be involved in a wilderness medicine interest group
3: Get involved in EM research
4: Go to EM related conferences (SAEM/ACEP, regional or national), EM related medical student symposoiums
5: Shadow in the ER associated with your medical school (more learning than working as a tech, and you get to know faculty you will be working with as a 3rd and 4th year)

or 6: study

I'm sure your time management skills are fine, and being in the ER is fun. But there is so much to learn so quickly in medical school that there is always more to study. It's better to start strong and say "I have more time off than I thought, I'm picking up a hobby" than to say "I wish I hadn't committed to 2 shift as a tech in the ER a week, I'm falling behind."

👍

all much better than swinging shifts as a tech

 

[TeamZissou]

Depends on if you want our program or not. If you're thinking MD then Res, County, UIC, UI Peorea, Madison and Milwaukee along with Indiana are some programs who have taken our grads in the last 3 yrs. PM me for more.

 

[combatwombat]

No - it won't help you match into EM.

I disagree. If you continue working in EMS throughout medical school, you can point that out during your residency interviews as evidence of your commitment. I am not an attending myself but have heard people at my program talk about this specifically.

If you are able to work limited hours, I'd go for it.

 

[deleted128562]

I'm an MS4, matched into EM. Have worked about 1 shift a week as a tech throughout med school (minus during a couple of third year rotations).

Honestly, I don't think it helped me at all in terms of getting interviews (I actually didn't get very many which I think is because I stupidly didn't do an away), but I think it DID help when I actually interviewed. Matched at a great place and they talked a fair amount about my work experience during the interview.

More than that though, it has been a great learning experience for me. IV's, foleys, splinting, etc etc are second nature to me at this point. I know what it's like to be the guy at the bottom of the food chain, I've seen all sorts of crazy stuff, and I've had some great teaching moments from attendings and nurses.

So I think it can be a really good opportunity - I wouldn't expect it to land you that interview at Vanderbilt or wherever (on its own), but if you go into it as a learning experience I think you'll get a lot out of it.

 

[Old_Mil]

Consider it this way: if working (even part time) in your four years of medical school takes away enough from your study time to result in a 10 point lower score on your USMLE steps...it's a bad trade. Nobody I know worked in medical school. Nothing you have experienced as a pre-medical student (or anywhere else in life for that matter) gives you a basis of understanding the amount of new material you are going to have to master during medical school.

I could *maybe* see doing a little part time work during your 3rd and 4th year. Your 1st and 2nd years you need to keep your nose in the books.

 

[bad virus]

Instructions are here.
And yes, you can have others do them, but again, the people that go to CORD are a)a little boring, but b)know each other pretty well. They've got a listserv that they communicate via as well. If you've got a letter from someone outside the club, it doesn't carry the same weight. Think of it as taking COMLEX instead of USMLE. You can argue until you're blue in the face that they test the same knowledge, but what residencies want is a way to compare people based on data they're comfortable with. Residencies cut applications by 75-90% before the interview process. You want your best shot.

Also, while not a red flag, if the only sLOR you get from an away is from one of the clinical faculty and not, say, the clerkship director or above, it gives people pause. Just being honest.

I don't know if I buy this. Both of my sLOR's were done by the clerkship COORDINATORS, not the program directors or apd's. Granted, I did not read the letter's for all I know they could have been signed by big bird, but I do know who sat with me and wrote them.

I batted 18/22 this season at arguably the biggest baddest names in the country by SDN standards, and matched at my top choice. Now if the clerkship coordinating MD writes the letter and the pd signs it, my theory goes out the window. I personally have a feeling though that who ever wrote the letter signed it.

My theory on all this how to match stuff is that there is no magic piece of the pie. You have a bunch of slices, all in different shapes and different flavors making up on whole pie. You're goal in med school is to eat as much pie as you can and make it out stuffed so that when the evaluators look at you, all they can say is: "Damn, that boy ate some pie!!!!!, I sure would love to have him on our pie eating team for next year!"

Arguably, some slices are bigger and tastier like step 1 and 3rd year clerkships, but still you gotta eat all kinds of PIE in the next three years. Try out some of that preclinical pie, because that will help you appreciate the step 1 pie. Dabble some in the extracurricular stuff, as that might give you a chance to eat some of that secret AOA flavor. Some research flavors are better than other's but when we're dealing with cherries, all are nicer than a pie with no cherries. Catch my drift here?

Actually, wtf am I talking about, gotta go out with some friends and buy some pies for the game.

 

[medicsb]

I've kept 2 jobs during medical school. One is teaching for a paramedic training program, which I only do it when I have time and probably teach around 10-15 4 hour sessions per year. The other job is critical care transport for an academic hospital that has an EM program (been working for them for many years prior to med school). I only pull shifts during breaks. I plan to work more during 4th year on more relaxed rotations. There is another medic who is also in medical school and I believe he actually works more than I. After starting med school, I did have to quit one job as I couldn't even pull the 24 hours per month that was required (well, I could have done 6 hours every friday night, but I really needed nights to decompress from studying). For me, studying came first and it should for anyone in med school. I was very careful about when I'd work.

Honestly, I still work because I like it (and it is nice to have some extra cash now and then), so I wouldn't recommend it for just padding a CV, especially if it could impact your studying.

 

[emtthink]

I obviously haven't gotten to the point of matching EM yet (I'm a 1st year), but I still occasionally pull shifts on a medic. However my company is very flexible, and I do not pull any shifts the weekend prior to a test, or if I am behind in studying I don't pull any shifts. I would suggest using the 1st few months of med school to figure out school, and how much "spare" time that you have. That is what I did.

 

[la gringa]

if you're in Chicago, the ED is probably full of local EM program grads... letters from them to local programs would mean something... not a huge factor, but would say, get you an interview you might not otherwise get. even better would be a phone call or email from that doc to the PD's, if they know them well enough.

most folks have time in the first 2 years, whether in breaks or summer or whatnot, to make some $$ and have a part-time job.... if it is either very flexible or very short hours.

 

[deleted109597]

I don't know if I buy this. Both of my sLOR's were done by the clerkship COORDINATORS, not the program directors or apd's. Granted, I did not read the letter's for all I know they could have been signed by big bird, but I do know who sat with me and wrote them.

I batted 18/22 this season at arguably the biggest baddest names in the country by SDN standards, and matched at my top choice. Now if the clerkship coordinating MD writes the letter and the pd signs it, my theory goes out the window. I personally have a feeling though that who ever wrote the letter signed it.

Sigh. Read the last sentence of the quote you posted.
Of course, I should know better by now than to disagree with medical students.

 

[fahimaz7]

Sigh. Read the last sentence of the quote you posted.
Of course, I should know better by now than to disagree with medical students.

Instructions are here.
And yes, you can have others do them, but again, the people that go to CORD are a)a little boring, but b)know each other pretty well. They've got a listserv that they communicate via as well. If you've got a letter from someone outside the club, it doesn't carry the same weight. Think of it as taking COMLEX instead of USMLE. You can argue until you're blue in the face that they test the same knowledge, but what residencies want is a way to compare people based on data they're comfortable with. Residencies cut applications by 75-90% before the interview process. You want your best shot.

Also, while not a red flag, if the only sLOR you get from an away is from one of the clinical faculty and not, say, the clerkship director or above, it gives people pause. Just being honest.

Sounds like his SLORs came with plenty of strength and were not interpreted with pause. Badvirus though is in the top 1% of EM applicants (I would guess by seeing him on here), so it's no surprise that he was offered great interviews and did very well in the match. With that said, having fantastic letters from PD/aPD would be of very good use to a guy that lacks the CV that is in question.

 

[bad virus]

And this is where I tell people to stop listening to your advice.
sLORs are written by PDs and aPDs. They don't write letters like the one you mentioned. The sLOR specifically asks what percent of people get honors, etc.
Second, a sLOR from anywhere will hold more merit than a non-sLOR. If he has a good letter from guys he works with, and they know guys at Cook, it might help him at Cook. Maybe. He still will need sLORs from faculty, and those will always get higher standing than any letter. Often, the community letters aren't read if the sLORs aren't good.

You are right that I misquoted you, but it was under this guise of thinking that I responded to you. My apologies for my mistake.