Do I have a better shot at EM or Anesthesia?

[Smiths11]

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So I realize that there are many "EM vs Anesthesia" threads out there, but my questions are a bit unique so I wanted to make my own.

I need help deciding not which one of these I should go for, but which one do I have a better shot at. I have a passion for both and while I do need to decide which one I like more, given my circumstances I'd also like to figure out which one is better with my credentials.

1. I am a DO student finishing up my 3rd year and have a low Step 1 score. Would I be strategically better off applying to EM assuming I kill Step 2 and perform fantastically in auditions? Reason I ask is, I've heard that EM PD's look more towards Step 2, and that auditions are more valuable for EM than they are for Anesthesia.

2. Next question, given my low board score, am I better off focusing on AOA match since they put a greater weight on auditions?

3. And finally, I am not very familiar with choosing 4th year rotations - since I am undecided between the two, can I just apply to a bunch of rotations for both, and then cancel either or before the end of my 3rd year once I finally decide? Sorry if this is a stupid question, but I really am trying to figure out my options since I am undecided.

Thanks for all the help in advance

 

[KinesiologyNerd]

Well... How are your clinical grades and comlex? Also, (and i dont mean offense here) if you're being honest with yourself what makes you think you'll kill step 2 after a bad step 1?

Just in general anesthesia is the less competitive specialty to match into right now.

 

[EmergDoc2B]

I just looked into this myself. EM is #1 and Gas#2 for me. It seems this past year EM was more competitive which shocked me a little. Im sure there are programs that go back and forth but for over all scores ect EM seems to be tougher this year and most likely next. So, with that being said you have a better chance numerically going with Anesthesia. However, as suggested above if you kill it on step 2 anything is possible.

 

[Smiths11]

Thanks for the replies thus far.

Yes, it seems EM is more competitive than Gas this year, and wouldn't be surprised if the difference is even greater next year.

But from everything that I've gathered:
1) Auditions matter more for EM, especially for AOA programs
2) Step 2 is more important to EM PD's than is Step 1, whereas for Anesthesia Step 1 >= Step 2 in importance

So, despite my low Step 1 score, assuming I shine in both my Step 2 and auditions, would EM not be a better choice for me?

Does that make sense or am I just wrong?

 

[67552931811]

Thanks for the replies thus far.

Yes, it seems EM is more competitive than Gas this year, and wouldn't be surprised if the difference is even greater next year.

But from everything that I've gathered:
1) Auditions matter more for EM, especially for AOA programs
2) Step 2 is more important to EM PD's than is Step 1, whereas for Anesthesia Step 1 >= Step 2 in importance

So, despite my low Step 1 score, assuming I shine in both my Step 2 and auditions, would EM not be a better choice for me?

Does that make sense or am I just wrong?

Just wrong in the sense that anesthesia is way cooler 😉. Just kidding. I actually don't know the answer to your question but wanted to cast my vote for going for gas.

Good luck to you with whatever you choose, dude/dudette.

 

[bashwell]

Thanks for the replies thus far.

Yes, it seems EM is more competitive than Gas this year, and wouldn't be surprised if the difference is even greater next year.

But from everything that I've gathered:
1) Auditions matter more for EM, especially for AOA programs
2) Step 2 is more important to EM PD's than is Step 1, whereas for Anesthesia Step 1 >= Step 2 in importance

So, despite my low Step 1 score, assuming I shine in both my Step 2 and auditions, would EM not be a better choice for me?

Does that make sense or am I just wrong?

I guess maybe as long as the EM program doesn't first screen or filter out for Step 1. An audition may help the program not filter your Step 1 if they know and like you, but that'd only work for that program.

 

[Psai]

Anesthesia is easier to get into because there is a much greater spread between top and bottom programs. EM seems to be much more equitable and community programs can be advantageous to being an awesome em doc. You can match well into gas without an away but they can help. EM you pretty much have to do aways to get those sloes. EM seems to be more do friendly in general as well

EM is doing very well right now, great jobs all over the country. Gas has very poor leadership that are obsessed with wasting money on a brand new headquarters and pushing a stupid idea that is basically the antithesis to the reasons why most people chose the field. They are also pumping out too many grads as well as facing increasing competition from crnas who are opening schools willy nilly

 

[EmergDoc2B]

Anesthesia is easier to get into because there is a much greater spread between top and bottom programs. EM seems to be much more equitable and community programs can be advantageous to being an awesome em doc. You can match well into gas without an away but they can help. EM you pretty much have to do aways to get those sloes. EM seems to be more do friendly in general as well

EM is doing very well right now, great jobs all over the country. Gas has very poor leadership that are obsessed with wasting money on a brand new headquarters and pushing a stupid idea that is basically the antithesis to the reasons why most people chose the field. They are also pumping out too many grads as well as facing increasing competition from crnas who are opening schools willy nilly

im curious where you get the ratings for anesthesia from? Ive never heard that there was that much difference between programs. Can you elaborate on that please. Thank you in advance.

 

[bashwell]

I'm speaking in generalities:

EM is a good mix of university or academic programs and community programs, and in EM many community programs are arguably equal if not better than the academic ones.

Anesthesia is mostly academic with some community programs. But the community ones generally aren't as well regarded as the academic ones.

 

[EmergDoc2B]

Thank you. Im going to have to look into the programs in my region with that in mind.

 

[URHere]

I agree with what's already been said here: EM seems to be getting more competitive while gas is getting consistently less competitive. Regardless, I wouldn't base your residency decision off of what you will be most competitive for, and certainly don't bank on a good step 2 score or shining SLOE evals (for EM). You are not able to fully guarantee either of those things and you'll be in a bad spot if things don't go as planned and you find out that you actually aren't all that competitive come September.

No matter how well you do on Step 2, remember that you stand the risk of being filtered out based on your Step 1 score. Not everyone has a Step 2 score when they apply for residency, but all applicants have a Step 1 score on file - it's a great equalizer and if your Step 1 score is low enough this could very well hurt you in either field. Whatever you choose, it's not a bad idea to apply to a back-up specialty such as FM or IM. Honestly, you could even apply to both EM and gas but it would be hard to do sub-i rotations in both before September (see below) and if your Step 1 is truly terrible you would still probably need a less competitive back-up. Triple applying would be brutal.

As for your other questions - I don't know much about the AOA match, so I won't give advice there. With respect to your MS4 rotations, you want advanced "sub-I" rotations in your specialty of choice as early as possible (so that you have LORs available by September). At my school, this gave us a 2-rotation window and there was a lot of competition for those sub-I spots in some specialties. If you apply EM, you should do a rotation at your home program and at least one away. For gas, I think an anesthesiology rotation and an ICU rotation would be a good choice. Because these are very different, try to choose sooner rather than later. If you have more elective time than I did, you could try to do short (2-week) rotations in either anesthesia or EM to help you decide which is better for you - I did something similar to rule out neuro early on. Once you decide, remember that you can also schedule additional away/audition rotations later in the season, and these may snag you interviews at those specific programs. Best of luck.

 

[Smiths11]

I agree with what's already been said here: EM seems to be getting more competitive while gas is getting consistently less competitive. Regardless, I wouldn't base your residency decision off of what you will be most competitive for, and certainly don't bank on a good step 2 score or shining SLOE evals (for EM). You are not able to fully guarantee either of those things and you'll be in a bad spot if things don't go as planned and you find out that you actually aren't all that competitive come September.

No matter how well you do on Step 2, remember that you stand the risk of being filtered out based on your Step 1 score. Not everyone has a Step 2 score when they apply for residency, but all applicants have a Step 1 score on file - it's a great equalizer and if your Step 1 score is low enough this could very well hurt you in either field. Whatever you choose, it's not a bad idea to apply to a back-up specialty such as FM or IM. Honestly, you could even apply to both EM and gas but it would be hard to do sub-i rotations in both before September (see below) and if your Step 1 is truly terrible you would still probably need a less competitive back-up. Triple applying would be brutal.

As for your other questions - I don't know much about the AOA match, so I won't give advice there. With respect to your MS4 rotations, you want advanced "sub-I" rotations in your specialty of choice as early as possible (so that you have LORs available by September). At my school, this gave us a 2-rotation window and there was a lot of competition for those sub-I spots in some specialties. If you apply EM, you should do a rotation at your home program and at least one away. For gas, I think an anesthesiology rotation and an ICU rotation would be a good choice. Because these are very different, try to choose sooner rather than later. If you have more elective time than I did, you could try to do short (2-week) rotations in either anesthesia or EM to help you decide which is better for you - I did something similar to rule out neuro early on. Once you decide, remember that you can also schedule additional away/audition rotations later in the season, and these may snag you interviews at those specific programs. Best of luck.

Thanks for the detailed reply. Of course, great Step 2 and SLOEs aren't guaranteed, and I certainly have FM as a backup in my mind. But, at this point, the only things that are under my control are the Step 2 and SLOEs. I'm not choosing based on what's most competitive for me, but given I am not that competitive, I may have no other choice. I truly enjoy both for different reasons, so it won't be the end of the world if I have to settle for one over the other, rather than settle for FM over either. (If I like Gas more than EM, but have a better shot at EM, I'd rather go for it than Gas which would put me at a higher risk of settling for FM).

As far as your other point, yes I am trying to schedule as many as sub-I's as possible. For now I am trying to schedule for both EM and Gas and will cancel one over the other when I have a better idea of what I want AND what I have a better shot at.

 

[DOFOSHO]

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[Psai]

why would you copy someone's avatar and use it as your own? i was the first person to have that avatar and i know because its a cropped image that exactly matches mine. be original for once in your life and make your own cool picture.

My avatar is copied
Don't think too hard about it

 

[Brorthopedic]

why would you copy someone's avatar and use it as your own? i was the first person to have that avatar and i know because its a cropped image that exactly matches mine. be original for once in your life and make your own cool picture.

LOL

 

[DOFOSHO]

.

 

[KinesiologyNerd]

He actually copied my name too at one point as Do Fo Sho. lol. AND my avatar.

These must be extremely troubling times for you. We aren't here for you.