EM PD - Ask Me Anything

[gamerEMdoc]

Hey gamerEMdoc,

Thanks a lot for this thread. Just wondered if you could give me an idea of when programs sit down and finalize their rank list. Everything going well for me, but I will not have a Step 2 score in until the 1st-2nd week of Feb now (beyond my control). Will this affect my position at a lot of places, if everything else is good/in line for my application?

Probably won't make a huge difference if everything else is solid. We general sit down in early February and do it, which I would guess is pretty common.

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[alexibluezz]

Hi gamerEMdoc,

Really appreciate all the insight you're giving us here--much thanks! I'm going to be applying next season, and I've picked up a red flag on rotations. I'm just wondering how big of a deal it is.

I got dinged on my psych eval both for being unprofessional (late multiple times) and not responding well to feedback (putting it into practice). Although I could have done a better job of communicating, I feel it was also circumstances (medical issues, limited opportunities on the rotation), as well as my preceptor being uncommunicative, that led to this. I have learned my lesson, and know better how to deal with these types of issues now.

My question: would you want to me to bring all this up in my PS, in interviews, or should I explain only if asked?

If it matters, the rest of my application is pretty middling; scores and ECs are all right. Also, I'm a DO student.

 

[gamerEMdoc]

Hi gamerEMdoc,

Really appreciate all the insight you're giving us here--much thanks! I'm going to be applying next season, and I've picked up a red flag on rotations. I'm just wondering how big of a deal it is.

I got dinged on my psych eval both for being unprofessional (late multiple times) and not responding well to feedback (putting it into practice). Although I could have done a better job of communicating, I feel it was also circumstances (medical issues, limited opportunities on the rotation), as well as my preceptor being uncommunicative, that led to this. I have learned my lesson, and know better how to deal with these types of issues now.

My question: would you want to me to bring all this up in my PS, in interviews, or should I explain only if asked?

If it matters, the rest of my application is pretty middling; scores and ECs are all right. Also, I'm a DO student.

I probably would only bring it up in interviews. Have a good answer to bring it up if asked, and maybe bring it up as an answer if someone asks about any challenging issues you had during medical school, etc. The reason I'd avoid it in the personal statement is, not everyone is going to read the applications that closely to even notice it, and if they don't and you put it in your personal statement, then you are calling attention to it. This would be totally different if it was in an ED evaluation or SLOE, because most places are going to read those more closely.

 

[Pinkyblack]

So is emergency medicine more competetive to get in or cardiology?

 

[Perfect Hair Day]

Well, feel free to message me anytime if you have any questions going forward. I'm always willing to help any student, no matter where they are in the process.

As for games, I had a blast with Destiny 2, but haven't played in a few weeks. I played COD for one night and was like, I can't believe I bought this... I've been playing the hell out of Wolfenstein 2 lately.

How do we feel about GTA V?

 

[Apollyon]

So is emergency medicine more competetive to get in or cardiology?

Your can't compare them apples to apples, because EM is a residency, and cardiology is a fellowship.

 

[Pinkyblack]

Yes, that is true. I like both and have the option to do either.

I moved from seattle to a remote area in ohio to do cardiology fellowship . Now 6months into it i noted that i like the pace and variety of ER work I used to do as an internist better. I think the lifestyle of emergency medicine is way better.
Eventually cards may pay more but if i am satisfied with ER then it wont matter much.

I have to say that this cards fellowship is a community program in a small rural area of ohio. I miss the culture and lifestyle of living in seattle. I feel like i am wasting my time here and to stay here for another 2.5 yrs is not worth it. Thinking of going back to seattle and do locus work in ERs ...

Any input appreciated..

Your can't compare them apples to apples, because EM is a residency, and cardiology is a fellowship.

 

[gamerEMdoc]

Yes, that is true. I like both and have the option to do either.

I moved from seattle to a remote area in ohio to do cardiology fellowship . Now 6months into it i noted that i like the pace and variety of ER work I used to do as an internist better. I think the lifestyle of emergency medicine is way better.
Eventually cards may pay more but if i am satisfied with ER then it wont matter much.

I have to say that this cards fellowship is a community program in a small rural area of ohio. I miss the culture and lifestyle of living in seattle. I feel like i am wasting my time here and to stay here for another 2.5 yrs is not worth it. Thinking of going back to seattle and do locus work in ERs ...

Any input appreciated..

Well a couple of things. First, you can surely get some work in an ED, but you are unlikely to make as much money as a board certified ED doc, and certainly will not get the best jobs in EM without being board certified. On top of this, unless you were med/peds trained in residency, you are going to have to see kids, and that's something you never really did during residency. Which potentially opens you up to more liability should you ever have a peds case go wrong. As for lifestyle, I'm not sure its better. EM has the highest burnout rate of any field. I'm not sure Cardiology is anywhere close to it. EM is NOT a lifestyle field. It can be, especially if you are only going to do it part time, but if you are going to try and work full time and make a sizeable income in EM, then believe me, its not easy. And to top that off, people that practice EM who aren't residency trained in EM have a higher burnout rate than EM docs who are residency trained.

Am I trying to talk you out of EM? Absolutely not. But I am trying to give you perspective that the grass isn't always greener before you make such a major decision, one that doesn't seem to be driven as much as a distaste for Cardiology as it is for a desire to live where you want to live. If you truly don't want to do cardiology, why practice a field you never trained in? If you want shift work, why not go do hospitalist work for IM? And if you have 2.5 years of cards left, and truly feel like EM is your calling, why not just go do an EM residency for nearly the same amount of time? How many people did you intubate as an IM resident? How many lines did you do? How many LPs? How many LPs on a neonate for neonatal fever? How much trauma did you see as an IM resident (typically zero). How many chest tubes did you do? How many slit lamp exams did you do? Corneal foreign bodies removed? Unless your IM training was very unusual, I'd guess the answer to these questions is either not many, or zero. Doing an IM residency no more prepares you to work full time in an ED than doing an EM residency prepares me to round on Cardiology patients. I could fake it for a little bit, but in the end, I'm going to hit the limit of my knowledge eventually and expose myself as undertrained to do the job at some point.

Tough decisions ahead, that only you can answer but you. Just my 2 cents on the matter. I think if you really want to do EM, then you should consider an EM residency. If not, I'd recommend gravitating to a shift work hospitalist job. Or consider a different fellowship more like EM (critical care fellowship) closer to where you geographically want to live.

 

[gamerEMdoc]

How do we feel about GTA V?

Played the single player on PS3 before the current console generation came out. Good game. I've never played GTA online. Too hard to go back now.

 

[Perfect Hair Day]

Played the single player on PS3 before the current console generation came out. Good game. I've never played GTA online. Too hard to go back now.

GTA V online is so much fun - especially fun to troll the other players. Example: player is inside a convenience store robbing it (inference from the map!) I'll steal a car and park it right up against the door to the bldg so they can't get out while the police are shooting at them. As soon as they respawn it's like a full-on blood-bath of revenge.

 

[Pinkyblack]

I appreciate your response gamerEMdoc. It was honest and realistic.

Yes, i am not trained in those areas that you mentioned and the pay is always less for internists. What i know for sure is that the VA ER of that area is a good fit for internist like me to moonlight or potentially work full time/ part time. There are minimal traumas and no Peds. They occasionally hire internist full time and otherwise they can moonlight. What are your thoughts on that?

Thanks much again

 

[gamerEMdoc]

When I was a med student I did a few VA rotations, and the ED was almost always IM docs. No trauma, no peds. So I think that is probably your best bet if you choose to go the EM route. And the VA isn’t a bad job. Sure, its not the most lucrative, but you are on the federal tort protection, so you can’t get sued. All the patients have coverage. And you are on the federal pension structure should that be your longtime gig. So its not a bad choice in a situation like this.

 

[Apollyon]

Actually, the FTCA (Federal Tort Claims Act) doesn't make you bulletproof, but it is MUCH harder to sue, and, if you are, there is a small army of Department of Justice lawyers to defend you.

 

[Pinkyblack]

Yes, the VA ER of seattle is actually now 90% EM trained doctors but i have enjoyed working there as an internist. They get paid more than us because of the board certification but it doesn’t matter to me as i feel satisfied after any shift that i have done there...

 

[Pinkyblack]

I noted most people who leave fellowship or a residency program do that at the end of the year. Is that what is advisable over leaving in the middle of the year?
Thanks

 

[gamerEMdoc]

GME contracts are yearly. So essentially, if you do choose to leave a residency/fellowship, the logical thing is, the just not sign the contract for the next year. Otherwise, you'd be in breach of your contract.

 

[kenjixshadow]

Hello gamer attending,

As up coming 4th year, I saw that two programs explicitly stated that they require ACLS certification on VSAS. In your opinion, should I get one? I only have BLS certification from school and am wondering if I can get away from not getting one.

 

[gamerEMdoc]

I'm surprised there are programs requiring it. It's pretty standard to train incoming residents with ACLS, PALS, and ATLS as part of PGY1 orientation. Seems odd to require it to apply for residency. I don't remember if I had ACLS in medical school honestly, I don't think I did. I think it was just BLS until I got into residency.

 

[Gru]

Thanks for giving insight into this whole confusing process!

Many coapplicants and I feel that these interviews are "useless*" in the sense that they aren't very useful to stratify us along a program's rank list. Do you feel this way? Are the interviews more just to move us up and down a predetermined rank list?

*not saying useless in that we should get rid of them. They're an excellent and necessary way to get to know a program, their leadership, the residents...

 

[gamerEMdoc]

Oh no, its the other way around. The interview is probably the most important part of the application after sloes. Even if the questions on the interview seem mundane and seem like the program is just trying to get to know you. Finding people that “fit” the program is extremely important.

 

[Pinkyblack]

GME contracts are yearly. So essentially, if you do choose to leave a residency/fellowship, the logical thing is, the just not sign the contract for the next year. Otherwise, you'd be in breach of your contract.

What are the consequences of breaking the contract in the middle of the year?

Thank you

 

[gamerEMdoc]

What are the consequences of breaking the contract in the middle of the year?

Thank you

You cant. Its a legal binding contract. They could sue you.

A typical gme contract will give you an out if the program is in breach of contract, and gives the program an out to fire you if you are in breach of contract. Otherwise you are stuck with eachother for a year. Look at your contract carefully. You dont just get to leave at the end of year if you decide to. There is likely a timeframe (90 days or more) that you have to provide written notice of leaving.

 

[Pinkyblack]

The timeframe is not noted in the contract that i have.

The program had been on hold by ACGME few years ago for similar issues that they have now. I will have to contact ACGME and ask about the timeframe for written notice of leaving.

Thanks much

 

[gamerEMdoc]

Pinky, is there a sample GME contract available online to view? If so, shoot me a PM if you want. I'm happy to take a look at it.

 

[Pinkyblack]

Pinky, is there a sample GME contract available online to view? If so, shoot me a PM if you want. I'm happy to take a look at it.

Thank you very much. I sent you a PM

 

[gamerEMdoc]

Happy Holidays everyone! I hope everyone gets a little break during the hectic interview season to enjoy some down time!

 

[BigGAC1]

Hey gamerEMdoc!

Quick question - when is the right time to send the "you're my number one" email? Is it now?

I still have 2 interviews scheduled this month, but regardless of how those interviews go I have a pretty good idea of what my rank list is going to look like. I hear through the grapevine that most programs have their rank lists pretty well finalized sooner than most applicants so I am just wondering when the best time to go ahead and send it is.

 

[Wjldenver]

I got asked by one of the administrators if I would be interested in starting up an EM related "ask me anything" thread, and I was thrilled to get the opportunity. I've answered tons of questions over the past year, but thought this would be a good way of trying to condense down the advice to one thread for people looking for advice in the future.

So if anyone has any burning questions about Emergency Medicine as a specialty, balancing life outside of EM, applying to EM, succeeding on your clerkship's, or any other questions that come to mind, feel free to ask away!

Does doing an EM residency lock you in? For example, physicians I know who have completed a FM residency have the flexibility to serve as a hospitalist and/or as an ER physician in various community hospitals. If someone specializes in, and completes an ER residency, will they still have the flexibility to serve as a hospitalist or family practice physician in various hospitals if they choose to do so? (Or are you locked into emergency medicine positions long-term?)

 

[gamerEMdoc]

Hey gamerEMdoc!

Quick question - when is the right time to send the "you're my number one" email? Is it now?

I still have 2 interviews scheduled this month, but regardless of how those interviews go I have a pretty good idea of what my rank list is going to look like. I hear through the grapevine that most programs have their rank lists pretty well finalized sooner than most applicants so I am just wondering when the best time to go ahead and send it is.

Programs will be making their rank list beginning of February, so I think its reasonable to send such an email in the next few weeks should you decide to send one.

 

[gamerEMdoc]

Any advice for those who muffed their Step 1? 210 was the lowest score you mentioned or were asked about. US allopathic student with all A’s so far for third year. Scored 199 on Step 1. Ouch. Quick facts: match rate for a Step 1 of 191-200 is 62%, match rate for a Step 2 of 231-240 is 90%. It’s obviously possible, just seems scary.

Do you think your ERAS filtering method of interviewing students that do away rotations with you is the norm for most programs, regardless of Step 1 scores? Do a lot of programs have a Step 1 filter of 200, 210, etc that will screen me out or is it possible that a strong Step 2 could keep me from being filtered out? I know you said SLOE’s and interviews are important to you, so try to crush those as well as Step 2 and leave the past in the past?

Some places have hard cutoffs for rotation/interviews. Others do not. Hard to generalize here. We have a “soft cutoff”, one we use to servce as a guide, but then take each applicant for rotation on a case by case basis based on the rest of their application. A single bad board score doesn’t sink someones chances.

 

[gamerEMdoc]

Does doing an EM residency lock you in? For example, physicians I know who have completed a FM residency have the flexibility to serve as a hospitalist and/or as an ER physician in various community hospitals. If someone specializes in, and completes an ER residency, will they still have the flexibility to serve as a hospitalist or family practice physician in various hospitals if they choose to do so? (Or are you locked into emergency medicine positions long-term?)

There’s a good bit of variety that you can do out of EM, though I don’t know anyone that serves as a hospitalist or FP doc. That would seem like an odd choice, since those jobs typically require more time for less money than working in EM. I think the more common route is seeing people go into administrator roles, directing an urgent care, doing some consierge medicine, etc.

 

[Wjldenver]

There’s a good bit of variety that you can do out of EM, though I don’t know anyone that serves as a hospitalist or FP doc. That would seem like an odd choice, since those jobs typically require more time for less money than working in EM. I think the more common route is seeing people go into administrator roles, directing an urgent care, doing some consierge medicine, etc.

Thanks for the info. I'll pass it on to my son who is trying to determine what specialty to pursue.

 

[Apollyon]

Thanks for the info. I'll pass it on to my son who is trying to determine what specialty to pursue.

Emergency medicine trains one for acute issues. As I tell people, "I don't go above the first floor". People that do family medicine residencies CAN work in some emergency departments, but they are trained in more chronic issues. There is overlap between FM and EM, but they are not the same. If the FM doc had a job that was looking for an EM doc, the FM person could be pushed out.

At my job (rural), there are three FM trained docs that work there, and they SUCK at EM (and this is complicated by them being not good people). However, we gotta take what we can get.

 

[gamerEMdoc]

Yeah, I mean there’s a reason specialty training and specialty boards exist. If it were simple to just go practice anohter specialty, there would be no reason to do a residency in the first place.

 

[unnumzaan]

How feasible would it be get a slow burn job working 120 hours straight out of residency?

I like EM, but know myself to be prone to burn out and don't have the best track record with overnight shifts.

 

[gamerEMdoc]

You can work as much or as little as you want. Its all about how much you will make. I’m not sure what the average number of hours worked is in EM. Id imagine somewhere around 150 or so. Maybe 120 clinically for academics. But there’s such a wide range of jobs. And ultimately if you want to be a locums and work one day a week, you can.

 

[Ooaclouds]

Hello
I was recently told regarding away rotations and that it is basically a prerequisite to even apply for EM.
I'm an IMG(250,258,pass, graduated 2015) and have worked for 2 yrs and rotated at 3 diff hospitals back home. I currently have an externship in NYC at a PCP/urgent care place which I do half of each throughout the week. Down side is that there's only 1 EM doctor here and people have told me that I need more letters from EM doctors. However there are 3 other IM doctors here.

So my question is
Would this suffice as an away rotation for the purpose of LOR or do I specifically need to do rotations in the hospital to qualify as an away rotation. Also I know it would always be better to get LORs from EM doctors but I'm running out of time and I'm just trying to get what I can.

In addition, would yall think I actually need to get some rotations in the hospital to increase the chances of getting interviews? Are there any additional "prerequisites" that I should we aware of before I even apply? I am fairly good at interviews but it's the getting interviews part that's an issue.

Hope someone replys and thanks for reading this if you do!

Have a nice day!

 

[surfguy84]

@gamerEMdoc been bouncing around between a few options, but recently have decided on and committed to EM. I'm slightly more than halfway through M3 btw. A few quick questions...

1. I'm a DO, low 240s step1, mostly honors on rotations, top 1/4 of class. About how many programs should I apply? I'm from CA and go to school in CA, any idea if those ties will help with CA/west coast programs?

2. Since I decided on EM relatively late, I don't have any EM specific ECs to this point - will I be at a big disadvantage?

3. I'm a non-trad (early 30s) and had an interesting and high-responsibility prior career. This came up at every med school interview and worked well in my favor. Will something like this make a difference in residency interviews or not so much?

Thanks a million.

 

[surfguy84]

Hello
I was recently told regarding away rotations and that it is basically a prerequisite to even apply for EM.
I'm an IMG(250,258,pass, graduated 2015) and have worked for 2 yrs and rotated at 3 diff hospitals back home. I currently have an externship in NYC at a PCP/urgent care place which I do half of each throughout the week. Down side is that there's only 1 EM doctor here and people have told me that I need more letters from EM doctors. However there are 3 other IM doctors here.

So my question is
Would this suffice as an away rotation for the purpose of LOR or do I specifically need to do rotations in the hospital to qualify as an away rotation. Also I know it would always be better to get LORs from EM doctors but I'm running out of time and I'm just trying to get what I can.

In addition, would yall think I actually need to get some rotations in the hospital to increase the chances of getting interviews? Are there any additional "prerequisites" that I should we aware of before I even apply? I am fairly good at interviews but it's the getting interviews part that's an issue.

Hope someone replys and thanks for reading this if you do!

Have a nice day!

I'll let the PD answer more completely, but you will need SLOEs to apply - these are obtained by rotating at various EM programs during Sub-I.

 

[gamerEMdoc]

Hello
I was recently told regarding away rotations and that it is basically a prerequisite to even apply for EM.
I'm an IMG(250,258,pass, graduated 2015) and have worked for 2 yrs and rotated at 3 diff hospitals back home. I currently have an externship in NYC at a PCP/urgent care place which I do half of each throughout the week. Down side is that there's only 1 EM doctor here and people have told me that I need more letters from EM doctors. However there are 3 other IM doctors here.

So my question is
Would this suffice as an away rotation for the purpose of LOR or do I specifically need to do rotations in the hospital to qualify as an away rotation. Also I know it would always be better to get LORs from EM doctors but I'm running out of time and I'm just trying to get what I can.

In addition, would yall think I actually need to get some rotations in the hospital to increase the chances of getting interviews? Are there any additional "prerequisites" that I should we aware of before I even apply? I am fairly good at interviews but it's the getting interviews part that's an issue.

Hope someone replys and thanks for reading this if you do!

Have a nice day!

You are somewhat behind the eight ball. You can’t really do “rotations” at an ED residency. You aren’t in medical school. You aren’t a resident. No program is going to provide you with malpractice insurance to come rotate for a month. You are kind of in no man’s land, and I’d be surprised if you are going to be able to secure aways at ED residencies to get SLOEs. And that’s going to close the door on most of the ED residency opportunities out there. You graduated in 2015, but won’t be applying until the next match? That means you will have either skipped or not matched in 3 matches. I don’t know all the details of you application obviously, but this doesn’t seem like a good setup to apply to a pretty competitive specialty. I’d seriously think hard about a backup.

 

[gamerEMdoc]

@gamerEMdoc been bouncing around between a few options, but recently have decided on and committed to EM. I'm slightly more than halfway through M3 btw. A few quick questions...

1. I'm a DO, low 240s step1, mostly honors on rotations, top 1/4 of class. About how many programs should I apply? I'm from CA and go to school in CA, any idea if those ties will help with CA/west coast programs?

2. Since I decided on EM relatively late, I don't have any EM specific ECs to this point - will I be at a big disadvantage?

3. I'm a non-trad (early 30s) and had an interesting and high-responsibility prior career. This came up at every med school interview and worked well in my favor. Will something like this make a difference in residency interviews or not so much?

Thanks a million.

1. Hard to say. Too be honest, I never know how to predict the number of applications, especially for west coasters. Its just so competitive to match at most California programs. Many Californians are going to wind up interviewing, and matching, on the east coast just out of necessity.
2. Nope. This isn’t that big of a deal.
3. This will come up in most residency interviews as well. Prior work experience and prior careers are always relevant. They shape who we are.

 

[deleted480308]

Hello
I was recently told regarding away rotations and that it is basically a prerequisite to even apply for EM.
I'm an IMG(250,258,pass, graduated 2015) and have worked for 2 yrs and rotated at 3 diff hospitals back home. I currently have an externship in NYC at a PCP/urgent care place which I do half of each throughout the week. Down side is that there's only 1 EM doctor here and people have told me that I need more letters from EM doctors. However there are 3 other IM doctors here.

So my question is
Would this suffice as an away rotation for the purpose of LOR or do I specifically need to do rotations in the hospital to qualify as an away rotation. Also I know it would always be better to get LORs from EM doctors but I'm running out of time and I'm just trying to get what I can.

In addition, would yall think I actually need to get some rotations in the hospital to increase the chances of getting interviews? Are there any additional "prerequisites" that I should we aware of before I even apply? I am fairly good at interviews but it's the getting interviews part that's an issue.

Hope someone replys and thanks for reading this if you do!

Have a nice day!

Try and land a transitional/prelim year somewhere that has an EM program

 

[Ooaclouds]

Im

You are somewhat behind the eight ball. You can’t really do “rotations” at an ED residency. You aren’t in medical school. You aren’t a resident. No program is going to provide you with malpractice insurance to come rotate for a month. You are kind of in no man’s land, and I’d be surprised if you are going to be able to secure aways at ED residencies to get SLOEs. And that’s going to close the door on most of the ED residency opportunities out there. You graduated in 2015, but won’t be applying until the next match? That means you will have either skipped or not matched in 3 matches. I don’t know all the details of you application obviously, but this doesn’t seem like a good setup to apply to a pretty competitive specialty. I’d seriously think hard about a backup.

Hey thanks a lot for the reply, I graduated in 2015 had to do military stuff and studied for step 1 where I got a 250. Then worked a PGY at home for some experience and money(and got married) and then took step 2 where I got 258 in this passing October and just finished my CS in December. So I'm just trying to get a few letters at the moment before I apply in September. I have confidence in my college resume as I have multiple volunteering and leadership positions; and I've always done well on interviews.
I know that as an IMG I will always need a backup, but I was given the notion that I don't have any chances if I don't have a SLOE.
Is the best options to apply to a prelim now?
And I guess my main question is that as a PD, when you look at an IMG, if that person doesn't have any SLOEs but a LOR from an ER doctor, is that enough to grant that guy an interview? Or is it actually a prerequisite nowadays

Thank you all for the replies! Only hoped that I had done better on my exams.

 

[gamerEMdoc]

Im


Hey thanks a lot for the reply, I graduated in 2015 had to do military stuff and studied for step 1 where I got a 250. Then worked a PGY at home for some experience and money(and got married) and then took step 2 where I got 258 in this passing October and just finished my CS in December. So I'm just trying to get a few letters at the moment before I apply in September. I have confidence in my college resume as I have multiple volunteering and leadership positions; and I've always done well on interviews.
I know that as an IMG I will always need a backup, but I was given the notion that I don't have any chances if I don't have a SLOE.
Is the best options to apply to a prelim now?
And I guess my main question is that as a PD, when you look at an IMG, if that person doesn't have any SLOEs but a LOR from an ER doctor, is that enough to grant that guy an interview? Or is it actually a prerequisite nowadays

Thank you all for the replies! Only hoped that I had done better on my exams.

The SLOE is by far and away the most important part of the application for applying to EM. Far more than board scores. Applying to EM without a SLOE immediately shuts the door at almost every program. A survey went out through CORD awhile back, I don't remember the exact numbers. But PD's were surveyed about whether they'd interview someone with 0 or 1 SLOE, vs 2. Most (around 80% or so) said they would interview with one. Another 10-15% or so said they required 2 SLOEs. Very few said they would interview anyone without a SLOE. So having no SLOEs pretty much shuts the door at over 90% of the programs you will apply to. Are there exceptions? Sure. Are they common? Nope. Back when we were an AOA program, SLOEs weren't as common among the applicants for whatever reason, there would be candidates with no SLOEs. But now, without a SLOE, we don't even generally consider an application complete.

 

[Ooaclouds]

The SLOE is by far and away the most important part of the application for applying to EM. Far more than board scores. Applying to EM without a SLOE immediately shuts the door at almost every program. A survey went out through CORD awhile back, I don't remember the exact numbers. But PD's were surveyed about whether they'd interview someone with 0 or 1 SLOE, vs 2. Most (around 80% or so) said they would interview with one. Another 10-15% or so said they required 2 SLOEs. Very few said they would interview anyone without a SLOE. So having no SLOEs pretty much shuts the door at over 90% of the programs you will apply to. Are there exceptions? Sure. Are they common? Nope. Back when we were an AOA program, SLOEs weren't as common among the applicants for whatever reason, there would be candidates with no SLOEs. But now, without a SLOE, we don't even generally consider an application complete.

Thanks a bunch, that was really informative and exactly what I needed to hear I guess.
Hope I miraculously find one soon or I may just have to do prelim I guess.

Thanks

 

[CollagenNtonic]

SLOE question - My dumb school only does P/F for EM electives, so it's hard to get a real clear idea of how my performance was graded on away rotations. We do get to view our preceptor's evaluation, though. Any thoughts as to whether or not SLOE quality can be gleaned from that eval? Thanks for all your insight during this process. It's been really helpful.

 

[Jabbed]

SLOE question - My dumb school only does P/F for EM electives, so it's hard to get a real clear idea of how my performance was graded on away rotations. We do get to view our preceptor's evaluation, though. Any thoughts as to whether or not SLOE quality can be gleaned from that eval? Thanks for all your insight during this process. It's been really helpful.

Was in a similar situation. From what I can tell the narrative portions of my eval were a copy/paste from the narrative portions of the SLOE. I never gleaned any idea of my actual ranking as there was no way for me to Honor/High Pass by definition. If I had to do it again I would meet with the course director during the rotation, explain my situation, and ask if they could give me an idea if they thought that I would get a "strong" SLOE from the rotation.

 

[gamerEMdoc]

SLOE question - My dumb school only does P/F for EM electives, so it's hard to get a real clear idea of how my performance was graded on away rotations. We do get to view our preceptor's evaluation, though. Any thoughts as to whether or not SLOE quality can be gleaned from that eval? Thanks for all your insight during this process. It's been really helpful.

Rotation grade and sloe rank dont always match up anyways. So I wouldnt worry. But if you are worried about what is going to be in your sloe, you can always fish for feedback. You may waive the right to see your sloe, but if you meet with the author during the rotstion and ask them for app advice and ask them how competitive of a candidate they honestly see you as, you may get some idea.

In the end though, because its human nature not to want to be brutally honest with people, and because the sloe is blinded, often times the nonblinded grade forms and direct feedback will make you think you are getting a higher sloe than you actually get.

 

[avgjoe3920]

Hello @gamerEMdoc,

What are your thoughts from an APD standpoint, on sending a letter to program you intend to rank #1? Mixed reviews on the other threads so I wanted to see from a program's standpoint, if they put any weight into it or even care that we send it? Thanks!

 

[gamerEMdoc]

I think programs appreciate some certainty. We're always excited to hear someone we have ranked highly is ranking us #1. But we also take it with a grain of salt because people lie to you every year. Smart programs should never ever change their rank list in order to stack people that tell them they are ranking them #1. Just like candidates shouldn't rank their list in order of the feedback they get from programs. Don't get me wrong, programs want residents who want to be there and residents I'm sure want to be at a program that valued them as a candidate. But from a programs standpoint, I think its the logical choice to rank candidates in the order you want them, no matter if you hear from a candidate or not after the interviews.