EM PD - Ask Me Anything

[tarsuc]

Probable dumb qn.
After doing a preliminary year (med/surgery), is it possible to get into a PGY2 year of EM if any vacancy might arise?

What specialties would allow such a transfer?

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[theSmurfette]

Probable dumb qn.
After doing a preliminary year (med/surgery), is it possible to get into a PGY2 year of EM if any vacancy might arise?

What specialties would allow such a transfer?

Usually, no.


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[gamerEMdoc]

Wait. Are you telling me I could be an NFL quarterback?

Depends solely on what your wonderlic score is.

 

[gamerEMdoc]

Probable dumb qn.
After doing a preliminary year (med/surgery), is it possible to get into a PGY2 year of EM if any vacancy might arise?

What specialties would allow such a transfer?

Would be really unlikely. Most PGY2 openings ask for candidates with one year of EM residency training.

 

[gamerEMdoc]

I just got my school class rank and I'm in the bottom third. Pretty upset because I consistently had good comments and above average shelf exam scores. My step 1 was 238, and I'm a US MD. I will be done with my 2nd EM rotation (away) this month, and my app goes out in September. Do I have a good shot?

None of what you mentioned (boards, class rank) are a predominant factor in determining your shot at matching. It's all up to the SLOEs. No one can reliably answer this question of "will I match EM" based on your application without knowing if you have good SLOEs or bad SLOEs (or in between).

Get good SLOEs, yes you match. Get bad SLOEs, no you won't. None of the other stuff will likely change that fact.

 

[deleted436726]

Get good SLOEs, yes you match. Get bad SLOEs, no you won't. None of the other stuff will likely change that fact.

That being said...what does one have to do (or not do) to actually get a bad SLOE?

Making this even more confusing is that I've heard many, if not most programs don't strictly follow the upper-middle-lower 1/3 breakdown and end up giving everyone an upper or middle 1/3 SLOE.

 

[Bea5T]

None of what you mentioned (boards, class rank) are a predominant factor in determining your shot at matching. It's all up to the SLOEs. No one can reliably answer this question of "will I match EM" based on your application without knowing if you have good SLOEs or bad SLOEs (or in between).

Get good SLOEs, yes you match. Get bad SLOEs, no you won't. None of the other stuff will likely change that fact.

Honestly, this kind of makes me feel like the first three years of medical school was a complete waste of time(and money). Does the rest of our app really mean that little?

 

[Vandalia]

Honestly, this kind of makes me feel like the first three years of medical school was a complete waste of time(and money). Does the rest of our app really mean that little?

Not at all. Do you think you are going to get a good SLOE without knowing the basic science, pathology, and clinical skills?

In the real world, the end result is all that matters.

 

[gamerEMdoc]

That being said...what does one have to do (or not do) to actually get a bad SLOE?

Making this even more confusing is that I've heard many, if not most programs don't strictly follow the upper-middle-lower 1/3 breakdown and end up giving everyone an upper or middle 1/3 SLOE.

Most programs are skewed a bit in their distribution. Its about where you anticipate ranking students, so if you have a great group of students one year, you may be more top heavy in your rankings. Low 1/3 do tend to be less frequent though no matter what.

 

[gamerEMdoc]

Honestly, this kind of makes me feel like the first three years of medical school was a complete waste of time(and money). Does the rest of our app really mean that little?

It doesnt mean very little, it just wont determine if you match. It may play a part in where you match. If you have 10 students with top 1/3 sloes, they are differentiated by the rest of their application. And boards are a frequent filter for some programs handing out interviews. So the rest of the app has meaning, but it all takes a back seat to the SLOEs.

And as noted below, doing well on rotation is a reflection of how good of a student you are. If you have barely passed through med school, its unlikely you are going to show up in the ED and look like an all star.

 

[boomshaketheroom]

Honestly, this kind of makes me feel like the first three years of medical school was a complete waste of time(and money). Does the rest of our app really mean that little?

What about the part where you studied and learned medicine? I feel like that was probably a little useful.

 

[gamerEMdoc]

Just wanted to let everyone know, I'm going to be attending the EMRA Residency Fair at ACEP this year. It's the first time I'll have ever gone. But if anyone is planning on attending, feel free to stop by! I'm going to try and weasel my way into the EMRA party that night as well!

 

[liveonthewater]

So theres a lot of talk about the recent increasing number of applications EM programs are receiving. After reading and watching some podcasts, many PDs and APDs are telling students that we are applying to too many programs and likely going on too many interviews. Their solution is to say that if you are an "average" applicant, then you only need to apply to about 20-30 programs and go on 10-12 interviews. I think the problem with this advice is that no one really knows what the "average" EM applicant looks like. That's why most of us jump online to ask what our chances are based on things we can easily quantify or compare with peers like board scores or clerkship grades. This is especially true if the student (like me) lacks an EM mentor that has experience in The Match.

@gamerEMdoc , could you, or anyone, maybe broadly define the "average" EM applicant? ie, board scores, SLOE rankings, etc. It sounds stupid to ask such a question but there has to be a cookie-cutter application that jumps into your brain when someone says "average applicant."

Thank you!

 

[gamerEMdoc]

So theres a lot of talk about the recent increasing number of applications EM programs are receiving. After reading and watching some podcasts, many PDs and APDs are telling students that we are applying to too many programs and likely going on too many interviews. Their solution is to say that if you are an "average" applicant, then you only need to apply to about 20-30 programs and go on 10-12 interviews. I think the problem with this advice is that no one really knows what the "average" EM applicant looks like. That's why most of us jump online to ask what our chances are based on things we can easily quantify or compare with peers like board scores or clerkship grades. This is especially true if the student (like me) lacks an EM mentor that has experience in The Match.

@gamerEMdoc , could you, or anyone, maybe broadly define the "average" EM applicant? ie, board scores, SLOE rankings, etc. It sounds stupid to ask such a question but there has to be a cookie-cutter application that jumps into your brain when someone says "average applicant."

Thank you!

I dont think there is a straight answer to this. Because the average applicant at a well known program that’s in a great city doesn’t look at all like the average candidate at a rural community EM program. I think candidates could get away with applying to a lot less programs, if they know where their competitive window is. But just spamming every program with your application won’t increase interviews because all of the programs that are out of your competitive window aren’t even looking at your application. Target programs geographically around your school and permanent address (because those programs are much more likely to consider your application) and be realistic about your chances. DO Candidate? Why waste the effort applying to all the programs that don’t have a single DO in their residency? IMG? Why apply to 200 programs if only a small percentage take IMGs. If a place publishes a Step 2 cutoff of 240 and you scored a 210, you are wasting your time.

I’m not saying to not have any dream programs. Absolutely, go ahead and apply to some dream places. But don’t just apply to 100 places thinking this will net you more interviews than applying to say 30-40 very strategically.

 

[yanks26dmb]

@gamerEMdoc

I'll keep things brief.

4th year student. Was very set on psych, finally got to see EM during an elective rotation and now want to do EM. Never on my radar before so only set up psych sub-i's. I realize my window is probably closed for the 2019 match, what can I do to apply as a pgy1? How do I get a sloe as an intern? Is this even realistic/should I give up on the dream?

FWIW, top third of class, both steps 240+, comlex 600+, passed pe first attempt, honors im and surgery.

Thank you for your feedback

 

[gamerEMdoc]

@gamerEMdoc

I'll keep things brief.

4th year student. Was very set on psych, finally got to see EM during an elective rotation and now want to do EM. Never on my radar before so only set up psych sub-i's. I realize my window is probably closed for the 2019 match, what can I do to apply as a pgy1? How do I get a sloe as an intern? Is this even realistic/should I give up on the dream?

FWIW, top third of class, both steps 240+, comlex 600+, passed pe first attempt, honors im and surgery.

Thank you for your feedback

Its only August. If you can secure a rotation in EM and get one SLOE, you'll have a chance. Is it a perfect application to have one SLOE? Nope. But some PDs will overlook it since you are a late convert. We ranked a candidate near the top of our list who rotated with us late in the game, who had no SLOEs, who was a late convert from ortho. He was excellent on rotation, and was an absolutely stellar resident. He's now one of our faculty. My point is, if you can weasel your way into a rotation by October or November, you at least have a shot because if you are really good clinically, it only takes one program to rank you highly to match.

If you can't, and EM is off the table for your PGY1, you could do a transitional year. It will get hard to get SLOEs from that year, but you could do EM rotations near the end of your 4th year (much easier to secure) and ask them to write you a SLOE for the following year.

If I were you, I'd see if there is any way at all of changing a month in Sept-Nov from one of your Psych AIs to an EM AI. If its a late one (Oct/Nov) you may not get a ton of interviews until that first SLOE comes in. As soon as it does, I'd be hitting up programs you think you may have a shot at via email to explain your situation and inquire about interviews should anyone cancel late in the season. This, combined with applying to some transitional programs in the match is the way I would go personally.

 

[ShowtimeKaner88]

A bit of neuroticism here, but when I put my personal statement into ERAS, it makes it look really short. It's a full page in Word 11pt font, single-spaced. It only takes up like 2/3rds of "page 1" in ERAS though. Is this going to be viewed negatively? I feel like I got all of my important points across and I tried to stay as concise as possible and not get fluffy or dramatic.

 

[surely]

Happens to everyone, totally depends on which browser you use, etc. I promise it'll all look the same as everyone else's on the program's side!

A bit of neuroticism here, but when I put my personal statement into ERAS, it makes it look really short. It's a full page in Word 11pt font, single-spaced. It only takes up like 2/3rds of "page 1" in ERAS though. Is this going to be viewed negatively? I feel like I got all of my important points across and I tried to stay as concise as possible and not get fluffy or dramatic.

 

[SpacemanSpifff]

So the other day a nurse complained to my resident that I didnt pay attention to her when she was trying to tell me something and that I was rude. The resident brought it up and said he believed me and wouldn’t hold me to it but I’m afraid now because this is my away rotation. I honestly didn’t do anything wrong in my opinion and will apologize to her when I get the chance, but any advice here? Never had anything like this before and the shift went really well otherwise.

As an away rotator your primary responsibility is not to piss anyone off, which is a difficult task to say the least. Whether you meant to or not you minimized a concern this nurse had, which is a quick way to become a persona non gratis amongst the staff. Apologizing, if you can make it sincere, is a good option. As far as the effect on your grade, if this particular RN is known to be easily ruffled it probably won't be an issue. Going forward re-double your efforts to demonstrate you are attentive to the nursing staff and their concerns - because you should be, they are more experienced than you. This doesn't stop as a med student it's key to being an effective resident as well.

 

[miacomet]

A bit of neuroticism here, but when I put my personal statement into ERAS, it makes it look really short. It's a full page in Word 11pt font, single-spaced. It only takes up like 2/3rds of "page 1" in ERAS though. Is this going to be viewed negatively? I feel like I got all of my important points across and I tried to stay as concise as possible and not get fluffy or dramatic.

Someone once thanked me for writing such a short personal statement (this was for my medical school application). Why do people think more is better? There isn't usually that much to be said in a residency application essay!

 

[gamerEMdoc]

A bit of neuroticism here, but when I put my personal statement into ERAS, it makes it look really short. It's a full page in Word 11pt font, single-spaced. It only takes up like 2/3rds of "page 1" in ERAS though. Is this going to be viewed negatively? I feel like I got all of my important points across and I tried to stay as concise as possible and not get fluffy or dramatic.

Doesnt matter at all.

 

[gamerEMdoc]

Thanks for answering all these questions! I have a question that's probably been asking 100x (sorry).

I have a 230 step 1 score. Super average (maybe a little below) applicant numbers wise - (all HP and 3 honors on 3rd year). But, SLOEs are HP/H/H with great comments (top 1/3). I have lots of community involvement and public health research. I won't be able to take step 2 and get a good score until late September, 1st week of Oct. I've heard a lot of conflicting information regarding if I will lose out on a significant number of interviews given that I'm pretty average on scores, and places want to see step 2 CK for these kinds of applicants. Will some places not interview me, and waitlist me given a later score? I know waitlist means you may miss out on interviews because it fills up. Thanks in advance!

Some programs might, some may not. There’s over 200 programs, and everyone is going to have different things they think are important. With your Sloes and scores you’ll easily match. But no one can say which programs will or will not extend an interview based in the date you take your step 2. I doubt it will matter to the majority.

 

[SW0LDIER]

Its only August. If you can secure a rotation in EM and get one SLOE, you'll have a chance. Is it a perfect application to have one SLOE? Nope. But some PDs will overlook it since you are a late convert. We ranked a candidate near the top of our list who rotated with us late in the game, who had no SLOEs, who was a late convert from ortho. He was excellent on rotation, and was an absolutely stellar resident. He's now one of our faculty. My point is, if you can weasel your way into a rotation by October or November, you at least have a shot because if you are really good clinically, it only takes one program to rank you highly to match.

If you can't, and EM is off the table for your PGY1, you could do a transitional year. It will get hard to get SLOEs from that year, but you could do EM rotations near the end of your 4th year (much easier to secure) and ask them to write you a SLOE for the following year.

If I were you, I'd see if there is any way at all of changing a month in Sept-Nov from one of your Psych AIs to an EM AI. If its a late one (Oct/Nov) you may not get a ton of interviews until that first SLOE comes in. As soon as it does, I'd be hitting up programs you think you may have a shot at via email to explain your situation and inquire about interviews should anyone cancel late in the season. This, combined with applying to some transitional programs in the match is the way I would go personally.

Thank you so much for doing this.

My scenario is somewhat similar. I'm actually applying DO ortho but have been realizing that the only other specialty I'd be happy in is EM (previous EM scribing for several years, EMT experience etc). I am very scared of not matching and would be unhappy in anything other than these two specialties. All of my current aways are in ortho but there is a reasonable possibility I can get an EM rotation in for the month 10/22-11/16 for a grand total of 1 SLOE. Step 1/2: 240s/260s. Should I go for it or apply for prelim surgery/TRIs and go for it as a PGY1?

Thank you again!

 

[mymembernames]

Do you consider EM a lifestyle specialty?

 

[gamerEMdoc]

Thank you so much for doing this.

My scenario is somewhat similar. I'm actually applying DO ortho but have been realizing that the only other specialty I'd be happy in is EM (previous EM scribing for several years, EMT experience etc). I am very scared of not matching and would be unhappy in anything other than these two specialties. All of my current aways are in ortho but there is a reasonable possibility I can get an EM rotation in for the month 10/22-11/16 for a grand total of 1 SLOE. Step 1/2: 240s/260s. Should I go for it or apply for prelim surgery/TRIs and go for it as a PGY1?

Thank you again!

Why would you not go for it? You can still apply for Tri as a backup. Yes, one SLOE isn't ideal. Especially one that comes late. But if you dont apply, you are guaranteed to not match in EM. If you apply, even if you only get a few interviews, at least there is a chance. With your board scores, if you can get a really good SLOE, you very well could match in EM. If you have an outstanding rotation somewhere, it only takes one, because even if they were your only interview, if they rank you high, then you can match there. Not suggesting this is the pathway to success, but I wouldn't just give up and accept doing a TRI without even trying.

 

[gamerEMdoc]

Do you consider EM a lifestyle specialty?

No. I also don't consider being a physician a "lifestyle" career choice, and I think the students that do and are constantly looking for a "lifestyle" field got into medical school for the entire wrong reason. Medicine takes years of dedication to get into, more years of dedication to specialize in, and years of dedication to get great at. Being a physician defines you as a person to an extent. You should go into something because you love it, because you are good at it, and because you can make a difference. Don't be a nameless "provider", be a physician that spends YEARS honing their craft, learning, improving, and setting an example. Being a good physician is your lifestyle.

 

[tarsuc]

Found the sub specialty SLOE uploaded in the CORD EM website.

Just wondering if everybody is using this, and it will be as impactful as a regular SLOE, if all rotations you manage to get are subspecialties and not regular EM. (FMG here)

 

[surely]

Found the sub specialty SLOE uploaded in the CORD EM website.

Just wondering if everybody is using this, and it will be as impactful as a regular SLOE, if all rotations you manage to get are subspecialties and not regular EM. (FMG here)

It's not as impactful as a traditional SLOE, since only a traditional SLOE can really assess how well you function in the emergency department. Even a peds EM SLOE isn't quite close enough, since the acuity and complexity is pretty different from regular EM. Bottom line: you need two regular SLOEs, which I know must be tough as an FMG.

 

[Rekt]

Typically, how long does it take for SLOE uploads? Have a couple SLOEs that said they're written, but nothing on ERAS

 

[gamerEMdoc]

Typically, how long does it take for SLOE uploads? Have a couple SLOEs that said they're written, but nothing on ERAS

Depends on how programs decide to write and upload their sloes. Some may do it after each rotation. Many wait until early Sept and write/upload them all as one big group.

 

[gamerEMdoc]

For the late EM converts like @SW0LDIER and @yanks26dmb or anyone else scrambling for a last second EM rotation in need of a SLOE:

I may have a rotation at my program in September and another on in October thanks to last second cancellations. Send me a PM if interested.

 

[surely]

For the late EM converts like @SW0LDIER and @yanks26dmb or anyone else scrambling for a last second EM rotation in need of a SLOE:

I may have a rotation at my program in September and another on in October thanks to last second cancellations. Send me a PM if interested.

That's a super nice offer. You should post this in all the other subspecialty forums and see if we can poach somebody and convert them to team triage

 

[CajunMedic]

My TRI does not allow for away rotations, and doubtful I'll get time off for ACEP/ACOEP. Who's the best person to reach out to at programs I'm interested in? i.e. 1 point below their FREIDA-listed COMLEX cutoff, or interest in general? PD or Coordinator?

 

[gamerEMdoc]

Coordinator. They usually are the ones filtering down the applicants for the PD based on what the PD is looking for. And if a ton of people are emailing, they can compile a list for the PD, as opposed to the PD getting spammed with 20 emails a day.

 

[Doots321]

Thanks for doing this gamerEMdoc. I am currently a 3rd year interested in EM and have one elective rotation coming up. One of our elective choices involves working all night shifts in the ED for one month. I was wondering whether I should take that option in order to get some extra procedural experience before 4th year (even though I will be doing at least 3-4 ER rotations 4th year) or if PDs preferred electives that would "broaden our clinical knowledge". I was thinking possibly pathology to help add some detail to my understanding of pathophys and anatomy. Thanks again.

Oh and one more question. As a DO student, how undesirable is it to have an above average Comlex Level 1 but no USMLE STEP 1? Would middle tier programs drop your rank significantly because of no USMLE Step 1, or would you say a solid USMLE Step 2 would be enough to make up for it? This would be regarding applying to POST MERGER ACGME residency programs, although I will be focusing more heavily on the "DO friendly" programs. Thanks.

 

[gamerEMdoc]

I honestly don't think a lack of a USMLE is that big of a deal at DO friendly places, especially places that used to be DO programs that switched during the merger. And if you take the USMLE step 2 and do well, it's really unlikely to matter.

Regarding rotations, I doubt pathology would be a good rotation. Honestly, I have no idea what a pathology rotation would actually entail, but I can't imagine a rotation that is more opposite of EM. If the third year rotation is available for EM, especially if it is at a place without a residency that you can get some experience without having to worry about a SLOE or grade, I'd take it. You can work on your H+Ps, efficiency, and minor procedural skills so when 4th year audition time hits, you start with a little advantage.

 

[DwightKShruteATTRM]

I will have completed my 3rd EM rotation on September 7th. Right now, no SLOEs have been uploaded. Both programs mentioned they would upload in September and the one I am finishing says expect up to a month. Ideally, I expect at least one SLOE to be uploaded before September 15th. As my other SLOEs are uploaded after the 15th, would you recommend emailing program coordinators to inform them about the new SLOEs or should I expect them to know?

Thanks!

 

[Bea5T]

So svi scores were released today. In retrospect, did you notice anything type of correlation with the acores? And what's considered a red flag score, if there is one?

 

[gamerEMdoc]

I will have completed my 3rd EM rotation on September 7th. Right now, no SLOEs have been uploaded. Both programs mentioned they would upload in September and the one I am finishing says expect up to a month. Ideally, I expect at least one SLOE to be uploaded before September 15th. As my other SLOEs are uploaded after the 15th, would you recommend emailing program coordinators to inform them about the new SLOEs or should I expect them to know?

Thanks!

You shouldn’t need to email them.

 

[gamerEMdoc]

So svi scores were released today. In retrospect, did you notice anything type of correlation with the acores? And what's considered a red flag score, if there is one?

Honestly, I barely looked at the scores last year. The score the students had, didn’t really correlate necessarily with how good the student interview was with me. This year, I plan on looking at the higher scores and the lower scores and watching their videos. I won’t watch everyone’s, but when I’m interviewing somebody who has a really high score or a low score, I’m going to watch there videos so I can compare and contrast to get a sense of whether or not I truly think the score holds any value.

 

[Brorthopedic]

Honestly, I barely looked at the scores last year. The score the students had, didn’t really correlate necessarily with how good the student interview was with me. This year, I plan on looking at the higher scores and the lower scores and watching their videos. I won’t watch everyone’s, but when I’m interviewing somebody who has a really high score or a low score, I’m going to watch there videos so I can compare and contrast to get a sense of whether or not I truly think the score holds any value.

What would you consider to be a low score?

 

[gamerEMdoc]

14 or below is all below the 10th percentile. It's mainly that I want to compare the outliers on each end to see if there is truly a noticeable difference that would be so big to warrant considering the score as a useful piece of data.

 

[deleted709753]

Hello I’m a 3rd year with a newfound interest in EM. My question is, what kind of third year performance do you look for? Is the number of honors the main thing you look at regarding ms3 performance?
According to one residency webpage I saw, for interview invites the average step 1 was 236 and the number of 3rd year honors was 2/6 rotations.

 

[gamerEMdoc]

Hello I’m a 3rd year with a newfound interest in EM. My question is, what kind of third year performance do you look for? Is the number of honors the main thing you look at regarding ms3 performance?
According to one residency webpage I saw, for interview invites the average step 1 was 236 and the number of 3rd year honors was 2/6 rotations.

What do I prefer? I prefer perfect board scores and honors on every rotation if I have the choice. Otherwise, there is no magic formula. It's not as simple as saying "if I score a 235 and get 1/3 of my rotations as honors, I'll be considered matchable". It just doesn't work that way. Because the 3rd year grades and boards don't take in to consideration the number one thing PDs look at, which is the students EM performance (ie SLOEs). If you have great SLOEs and are fantastic in the ED, it won't matter what your "percent honors" was in non-EM rotations. Nor should it. No field is the same. Being great as a student on Psychiatry is not the same as being great in the ED.

Most of the rest of the application becomes more of a tie breaker. If you are trying to differentiate candidates with similarly great SLOEs (or similarly not great SLOEs), then the grades and boards are going to come more in to play. But they take a backseat.

So just do the best you can. Don't worry about targeting some preconceived notion of a magic number you need to hit. Hit the highest numbers you can, but realize the only magic formula there is to matching in EM is "good SLOEs = match".

 

[deleted436726]

How badly is it going to affect me if I've only gotten a Pass in the two EM rotations (MS3 home + one MS4/sub-I away) I've done so far? The main reason I only got a Pass on my away sub-I was because I didn't do well on their in-house exam. Granted, I definitely should have studied harder but I also didn't have the benefit of experiencing a NBME or SAEM shelf as my home EM rotation doesn't make us take an exam.

All that being said, the clinical comments I've received have been positive, so I hope that the SLOEs won't turn out too badly (but who knows, they've already been uploaded). Step scores are pretty average. No other red flags. How is all of this going to affect my chances for matching into EM?

 

[tarsuc]

Would having an MPH or an MHS make any impact in a EM residency application?

 

[mymembernames]

Will it be a problem if I take CS November 16th and get my score back between January 30 to February 20, 2019 for the match / rank list?

 

[gamerEMdoc]

How badly is it going to affect me if I've only gotten a Pass in the two EM rotations (MS3 home + one MS4/sub-I away) I've done so far? The main reason I only got a Pass on my away sub-I was because I didn't do well on their in-house exam. Granted, I definitely should have studied harder but I also didn't have the benefit of experiencing a NBME or SAEM shelf as my home EM rotation doesn't make us take an exam.

All that being said, the clinical comments I've received have been positive, so I hope that the SLOEs won't turn out too badly (but who knows, they've already been uploaded). Step scores are pretty average. No other red flags. How is all of this going to affect my chances for matching into EM?

So to summarize, you are saying you are a middle of the road candidate. People in the middle of many programs lists match. You may not match exactly where you want, but statistically you'll probably be ok as long as none of the SLOEs are worse than you think.

 

[gamerEMdoc]

Will it be a problem if I take CS November 16th and get my score back between January 30 to February 20, 2019 for the match / rank list?

Nope

 

[gamerEMdoc]

Would having an MPH or an MHS make any impact in a EM residency application?

It won't hurt, but I wouldn't spend a ton of time getting a masters degree thinking that is the key to successfully matching in EM. Get it because you want it, not because it's going to make a huge difference in your residency application.