EM PD - Ask Me Anything

[axl099020]

It is repeatedly stressed in this thread how important SLOEs are. As someone who has already matched - at a program I love, I feel like the way SLOEs are set up and weighed needs some significant improvement.

-Picking your away rotation becomes more of a game than ever, because rotations are absolutely non standardized in how they evaluate students and write SLOEs. There is even a thread here of "Which residencies to avoid because they write bad SLOEs".
-Despite an instructional document on how to write SLOEs (which students are top middle and bottom 1/3, and that bottom 1/3 still indicates a student deserving to match), I don't feel residencies really follow that; there is grade inflating, and I have been told by some leadership that a bottom 1/3 SLOE is particularly damning

Not to say SLOEs aren't important. I'm just sitting here watching these Sub-interns rotating at my institution trying their very best, and It really kills me that these letters make or break you.

Of note: Predictors of a Top Performer During Emergency Medicine Residency. - PubMed - NCBI

I'm interested in hearing your thoughts, because as one of the most progressive specialties in medicine, I really think we can do better. I'm just talking aloud to myself on how we can improve this process, and incorporate a more standardized SLOE - alongside other important resident selection factors, to provide the most holistic way of selecting residents as possible.

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[gamerEMdoc]

I get it, SLOEs definitely aren’t perfect. But they are far and away better than the alternative of plain letters of recomendation. The SLOE is more standardized than medical school grades. Medical school grades aren’t standardized, they are all over the place (ABCDE, P/F, Hon/HP/P, 0-100%), and the distribution varies widely amongst the schools and the distribution isn’t easily accessible. The only standardized thing, on the entire application, are board scores and the SVI. So while the SLOE isn’t perfect, to me its better than looking at EM grades (which are also on the SLOE anyways). And I just don’t think standardized test scores predict who makes a good multitasking EM doc. So its the best piece of the application we have at the moment. If there is a better way to do it, I’m sure people would listen. I’m just not sure there is.

I agree that there are some places that grade harder than others, but this is visible on the SLOE. The info is all there, in terms of the distribution they hand out. In terms of the low 1/3 being bad, I agree that the SLOE instructions state that low 1/3 students can still match but I’m not sure how true that really is depending on the program. My program has never gone into the low 1/3 of our match list in the 6 years I’ve been there, and the majority of our match list comes from the top 1/3 of our list. And we aren’t a particularly competitive program.

The comments on the SLOEs really help for students ranked in the “low 1/3”. They aren’t all equal. Some low 1/3 students will have MAJOR red flags in their comments where you’d never consider that person as a candidate. Others are just students that just had a bad rotation and their other good SLOEs reflect that. Those are ones you just disregard the bad SLOE. It’s all about context. You have to take all of the information as a whole.

 

[Perfect Hair Day]

I get it, SLOEs definitely aren’t perfect. But they are far and away better than the alternative of plain letters of recomendation. The SLOE is more standardized than medical school grades. Medical school grades aren’t standardized, they are all over the place (ABCDE, P/F, Hon/HP/P, 0-100%), and the distribution varies widely amongst the schools and the distribution isn’t easily accessible. The only standardized thing, on the entire application, are board scores and the SVI. So while the SLOE isn’t perfect, to me its better than looking at EM grades (which are also on the SLOE anyways). And I just don’t think standardized test scores predict who makes a good multitasking EM doc. So its the best piece of the application we have at the moment. If there is a better way to do it, I’m sure people would listen. I’m just not sure there is.

I agree that there are some places that grade harder than others, but this is visible on the SLOE. The info is all there, in terms of the distribution they hand out. In terms of the low 1/3 being bad, I agree that the SLOE instructions state that low 1/3 students can still match but I’m not sure how true that really is depending on the program. My program has never gone into the low 1/3 of our match list in the 6 years I’ve been there, and the majority of our match list comes from the top 1/3 of our list. And we aren’t a particularly competitive program.

The comments on the SLOEs really help for students ranked in the “low 1/3”. They aren’t all equal. Some low 1/3 students will have MAJOR red flags in their comments where you’d never consider that person as a candidate. Others are just students that just had a bad rotation and their other good SLOEs reflect that. Those are ones you just disregard the bad SLOE. It’s all about context. You have to take all of the information as a whole.

When Program X rates Student A in "Bottom 1/3" on the SLOE - does that necessarily reflect that is where Student A will fall on Program Y's rank list?
I want to think that "horses for courses" applies here, but I'm merely an MS4 stuck in a giant real-life game of Jumanji and I don't know all the rules.

 

[gamerEMdoc]

When Program X rates Student A in "Bottom 1/3" on the SLOE - does that necessarily reflect that is where Student A will fall on Program Y's rank list?
I want to think that "horses for courses" applies here, but I'm merely an MS4 stuck in a giant real-life game of Jumanji and I don't know all the rules.

Just like there is program variation on writing the SLOE, there is variation on interpreting them as well. The best part of the SLOE is that it gives you all the data. You know that a mid 1/3 at a place that is 99% all top 10 and top 1/3's is really a low 1/3 or worse... and that a mid 1/3 at a place where only 5% get top 10 and 10% get top 1/3 is really good. The SLOE ranking can't really be interpreted without the context of the grading distribution of the program.

As for does it correlate from one to another. Im sure that's interpreter dependent, but its something I definitely consider. A mid 1/3 candidate at USC is I'm sure a better candidate than a top 1/3 candidate at a random community hospital. I take that into account. Same with a ranking from a single author, as opposed to a "SLOE committee" (which should be more accurate than a single author SLOE).

You have to take a lot of the context of the SLOE into consideration. It's not as simple as looking at the bottom, seeing the SLOE ranking, and making your decision based on that.

 

[JennyIgotyourNumber]

What's a typical multiple of their residency spots that programs interview?

In other words, if a program has 10 spots, they may decide to interview 3x that e.g. 30 people. What's your guess the range of those multiples? Say ~3x for super desirable programs, to say ~6x for more desirable programs?

 

[gamerEMdoc]

What's a typical multiple of their residency spots that programs interview?

In other words, if a program has 10 spots, they may decide to interview 3x that e.g. 30 people. What's your guess the range of those multiples? Say ~3x for super desirable programs, to say ~6x for more desirable programs?

Much more than that.

I'd imagine most programs interview about 10 people for every spot. Some a little more, some a little less. But that's the general rule of thumb. Doesn't necessarily matter how competitive your program is. The more competitive you are, the more competitive the candidates you will be interviewing, therefore you'll be competing for those candidates with other competitive programs.

You figure interview season has maybe 12-14 weeks of interviews. The bigger your program is, the more faculty you have, the more that your can interview each week. So you can easily interview 80 people in 12 weeks for a program that has 8/year as an example.

 

[gamerEMdoc]

Interviews on our end start tomorrow. Let the games begin!

 

[deleted436726]

1. I'm sitting at a grand total of 4 interviews right now (1 home, 2 away/AI, 1 "regular"). Should I be worried right now, or is it still early?
2. I suspect that the SLOE from my first AI might be questionable, but the second one (which was uploaded only recently) should be much better. Assuming that the questionable SLOE was holding me back from getting interviews, will programs pay attention to a better SLOE that was uploaded later?

 

[Perfect Hair Day]

Similar question for @gamerEMdoc

Currently sitting at 6 interview invitations, in addition to two interviews already completed during AIs. One of the 6 invitations is from a place where I rotated, so 5 invitations where I have no connection per se. Wondering if I should be panicking or if it is still early days yet.

 

[gamerEMdoc]

1. I'm sitting at a grand total of 4 interviews right now (1 home, 2 away/AI, 1 "regular"). Should I be worried right now, or is it still early?
2. I suspect that the SLOE from my first AI might be questionable, but the second one (which was uploaded only recently) should be much better. Assuming that the questionable SLOE was holding me back from getting interviews, will programs pay attention to a better SLOE that was uploaded later?

Still early. I consider the first week of November to be the "time to get nervous" date. That's when I think its appropriate to send some emails to program coordinators to ask about the status of your application and to try to dig up a few more interviews, as well as to start thinking about a backup plan. If you are anywhere close to 10 by the first week of November, you should almost certainly be fine.

Similar question for @gamerEMdoc

Currently sitting at 6 interview invitations, in addition to two interviews already completed during AIs. One of the 6 invitations is from a place where I rotated, so 5 invitations where I have no connection per se. Wondering if I should be panicking or if it is still early days yet.

Interviews are interviews, don't discount the ones that are at places you rotated. They most definitely "count" towards your total. I'd argue that since places tend to give the benefit of the doubt to people that rotated with them if they are middle of the road or above, those will be some of your best chances to match. So at this point, if you have 8 interviews, you are definitely in a good place.

 

[gamerEMdoc]

You mention sending some LOI emails around the first week of November. Is that too late for some programs? I assume places like Stanford or UCI have already filled all their interview spots for the season by October and they don't send anymore after that.

Sure, but places like that are going to be more exclusive are also probably not going to respond to an email asking for an interview. If you are sitting on 4 interviews by November, why would Stanford interview you? The point of the LOIs in mid November is for people struggling to get anywhere close to 10 interviews, to try to dig up more to get closer to a higher percentage match rate. The people who have few interviews by November aren't getting a response from Stanford.

Also, I'd argue most programs have sent out invites to fill the majority of their spots by now (DO NOT FREAK OUT). Probably at least 2/3 to 3/4 of the spots. But what that doesn't account for is, many of those invites may get declined, and a ton that get accepted will get cancelled later. A ton of invites are to be had in "cancellation season" in December or January. So it takes time, programs send out a ton of invites, try to make the schedule work, and then reassess once they see how many holes they have left to fill. It all doesn't happen the first week they send out invites.

 

[gamerEMdoc]

I feel like there was something wrong with my app.. I applied very broadly but only got 10 interviews to middle tier places. MD and grades were HP/HP and board scores were good.

You have 10 interviews in the first few weeks of interview season. I'm pretty sure there is nothing wrong with your app. More likely, you are a middle of the road candidate at more competitive places. That doesn't mean "something is wrong" with your app.

 

[gamerEMdoc]

Maybe, there is a law of diminishing returns with applications. Once you apply to programs outside your geographic location, adding more doesn't equal getting more interviews. The percentage of interviews you get vs apps sent out is dependent on where you applied. For instance, you may get interviews at 50% of the programs you apply to that are in states around your permanent address or med school. But that number goes down drastically when you go beyond that. So just adding a huge number of programs when you apply doesn't really add much if you have no ties that area, haven't rotated around there, etc.

Will you get more offers in the coming weeks? Probably. But if you don't, and there are places you really were interested in outside of your geographic area, reach out to them in a few weeks.

10 interviews is good at this point.

 

[emletters]

Sitting on 4 invites. Just had my second SLOE uploaded and assigned today. Hoping that I didn’t fly under the radar and missed the mass wave of invites. Didn’t hear a single thing today or yesterday...

 

[emletters]

I’m sure it’s been answered before but I can’t seem to find it, should we update programs when we get a crucial piece of info in on our app, like a second SLOE?

 

[gutonc]

I’m sure it’s been answered before but I can’t seem to find it, should we update programs when we get a crucial piece of info in on our app, like a second SLOE?

A crucial piece of information that should immediately be sent directly to programs should be limited to first author NEJM papers and Nobel Prizes.

Everything else can wait until your interview or will be picked up if it matters.

 

[emletters]

A crucial piece of information that should immediately be sent directly to programs should be limited to first author NEJM papers and Nobel Prizes.

Everything else can wait until your interview or will be picked up if it matters.

Well the way we talk about SLOE’s on here, you’d think they were Nobel Prizes.... thanks!

 

[Perfect Hair Day]

Also, I'd argue most programs have sent out invites to fill the majority of their spots by now (DO NOT FREAK OUT). Probably at least 2/3 to 3/4 of the spots. But what that doesn't account for is, many of those invites may get declined, and a ton that get accepted will get cancelled later. A ton of invites are to be had in "cancellation season" in December or January. So it takes time, programs send out a ton of invites, try to make the schedule work, and then reassess once they see how many holes they have left to fill. It all doesn't happen the first week they send out invites.

I want to cuddle with this post.

 

[peacefulpanda]

I just realized a huge oversight on my part and did not realize I had to specifically assign my board scores to programs until now. I am freaking out cause of this mistake and wondering how this might affect me. I did only have one SLOE uploaded up until this point and expect the second one to be uploaded soon.

 

[gamerEMdoc]

I just realized a huge oversight on my part and did not realize I had to specifically assign my board scores to programs until now. I am freaking out cause of this mistake and wondering how this might affect me. I did only have one SLOE uploaded up until this point and expect the second one to be uploaded soon.

Worrying about it changes nothing. How will it affect you? Who knows. All you can do is submit them and see what happens over the next few weeks honestly.

 

[amonty144]

Hello @gamerEMdoc..one quick question regarding asking questions during interviews. Are there any general questions that you think are helpful and insightful to ask during our interviews. I know you've mentioned researching each program and ask specifics but any list of questions that you think are helpful? Thank you!

 

[kansas2texas]

@gamerEMdoc what are your thoughts on interviewing at so called 'safety' schools. I.e. if you're going to interview at lets say 15 programs how many of them should be safeties? And a follow up would a safety only be a non-top tier in your region, or would non-top tiers outside of your region also be safeties if you already have an interview there? Trying to make the best choices as far as setting up my interviews with the best chance of matching

 

[gamerEMdoc]

@gamerEMdoc what are your thoughts on interviewing at so called 'safety' schools. I.e. if you're going to interview at lets say 15 programs how many of them should be safeties? And a follow up would a safety only be a non-top tier in your region, or would non-top tiers outside of your region also be safeties if you already have an interview there? Trying to make the best choices as far as setting up my interviews with the best chance of matching

If you have 15 interviews, you are going to match. Interview at the places you actually want to go to. Don't waste the time of programs you don't consider good enough for you, and take up an interview spot for someone who actually may want to go there. People way overthink interview season. Trust me, if you are sitting on that many interviews by now, you don't need safety programs. Just accept the ones you actually want may want to end up at for residency.

 

[gamerEMdoc]

Hello @gamerEMdoc..one quick question regarding asking questions during interviews. Are there any general questions that you think are helpful and insightful to ask during our interviews. I know you've mentioned researching each program and ask specifics but any list of questions that you think are helpful? Thank you!

I think the best questions are ones that the person actually wants to know, rather than some stock question that they use. What do you genuinely want to know about a place that may affect your decision to rank there. If you want to have some standard questions in your back pocket because you can't think of anything you actually want to question about the program, and feel uncomfortable not having a question, some old standby's are things like:

- Whats your favorite aspect of working in this program?
- Do you forsee any changes with the program on the horizon?
- Have you ever had a situation where a resident needed assistance and how did the residency respond?
- What do you look for in a candidate?
- What would you say makes your program standout compared to other (community, university based, etc) residency programs?
- What support is there for research (if thats an interest of yours)
- Have any of your residents matched in a (insert fellowship here) fellowship? Again, if you are interested in something specific.
- How does your program handle mentorship?

There's a ton of similar generic questions, and variations of the above, that I get asked a lot.

 

[AthleteDoc7]

If you have 15 interviews, you are going to match. Interview at the places you actually want to go to. Don't waste the time of programs you don't consider good enough for you, and take up an interview spot for someone who actually may want to go there. People way overthink interview season. Trust me, if you are sitting on that many interviews by now, you don't need safety programs. Just accept the ones you actually want may want to end up at for residency.

this is good to hear. I’m in the extremely fortunate position of having way too many interviews and needing to decide where i’m canceling to give an opportunity to other applicants, but it feels like a real possibility many top places could just pass me by on my rank list. i’ll try to stick to your advice, it just really is such a nerve wracking process. I wish a program could just offer me a job like every other career on earth so I could take it and be done lol

 

[amonty144]

Thank you so much @gamerEMdoc !! Also one more question regarding post-interview thank you emails. Is it better to send one to each faculty member who has interviewed us or just one email to the PD or coordinator? Thank you!

 

[borderlineinCle]

This happened this evening on the 2018 spreadsheet, any suggestions? @surely ?

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[gamerEMdoc]

Thank you so much @gamerEMdoc !! Also one more question regarding post-interview thank you emails. Is it better to send one to each faculty member who has interviewed us or just one email to the PD or coordinator? Thank you!

Doesn't matter. You don't necessarily have to send an email. If you choose to, you can send one email to all involved cc. Or you can send individual ones. Or one to the program coordinator, who will forward it on. Its not really a big deal.

 

[gamerEMdoc]

This happened this evening on the 2018 spreadsheet, any suggestions? @surely ?View attachment 240934


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I have no idea, as far as I can tell that spreadsheet is completely anonymous. I'm not sure it could ever be tracked who said that. Scary stuff.

 

[borderlineinCle]

I have no idea, as far as I can tell that spreadsheet is completely anonymous. I'm not sure it could ever be tracked who said that. Scary stuff.

Someone deleted the row. Maybe it was the person who wrote it originally and maybe they’re ok... scary indeed :/


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[surely]

Just saw this thread. Yikes. Spent some time investigating my options, and it doesn't seem Google has a mechanism for reporting suicide threats except those made on Youtube. The spreadsheet is anonymous, and I unfortunately have no access to things like IP addresses...

To the person who posted about buying a gun: PM me your phone number. I'd love to talk to you. If that's intimidating, texting works too! The important part is that you can be an excellent doc and have a fulfilling life.

To everyone else who immediately flooded the spreadsheet with supportive messages the suicide hotline number (800-273-8255)... You guys warm my heart. I hope your message gets through to those among us who are struggling.

 

[theSmurfette]

Sitting at 1 non-home EM invite. Re-applicant, so pickings are already insanely slim. Only 1 official rejection out of the 42 EM programs I applied to. I get that I’m last year’s cast-off that no one wanted but geez! I didn’t think it would be this hard.

Is there any utility in cold-calling programs? Or is email just as good? Would it be any use messaging current interns (former classmates of mine) to see if they can put in a good word for me?


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[hopefullyEM2019]

Hey all! I just found out today that my EM home grade (rotation over ~3-4 months ago, peers got grade uploaded) was never uploaded onto my transcript for whatever reason. I also don't know what I got (H/HP/P), or what my transcript actually says (incomplete? blank?) other than that the grade isn't there. I'm a US MD applicant with slightly above average stats, 2 EM rotations. Sitting at 3 non-audition interviews, applied broadly, etc etc. so not exactly doing amazing either. I was wondering if anyone knew how big of an impact (if any) this had on my application.

EDIT: to be clear, both SLOEs are uploaded.

 

[BringBackScrubs]

When do programs make their rank list? Asking because I'm taking a chill EM elective in Feb and might be too tired to care or impress them then aha.

Haha, I remember my motivation tanked after interview season. I will be cautious being too chill/lazy though - programs do talk to one another.

 

[borderlineinCle]

Sitting at 1 non-home EM invite. Re-applicant, so pickings are already insanely slim. Only 1 official rejection out of the 42 EM programs I applied to. I get that I’m last year’s cast-off that no one wanted but geez! I didn’t think it would be this hard.

Is there any utility in cold-calling programs? Or is email just as good? Would it be any use messaging current interns (former classmates of mine) to see if they can put in a good word for me?


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did you do anything to improve your application? just curious. best of luck!

 

[gamerEMdoc]

Hey all! I just found out today that my EM home grade (rotation over ~3-4 months ago, peers got grade uploaded) was never uploaded onto my transcript for whatever reason. I also don't know what I got (H/HP/P), or what my transcript actually says (incomplete? blank?) other than that the grade isn't there. I'm a US MD applicant with slightly above average stats, 2 EM rotations. Sitting at 3 non-audition interviews, applied broadly, etc etc. so not exactly doing amazing either. I was wondering if anyone knew how big of an impact (if any) this had on my application.

EDIT: to be clear, both SLOEs are uploaded.

I doubt it really impacted the application.

 

[gamerEMdoc]

When do programs make their rank list? Asking because I'm taking a chill EM elective in Feb and might be too tired to care or impress them then aha.

The same time you make yours. They both get certified around the same time. If I remember right, I think that’s in February?

That being said, I’d imagine those programs have some sort of running rank list. I can’t imagine interviewing nearly 100 people and then sitting down and trying to rank them all against each other at the last second. I keep our rank list PowerPoint up to date based on the total candidate score every week after interviews, and then at the end we fine-tune it as a group.

 

[theSmurfette]

did you do anything to improve your application? just curious. best of luck!

I’ve attempted to fix what could be fixed but most of my deficiencies can’t be improved (low scores, CS fail). I’m working in EM research (bench and clinical) this year which will likely lead to a few publications but none before rank lists are due. I know my best chance, and probably my only true opportunity, of doing an EM residency is at my home program. I don’t look too hot on paper and I get that.


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[CajunMedic]

Headed to ACOEP and will hopefully talk to some programs at the residency fair. Any suggestions for approaching them about interviews (especially ones that I had interviewed at before) without sounding needy/desperate?

 

[deleted436726]

If your grade on an away rotation would have been otherwise solid except for very specific reason (e.g. bombing the final shelf exam), would that be worth mentioning as an add-on to your personal statement? Deciding whether or not to mention this (since it may have contributed to a subpar SLOE) and whether it would make any difference this late in the game.

 

[gamerEMdoc]

If your grade on an away rotation would have been otherwise solid except for very specific reason (e.g. bombing the final shelf exam), would that be worth mentioning as an add-on to your personal statement? Deciding whether or not to mention this (since it may have contributed to a subpar SLOE) and whether it would make any difference this late in the game.

No, I wouldn't mention it. Unlikely that it would make a difference, and comes across as making excuses.

 

[gamerEMdoc]

Headed to ACOEP and will hopefully talk to some programs at the residency fair. Any suggestions for approaching them about interviews (especially ones that I had interviewed at before) without sounding needy/desperate?

I'd just stop by, tell them you interviewed at their program last year, and really was impressed by it, and would love to get an opportunity to interview there again if any openings occur.

 

[deleted436726]

Is there a strong degree of correlation between what one receives for a final clerkship grade and their global assessment on a SLOE? Let's say, for example, you only get a Pass (out of a possible High Pass or Honors). Does this automatically mean you're relegated to lower 1/3 (or worse, unlikely to rank) on the SLOE?

 

[gamerEMdoc]

Many programs, I'd say the majority at least, are pretty top heavy with their grades. I've seen some places give as high as 90% honors, so at a place like that, who the heck knows where anyone is going to fall.

In general though, you can expect:
- Honors = Top 10 or Top 1/3
- HP = Top 1/3 or Mid 1/3
- Pass = Mid 1/3 or Low 1/3

There are certainly exceptions to this rule. Someone might be a phenom clinically, a true top 10, but miss the cutoff for honors because of a test result or something. But for the most part, the above holds pretty true except with the most top heavy grading places.

I purposely try tip my hand a bit to students so they know where they stand. Honors is mostly top 10%, HP is mostly top 1/3 (and sometimes mid 1/3), and Pass is mostly mid 1/3 with a few bottom 1/3. We just dont have many people rotate that we actually rank in our bottom 1/3 save a few every year. The problem is, many of the students that come through are DOs, and the grading scales are rarely Hon/HP/Pass at DO schools. Many are pass/fail, some a percentage, some are ABCDE. So even though I internally have an "honors" or "HP" grade on someone, that's not always reflected in the actual schools grading system. It's kind of frustrating.

 

[emthrowaway19]

.

 

[gamerEMdoc]

Hey, using a throwaway for the sake of anonymity but I just got my step 2 score back- a DO applicant with
Step 1-220, step 2-literally the same score. ~530s, 550s on level 1, 2 respectively and pass on PE. When I initially applied I ultimately received ~8 interviews, 1 waitlist but nearly half of my interviews are from away rotations. I'm devastated considering some of the aways, a couple do require both a step 1 and step 2 score and while a step 2 is not required for an interview for some programs, it may play a huge role in ranking. There's really no justification to why this happened, felt more prepared this time around too but I'm assuming taking it so late played a part into this. My question is, do I release the score to programs or not- it's only going to hurt me but then again, I'm not a strong applicant to begin with. Thoughts?

I don't think it matters to be honest. Your COMLEX stayed the same as well. If you don't release it, programs will think you either didn't take it, or bombed the test. Release it, and they'll know you stayed the same. Regardless, it'll be your clinical performance (SLOEs and the rotation performance at all those aways) and how you interview that's going to be the driving factor in whether or not you match.

 

[JennyIgotyourNumber]

I was surprised to get an interview at a very high-profile program, since my board scores aren't impressive. I want to know how my board scores may factor into how I will be ranked by such a program.

I know board scores are part of who programs decide to invite, but do they play into how programs rank? My intuition is they may not or may only minimally: as long as a candidate has crossed whatever threshold that earns the invite, other factors (SLOES, interview, personality, demographics, CV points of interest, "fit") would determine rank, rather than board scores. Is this correct?

 

[gamerEMdoc]

I was surprised to get an interview at a very high-profile program, since my board scores aren't impressive. I want to know how my board scores may factor into how I will be ranked by such a program.

I know board scores are part of who programs decide to invite, but do they play into how programs rank? My intuition is they may not or may only minimally: as long as a candidate has crossed whatever threshold that earns the invite, other factors (SLOES, interview, personality, demographics, CV points of interest, "fit") would determine rank, rather than board scores. Is this correct?

Depends on the program. I use a scoring system that weighs different aspects of the application differently, and assigns each part a score, with some aspects of the application accounting for more points than other parts, all weighted towards what I value the highest in an application. In the days leading up to an interview, I score the application (then add the interview score afterwards) to give the candidate a total app score. We then use this score to establish the basis of our rank list, but still move people up and down from there when we tinker with it. It just gives you a base to start.

Without disclosing my scoring system, to me personally, the most important thing in the application (and highest weighted) for determining rank in order:

Tier 1 (ie far and away the most important):
SLOEs / EM grades
Interview / Personality / Fit

Tier 2: (important, but not to the extent that it trumps tier 1)
Board Scores
Clinical Grades
Class Rank

Tier 3 (not that important, but still factors in a tiny bit)
CV stuff (though if really impressive, I'd move this up to a tier 2 importance)
Preclinical Grades

SVI and Personal statement don't factor into my decision making.

 

[DwightKShruteATTRM]

@gamerEMdoc
What is your strategy as a PD when making your applicant rank list? Is it largely set in stone before interviews? How important is the interview to your applicant ranking, especially when compared to SLOEs, board scores, etc?

 

[gamerEMdoc]

@gamerEMdoc
What is your strategy as a PD when making your applicant rank list? Is it largely set in stone before interviews? How important is the interview to your applicant ranking, especially when compared to SLOEs, board scores, etc?

The interview is a huge part of the process, especially for people that hadn't rotated here, because that's your only chance to see how well they fit in with your group.

Here's how our process works. I've eluded to a little bit of this in the past.

Prior to the interview, I score the applications for the week. The score is a weighted scoring system that factors in all the different parts of the application, but is weighted to give the most importance to the parts of the app that I think are the most valuable (see post above). After the interview, we as interviewers sit around and give an interview score, that gets added to the applicants total score to give them a total "application score". We then order our rank list from top to bottom from highest scoring applicant to lowest scoring applicant to form our initial rank list.

In the weeks before we certify, we then take an hour or two as a group with all the residents to go over each candidate (I have a powerpoint summary slide on every candidate with their app score, board scores, SLOEs, and picture). The residents and faculty all give their input on who we should move up or down from their initial app score ranking, and make any suggestions on who not to rank. We take that feedback, then the PD and I sit around the next day and basically move the people based on feedback and our gut to determine our final rank list.