EM PD - Ask Me Anything

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Some people come and want to work a whole shift. To be honest, any time a student asks about coming to do a second look, I tell them by no means do they have to, and its only for their sake to see if we are a good fit for them. They can stay as long or as short as they want. None of it affects how we rank them, so its all up to the student how long they want to stick around.

Honestly, I generally don't like the idea of second looks to begin with. I don't begrudge students that want to do them to really get a better look at the functioning of the ED, but honestly, I just feel like for many they feel like they HAVE to do this stuff, and its completely not necessary.
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gamerEMdoc said:
Some people come and want to work a whole shift. To be honest, any time a student asks about coming to do a second look, I tell them by no means do they have to, and its only for their sake to see if we are a good fit for them. They can stay as long or as short as they want. None of it affects how we rank them, so its all up to the student how long they want to stick around.

Honestly, I generally don't like the idea of second looks to begin with. I don't begrudge students that want to do them to really get a better look at the functioning of the ED, but honestly, I just feel like for many they feel like they HAVE to do this stuff, and its completely not necessary.
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Just to add to the "anti"-2nd look thought process...I legitimately did two 2nd looks (for IM...not EM) in my process because neither program was really on my radar pre-application process and I applied to both for geographic reasons. They were both quite different and in the running to be my #1 (and both ended up in the Top 3).

To the credit of both programs' PD/PC's, the 2nd looks were straight up "Sub-I" days where I met a Chief Resident at the beginning of the day who introduced me to a wards (one place)/MICU (the other place) attending at 7am and then left me with the team for the rest of the day until I quit/they kicked me out. I didn't meet with any other faculty. I didn't talk with the PD or PC or any other residents/faculty not directly involved in the care of the patients on the team census that day.

A second look that serves any other purpose than seeing how a particular programs works on a daily basis is a waste of everybody's time and your money.
 
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You dont have to contact programs. No one “requires” you to stay in touch. No one will forget about anyone. It doesnt matter if you interview early or late.

If you feel the need to contact the programs post interview, you can of your own free will. But understand it doesnt magically improve a candidates rank standing, one way or another. With one exception. That would be the candidate who just wont stop contacting the program over and over to “express interest”. One (two at most) emails reiterating interest are fine. Emailing over and over, clearly trying to fish for info of where you rank is an immediate red flag.
 
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Last interviews tomorrow. I can't believe this process is wrapping up. We are holding our rank list meeting with our residents in two weeks. Should have everything finalized by the end of the month. I hope everyone's interview season went as good as ours did!
 
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gamerEMdoc said:
I work in an academic job. Our older docs have no nights. I make a fairly competitive salary compared to non-academics. And its in the Northeast. And our APPs make 1/3 of what we make. And its 12 shifts a month. And we ALWAYS have jobs open. I just don't think its as generalizably a tough market as you make it out to be. I have no doubt that if you want to get a great job with no nights making a killing in Salt lake city, then sure, you aren't getting that job straight out of residency. I totally agree. But I have yet to have a resident come straight out of residency and not find a job in the region they want to live in for a very competitive salary. I still think the job market is in our favor.
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I don't know any recent grads making decent coin in NYC, since no one is! Or in Denver anymore. Maybe your grads got the best jobs in those areas, or perhaps they went elsewhere? I should have specified that by NE I meant major metro NE :)
 
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As a current 3rd year student, how time sensitive is it for you to see a Comlex PE/Step 2 CS score result after application submission? For example if my school only has dates left in November or December and programs start sending out interviews in October will that stall my application and a chance at an interview, or are interview invites sent regardless of these scores? I will definitely have my Comlex Level 2/Step 2 CK results back by early fall, just not the PE/CS ones.Thanks!
 
Doots321 said:
As a current 3rd year student, how time sensitive is it for you to see a Comlex PE/Step 2 CS score result after application submission? For example if my school only has dates left in November or December and programs start sending out interviews in October will that stall my application and a chance at an interview, or are interview invites sent regardless of these scores? I will definitely have my Comlex Level 2/Step 2 CK results back by early fall, just not the PE/CS ones.Thanks!
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That’s going to be very program dependent. Some programs put more weight into board scores than others. It’s also going to depend on how good your step one was. If you did well on your COMLEX1 / step 1, Then I’m sure many programs will be comfortable standing an interview. If you did below their cutoff, they may weight for your step 2, or pass altogether.

Also, realize if you have decent SLOEs, you’ll get interviews regardless.
 
How much, if any, does having a MS degree in physiology (with thesis) help an applicant? Is it just a little boost that adds to the complete picture? Or do programs actively place weight towards having a graduate degree?

I see some programs say "x number of our residents have a graduate degree." And the charting outcomes lists the percent of applied/matched that have a graduate degree.
 
20Hopeful16 said:
How much, if any, does having a MS degree in physiology (with thesis) help an applicant? Is it just a little boost that adds to the complete picture? Or do programs actively place weight towards having a graduate degree?

I see some programs say "x number of our residents have a graduate degree." And the charting outcomes lists the percent of applied/matched that have a graduate degree.
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I cant speak for all programs, but it rarely adds much other than maybe a small talking point during the interview. We don’t factor in graduate degrees into our application scoring. I’d venture to say many EM progrmas fall in that direction, and I bet the folks that do have a graduate degree were often times not even asked about it on the interview trail. I could be wrong, I’m making assumptions based on how I view and score apps, and I realize every program places a different value on different things.
 
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In your opinion, what factors should influence where we decide to apply for our away EM rotation?
 
solitarius said:
In your opinion, what factors should influence where we decide to apply for our away EM rotation?
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First and foremost, you want to rotate at the top 2-3 places you may want to match. Or at least try to. Your rotations should be heavily influenced by your match plans. DO candidate with borderline board scores? You are going to want to hit up community EM programs and former AOA programs. From California and hell bent on matching west coast? You’re going to want to rotate at several places in California (assuming your application is competitive enough). You need to realistically look at where your application stands with your board scores and academic standing, and apply to programs that are your top choices to potentially match at that you think you’ll have a reasonable chance at.
 
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gamerEMdoc said:
First and foremost, you want to rotate at the top 2-3 places you may want to match. Or at least try to. Your rotations should be heavily influenced by your match plans. DO candidate with borderline board scores? You are going to want to hit up community EM programs and former AOA programs. From California and hell bent on matching west coast? You’re going to want to rotate at several places in California (assuming your application is competitive enough). You need to realistically look at where your application stands with your board scores and academic standing, and apply to programs that are your top choices to potentially match at that you think you’ll have a reasonable chance at.
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Can you define what this means? Step 1? Research?

Most of it is SLOEs, so how would we know how competitive we are?
 
Your SLOEs will dictate how competitive you are in the match. But in order to secure rotations, that's going to be based around things like your board scores and your CV. Someone who was an ED scribe for 3 years and has a 265 step 1 is going to have a much easier time securing a rotation at a competitive spot compared to someone with a 220 who has a bare bones CV. Every case is different, and trying to find people who rotate is a very inexact science. I wish there was a better process. I just look at their CV, see what they've done with their life, see where their hometown is, where they went to med school, and look at their boards and try to make an educated guess if they'd be a decent student to have for a month. It's obviously not perfect.
 
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Yeah that happens all the time. Some people are talkers. Some people get right to the point. I only have so many questions to ask. So if someone is quick with their answers, I often finish a few minute early. Its not bad. Every conversation is different.
 
gamerEMdoc said:
Your SLOEs will dictate how competitive you are in the match. But in order to secure rotations, that's going to be based around things like your board scores and your CV. Someone who was an ED scribe for 3 years and has a 265 step 1 is going to have a much easier time securing a rotation at a competitive spot compared to someone with a 220 who has a bare bones CV. Every case is different, and trying to find people who rotate is a very inexact science. I wish there was a better process. I just look at their CV, see what they've done with their life, see where their hometown is, where they went to med school, and look at their boards and try to make an educated guess if they'd be a decent student to have for a month. It's obviously not perfect.
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That being said, I've heard that it is not that difficult to get rotations assuming you get everything in on time/early. What is your bar for "decent" student to have for a month in terms of CV & board scores, taking into consideration the rolling admission?
 
@gamerEMdoc..I just realized today that I hadn't updated my Step 2CS score report. I updated today so hopefully programs will receive it but will it hurt my rank for programs? Will they consider not ranking you if they haven't received the score by certain date? I'm worried..Thank you! Some of my programs finished interviewing early December..so they are probably done with their rank list by now..will they drop or not rank those without CS score?
 
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Osteoth said:
That being said, I've heard that it is not that difficult to get rotations assuming you get everything in on time/early. What is your bar for "decent" student to have for a month in terms of CV & board scores, taking into consideration the rolling admission?
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Too hard to answer, since every place is different. Every place will have different cuttoffs, if they have cutoffs at all. We don't have any hard cutoffs, though I like to see a COMLEX above 500 or a USMLE above 220, but I still will accept lower to rotate as long as their CV makes them sound like a decent candidate.
 
amonty144 said:
@gamerEMdoc..I just realized today that I hadn't updated my Step 2CS score report. I updated today so hopefully programs will receive it but will it hurt my rank for programs? Will they consider not ranking you if they haven't received the score by certain date? I'm worried..Thank you! Some of my programs finished interviewing early December..so they are probably done with their rank list by now..will they drop or not rank those without CS score?
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Unlikely to hurt you, I wouldn't worry. I doubt many have finalized their rank lists already. We finished interviewing earlier this year than any year previous, and yet just had our rank list meeting with our residents today. PD and I will then make any suggested changes based on resident feedback and go back through the list again before finalizing at the beginning of February. I can't imagine that most programs have already submitted or anything like that.
 
You might have answered this already but hard to find in all the 26 pages of posts :). How should we approach the process of applying to rotations, particularly in regards to applying to multiple? Say I want to do 2 away rotations - I'd obviously like to apply to maybe my top 4 programs or so to make sure I get 2 secured. But if I end up getting accepted to three, would it look bad to decline one? Or even worse, maybe I get accepted to my #3 first and accept their offer, but then #1 accepts me a month later and I would rather go there - would it look bad to withdraw from the one I already accepted? Not sure how to tackle this :)
 
cameraman342 said:
You might have answered this already but hard to find in all the 26 pages of posts :). How should we approach the process of applying to rotations, particularly in regards to applying to multiple? Say I want to do 2 away rotations - I'd obviously like to apply to maybe my top 4 programs or so to make sure I get 2 secured. But if I end up getting accepted to three, would it look bad to decline one? Or even worse, maybe I get accepted to my #3 first and accept their offer, but then #1 accepts me a month later and I would rather go there - would it look bad to withdraw from the one I already accepted? Not sure how to tackle this :)
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This happens all the time. Programs accept students for rotation, then get dropped when they get accepted elsewhere. This is a pretty common occurrence. It's not a big deal, unless you are cancelling at a place you really would like to end up at. If you apply to rotate at a place, and they accept you, then you cancel on them, you can't expect them to interview you (though some still will). And that may mean closing the door on one of your top programs.
 
Was pretty surprised to hear that a program recently notified some interviewees that they were "UNLIKELY to match". This just sounds like an obnoxious unnecessary move on the program's part that puts them at risk for SOAP down the road. I've never heard of a program doing this before and feel like it is only disadvantageous to them. Any thoughts from an APD perspective?
 
Sunna12 said:
Was pretty surprised to hear that a program recently notified some interviewees that they were "UNLIKELY to match". This just sounds like an obnoxious unnecessary move on the program's part that puts them at risk for SOAP down the road. I've never heard of a program doing this before and feel like it is only disadvantageous to them. Any thoughts from an APD perspective?
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Program? I mean, statements like yours can be anywhere from gospel to innuendo to absolute falsehood. Even if you PM it to @gamerEMdoc , who can vet it much better, that could really clarify.

And, after 16 years on SDN, I know people value their anonymity, but, really - if you say it's NY Presbyterian, or UCSF, or Tampa General, do you honestly think that crack teams of forensic internet sleuths are going to be assigned, to track you down?

I kid, but, otherwise, it could be construed as fear mongering.
 
I guess there's something to be said for honesty, but this is just a little too overt imo.
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Makes no sense from the programs side. What does the student gain from knowing they aren't going to match there? Its not like that helps the student in any way by allowing them to change their rank list. The program doesn't benefit students from letting them know. This smells to me like people who don't understand how the match works. Just a guess. But they are letting students know so they can change their rank list in case they have that program ranked highly. But that's not how the match works. Ranking a program highly you don't have a chance at doesn't mess up your match chances elsewhere. The whole thing makes no sense.
 
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LChristmas said:
I guess there's something to be said for honesty, but this is just a little too overt imo. View attachment 248700
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That is incredibly strange. I have no doubt that the program leadership thought they were doing a solid to the folks, giving them a realistic idea of their match potential.

Let’s say Henry ford ranked them low - this email only serves to potentially have applicants leave Henry Ford off their rank list completely, which hurts both applicant and program.

Let’s say Henry Ford DID NOT RANK them - well, usually the only reason this occurs is blatant unprofessionalism, or some other intense red flag that wasn’t apparent pre-interview. Either way, it seems weird to tell the folks they are a strong applicant if there is truly a professionalism issue.

Either way, incredibly strange and off putting.
 
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WildcatS11 said:
That is incredibly strange. I have no doubt that the program leadership thought they were doing a solid to the folks, giving them a realistic idea of their match potential.

Let’s say Henry ford ranked them low - this email only serves to potentially have applicants leave Henry Ford off their rank list completely, which hurts both applicant and program.

Let’s say Henry Ford DID NOT RANK them - well, usually the only reason this occurs is blatant unprofessionalism, or some other intense red flag that wasn’t apparent pre-interview. Either way, it seems weird to tell the folks they are a strong applicant if there is truly a professionalism issue.

Either way, incredibly strange and off putting.
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I totally agree. If they were ranked low on HFM's rank list, then this only hurts HFM, because the canddiates that get this message may just drop them from their list. And if HFM went down further on their list than they anticipated, they could be at risk to SOAP. If they only sent it to people they chose to not rank anyways, then it doesnt affect them, but just makes them look like sadists. And hurts them down the road when students here about this for future years. There is absolutely no benefit to either the student nor the program in sending something like this. I've never ever heard of someone doing this.
 
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gamerEMdoc said:
I totally agree. If they were ranked low on HFM's rank list, then this only hurts HFM, because the canddiates that get this message may just drop them from their list. And if HFM went down further on their list than they anticipated, they could be at risk to SOAP. If they only sent it to people they chose to not rank anyways, then it doesnt affect them, but just makes them look like sadists. And hurts them down the road when students here about this for future years. There is absolutely no benefit to either the student nor the program in sending something like this. I've never ever heard of someone doing this.
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Now let's just imagine for a minute that applicants who received this email end up matching there because HFM goes that far down their rank list...
 
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talk about disrespectful to the people who spent time and money flying to interview at your program. that notice benefits no one, and only hurts themselves for future years. thank goodness this place was no where near my radar, not a place I’d want to end up.
 
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gamerEMdoc said:
Rank list is done. A few weeks to relax, then its time to start looking at 3rd year apps to rotate. 2020 match is only a year away!
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Congrats! Hope you have some relaxing time. Do you ever tweak your rank list after this based on anything your applicants tell you?
 
Nope we submitted the list, generally do before we reach out to people and let a small number know that we have them competitively ranked. Students telling us where they are going to rank us doesn’t change our list. We are going to rank people in the order we want them. That’s the smart way to approach your rank list.
 
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gamerEMdoc said:
Nope we submitted the list, generally do before we reach out to people and let a small number know that we have them competitively ranked. Students telling us where they are going to rank us doesn’t change our list. We are going to rank people in the order we want them. That’s the smart way to approach your rank list.
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Do you expect a reply to your email to applicants telling them you're ranking them highly?
 
gamerEMdoc said:
I reply to some, but not every one. Our PD prefers to make calls to our top tier of candidates, though we certainly match people that dont get called.
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I think the q was for the opposite situation - if an applicant receives a voice mail or email
 
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gamerEMdoc said:
I reply to some, but not every one. Our PD prefers to make calls to our top tier of candidates, though we certainly match people that dont get called.
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I think it's interesting that programs call as really it's only to influence rank lists at the end of day. The NRMP should make a strict no post-interview communication policy for both applicants and programs similar to what I believe Canada does. I have received one such message and it definitely has made me think that I should rank this program higher as I do feel loved. This is ridiculous really as I'm actually considering ranking a program potentially lower as I received no contact which should not be the case. I know from a program's perspective you mentioned, as well as in the AliEM videos, that applicant's LOIs essentially makes zero impact and I don't think programs should contact applicants as it can have a greater impact by making ranking programs more difficult.
 
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Spagett! said:
I think the q was for the opposite situation - if an applicant receives a voice mail or email
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Oh shoot, I did read that wrong. Yeah, honestly I don't think is a big deal if you dont because the rank list is submitted and isn't going to change on our end. So while a reply is appreciated, not replying isn't hurting anyone. However, that's just my programs perspective. n=1
 
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HOPEtbiEM19 said:
I think it's interesting that programs call as really it's only to influence rank lists at the end of day. The NRMP should make a strict no post-interview communication policy for both applicants and programs similar to what I believe Canada does. I have received one such message and it definitely has made me think that I should rank this program higher as I do feel loved. This is ridiculous really as I'm actually considering ranking a program potentially lower as I received no contact which should not be the case. I know from a program's perspective you mentioned, as well as in the AliEM videos, that applicant's LOIs essentially makes zero impact and I don't think programs should contact applicants as it can have a greater impact by making ranking programs more difficult.
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I actually totally agree with you, I think all the post-interview stuff is silly. If the NRMP did ban LOIs from students and calls/emails from programs, I'd be perfectly ok with it. But until that happens, I feel like if you don't tell at least some of the candidates where you stand, you are at a disadvantage to programs that do for some candidates. I always stand by the statement for programs and students, that neither side should let these comments effect their rank list. However, I also acknowledge that some places/candidates aren't going to heed that advice because they place value in feeling wanted.

As a side note, one concern of mine of banning all communication post-interview is how that would effect advising. I help a lot of students and give advice all year long, and students that rotate with me early on are sometimes in touch and ask questions mid interview season, unrelated to rank list. I would hope that wouldn't be banned by some sort of banning all communication between programs and students.
 
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Out of curiosity, how far down the list do most programs go?
 
doc2be245 said:
Out of curiosity, how far down the list do most programs go?
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National average from the match data is 6.4 ranks/spot in 2018 for EM, and that varies only a little bit each year going back the last 5 years. So for a program ranking 10 spots, they go down to about 65 on their list. However, that's an average, there are some that match way better, others that match lower, and it can vary a ton from year to year. We've been matching over the last few years about 4.5/spot on average, but it only takes one year where you match way lower to bring that number down to the average.

Most programs are going to interview about 10 candidates for each one spot, so 100 candidates for a 10/year residency.

That means most programs are going down to the middle of their list to fill their spots.
 
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@gamerEMdoc I'm a current applicant who has been fortunate enough to have received many interviews in the North East. But am having trouble coming up with my rank list.

I'm most interested in academics, becoming involved in residency leadership (PD, APD, Clerkship Director, etc.). There are certain programs I interviewed at that are "more academic" but the fit of the residents isn't as great (I didn't really get a gut reaction that I clicked there as much as I did at some other community programs in the area). While this isn't to say I hated these academic places, they were just not as "home-y" as the community programs.

How do you decide on what to rank higher? A less academic program where you think you fit in better, or a more academic program a little further away from home (30 mins further), but the residents aren't as fun. Specifically with respect to my goal of landing an academic position later on as APD, PD, Clerkship Director, etc.
 
CardiacLion said:
@gamerEMdoc I'm a current applicant who has been fortunate enough to have received many interviews in the North East. But am having trouble coming up with my rank list.

I'm most interested in academics, becoming involved in residency leadership (PD, APD, Clerkship Director, etc.). There are certain programs I interviewed at that are "more academic" but the fit of the residents isn't as great (I didn't really get a gut reaction that I clicked there as much as I did at some other community programs in the area). While this isn't to say I hated these academic places, they were just not as "home-y" as the community programs.

How do you decide on what to rank higher? A less academic program where you think you fit in better, or a more academic program a little further away from home (30 mins further), but the residents aren't as fun. Specifically with respect to my goal of landing an academic position later on as APD, PD, Clerkship Director, etc.
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So to answer this question, it really depends on what your long-term goal is when you say you want to do residency admin. If you want to do residency admin in a community program, you can do so easily through a community residency. If you want to do residency admin at a prestigious University based program, to become faculty you MAY fight an uphill battle. Maybe. I'll relate my own story. I was a pretty competitive applicant and had plenty of University program invites, but I chose to train at a community program because that's where I had the best rotations. It was where I felt comfortable. Everyone has different things they weigh when ranking residencies, its a very personal decision, but for me I liked training in a community EM program. When it came time to getting a job (after my military days were over) I had no trouble getting a job as faculty in a community EM program. I was there a year and became the assistant PD. I was the Associate PD the next year. I've had offers to interview at PD jobs, and have been inquired about for an APD job at a University program, none of which I pursued. There are opportunities for program leadership, and if you train in the community it certainly doesn't mean you can't do it. I have plenty of graduates that are faculty in residencies, both in my own and elsewhere. Two of my graduates are Associate PDs elsewhere. Once you are in as faculty, its all about having the interest in program leadership, and then there being an opening.

I'm not saying this easily possible, because it depends on where you want to work and when the admin jobs actually open up. Sometimes the PD/APD are younger and have no plans on ever moving on. Sometimes there is frequent turnover. Every place is going to be different.

So the short answer, no, you aren't closing the door on program leadership if you do a community EM residency.
 
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