EM PD - Ask Me Anything

[gamerEMdoc]

Unfortunately, I found that hangout significantly lacking in actual advice. I think next week's hangout with CORD will prove to be more fruitful.

I think the question that needs a definitive answer from cord is, if I choose to do more than one em rotation and my school lets me, will programs hold that against me. There needs to be a hard stance by them if the expect students to follow their recommendations.

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[EDCuddler]

So, I'm curious. Let's say I get my one EM SLOE, then I sign up for a bunch of EM subspecialty rotations around the country (I'm a DO student with no home programs). Will I be penalized for the travel? Would it be acceptable to travel if I am following travel guidelines? In the most extreme case, I would even be willing to quarantine in another state for two weeks before my rotation starts.

And lets say I go through with this plan. Would I have to explain how I traveled responsibly in my personal statement or something? I would really love to get your thoughts on this.

 

[gamerEMdoc]

So, I'm curious. Let's say I get my one EM SLOE, then I sign up for a bunch of EM subspecialty rotations around the country (I'm a DO student with no home programs). Will I be penalized for the travel? Would it be acceptable to travel if I am following travel guidelines? In the most extreme case, I would even be willing to quarantine in another state for two weeks before my rotation starts.

And lets say I go through with this plan. Would I have to explain how I traveled responsibly in my personal statement or something? I would really love to get your thoughts on this.

I honestly dont know. I think the intent is for students to stay at their schools / clinical sites as much as possible. So maybe some would question it. I just dont know. This is an unprecedented year and no one knows how anyone is going to react to any of this.

 

[pepperonipizzas]

So, I'm curious. Let's say I get my one EM SLOE, then I sign up for a bunch of EM subspecialty rotations around the country (I'm a DO student with no home programs). Will I be penalized for the travel? Would it be acceptable to travel if I am following travel guidelines? In the most extreme case, I would even be willing to quarantine in another state for two weeks before my rotation starts.

And lets say I go through with this plan. Would I have to explain how I traveled responsibly in my personal statement or something? I would really love to get your thoughts on this.

I'm in the same boat, DO student with no home programs. But worse, our school just notified us that they only have half of their normal rotations due to COVID and ALL rotations are reserved for 3rd years. We are not allowed to contact any docs in our region for rotations. They pretty much said move to the state you want to match in... well I wish I knew.

So that being the case, I think my options are move to the state that I will do my one EM/SLOE, and try to set up rotations there. But seems like setting up 2-3 geographically close rotations let alone an entire 6 months to a year in one spot is proving to be impossible and we might have to travel around. I fear my app will get screened out based on "irresponsibly traveling during covid" without the opportunity to explain myself. How would you proceed @gamerEMdoc

 

[Dr Mantis Toboggan]

I'm in the same boat, DO student with no home programs. But worse, our school just notified us that they only have half of their normal rotations due to COVID and ALL rotations are reserved for 3rd years. We are not allowed to contact any docs in our region for rotations. They pretty much said move to the state you want to match in... well I wish I knew.

So that being the case, I think my options are move to the state that I will do my one EM/SLOE, and try to set up rotations there. But seems like setting up an entire 6 months to a year in one spot is proving to be impossible and we might have to travel around. I fear my app will get screened out based on "irresponsibly traveling during covid" without the opportunity to explain myself. How would you proceed @gamerEMdoc

how much tuition are they charging you for such amazing advice/help? Should be $0.

 

[pepperonipizzas]

how much tuition are they charging you for such amazing advice/help? Should be $0.

About 60k..

 

[Dr Mantis Toboggan]

About 60k..

No words. Sorry.

 

[gamerEMdoc]

I'm in the same boat, DO student with no home programs. But worse, our school just notified us that they only have half of their normal rotations due to COVID and ALL rotations are reserved for 3rd years. We are not allowed to contact any docs in our region for rotations. They pretty much said move to the state you want to match in... well I wish I knew.

So that being the case, I think my options are move to the state that I will do my one EM/SLOE, and try to set up rotations there. But seems like setting up 2-3 geographically close rotations let alone an entire 6 months to a year in one spot is proving to be impossible and we might have to travel around. I fear my app will get screened out based on "irresponsibly traveling during covid" without the opportunity to explain myself. How would you proceed @gamerEMdoc

I don't think it will get screened out. Just do your one EM rotation, get one SLOE. No one is going to know where you did your other 4th year rotations, no one will look at your app that closely even if it was somehow on the transcript, and even if they did and asked you about it, saying my school abandoned me isn't going to hurt you.

 

[gamerEMdoc]

FYI, if anyone knows any "orphan" EM interested candidates who can't find one EM rotation, DM me and let me know, I'm likely to have some open spots. I emailed everyone that is already scheduled explaining they should only be doing one and telling them if they have to cancel, we won't hold it against them come time to interview. I am expecting to see a decent number of cancellations. That being said, I can't take any US or non-US IMGs. For interview and match, we do, but for rotation, our state has some regulation against students from non-US schools getting clearance to rotate as students in state.

 

[Turducken21]

Looks like I won't have my SLOE until mid November at the earliest. How much trouble am I in? I'm honestly considering a gap year

 

[gamerEMdoc]

Looks like I won't have my SLOE until mid November at the earliest. How much trouble am I in? I'm honestly considering a gap year

Why? Programs can't access apps until the last week of October. In the past it takes programs 4-6 weeks to send out invites. And this year programs are being told to consider candidates even if they have no sloes. Why would you do a gap year? Just apply, and then if it doesn't go your way, then do something. Why give up now.

 

[Turducken21]

Well if I did take a year off, I would want to complete another degree like an MPH or MBA. Those applications are basically due now for most schools so I need to make up my mind. I would just hate to miss out on a decent residency just because my school can't schedule me for an EM rotation until late in the cycle. I know programs are told to consider candidates without a sloe but idk, would I really be taken that seriously at good programs without one? Maybe I'm just being dramatic but it's a concern of mine. Thanks for your response.

 

[gamerEMdoc]

Oh I see, I wasn't aware of the MPH/MBA timeline. Makes sense.

 

[The Knife & Gun Club]

Im in no way an

Well if I did take a year off, I would want to complete another degree like an MPH or MBA. Those applications are basically due now for most schools so I need to make up my mind. I would just hate to miss out on a decent residency just because my school can't schedule me for an EM rotation until late in the cycle. I know programs are told to consider candidates without a sloe but idk, would I really be taken that seriously at good programs without one? Maybe I'm just being dramatic but it's a concern of mine. Thanks for your response.

authority on this, but if you really care about this disciples and see yourslelf using the degree, I’d say do it.

consider it’s an extra year of lost income, and more loans without a huge bump in income. But you’d also get To avoid the ****show this is going to be this upcoming app cycle.

 

[hopefullyafutureDOstudent]

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

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

Hi Doc! thanks for doing this thread

I just posted a thread on this, but I was wondering how you and other PD's are viewing the new CORD guidelines of 1 SLOE per applicant. If we have had other auditions scheduled since before COVID and they are all still available and want us to come, should we still cancel?

Will it look bad to you and other PD's if we keep these auditions and show up with a lot of SLOE's ?

 

[gamerEMdoc]

Hi Doc! thanks for doing this thread

I just posted a thread on this, but I was wondering how you and other PD's are viewing the new CORD guidelines of 1 SLOE per applicant. If we have had other auditions scheduled since before COVID and they are all still available and want us to come, should we still cancel?

Will it look bad to you and other PD's if we keep these auditions and show up with a lot of SLOE's ?

Yes. It will look bad. How bad, I don't know. This is something I haven't seen anyone discuss. But the general consensus I've heard from things like the EMRA hangouts is that any more than one you will be asked to justify it.

Here's my best guess:
- 2 rotations/sloes, you'll get asked about it but if you have a good reason, some people will let that slide, some won't
- 3 or more EM rotations- you will be routinely blacklisted and considered selfish and not a team player

 

[ERinspired]

Why? Programs can't access apps until the last week of October. In the past it takes programs 4-6 weeks to send out invites. And this year programs are being told to consider candidates even if they have no sloes. Why would you do a gap year? Just apply, and then if it doesn't go your way, then do something. Why give up now.

Hi GamerDoc, based on this comment it seems that I shouldn’t panic too much about relying on a SLOE from a rotation that will end Oct 23?

 

[hopefulERdoc251]

@gamerEMdoc , thanks for all the useful information you've been providing us with! I have 2 questions (not sure if there's a right answer, if any).

My home institution has an EM residency program which I'll be rotating through to get a SLOE. I am also currently signed up for a home EMS rotation as well, and was wondering if I received a LOR from them if that would be frowned upon? I don't believe it would be a SLOE, rather just a LOR.

Also, my significant other and I are couples matching this year...both in EM....and I know CORD came out with application limits for this upcoming year. Is there any word on if there is a cap for couples that are trying to couples match? I didn't recall seeing one on the CORD statement but I was just wondering. We both are very competitive based on solely board scores, but I know the SLOE will be the main deciding factor on how successful couples matching will be for us. Thanks again for everything!

 

[Pokedoc]

Hi GamerDoc, based on this comment it seems that I shouldn’t panic too much about relying on a SLOE from a rotation that will end Oct 23?

During the EMRA Hangouts session yesterday they stated specifically that not having a SLOE on file by the time that ERAS opens on Oct 21st (and thus not having a complete application) will likely severely limit your ability to match, or at least match well. I was actually surprised by how open and direct Dr. Gallahue and Dr. Jung were in regards to this aspect in particular. Basically they said that the extended deadline benefits us in that it gives us as students more time to get a SLOE by the deadline, however it will provide PDs with much less time than they are used to when it comes to reviewing apps for interviews (which is already a crazy process in a normal year), so Dr. Gallahue at one point straight up said that if you do not have one residency-based SLOE you will not match. That might have been hyperbole but it is what she said, though I'm sure even she can't speak for how all PDs will handle this upcoming season.

One thing that was a clear though was that you really should not be getting any more than 1 or 2 SLOEs. They basically said that the only way to have two SLOEs and not be penalized is if your institution has two associated EM residencies that absolutely do not take any students other than the ones from your school, which means that you would not be taking a spot from any other potential student who does not have an opportunity to get one. The example she used was Harvard, where this is apparently the case. It was disheartening though to hear how other students are receiving different advice from their programs, in that they should still be going on as many auditions as possible despite the recommendations. One student described how their program has four (!) "associated" residency programs, and that they were being advised by their school to apply to all of them and take as many as they could get. Dr. Hughes was VERY clear that this was a horrible idea, because even though the programs are associated with their institution having any more than two SLOEs on your app will essentially be a death knell for any student no matter the circumstances when it comes to matching. At one point they alluded to the fact that based off of the conversations they have been having with many PDs across the country, this is almost universally how it will be handled.

gamerEMdoc has already stated previously in this thread much of what I echoed above, just thought that I would provide some insight from another source for those who could not watch the meeting yesterday as it was actually very informative.

Edit: To clarify what I said above they stated that if the only chance you have to get a SLOE is from a rotation that won't end until after the opening date for ERAS, then definitely take it. Just that if you can get an earlier one then that is definitely going to be preferable.

 

[Pokedoc]

@gamerEMdoc , thanks for all the useful information you've been providing us with! I have 2 questions (not sure if there's a right answer, if any).

My home institution has an EM residency program which I'll be rotating through to get a SLOE. I am also currently signed up for a home EMS rotation as well, and was wondering if I received a LOR from them if that would be frowned upon? I don't believe it would be a SLOE, rather just a LOR.

Also, my significant other and I are couples matching this year...both in EM....and I know CORD came out with application limits for this upcoming year. Is there any word on if there is a cap for couples that are trying to couples match? I didn't recall seeing one on the CORD statement but I was just wondering. We both are very competitive based on solely board scores, but I know the SLOE will be the main deciding factor on how successful couples matching will be for us. Thanks again for everything!

I'm obviously not gamerEMdoc but this was specifically addressed in the EMRA meeting yesterday so I think I might be able to help as well.

Doing both the residency based EM rotation and the EMS rotation will not be a problem, and will actually benefit you, Don't get a normal LOR from the EMS rotation though. There will be a specific "sub-specialty" SLOE distributed by CORD here in the near future that rotations like EM ultrasound, toxicology, wilderness medicine, and EMS should use for their evaluations, and will make the process more standardized. Really any evaluation that you get from a clinical rotation should be in the form of one of these SLOEs, as there will even be a non-EM residency based SLOE distributed in the near future as well that should be used in lieu of a classic letter of recommendation from preceptors.

The recommendations from CORD are for normal applicants to do 12 residency interviews, and for abnormal applicants (like couple-matches) to do a max of 17. This is based off of NRMP data that shows how 12 interviews provide something like a 98% chance of matching normally, while 17 provides basically as close to 100% chance of matching as you can get. Now this data is based off of normal years where traveling to interviews is limited by funding and time, which is not the case this year so I'm not exactly sure if it will hold up if other students decide not to abide by this particular recommendation and go on as many as they can get their hands on. From what I understand from alumni I have spoken with though even if the interviews are virtual you likely won't want to do more than the currently recommended number as you will be exhausted/drained by that point and will be receiving diminishing returns.

 

[boolin_1]

During the EMRA Hangouts session yesterday they stated specifically that not having a SLOE on file by the time that ERAS opens on Oct 21st (and thus not having a complete application) will likely severely limit your ability to match, or at least match well. I was actually surprised by how open and direct Dr. Gallahue and Dr. Jung were in regards to this aspect in particular. Basically they said that the extended deadline benefits us in that it gives us as students more time to get a SLOE by the deadline, however it will provide PDs with much less time than they are used to when it comes to reviewing apps for interviews (which is already a crazy process in a normal year), so Dr. Gallahue at one point straight up said that if you do not have one residency-based SLOE you will not match. That might have been hyperbole but it is what she said, though I'm sure even she can't speak for how all PDs will handle this upcoming season.

One thing that was a clear though was that you really should not be getting any more than 1 or 2 SLOEs. They basically said that the only way to have two SLOEs and not be penalized is if your institution has two associated EM residencies that absolutely do not take any students other than the ones from your school, which means that you would not be taking a spot from any other potential student who does not have an opportunity to get one. The example she used was Harvard, where this is apparently the case. It was disheartening though to hear how other students are receiving different advice from their programs, in that they should still be going on as many auditions as possible despite the recommendations. One student described how their program has four (!) "associated" residency programs, and that they were being advised by their school to apply to all of them and take as many as they could get. Dr. Hughes was VERY clear that this was a horrible idea, because even though the programs are associated with their institution having any more than two SLOEs on your app will essentially be a death knell for any student no matter the circumstances when it comes to matching. At one point they alluded to the fact that based off of the conversations they have been having with many PDs across the country, this is almost universally how it will be handled.

gamerEMdoc has already stated previously in this thread much of what I echoed above, just thought that I would provide some insight from another source for those who could not watch the meeting yesterday as it was actually very informative.

she didn't say this. they said that you will be at a disadvantage for sure, but did not say you will not match. if your earliest residency-based SLOE is after Oct 21st, then that is fine. Try your hardest to get an earlier rotation to see if you can get a letter in before Oct 21st. Also keep in mind that your rotation ends Oct 23rd, @ERinspired , does not mean you'll get a letter on the 24th. it could take them weeks to write it.

 

[Pokedoc]

she didn't say this. they said that you will be at a disadvantage for sure, but did not say you will not match. if your earliest residency-based SLOE is after Oct 21st, then that is fine. Try your hardest to get an earlier rotation to see if you can get a letter in before Oct 21st. Also keep in mind that your rotation ends Oct 23rd, @ERinspired , does not mean you'll get a letter on the 24th. it could take them weeks to write it.

I was really surprised when she said it (and I honestly couldn't tell if she misspoke at the time though she did not correct herself), but she did absolutely say "if you don't have one you won't match". When they upload the meeting on the EMRA website I'll link and timestamp the moment I am talking about for clarification and so that you can see what I am talking about. It was odd because it went against everything they have said about PDs needing to be more lenient towards applications with fewer SLOEs than normal this application season, however they did clarify repeatedly that one SLOE should be seen as a complete application this season (not zero).

I'm not trying to freak people out, I'm just trying to provide as much information as possible so that other students can make an informed decision.

 

[boolin_1]

I was really surprised when she said it (and I honestly couldn't tell if she misspoke at the time though she did not correct herself), but she did absolutely say "if you don't have one you won't match". When they upload the meeting on the EMRA website I'll link and timestamp the moment I am talking about for clarification and so that you can see what I am talking about. It was odd because it went against everything they have said about PDs needing to be more lenient towards applications with fewer SLOEs than normal this application season, however they did clarify repeatedly that one SLOE should be seen as a complete application this season (not zero).

I'm not trying to freak people out, I'm just trying to provide as much information as possible so that other students can make an informed decision.

my understanding of that comment was that if you don't have a SLOE at the end of it all, you won't match. and if you don't have a SLOE by the time apps open on Oct 21st, you'll be at an disadvantage for sure, but you'll still get interviews if it comes in later than Oct 21st

 

[gamerEMdoc]

Hi GamerDoc, based on this comment it seems that I shouldn’t panic too much about relying on a SLOE from a rotation that will end Oct 23?

Not at all. Programs won't see your app until the last week of Oct at the earliest, but most programs take several weeks once ERAS opens before they start even granting their initial interviews. And this year, CORD is saying expect one SLOE and it may not come until the winter. I think you'll be fine.

 

[gamerEMdoc]

During the EMRA Hangouts session yesterday they stated specifically that not having a SLOE on file by the time that ERAS opens on Oct 21st (and thus not having a complete application) will likely severely limit your ability to match, or at least match well. I was actually surprised by how open and direct Dr. Gallahue and Dr. Jung were in regards to this aspect in particular. Basically they said that the extended deadline benefits us in that it gives us as students more time to get a SLOE by the deadline, however it will provide PDs with much less time than they are used to when it comes to reviewing apps for interviews (which is already a crazy process in a normal year), so Dr. Gallahue at one point straight up said that if you do not have one residency-based SLOE you will not match. That might have been hyperbole but it is what she said, though I'm sure even she can't speak for how all PDs will handle this upcoming season.

One thing that was a clear though was that you really should not be getting any more than 1 or 2 SLOEs. They basically said that the only way to have two SLOEs and not be penalized is if your institution has two associated EM residencies that absolutely do not take any students other than the ones from your school, which means that you would not be taking a spot from any other potential student who does not have an opportunity to get one. The example she used was Harvard, where this is apparently the case. It was disheartening though to hear how other students are receiving different advice from their programs, in that they should still be going on as many auditions as possible despite the recommendations. One student described how their program has four (!) "associated" residency programs, and that they were being advised by their school to apply to all of them and take as many as they could get. Dr. Hughes was VERY clear that this was a horrible idea, because even though the programs are associated with their institution having any more than two SLOEs on your app will essentially be a death knell for any student no matter the circumstances when it comes to matching. At one point they alluded to the fact that based off of the conversations they have been having with many PDs across the country, this is almost universally how it will be handled.

gamerEMdoc has already stated previously in this thread much of what I echoed above, just thought that I would provide some insight from another source for those who could not watch the meeting yesterday as it was actually very informative.

Edit: To clarify what I said above they stated that if the only chance you have to get a SLOE is from a rotation that won't end until after the opening date for ERAS, then definitely take it. Just that if you can get an earlier one then that is definitely going to be preferable.

Crazy. The EMRA/CORD hangout the week before specifically said expect one SLOE and it may not come until December. Haha. No one knows, unfortunately, and all we are getting is individual opinion.

Obviously get your SLOE as early as possible. But that has always been the case, the date is just moved back this year. I just know how these interviews roll out, so finishing one in late Oct, assuming whoever writes it can write it promptly, is very unlikely to hurt.

 

[gamerEMdoc]

she didn't say this. they said that you will be at a disadvantage for sure, but did not say you will not match. if your earliest residency-based SLOE is after Oct 21st, then that is fine. Try your hardest to get an earlier rotation to see if you can get a letter in before Oct 21st. Also keep in mind that your rotation ends Oct 23rd, @ERinspired , does not mean you'll get a letter on the 24th. it could take them weeks to write it.

I would ask early on in the rotation who writes the programs SLOEs (everyone should do that) and I would ask that person if they can get it done promptly given the application timeline. Trust me, they should understand if they are fairly reputable. I pump at least 20 or more of these out in a 2 week period from Sept 1-15th every year in preparation for the deadline. You have to get them done, everyone is counting on you for their app.

 

[ERinspired]

Crazy. The EMRA/CORD hangout the week before specifically said expect one SLOE and it may not come until December. Haha. No one knows, unfortunately, and all we are getting is individual opinion.

Obviously get your SLOE as early as possible. But that has always been the case, the date is just moved back this year. I just know how these interviews roll out, so finishing one in late Oct, assuming whoever writes it can write it promptly, is very unlikely to hurt.

Thank you for all your help GamerDoc!

I’m really struggling with the dichotomy of what has happened with the CORD/Consensus statement. On the one hand, opportunities are more limited this year, so having a strong position on limiting auditions so that everyone is able to get one is important. On the other hand, by doing this, it is forcing us to choose which rotation we have that we value the most. My later spot is at a residency program I very much want to match at. But in keeping that rotation, I am unable to get an earlier spot not because there isn’t anything available but because I’m trapped by the limit set. Which means that the recommendation that was created to help everyone ensure they have what they need to match favorably is actually potentially keeping me from doing so.

 

[martvubo]

I know peds is a subspecialty, so explicitly by what the CORD recs say it should be kosher, but they specifically name ultrasound and tox, which seem way more niche in a meaningfully different way (i.e. peds is still "initial management of undifferentiated patients" just with a limited patient population, while those others are specific aspects of management).

Do you think a peds EM SLOE would be viewed as "trying to skirt the rules" or is it fine?

 

[gamerEMdoc]

I know peds is a subspecialty, so explicitly by what the CORD recs say it should be kosher, but they specifically name ultrasound and tox, which seem way more niche in a meaningfully different way (i.e. peds is still "initial management of undifferentiated patients" just with a limited patient population, while those others are specific aspects of management).

Do you think a peds EM SLOE would be viewed as "trying to skirt the rules" or is it fine?

No its fine. Basically anything that is a fellowship in EM is what the subpecialty sloe is for.

 

[gamerEMdoc]

Thank you for all your help GamerDoc!

I’m really struggling with the dichotomy of what has happened with the CORD/Consensus statement. On the one hand, opportunities are more limited this year, so having a strong position on limiting auditions so that everyone is able to get one is important. On the other hand, by doing this, it is forcing us to choose which rotation we have that we value the most. My later spot is at a residency program I very much want to match at. But in keeping that rotation, I am unable to get an earlier spot not because there isn’t anything available but because I’m trapped by the limit set. Which means that the recommendation that was created to help everyone ensure they have what they need to match favorably is actually potentially keeping me from doing so.

I hear you. It's frustrating for sure. Ideally you want to make your one rotation count, so if you have a program that is your top choice, you would do it there. The problem is, if you can't get that rotation until November, then you are risking not having a SLOE until too late all to rotate at your #1. Its maddening.

My best advice would be to rotate at your ideal place and keep that one, as long as you can get a SLOE before Nov 1. Otherwise, you have to take what you can get.

 

[pillowsnice]

Forgive me if I am misunderstanding, but anyone who does a rotation at a residency affiliated program will get a group SLOE, but since my home rotation will be my only EM exposure, I can also ask individual attendings that I worked shifts with to write an individual SLOE? Or is that like "double dipping" since I will already receive a group SLOE from that rotation, but an individual SLOE from 1-2 attendings that I thought I worked well with.

 

[gamerEMdoc]

Forgive me if I am misunderstanding, but anyone who does a rotation at a residency affiliated program will get a group SLOE, but since my home rotation will be my only EM exposure, I can also ask individual attendings that I worked shifts with to write an individual SLOE? Or is that like "double dipping" since I will already receive a group SLOE from that rotation, but an individual SLOE from 1-2 attendings that I thought I worked well with.

Yeah, you don't get more than one sloe from the same rotation. You get one SLOE from a rotation. You don't double dip. That way, the program ideally takes everyones opinion to form an idea of how you rank among your peers, not just one person. This is how rank lists are made. Otherwise, if it were just one persons opinion, it would diminish the credibility of the SLOE since it would be really easy to just try to find the one person that is a super easy grader, or who you can suck up to. Its better to have one group consensus come together to determine the SLOE ranks.

 

[camtheram1815]

@gamerEMdoc

Any ideas on the minimum number of total letters, both SLOE and otherwise, to be considered complete this year. Will three total letters (one EM SLOE, two non-EM physician SLOEs via the upcoming template in July) be enough?

Thanks in advance!

 

[gamerEMdoc]

Depends. There is no “complete” app, that is defined by the programs. You can submit up to four. Not everyone expects four, some do. Personally I think students should get 4 letters just to be safe, but honestly in normal years I make my decision off two sloes and thats it and I really dont care about much beyond that. But thats just me.

 

[pillowsnice]

Yeah, you don't get more than one sloe from the same rotation. You get one SLOE from a rotation. You don't double dip. That way, the program ideally takes everyones opinion to form an idea of how you rank among your peers, not just one person. This is how rank lists are made. Otherwise, if it were just one persons opinion, it would diminish the credibility of the SLOE since it would be really easy to just try to find the one person that is a super easy grader, or who you can suck up to. Its better to have one group consensus come together to determine the SLOE ranks.

Thanks for the response. Can individual SLOEs be written by EM physicians not involved in the group SLOE? That was my understanding from a few advisors at my institution.

Also, how late can a LOR be submitted this year with the new deadline?

 

[gamerEMdoc]

Thanks for the response. Can individual SLOEs be written by EM physicians not involved in the group SLOE? That was my understanding from a few advisors at my institution.

Also, how late can a LOR be submitted this year with the new deadline?

No. You should not get more than one SLOE from a rotation. It makes absolutely no sense to have a group consensus statement, then have some random faculty who worked with you twice write something based on a smalerl sample size that may contradict everyone else in the residency. It completely goes against the purpose of the SLOE. You definitely should not be getting more than one SLOE per rotation.

As for letters and timeframe for submission, you can upload letters all the way up to the match. There is no deadline of when a letter must be submitted for. However, IDEALLY, you would want your SLOE (2 sloes in a normal year) to be uploaded by the time programs have access to your app, which is usually mid-Sept but this year its the last week of October.

 

[Doctor_Strange]

Is 3 weeks too short to give a program notice about possibly not attending the audition? One of my board exams got axed and it threw my schedule in flux. Start date was to be 6/29.

I don't want to burn any bridges, so I am debating just taking my exam after my one and only auditon but I would prefer not to really.

@gamerEMdoc, if this was at your program is it too late to even ask such a thing to the program coordinator?

 

[gamerEMdoc]

Is 3 weeks too short to give a program notice about possibly not attending the audition? One of my board exams got axed and it threw my schedule in flux. Start date was to be 6/29.

I don't want to burn any bridges, so I am debating just taking my exam after my one and only auditon but I would prefer not to really.

@gamerEMdoc, if this was at your program is it too late to even ask such a thing to the program coordinator?

I wouldn't cancel my one and only rotation only because you aren't guaranteed to get another one, at least not before ERAS opens up. That seems really risky. Unless you actually have two and aren't saying it.

If that is truly your one and only, I'd consider asking the program if you can push it back to Aug or Sept possibly. If they can't, I think you are stuck and should do the rotation.

 

[Doctor_Strange]

I wouldn't cancel my one and only rotation only because you aren't guaranteed to get another one, at least not before ERAS opens up. That seems really risky. Unless you actually have two and aren't saying it.

If that is truly your one and only, I'd consider asking the program if you can push it back to Aug or Sept possibly. If they can't, I think you are stuck and should do the rotation.

I appreciate the candid advice! I think I will stick with it -- who is to say the hospital system or some other site I am interested in closes their doors due to a local COVID outbreak etc. Too many variables.

Thank you!

Edit: It's also my only EM rotation. EMRA / CORD made it abundantly clear so I don't wanna red flag myself. On the topic of notice for cancellation, as a rule going forward would you think 3 weeks notice is cutting it close or is that not unusual?

 

[gamerEMdoc]

I appreciate the candid advice! I think I will stick with it -- who is to say the hospital system or some other site I am interested in closes their doors due to a local COVID outbreak etc. Too many variables.

Thank you!

Edit: It's also my only EM rotation. EMRA / CORD made it abundantly clear so I don't wanna red flag myself. On the topic of notice for cancellation, as a rule going forward would you think 3 weeks notice is cutting it close or is that not unusual?

Thats cutting it close for a rotation, but more than enough heads up for an interview.

 

[surely]

Thats cutting it close for a rotation, but more than enough heads up for an interview.

Now that interviews are going to be virtual, even a week's notice of declining an interview should be plenty!

 

[deleted645092]

Regarding extenuating circumstances, what if I took a year off between 3rd and 4th year? It was non-academic and non-health related. I‘m a DO student with 2 always right now, no home hospital so I’m an “orphan”, and I’m anticipating my first one being subpar because of how much time I was away from the hospital.

 

[Dr.Bruh]

@gamerEMdoc few questions for ya if you dont mind.

My DO school doesn't have a home program but I was able to get 2 preceptor based (not associated with residency programs) EM rotations locally through my school for the fall. Is it correct that doing these non-residency/non-SLOE based EM rotations will not "look bad" since i'm not taking away anyones "spot" for a SLOE?. Will PDs be able to tell the difference on my transcript that these were non-residency rotations (my fear is that my transcript will just say i had like 3 EM rotations in the fall even though only 1 was a 'true' away/SLOE EM rotation). One of these rotations will be non-residency rotations will be designated as my EM CORE rotation (my school requires a 4th year EM rotation), and I'm concerned how my school codes that on my transcript may cause some confusion.

 

[surely]

Regarding extenuating circumstances, what if I took a year off between 3rd and 4th year? It was non-academic and non-health related. I‘m a DO student with 2 always right now, no home hospital so I’m an “orphan”, and I’m anticipating my first one being subpar because of how much time I was away from the hospital.

Do a rotation in something else first, like internal medicine or family medicine or ultrasound or even critical care, then do ONE EM rotation. Don't give yourself a red flag.

 

[Doctor_Strange]

Regarding extenuating circumstances, what if I took a year off between 3rd and 4th year? It was non-academic and non-health related. I‘m a DO student with 2 always right now, no home hospital so I’m an “orphan”, and I’m anticipating my first one being subpar because of how much time I was away from the hospital.

That's my worry as well. July will be my first time back in the hospital since early March. I'm hoping the program takes that into account all things considered.

 

[deleted645092]

Do a rotation in something else first, like internal medicine or family medicine or ultrasound or even critical care, then do ONE EM rotation. Don't give yourself a red flag.

Unfortunately its June right now and these are scheduled for July and August.

 

[surely]

Unfortunately its June right now and these are scheduled for July and August.

Keep the one in August and find something else to do in July!

 

[deleted645092]

Keep the one in August and find something else to do in July!

Lol man I don't want to sound like I'm giving attitude because presuming youre a resident or attending you'd know better than me, but trust me when I say I've been trying for months to get ANYTHING. I've had applications in for other specialties and these are the only two I can get right now. I don't have a home program and I live out of state from my school because of my SOs residency. I can't even get anything at their hospital. If I could do something else to get back into the swing of things I would.

I know everyone else is in the same boat being out of the hospital since March, but I haven't seen patients for over a year.

 

[bicyclechief]

This is probably a dumb question, but when you are speaking about only doing 1 EM rotation are you saying 1 visiting rotation or 1 EM rotation as a whole (both home or away)? I have no residency program so I was hoping to do an away and 1 home, but I do not want that seen as a red flag. I am having difficulty securing an EM away as is.

 

[surely]

Lol man I don't want to sound like I'm giving attitude because presuming youre a resident or attending you'd know better than me, but trust me when I say I've been trying for months to get ANYTHING. I've had applications in for other specialties and these are the only two I can get right now. I don't have a home program and I live out of state from my school because of my SOs residency. I can't even get anything at their hospital. If I could do something else to get back into the swing of things I would.

Yep, am a resident. I just don't want you to apply with two EM rotations and have PDs decline the opportunity to interview you because you did something they perceive as selfish and unsportsperson-like. If you can't get something (anything) for July, the right thing to do is cancel your August rotation, keep the July EM rotation, and keep trying to find something else to do in August. Go through CaseFiles between now and then. Do Rosh Review. See if you can shadow an ED doctor in your town off the record! Just don't hose your application by acting like your circumstances make you more deserving, y'know?