EM Competitiveness

[Backpack234]

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First off, thank you to this entire thread. I began a thread that remains at the top right now discussing my decision between EM and Rad Onc. As this thread implies, I have made my final decision towards EM. Again, thank you to everyone who provided the great feedback and information.

With that said, now I'm turning my attention toward 4th year/EM residency applications. Coming from a school without a program I understand that I will need to do two away rotations to get the mandatory number of SLOEs. Also, I've been trying to research step scores/competitiveness factors and have found conflicting data. On careers in medicine the average step 1 is shown at 225, step 2 at 239. On various threads I've seen here, I've found statements such as "250+ to get into Florida programs!" "EM is way more competitive now!" and "Step scores may have jumped 20 pts in the last 2 years".

The questions that I have here are

1: As a student coming from a program that never treated me as an intern during 3rd year, I haven't been too responsible for EM procedures or been given my own patients. Naturally I'm a bit nervous about performing well at away rotations. Would someone elaborate as to what makes a good away rotation student in this field?

2: If there are any recently matched applicants or residents familiar with the process, would someone be able to explain the expectations for step scores/grades/research/etc. set by the EM application process? I'm also wondering if there is a resource that would show average scores for recently accepted residents at various programs. I.e. if Carolinas Medical doesn't accept anyone <240, I shouldn't apply. This information would be very valuable.


Again thank you all. I look forward to where this thread leads.

 

[@JackShephard]

EM step 1 mean is still < 230.

I don't know about individual programs. There are very few residency programs in America that say, "we don't accept anyone with a 240."

 

[QuackaDO]

First off, thank you to this entire thread. I began a thread that remains at the top right now discussing my decision between EM and Rad Onc. As this thread implies, I have made my final decision towards EM. Again, thank you to everyone who provided the great feedback and information.

With that said, now I'm turning my attention toward 4th year/EM residency applications. Coming from a school without a program I understand that I will need to do two away rotations to get the mandatory number of SLOEs. Also, I've been trying to research step scores/competitiveness factors and have found conflicting data. On careers in medicine the average step 1 is shown at 225, step 2 at 239. On various threads I've seen here, I've found statements such as "250+ to get into Florida programs!" "EM is way more competitive now!" and "Step scores may have jumped 20 pts in the last 2 years".

The questions that I have here are

1: As a student coming from a program that never treated me as an intern during 3rd year, I haven't been too responsible for EM procedures or been given my own patients. Naturally I'm a bit nervous about performing well at away rotations. Would someone elaborate as to what makes a good away rotation student in this field?

2: If there are any recently matched applicants or residents familiar with the process, would someone be able to explain the expectations for step scores/grades/research/etc. set by the EM application process? I'm also wondering if there is a resource that would show average scores for recently accepted residents at various programs. I.e. if Carolinas Medical doesn't accept anyone <240, I shouldn't apply. This information would be very valuable.


Again thank you all. I look forward to where this thread leads.

On #2... wouldn't it be nice if people's step scores were reported so you could see just how you measure up? It sure would... but that's one huge reason why it's not. Every program wants to keep some element of unknown to their classes in regards to scores so they can always say "we had very competitive applicants" and so they also don't get pigeon holed into being a program that "only accepts 240+" or one that usually gets bottom of the barrel. Unfortunately no such resource exists in that form but NRMP has put out data about overall averages, just not on specific programs but even that data is a few years old. There is a lot of anecdotal info spewed across pages here in the forum about who are the "240+ only" type places but even those have exceptions and should taken with a grain of salt. It's a LOT of leg work but if you are willing to put in the time going through the interview invite threads and seeing where people got invites and the seeing in the rank list threads what their stats were (if they weren't anonymous or if they posted them) can give you some clues but even that is still pretty hazy. I can tell you this... every year people in the low 200s match and every year people with 250+ do not match. There really isn't a set standard and some places are really willing to look at more than scores while some really aren't willing to look past them, it's just putting in the research and leg work to figure out which box you think the places you are looking into fall in. Sorry, wish there was a nice big resource like what you asked for but I'm not aware of any such resource for ANY specialty and there definitely isn't one for EM.

 

[deleted547339]

EM step 1 mean is still < 230.

I don't know about individual programs. There are very few residency programs in America that say, "we don't accept anyone with a 240."

This is really entirely speculation.

 

[deleted547339]

First off, thank you to this entire thread. I began a thread that remains at the top right now discussing my decision between EM and Rad Onc. As this thread implies, I have made my final decision towards EM. Again, thank you to everyone who provided the great feedback and information.

With that said, now I'm turning my attention toward 4th year/EM residency applications. Coming from a school without a program I understand that I will need to do two away rotations to get the mandatory number of SLOEs. Also, I've been trying to research step scores/competitiveness factors and have found conflicting data. On careers in medicine the average step 1 is shown at 225, step 2 at 239. On various threads I've seen here, I've found statements such as "250+ to get into Florida programs!" "EM is way more competitive now!" and "Step scores may have jumped 20 pts in the last 2 years".

The questions that I have here are

1: As a student coming from a program that never treated me as an intern during 3rd year, I haven't been too responsible for EM procedures or been given my own patients. Naturally I'm a bit nervous about performing well at away rotations. Would someone elaborate as to what makes a good away rotation student in this field?

2: If there are any recently matched applicants or residents familiar with the process, would someone be able to explain the expectations for step scores/grades/research/etc. set by the EM application process? I'm also wondering if there is a resource that would show average scores for recently accepted residents at various programs. I.e. if Carolinas Medical doesn't accept anyone <240, I shouldn't apply. This information would be very valuable.


Again thank you all. I look forward to where this thread leads.

What will be most well-received on away rotations is saying to the resident with whom you're working "hey XXX, I've never done an I&D/I've only sutured a few times/I don't know how to intubate....would you mind walking me through this one then I'll try the next one on my own?" You are not expected to overwhelm people with your knowledge base or skill set; you're going to learn that stuff in residency. You'll blow them away with your attitude and work ethic.

What you DON'T want to do is get in over your head on an externship. Don't be the guy who says "sure, I'll go I&D that abscess" acting like you know how to do it then totally botch it. Know your limitations, ask for help and be ready to take advice and learn.

Be eager to learn, show up early and stay late, get patients blankets, etc.

 

[namethatsmell]

Answers below in bold.

First off, thank you to this entire thread. I began a thread that remains at the top right now discussing my decision between EM and Rad Onc. As this thread implies, I have made my final decision towards EM. Again, thank you to everyone who provided the great feedback and information.

With that said, now I'm turning my attention toward 4th year/EM residency applications. Coming from a school without a program I understand that I will need to do two away rotations to get the mandatory number of SLOEs. Also, I've been trying to research step scores/competitiveness factors and have found conflicting data. On careers in medicine the average step 1 is shown at 225, step 2 at 239. On various threads I've seen here, I've found statements such as "250+ to get into Florida programs!" "EM is way more competitive now!" and "Step scores may have jumped 20 pts in the last 2 years".

The questions that I have here are

1: As a student coming from a program that never treated me as an intern during 3rd year, I haven't been too responsible for EM procedures or been given my own patients. Naturally I'm a bit nervous about performing well at away rotations. Would someone elaborate as to what makes a good away rotation student in this field?

Relax. You shouldn't be treated as an intern as a 3rd year. Just keep putting yourself out there to observe and hopefully do procedures. Also, if at all possible, do your home EM rotation before any anyways...you'll look better when you rotate away since you'll have more of an idea of what's going on and your home program is most likely to be the most generous when it comes to evaluations.

2: If there are any recently matched applicants or residents familiar with the process, would someone be able to explain the expectations for step scores/grades/research/etc. set by the EM application process? I'm also wondering if there is a resource that would show average scores for recently accepted residents at various programs. I.e. if Carolinas Medical doesn't accept anyone <240, I shouldn't apply. This information would be very valuable.

Search this forum and the EMRA and SAEM websites as TONS has been written about on this. The short story is: DO NOT let your step scores stop from applying to any place that interests you.

Again thank you all. I look forward to where this thread leads.

 

[red10]

I dont think you can rest on your score at any school. You can certainly "make up for" a lack luster Step 1 score through other parts of your app. But a 240+ alone isnt going to get you in every door (especially if you're trying to get into those "best of the best,sir...with honors" type places).
for example: I got an interview out of my region at a school lots of people in-region and with better scores than me were being rejected from. On my interview day the PD was like "you guys are here because of the leadership on your application. we want leaders." So would having a 240 have hurt me? no. But I got the interview with just an average Step 1 score because I had other parts of my application that were worth paying attention to.

TLDR: Your score is ONE PART of your application. Do your best, improve on step two and apply where ever you want to go

 

[Alvarez13]

What will be most well-received on away rotations is saying to the resident with whom you're working "hey XXX, I've never done an I&D/I've only sutured a few times/I don't know how to intubate....would you mind walking me through this one then I'll try the next one on my own?" You are not expected to overwhelm people with your knowledge base or skill set; you're going to learn that stuff in residency. You'll blow them away with your attitude and work ethic.

What you DON'T want to do is get in over your head on an externship. Don't be the guy who says "sure, I'll go I&D that abscess" acting like you know how to do it then totally botch it. Know your limitations, ask for help and be ready to take advice and learn.

Be eager to learn, show up early and stay late, get patients blankets, etc.

This is good advice. 95% of the EM guys I worked with love to teach and get off on you being eager to learn. Number 1 rule is to keep the patient safe. If you don't know or are nervous, don't hide it.

 

[@JackShephard]

This is really entirely speculation.

Not exactly, a little birdie told me that.

 

[doctorFred]

What you DON'T want to do is get in over your head on an externship. Don't be the guy who says "sure, I'll go I&D that abscess" acting like you know how to do it then totally botch it. Know your limitations, ask for help and be ready to take advice and learn.

Be eager to learn, show up early and stay late, get patients blankets, etc.

+1. my medical student evaluations are overwhelming colored by their disposition. you can have little to no functional knowledge of emergency medicine, but if you smile, enthusiastically agree to everything i ask, and help me with all the "boring stuff" like making phone calls, running back into the room to ask the patient their PMD, grabbing meal trays, and letting me borrow your pen, you're getting a very good evaluation.

much of what you learn about being an ER doc, you learn on the job. but you can't teach a good attitude.

 

[Alvarez13]

+1. my medical student evaluations are overwhelming colored by their disposition. you can have little to no functional knowledge of emergency medicine, but if you smile, enthusiastically agree to everything i ask, and help me with all the "boring stuff" like making phone calls, running back into the room to ask the patient their PMD, grabbing meal trays, and letting me borrow your pen, you're getting a very good evaluation.

much of what you learn about being an ER doc, you learn on the job. but you can't teach a good attitude.

Just remembered another thing that helped. If you can make the faculty or residents laugh, your grade goes up another letter grade. Personality is extremely important in this line of work and these guys live a good YouTube video or joke.

 

[doctorFred]

that's true, but be careful. if we're getting killed and i'm seeing 3-4 an hour and you're trying to show me jedi cats on youtube, i will not be amused.

 

[@JackShephard]

This is really entirely speculation.

Btw, I remember where I heard the 225 mean Step 1 from:

It's the Association of American Medical Colleges. Characteristics of Entering Residents, 2012-2013. Washington, DC: Association of American Medical Colleges; 2013

It's not speculation at all.