EM for FMG with no SLOR

[Prop]

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Hi all,

So I've been lurking around this forum for the last couple of months, since I just realized how incredible cool EM is...
Up until now, I've been working towards obtaining a residency spot in Pediatrics, but after taking my final exams in surgery (where we're also tested in acute medicine), I gained an enourmous respect for your field.
We don't have an EM residency here in Denmark, though they're working on it, so the only way I can get into EM is to go to the US (and that's what i want to do anyway)...

So my question is: Being an FMG, what can I do to get into residency? I know the obvious about getting great USMLE scores (only took step 1 so far, getting >220), but what else can I do? I have done 2 months of electives in the US in pediatrics, but none in EM, so I will have no SLOR... is it still possible to match in EM, or is the an absolute requirement? What about research? As I mentioned we do not have EM here, but the Anesthesiologists conduct research in Emergency Medicine (mostly car accidents and so on). Do you think doing some research with them would help my application?

I appreciate any input you have to offer.

Thanks,
Lars

 

[Hard24Get]

could you hustle and hook up an away rotation for August? I don't know alot about FMG stuff, but it seems like it would be hard to match without ANY EM experience

 

[MushieCookie]

You need a SLOR...period. If you don't have one, you do not stand a chance at even having your application looked at.

I am an international medical graduate, PM me if any questions.

If you want to match into EM, you need to do an elective where you can get a SLOR.

If you really want EM as a career, you may want to get involved in research (not necessary, but can only help your chances) and sit out a year if you cannot get hooked up with an EM elective where you can get a SLOR. Remember, you can get SLORs from programs that has an EM residency program.

Good luck.

 

[cleansocks]

Hey, just in case you can only do an EM rotation in a non-residency emergency room, my SO matched into a great EM program with a SLOR from a chief of EM in a non-residency ED in the US. You just have to tell them to answer "as if they were a director" on those questions that ask about "their" residency program.

 

[Prop]

Thank you so much for the answers...
However, I simply haven't got the time to do a rotation before I finish med school... So I guess EM is pretty much unobtainable for me.
Do you think doing an observership later on would help me?

Thanks again

 

[bartleby]

You would be better off trying to match in a prelim year in internal medicine in a facility that has an EM residency and trying to get your rotating EM month and any possible elective (do it in EM if possible) early on the year. That would get you a exposure to the faculty for an SLOR and a year or experience under your belt would hardly been seen as a bad thing. You would be better off doing this than going into the match this year with alw likelihood off success, which would complicate your life by then forcing you to explain why you didn't match in EM once before.

Good luck

 

[Ronny121]

Hi, I am new to this forum. I have a couple of questions regarding the SLOR. I am a foreign medical graduate. I did Emergency Medicine Fellowship from George Washington University(gwu), which is affiliated to multy specality hospital in india. I got certified from the GWU. I got a LOR from the director of Emergency medicine program. But it is not an SLOR. I had 6 weeks of wound care training from the GWU. Can i get an SLOR for that period i did rotation from GWU? If so, what is mode of pattern i should get the SLOR? Can any one in these can help me out regarding this issue. it is highly appreciated.

 

[Prop]

You would be better off trying to match in a prelim year in internal medicine in a facility that has an EM residency and trying to get your rotating EM month and any possible elective (do it in EM if possible) early on the year. That would get you a exposure to the faculty for an SLOR and a year or experience under your belt would hardly been seen as a bad thing. You would be better off doing this than going into the match this year with alw likelihood off success, which would complicate your life by then forcing you to explain why you didn't match in EM once before.

Good luck

Thank you so much... That was a very good answer.
Do you think I could do the same with Peds (ie starting a Peds Residency, obtaining a SLOR from the rotation in Peds EM, and then applying to EM later on), or would this be a bad idea?
I guess it would be easier just going to the US now while still in Med school, but I would have to postpone my graduation date for 6 months, which I'm not interested in...

 

[quideam]

Hey, I agree completely - try for a prelim medicine year (or transitional year, though those are harder to get, but you can try) instead of starting residency. It's not easy to switch specialites, particularly with the way slots are funded, because once you start training you're only funded for that number of years. So, programs would have a bit of a disincentive to taking you because the hospital would have to cover your cost for at least a year (if you do one year of peds before switching). Just try for prelim - prelim medicine is not tough to get, and, like the previous poster said, it will give you exposure to EM faculty at the program, which can onlyl help. Good luck!

Oh, btw, if it is an option for you to postpone graduation, you might want to think about doing it that way - once you've graduated and started residency training, you'll have much less flexibility in terms of away rotations or observerships, etc. It's probably not the most enticing concept, but you should definitely at least consider the pros and cons.

 

[Prop]

Yeah, I remember reading something about the funding for residency programs, so I guess I shouldn't apply for Peds...
I already postponed graduation to do 2 rotations in the US, so I just can't postpone it one more time...
Thank you so much for all the answers. I really hope it'll work out some way or another...

 

[howelljolly]

Hey, just in case you can only do an EM rotation in a non-residency emergency room, my SO matched into a great EM program with a SLOR from a chief of EM in a non-residency ED in the US. You just have to tell them to answer "as if they were a director" on those questions that ask about "their" residency program.

That sounds unethical to me. The SLOR can only be filled out by specific faculty. Heres the template. http://www.cordem.org/DOWNLOAD/2009-10slor_form.doc

 

[howelljolly]

Yeah, I remember reading something about the funding for residency programs, so I guess I shouldn't apply for Peds...
I already postponed graduation to do 2 rotations in the US, so I just can't postpone it one more time...
Thank you so much for all the answers. I really hope it'll work out some way or another...

You could do Peds and then Peds-EM. That seems to be common for FMGs.

 

[Prop]

You could do Peds and then Peds-EM. That seems to be common for FMGs.

I realize that, but I'm thinking that I might want to see both kids and adults.

But on that subject, how does peds EM compare to adult EM? Do you have the same possibilities with regards to hours and number of calls each month? Can you only work in a peds ER in a childrens hospital, or can you work in a mixed ER, only seeing children? What is the hourly pay compared to adult EM?
I'm sure all this has been covered extensively, but maybe somebody could give me the hard facts...

Again, thank you so much for all the answers.

 

[howelljolly]

I realize that, but I'm thinking that I might want to see both kids and adults.

But on that subject, how does peds EM compare to adult EM? Do you have the same possibilities with regards to hours and number of calls each month? Can you only work in a peds ER in a childrens hospital, or can you work in a mixed ER, only seeing children? What is the hourly pay compared to adult EM?
I'm sure all this has been covered extensively, but maybe somebody could give me the hard facts...

Again, thank you so much for all the answers.

Im just suggesting that, if it ever comes down to it. If you're set on EM but ultimately can't get a SLOR or a catogorical EM residency...

 

[jbar]

At our hospital peds EM has most of their shifts weekends and nights since that's when people bring in their kids. Adult is the other way around, more people on during the day.

 

[Phledge]

That sounds unethical to me. The SLOR can only be filled out by specific faculty. Heres the template. http://www.cordem.org/DOWNLOAD/2009-10slor_form.doc

I just visited the CORD website and the instructions are unclear. On the one hand, it states that only EM faculty are to complete a SLOR. Well, that's easy enough, and the previous poster has done nothing unethical. On the other hand, it states that one must know the number of slots available in their program and the average clerkship grades for previous applicants. So it doesn't say that specific faculty must fill out the SLOR (except, obviously, EM faculty), but I don't know how an EM physician, even a chief, could complete the SLOR without information specific to being part of a program. Any comments?

Disclaimer: I happen to have a horse in this race since right now I only have one rotation scheduled at a program (and it's not until October! ack!), but one scheduled in August at a non-program ED, from whence I'd love to get a SLOR if it "counts." Will it?

 

[howelljolly]

I just visited the CORD website and the instructions are unclear. On the one hand, it states that only EM faculty are to complete a SLOR. Well, that's easy enough, and the previous poster has done nothing unethical. On the other hand, it states that one must know the number of slots available in their program and the average clerkship grades for previous applicants.So it doesn't say that specific faculty must fill out the SLOR (except, obviously, EM faculty), but I don't know how an EM physician, even a chief, could complete the SLOR without information specific to being part of a program. Any comments?

Disclaimer: I happen to have a horse in this race since right now I only have one rotation scheduled at a program (and it's not until October! ack!), but one scheduled in August at a non-program ED, from whence I'd love to get a SLOR if it "counts." Will it?

They suggest, reccomend, prefer.... that the SLOR is filled out by the residency PD or the med school clerkship director.

If you're getting it from a non-residency ED, ipso facto, you are not getting it from a residency PD. Reading the post, it didnt seem like the letter was obtained from a clerkship director. Asking the attending to write the SLOR "as if..." just dont sound kosher.