EM LOR necessary to match?

[turkdlit]

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Hello all,

I'm planning on applying to Ophthalmology in 2009, and my advisor assures me I need a second residency option in case I don't match (which I totally agree with). So I've decided to concurrently apply to EM , but won't be able to secure an EM LOR b/c all my electives 4th year will be in ophthalmology.

So my question is...how many, if any, LORs from EM attendings are required or recommended? My searches on SDN have shown most apply with 1 to even 4 LORs from ER docs...

I know many of you who are very passionate about EM might read this and be pissed that people like myself are applying to it as a "backup". But I would love to get your opinions on this...thanks! And congrats to all who recently matched.

Turk.

 

[xaelia]

A lack of EM letter may impede matching, even if EM folks are calling on your behalf.

N = 1.

 

[WallowaWanderer]

Most places want at least one SLOR. I don't think you'll do very well without at least one, and you need to get it by October. You may be able to squeeze by with just a narrative LOR, but you really should get a SLOR. I think that most people have 2 SLORs.

You already touched on this, but the lifestyles and the kinds of people that go into ophthalmology vs. emergency medicine are very different. Buyer beware. It's not that I'm offended that you are choosing EM as a backup, but it's a specialty that peopl tend to either love or hate and there's not much in between. I spent some time on ophthalmology and got the general impression that they prefer to work during the daylight hours. Have you looked at ENT, Radiology, Anesthesia, etc?

 

[jbar]

it is also worth thinking about how sure can you really be that you would want to do EM without doing a sub I. I don't know what your school does for rotations, so maybe you've spent a lot of time down there. But at most places it would be hard to get a feel for the specialty without playing intern for a month.

 

[awdc]

So I've decided to concurrently apply to EM , but won't be able to secure an EM LOR b/c all my electives 4th year will be in ophthalmology.

Am I missing something here? So unless you have done a 3rd year rotation in EM, I don't see how you would even receive interviews for EM... let alone obtain a SLOR or match into EM if your ophtho match is unsuccessful.

 

[anothertbmember]

what the first 2 said. At least 1 SLOR and if you have yet to do an EM rotation do one before you decide it's your back-up. Plenty of my classmates were considering it and then hated it after their rotation.

 

[iridesingltrack]

As part of the echo chamber...

You will need at least one Standard Letter of Recommendation (SLOR) from an EM physician, generally the clerkship director/assistant clerkship director from your rotation to be considered for an EM residency. The SLOR is specific to EM and contains elements that directly relate to your percieved ability to be an emergency physician (see http://www.cordem.org/slor.htm for details). I would imagine you'd have to do a rotation in EM to get a letter.

If all your 4th year electives are ophtho but you seriously want EM as your fall back position, then replace one ophtho rotation with EM, preferrably by October, as was stated above; an added bonus to this is it will give you insight into the viability of your plan in regards to career satisfaction.

For what its worth, one of my good friends was considering both ophtho and EM; he chose ophtho, our loss. So, while the comparison may be unusual others have been in a similar position.

Good luck.

 

[sleepymed]

I think alot of PDs take into consideration commitment to the field. Are you a member of ACEP? Part of EMIG? Are you excited about EM? If you don't have a sub-I in EM, I think that will be taken as a reflection of lack of interest in the field, and you might not be worth the risk; nobody wants to invest a year of their time in you, only to have you switch into another field a year later. But of course, that is only one (wo)man's opinion.

 

[Hard24Get]

I agree with sleepymed et al. But I would also add this: would you really want to "settle" for a career in EM if optho is truly your life's dream? It is no small thing to throw away a dream. If you are really into EM and think you could be happy, then it is worth doing a sub-I, joining the clubs, etc, because if you do match without these things it probably won't be in your top 3 or 5 or so.

If your heart is really set on optho (which it seems like it is), I highly recommend applying for medicine as a backup, because then you can still apply that first year for optho if you want. Alternatively, you could do a year of research, which optho seems to like. I just say all this because I have rotated through both specialties and would be miserable if I found I had to "settle" for optho last week. Think carefully!

 

[AmoryBlaine]

Gotta add to the general horde of responses here. How is EM a good back-up for Ophtho? I imagine that 99% of unsuccesful Ophtho applicants would seek a prelim med or TY year and reapply.

Ophtho is largely a clinic based, 9-5, extremely well compensated, microscopic field. EM is none of those things.

Plus, at the risk of sounding callous, I have definitely noticed an "ophtho personality" (n= maybe 20) and it ain't the type to enjoy emergency care.

 

[southerndoc]

How does that work applying to both NRMP and SF Match at the same time? Can you do that?

 

[turkdlit]

Wow, thanks for all the responses! They're all very helpful...

I pretty much knew that I would need at least one SLOR, and probably need to do and honor a Sub-I. My reasons for liking both fields doesn't have much to do a my "personality type", whether I like big or small, 9-5 or irregular hours...I just love ophtho and given that I need second plan of action, I've always been interested in EM as well. I like more than one field, which is pretty normal for most of us I would imagine.

I guess my only option will be to cancel one of my electives to do an ER sub-I. Its useful to know that ER programs consider commitment to the field an important factor, which may make this process more difficult for me. I always considered medicine but thorughout my rotations I found the constant rounding wasn't for me.

You can apply to both SF Match and NRMP at the same time, because theu match at different points in time (January vs. March). It is a bit risky to apply to 2 residencies at the same insitution though...if they know this, they might question your commitment. Although, from what I understand, ophtho and other competitive specialties are becoming more aware and forgiving of those who have back-ups.

Thanks again for all your repsonses!

How does that work applying to both NRMP and SF Match at the same time? Can you do that?

 

[xaelia]

Hm...I was thinking Ophtho, and I went through and crossed all my I's and Q's super early for their early match to make sure I was on scheduled to get as many interviews as possible...and then I did my Ophtho rotations and I was much less excited about it. The two professions really are totally different - Ophtho is a lot of repetition of the same exam or the same procedure over and over on the same type of patient. Either you do general vision screening exams, or you subspecialize and you deal with the same subsegment of the eye over and over, as many as you can cram into your practice to reduce the hit from your high overhead costs. So, yeah, it seems unlikely that there's a personality type that'd be happy with either specialty, without preference.