EM PD - Ask Me Anything

[gamerEMdoc]

Hey! I think my top program's last interview day is coming up this week. I don't know when they are going to have their final rank list meetings but I would ideally like to get my letter of intent sent in before those discussions take place. At the same time, I don't want to send it too early either. Do you have any thoughts on what the optimal time would be to send it out? In past years there have been recommended time frames but things are so wonky this application cycle, I doubt they hold true this year. I know LOIs probably aren't going to make or break me but at the same time I want to do everything I can to ensure a good match. I still have 2 interviews left but I'm nearly certain that they will not be able to dislodge my top spot. Should I just go ahead and fire off my LOI a day or two after their last interview day?

Its not going to hurt you when you send it. And the data on these even helping is pretty skeptical IMO. I've seen one study that showed a percentage of PDs said it made a difference by 1-2 spots and others said no difference at all. I doubt anyone is taking someone from the middle of the list and ranking them to match based on an LOI. 1-2 spots is a negligible difference if that's all it does.. And I've seen studies that showed it doesn't help at all. So these, at best, will help very little. At worst, they will do nothing. So just don't sweat it. Send it end of Jan / first week of February, and dont worry about it.

This is a decent video of a handful of PDs talking about this topic, with timestamps for various aspects of post-iv communication and references.

EM Match Advice: Post Interview Communications

EM Match Advice: Post Interview Communications hosted by Dr. Michael Gisondi

www.aliem.com

To summarize though, most say while its nice to know you are #1, it makes very little or no difference. And most people find the "I'm ranking you highly" email vague and unhelpful.

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Members don't see this ad.

 

[gamerEMdoc]

Another dumb question from me: I have a gnawing sense of dread in this lull between interviewing and Match day, which I'm sure is common for everyone. But I've barely had any post-interview interaction or communication with most programs I've interviewed with. Most of my interviews were mid-November to mid-December. Programs don't forget about you, right? I don't have any genuine questions or follow up after interviews and I feel like I'm slacking because of this and am afraid it'd affect my ranking since it's been so long. Sorry, I know I'm probably just being paranoid but would like some perspective on this lol.

No. Post-IV communication is supposed to be minimal. Or none at all. That's the intent of the NRMP rules. There can be some if there are questions or if you have a mentoring relationship with the student, but there isn't supposed to be a ton of post-interview communication.

The months from interviews to the match can be filled with anxiety, but I assure you, you should not have an expectation that you will hear from programs. Some contact you, some don't. Some that contact you may be contacting everyone they interview, some only contact their top ranks. Many contact no one at all. DO NOT place any stock in post-interview communication in terms of where you rank programs.

 

[gamerEMdoc]

How awkward do I have to be in an interview to get dropped on the rank list. Like let’s say my first 3 interviewers went well then I just get nervous and ramble with one of them. 😅

I don't think there is any possible way of quantifying that. All I can say is, the interview, along with SLOEs, are the dominant aspects of the app that determine rank position when you look at PD surveys. There's no way of knowing how one interview of 4 going haywire affects your chances, if it was even really that bad.

 

[Cboot]

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!

I am an OMS III and began medical school wanting to go into Emergency medicine... but failed my USMLE step one and did very poorly on COMLEX. I know I'm not in a good position to match, and everyone keeps asking me what my backup plan is...but I don't have one. I've only ever wanted to do EM. Obviously, I need to do well when I retake the USMLE, but is there anything else I can do to overcome this giant Red Flag?

 

[gamerEMdoc]

Your best bet of matching EM will be if you have stellar clinical perfomance. If you have a few EM rotations and are clinically a standout, you very well may be able to match at some DO friendly programs with a USMLE failure as long as you've passed your COMLEX's and showed improvement on COMLEX 2. But if you are middle of the road, or worse, clinically, then you very well may not. So ultimately, just like anyone else, your SLOEs will determine your fate in large part.

 

[pillowsnice]

When does the rank list thread start? Anxious to see where everyone is placing everything

 

[hopefulERdoc251]

@gamerEMdoc

Hey gamer, quick question - would you find it unprofessional to cancel an interview 6-7 days before the interview? I got off a WL at another place and after getting off that WL, I hit my # of interviews i had wanted to go to. Thanks!

 

[gamerEMdoc]

No, I don't think so. 1 week beforehand, in this current environment, is appropriate since it's a lot easier to get people to fill on short notice.

 

[bigshort]

@gamerEMdoc did any applicants end up getting doxxed/blacklisted on the PD listserv this year lol? What would even cause this to happen?

 

[gamerEMdoc]

@gamerEMdoc did any applicants end up getting doxxed/blacklisted on the PD listserv this year lol? What would even cause this to happen?

I've never seen that happen to be honest

 

[dr.wieners]

2020-21 ROL thread

2020-2021 Emergency Medicine Rank Order List Thread

Late to the party on this as I am a current 3rd year but have been using last year's ROL to inform my decisions for upcoming VSAS and beyond. Please let me know if anyone has any questions/concerns or functionality issues. Per SDN tradition, here is this year's Rank Order List (ROL) thread...

forums.studentdoctor.net

 

[gamerEMdoc]

 

[jakomo]

Hi gamerEMdoc,

Was hoping you could give some advice for a guy who will probably apply for a second residency.

A bit about myself: I'm a Canadian citizen, graduated from an offshore medical school, completed Family medicine residency at a large academic center in the US. I did an EM centered QI project during residency, and have 2 publications pending [fingers crossed]. Passed all my boards on the first try with decent scores (Less stellar step 2ck score; No explanation other than I had a bad day and own it). Was chief resident, and also had a couple residency awards. I graduated summer of 2020.

I'm currently doing a mix of urgent care and working as the fast track/support doc in a Canadian ED. I'm finding that I really enjoy emergency medicine, and can't shake the interest. I want to become residency trained/board certified. Would you be able to provide advice as to how I may be able to get the attention of PD's? I've researched this heavily, and I understand I have many factors working against me (school, citizenship, funding), but I'd still like to take a shot at applying - and when I do, I'd like it to be the best shot possible.

I'll be trying to get in touch with the PD's at my former place of residency, and scouting out for newer/younger residency programs. Would it be frowned upon for me to reach out directly to PD's to express interest/get advice prior to the application cycle?

I would be so grateful for any guidance you could give. Thanks so much in advance!

 

[gamerEMdoc]

Best thing you could do, if possible, is network as best you can. I think emailing PDs early in interview season is probably just going to annoy more people than will help. But tons of programs held virtual meet and greets ahead of interview season that would allow someone to show interest and get their name on a programs radar. I wouldn't see why that may not happen next year as well. But more importantly, I think the EMRA residency fair could be of big time value in this situation, especially if virtual again (bc it was free, lasted a week, and very flexible in scheduling times with programs). You could meet with 10 or more programs that you target as realistic possibilities, express your interest, and tell them your story. Will make a huge difference in terms of not just getting lost in the pile of applicants.

 

[newdoctobe]

Hello gamerEMDdoc
Hoping to get your opinion as a PD: I am an MS1 who had to take a LOA about 12 weeks into MS1 because of a family health emergency (covid related). At the time, my school recommended I take a 4 week LOA and extend it to a year if it goes over the 4 weeks. This means I have to restart with the next class. It did take longer than 4 weeks so I will be joining with the next class. Of note, I did pass my tests thus far. So here are my questions. I wanted to assess how this will impact matching to a residency program (interested in EM/IM). I am in an MD school but there will be a couple of red flags as I see it;
1. My age - I will be 39 yo at the time of applying for match (this is a second career for me)
2. LOA on my application.
Is this going to ruin my chances of matching? Since I do have a successful previous career in health care, do I need to seriously consider going back to that career given what has happened? I still want the MD but if this will derail my future prospects, I do owe it to myself to think practically. Thank you.

 

[gamerEMdoc]

I highly doubt an LOA for a good reason will effect you. LOAs when people have legitimate medical problems or family health issues are not what hurt candidates. LOAs bc of mental health issues, relationship problems, repeated class failures, extra time to pass boards... those are going to scare programs. I think you’ll be fine.

 

[newdoctobe]

I highly doubt an LOA for a good reason will effect you. LOAs when people have legitimate medical problems or family health issues are not what hurt candidates. LOAs bc of mental health issues, relationship problems, repeated class failures, extra time to pass boards... those are going to scare programs. I think you’ll be fine.

What are your thoughts on the issue of age along with the LOA. Would that be a problem?

 

[gamerEMdoc]

What are your thoughts on the issue of age along with the LOA. Would that be a problem?

I dont see why age would be a problem. Plenty of people who took a non-traditional route still match.

 

[attitudeofgratitude]

What does R3 look like from the Program's end

like for us it says "institution and program description" with the name of the college/hospital and then the specialty, then status, then nrmp code, and then acgme code. We have the ability to search programs by state/specialty, how do Programs search for applicants?

 

[bigshort]

What does R3 look like from the Program's end

like for us it says "institution and program description" with the name of the college/hospital and then the specialty, then status, then nrmp code, and then acgme code. We have the ability to search programs by state/specialty, how do Programs search for applicants?

great question that I too have wondered about

 

[Dibble20]

Hey everyone, long time lurker and first time poster. I was just wondering where the 2021 EM Rank Order List thread can be found. I saw mention of it a little ways back up the page but the link doesn't seem to be working. Any help would be greatly appreciated.

 

[gamerEMdoc]

What does R3 look like from the Program's end

like for us it says "institution and program description" with the name of the college/hospital and then the specialty, then status, then nrmp code, and then acgme code. We have the ability to search programs by state/specialty, how do Programs search for applicants?

When our PC put them in she searched by name. You can see the persona aamc, nrmp numbers and school. Im sure you can search by any of them.

 

[dr.wieners]

Hey everyone, long time lurker and first time poster. I was just wondering where the 2021 EM Rank Order List thread can be found. I saw mention of it a little ways back up the page but the link doesn't seem to be working. Any help would be greatly appreciated.

 

[gamerEMdoc]

Good luck today everyone!

 

[Oligodinero]

Good luck today everyone!

Thanks. Matched EM. Your advice was invaluable. Much respect!!

 

[LibBum]

Good luck today everyone!

Also matched into EM today. Thanks for the advice in July when **** was hitting the fan and I didn't know how the cycle would play out. Got interviews from top 10 programs down to HCA. Appreciate your guidance and support.

 

[Dr.TurkandJD]

Congrats on becoming the PD man! Hope we run into each other again at some conference!

 

[rdrozays]

Hey GamerEMDoc,

I’ll be starting med school this fall. How do you anticipate residencies adjusting to step 1 going to pass/fail? Will school prestige matter matter more than before? Will step 2 be used to stratify applicants?
Any advice or insight you could give into how to start building a competitive residency application from day 1 would be greatly appreciated!

 

[gamerEMdoc]

Hey GamerEMDoc,

I’ll be starting med school this fall. How do you anticipate residencies adjusting to step 1 going to pass/fail? Will school prestige matter matter more than before? Will step 2 be used to stratify applicants?
Any advice or insight you could give into how to start building a competitive residency application from day 1 would be greatly appreciated!

I dont think school prestige will matter any more than it does. All I think will happen will be, for the programs that care about board scores, all the emphasis will shift to Step 2.

 

[miacomet]

I know you are generally optimistic about the future of EM. Admittedly I work in a tight job market that rarely has openings; we had twenty applicants for a part-time position and as many for moonlighting positions. None of the new grads in our area got jobs. The private groups in my state- yes, the entire state- now only offer positions as FSEDs. When a person leaves one of their shops, then the non partnership track docs can move into a regular ED and start on the partnership track. There are no jobs in places that always had ample jobs (Chicago, Alaska, NYC, Texas) and even VAs and IHS seem overrun lately.

With so many residencies opening, and few fellowship options, I feel...had. I'm not trying to troll, but are you still optimistic about the future of EM?

 

[gamerEMdoc]

Optimistic? I don’t expect things to keep going up and up and up if we keep adding residencies, but I’m not nearly as pessimistic as some, which I guess makes me an optimist here. The EM market was decimated by COVID. People are blaming a job market that saw a 20% reduction based on a once in a lifetime pandemic on things like HCA residencies and NP autonomy. I’m not saying those things aren’t concerning, but I don’t believe at all that the current state of the job market is as it is for any reason except COVID.

I will say that all my graduates have jobs except one, who has had 3 separate job offers over the last 2 months and is weighing which one he wants. All are in the midwest and out west for him. Two others got jobs in Colombus, Ohio. One in New Mexico. A few in and around our area. One in Florida. In the past two years we‘ve had people hired in southern CA, austin Tx, waco tx, Ny, baltimore, Jacksonville, and all over the state of PA. I just have not seen with my own residents applying the same concerns you are, I realize the job market is really tight at the moment with COVID, but things do seem to be opening up lately a bit.

I think if volumes return to normal, we will actually see a big hiring push. So many places cut staff with decreasing volumes. While volumes returned in some places, it hasn’t in others. So this may happen regionally.

But who knows. Maybe COVID won’t go away. Maybe reduced volume is the new norm? If that’s the case, then I’d be way more concerned about the job market than I am now.

 

[gamerEMdoc]

Consensus statement on EM rotations / SLOEs this year. Here's the highlights:

1. No student should do more than 2 EM rotations at residency programs
2. No student should have more than 2 eSLOEs
3. Students with home rotations should do one home and one away rotation (or 2 home if you have 2 home sites). No aways before Aug 1.
4. Students without home rotations should do 2 aways, one may be before Aug 1st to count as a "home"
5. Programs should consider applicants with only one sloe since getting aways may still be difficult for some

The document here goes into the nuances.

https://www.cordem.org/globalassets/files/position-statements/2021-consensus-statement_-part-1_-aways--esloes.pdf

 

[Rekt]

Optimistic? I don’t expect things to keep going up and up and up if we keep adding residencies, but I’m not nearly as pessimistic as some, which I guess makes me an optimist here. The EM market was decimated by COVID. People are blaming a job market that saw a 20% reduction based on a once in a lifetime pandemic on things like HCA residencies and NP autonomy. I’m not saying those things aren’t concerning, but I don’t believe at all that the current state of the job market is as it is for any reason except COVID.

I will say that all my graduates have jobs except one, who has had 3 separate job offers over the last 2 months and is weighing which one he wants. All are in the midwest and out west for him. Two others got jobs in Colombus, Ohio. One in New Mexico. A few in and around our area. One in Florida. In the past two years we‘ve had people hired in southern CA, austin Tx, waco tx, Ny, baltimore, Jacksonville, and all over the state of PA. I just have not seen with my own residents applying the same concerns you are, I realize the job market is really tight at the moment with COVID, but things do seem to be opening up lately a bit.

I think if volumes return to normal, we will actually see a big hiring push. So many places cut staff with decreasing volumes. While volumes returned in some places, it hasn’t in others. So this may happen regionally.

But who knows. Maybe COVID won’t go away. Maybe reduced volume is the new norm? If that’s the case, then I’d be way more concerned about the job market than I am now.

Staffing was cut and volumen has been returning for awhile now. Everyone, mostly CMGs, can see that the pts are still being seen with even less coverage so there is no reason to hire.

I understand since you're faculty it's not in your best interest to tell everyone to stay away from EM. But you can't possibly think it's stable with our expansion. Job hunting I've seen now about 7 more programs slated to open to take residents July 2022. There just aren't going to be spots.

 

[izomiac]

I finished my FM residency about five years ago and wound up taking a job as a nocturnist in a rural ED, which I love. Lately I've been reading all the internet doomsaying about the EM job market, and I've seen far more people vying for hours at my ED than I'm used to, so I have to wonder if there might be some truth in the pessimism. As such, I'm considering contingency plans that might allow me to still make a career out of rural EM. One of them is doing a second residency. Is this a viable plan? Any tips?

Here's my background. During my clinical years in medical school I got bit by the MBA bug, and learned it'd be easier to complete medical school and squeeze a one-year program in before residency since it was too late to do a combined program. I applied to the EM programs I rotated with, didn't get in (not going to lie -- my Step I & II scores suck), and did the MBA as planned. Afterwards I was convinced I wanted to run my own practice and applied straight FM, and completed my residency without issue. I looked for jobs in urgent care or clinic, and actually had a contract in hand for a great clinic position when TeamHealth contacted me out of the blue to see if I was still interested in EM. They had a program specifically built to transition FM grads into EM and I figured I'd might as well give it a shot since I knew that door was rapidly closing. My initial plan was to gain some more acute care experience, pay down some student loans, and open my own urgent care clinic after my two year commitment was done (or when I got burned out). Five years later I'm still here and loving it.

While I'm reasonably certain I'll be able to keep my job for a while yet, I'd rather not have to reinvent myself when I'm 50. So I figured I'd make plans now, and if my best course of action is to endure another intern year then I'd might as well do it in the next few years while I'm still young and have relatively few commitments. And if it's not viable then I'll plan a more gradual exit strategy.

 

[sylvanthus]

Playing through ME1 when im not distracted by civ4. Best civ of the series by far.

 

[deleted1012224]

Hey GamerEMDoc,

Any steps a first-year med student can take early on in order to build a competitive EM residency application? Have a strong interest in EM and am starting med school this summer, so would like to do whatever I can to prepare myself.

Thanks!

 

[gamerEMdoc]

Staffing was cut and volumen has been returning for awhile now. Everyone, mostly CMGs, can see that the pts are still being seen with even less coverage so there is no reason to hire.

I understand since you're faculty it's not in your best interest to tell everyone to stay away from EM. But you can't possibly think it's stable with our expansion. Job hunting I've seen now about 7 more programs slated to open to take residents July 2022. There just aren't going to be spots.

I'm not telling people to go into anything. Pursue EM. Don't. I'm not out there trying to get ANYONE to apply to this specialty. I'm just trying to help the ones that want to get there. It's not in my best interest one way or the other. If 1000 less people apply to EM, its not going to effect my life. And we shouldn't pretend that all the attendings who are online telling students to avoid EM don't have their own vested interest in preventing an oversupply of the market to protect their own income.

My advice ALWAYS is to do what makes you happy, not what you think is going to be the best way to make money. The job market, like any other market will fluctuate, correct, and stabilize. It will be guided by the supply and demand of the market. Period. Our salaries may go down at times. Up at times. If we oversupply, things will go down. It will level out in the long run because that's what markets do. We may all make less money if we continue to oversupply, but then the supply will probably go down, and those losses will level out, etc.

I've always told students to do what makes you happy, and you'll be happy. Do any field for the money and you'll be miserable when there is a downturn. Markets fluctuate. Healthcare is a market, like any other business.

And also, I've stated there is long-term reason for concern based on residency expansion and never claimed the market was stable as you suggested. I just don't believe that expansion is the cause of the CURRENT market problem.

 

[gamerEMdoc]

I finished my FM residency about five years ago and wound up taking a job as a nocturnist in a rural ED, which I love. Lately I've been reading all the internet doomsaying about the EM job market, and I've seen far more people vying for hours at my ED than I'm used to, so I have to wonder if there might be some truth in the pessimism. As such, I'm considering contingency plans that might allow me to still make a career out of rural EM. One of them is doing a second residency. Is this a viable plan? Any tips?

Here's my background. During my clinical years in medical school I got bit by the MBA bug, and learned it'd be easier to complete medical school and squeeze a one-year program in before residency since it was too late to do a combined program. I applied to the EM programs I rotated with, didn't get in (not going to lie -- my Step I & II scores suck), and did the MBA as planned. Afterwards I was convinced I wanted to run my own practice and applied straight FM, and completed my residency without issue. I looked for jobs in urgent care or clinic, and actually had a contract in hand for a great clinic position when TeamHealth contacted me out of the blue to see if I was still interested in EM. They had a program specifically built to transition FM grads into EM and I figured I'd might as well give it a shot since I knew that door was rapidly closing. My initial plan was to gain some more acute care experience, pay down some student loans, and open my own urgent care clinic after my two year commitment was done (or when I got burned out). Five years later I'm still here and loving it.

While I'm reasonably certain I'll be able to keep my job for a while yet, I'd rather not have to reinvent myself when I'm 50. So I figured I'd make plans now, and if my best course of action is to endure another intern year then I'd might as well do it in the next few years while I'm still young and have relatively few commitments. And if it's not viable then I'll plan a more gradual exit strategy.

It's definitely viable. I see some candidates do this every year. Someone who already has worked in an ED as a physician brings a wealth of experience with them, regardless of their background.

 

[gamerEMdoc]

Hey GamerEMDoc,

Any steps a first-year med student can take early on in order to build a competitive EM residency application? Have a strong interest in EM and am starting med school this summer, so would like to do whatever I can to prepare myself.

Thanks!

I think the main thing early on that you can do is get involved with your schools EM interest group and finding an advisor at some point, but there's little you will do in the first two years other than not fail out that will prevent you from matching in EM.

 

[skierm9]

I am not sure if this has already been addressed but do you think it is looked down upon to have a subspecialty SLOE (Peds EM)? I am an EM applicant without a home EM rotation. I have 1 EM "home" rotation set up and am waiting to hear back from a few programs for a second rotation (applied to both Peds EM and EM rotations). I am interested in Peds EM and would like to see what it is like at a Peds ED. I would try to do an additional EM rotation but due to the 1 away rotation rule (and 1 "home" rotation), I feel like my options are limited. My hesitation is that I know a normal SLOE is going to be stronger. My plan is to get an O-SLOE from my home program as my third letter.

 

[acetylcholinesterasee]

I am not sure if this has already been addressed but do you think it is looked down upon to have a subspecialty SLOE (Peds EM)? I am an EM applicant without a home EM rotation. I have 1 EM "home" rotation set up and am waiting to hear back from a few programs for a second rotation (applied to both Peds EM and EM rotations). I am interested in Peds EM and would like to see what it is like at a Peds ED. I would try to do an additional EM rotation but due to the 1 away rotation rule (and 1 "home" rotation), I feel like my options are limited. My hesitation is that I know a normal SLOE is going to be stronger. My plan is to get an O-SLOE from my home program as my third letter.

What did you end up doing? I'm in a similar situation. Ended up just doing two EM rotations but hoping to set up an informal peds EM experience at my institution later this year

 

[gamerEMdoc]

Sorry I never saw the original question about the subspecialty SLOE. Hopefully it all worked out. I think most app reviewers like to see subspecialty SLOEs, but more so in addition to 2 actual sloes from EM programs. I realize that's not always possible, since rotations can sometimes be hard to come by in July-Oct, especially these past 2 years. In the end things like subspecialty sloes or OSLOEs are still more valuable than just a random LOR from another specialty. Once you have 2 regular SLOEs, after that the rest doesn't matter all the at much, you can mix and match your letters however you want.

 

[Bollinger_MD]

Consensus statement on EM rotations / SLOEs this year. Here's the highlights:

1. No student should do more than 2 EM rotations at residency programs
2. No student should have more than 2 eSLOEs
3. Students with home rotations should do one home and one away rotation (or 2 home if you have 2 home sites). No aways before Aug 1.
4. Students without home rotations should do 2 aways, one may be before Aug 1st to count as a "home"
5. Programs should consider applicants with only one sloe since getting aways may still be difficult for some

The document here goes into the nuances.

https://www.cordem.org/globalassets/files/position-statements/2021-consensus-statement_-part-1_-aways--esloes.pdf

I am a former ENT resident (2018-2020) and planning to apply to EM in the upcoming match. I couldn't complete a clinical rotation at any institution due to my lack of affiliation to a medical school and COVID. Thus, I could not obtain a SLOE for the upcoming match.

Would I be considered for an interview?

Will my application be discarded for either one or both of these non-traditional scenarios?

Appreciate any tips one way or the other.

 

[KarlPilkington]

I am a former ENT resident (2018-2020) and planning to apply to EM in the upcoming match. I couldn't complete a clinical rotation at any institution due to my lack of affiliation to a medical school and COVID. Thus, I could not obtain a SLOE for the upcoming match.

Would I be considered for an interview?

Will my application be discarded for either one or both of these non-traditional scenarios?

Appreciate any tips one way or the other.

You're in a tough spot.
Lack of a SLOE is not always a non-starter but is a HUGE obstacle. I've looked at applications from people without formal SLOES but generally it is going to be hard to get someone to pick up an application a SLOE.
The bigger issue is that you weren't able to do a clinical rotation. I think of SLOES as a standardized way to evaluate someone's rotation. Without a rotation not only do I not have any measure of how they would perform I also don't have any idea if they actually want to do Emergency Medicine. I'm sure someone along the way has successfully matched without a SLOE AND without a rotation but in the current climate I would think this would be almost impossible.
If you previously matched into ENT then I would imagine your grades/scores are decent. I think to have have chance of matching in EM you gotta really flesh out what led you to ENT, what happened, and what now has led you to EM. Ideally your former PD in ENT could help by talking with EM folks at your former institution.
I know all situations are unique and would be happy to talk privately if you wanted a more detailed take on your file.

 

[The Knife & Gun Club]

I am a former ENT resident (2018-2020) and planning to apply to EM in the upcoming match. I couldn't complete a clinical rotation at any institution due to my lack of affiliation to a medical school and COVID. Thus, I could not obtain a SLOE for the upcoming match.

Would I be considered for an interview?

Will my application be discarded for either one or both of these non-traditional scenarios?

Appreciate any tips one way or the other.

I would imagine there will be some programs that would be willing to grant an interview without a sloe, but you’ve gotta sell it and apply to every program on ERAS.

Im curious what made you want to make the switch? My N is small but most of the ENTs I’ve met have a disdain for the ED that’s surpassed only by general surgeons. On an off-service month I had an Ent Refer to EM as “parasitic doctors that contribute nothing to patient care besides iatrogenic incompetence injury.”

 

[Bollinger_MD]

I would imagine there will be some programs that would be willing to grant an interview without a sloe, but you’ve gotta sell it and apply to every program on ERAS.

Im curious what made you want to make the switch? My N is small but most of the ENTs I’ve met have a disdain for the ED that’s surpassed only by general surgeons. On an off-service month I had an Ent Refer to EM as “parasitic doctors that contribute nothing to patient care besides iatrogenic incompetence injury.”

Unfortunately, your interactions with ENT physicians don't shock me. There are probably 100+ current/former Mizzou EM employees (attendings, residents, nurses, etc.) that could attest that I do not fit your cohort. I developed a lot of amazing work relationships and friendships during my time as a consulting physician in the ED.

Hate to leave a cliffhanger, but it's probably best that I save the rest of the story for my personal statement. Thanks for the candid feedback!

 

[gamerEMdoc]

I don’t think there is an expectation to get SLOEs for people switching specialties or applying to EM after completing another residency. The SLOE is meant to compare 4th year students to other 4th year students.

That being said, being an applicant switching specialties can be a difficult obstacle to overcome for sure. I almost always interview a handful of them every year.

 

[MedScat]

@gamerEMdoc how many programs is enough programs? Mostly honors, honored home EM, not sure about away EM yet. 233/256 step 1/step 2 respectively. Lots of volunteer work, gold humanism honor society. Want to stay in NY region. I have 35 so far and I was confident it was enough but I'm now getting last minute jitters

 

[pazzo]

@gamerEMdoc looking for advice! DO applicant, honored 3rd year EM rotation and 4th year home, step 247/265, from the southeast, non-trad, solid experience. Had a weird shift with the APD who will be writing one of my SLOEs. Don't feel good about it even though all of my other shifts have gone really well. How many programs should I look at? Should I not assign that SLOE and just apply with the other one hoping it's good?

 

[lucid_leprechaun]

@gamerEMdoc looking for advice! DO applicant, honored 3rd year EM rotation and 4th year home, step 247/265, from the southeast, non-trad, solid experience. Had a weird shift with the APD who will be writing one of my SLOEs. Don't feel good about it even though all of my other shifts have gone really well. How many programs should I look at? Should I not assign that SLOE and just apply with the other one hoping it's good?

Almost the same scores I had and same region so can relate. I think I applied to 50 or so, went on 11 interviews. I used all my SLOEs on the assumption that not including one will look suspicious. Honored all rotations. But I also got surprised by match so you never know. I would just include it.