Are you MD or DO? and do you mean surprised in a good way or bad way?
EM PD - Ask Me Anything
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MD so a bit different. At the time it was a bad surprise but in retrospect I’m pretty happy with how things went. Either way matched and that’s the important part. Very happy now that I’ve finished training.
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50 programs as a US MD with those scores? is that standard? I have 33 on my list right now and thought it was enough
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I think it depends on what you want. Me I'd rather go to my home institution (going to rank it in top 5 and it's probably a mid to low tier program) than many other programs so it doesn't make a lot of sense to apply to a ton of others, I think I'm going to be doing around 30ish as well.
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I mean i have my preferences...but I want to make sure I match lol. I thought 30ish would be safe but seeing a USMD apply to 50 was quite alarming
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I honestly had pretty broad geographic scope so that bumped my number up. I’m sure 30 something is fine. It was also a different year so not sure how many applicants are applying now.
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Most places write their SLOEs based on group consensus, not one persons opinion. Without actually knowing your sloes, theres no way to DEFINITELY answer your question, however, as a general rule I’d argue any more than 50 programs is probably overkill in general. All has to do with where you apply. For instance, someone with low tier boards and average sloes applying to 50 of the most uncompetitive programs will get interviews. Applying to 50 of the most competitive and they won’t; if they add another 50 to get to 100 and they are still all competitive places, they still won’t get as many interviews. The overall number isn’t as important as actually where you are applying to. If you are super competitive but want to end up in a rural community place for whatever reason, you could apply to 20-30. That’s what I did. And I got 20 some interviews. I only went on 8 of them. Why? Because I knew I’d match at my top choice. I didn’t see the point, I was a compettive applicant applying to places that just weren’t real competitive.
As for the SLOE, theres just know way of knowing how one interaction is going to hurt you or if you are reading too much into it. But you are probably reading too much into it tbh.
Ultimately your scores are very competitive. Hopefully your sloes are as well. I wouldn’t apply without a forth year sloe unless you knew for certain it was terrible and you had no choice.
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See my last answer. There is no way of knowing this without knowing your SLOEs. Two top 10’s? You could apply to 2 places, the places that gave you them, and you’ll probably match at one of them. Now should anyone only apply to 2 places? Of course not, but my point is, there is no perfect number, you can literally match with 1 interview. You can not match with 14.
In general, I rarely think most people need to apply to more than 50 programs, assuming you are targeting places within your competitiveness. Applying strategically makes more sense than just spamming 150 programs.
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How the heck can we tell approximately what kind of SLOE we're getting? If we honored the rotation and got good clinical comments, does that mean we are likely top 1/3 or does it not work that way?
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The short answer is you can’t. Depends on the place you rotate at. Some give honors to like 10% of students and if thats the case, its probably top 10 or top 1/3. Some give honors to 90%, and if thats the case, it could be anything. So there are no absolutes, but chances are if you got honors, the sloe will be at least a top 1/3 at most places.
Unfortunately, unless the place that wrote your SLOE tells you (most don’t) or you have an advisor who has access to your app and can at least let you know if you are competitive or not, you are left guessing. Which is why people overapply.
As a general rule, you’ll know fairly early how competitive you are. Someone with great sloes will get lots of invites early in the first month to the point where they will have to start turning some down. People with average sloes will get a few invites early but it will be a slower march to 10 or so invites. And people with bad sloes or major red flags will struggle to get invites all interview season.
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He's a question I cannot find an answer to.
I have 2 SLOEs. That's what my medical school said I needed this year.
Almost every program I'm seeing on their website has a minimum of 3 letters before your ERAS is complete.
Someone please tell me this is not the case, they're not updating their websites, and I don't have to run around trying for a 3rd LOE so close to the end...
I have 2 SLOEs. That's what my medical school said I needed this year.
Almost every program I'm seeing on their website has a minimum of 3 letters before your ERAS is complete.
Someone please tell me this is not the case, they're not updating their websites, and I don't have to run around trying for a 3rd LOE so close to the end...
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3 letters doesn't mean 3 sloes. It means 3 letters. 2 should be SLOEs, but sometimes you can't get both by the time ERAS opens. You can submit up to 4 letters to any program.
Those 4 letters should be, IDEALLY:
- 2 esloes
- Anything else. Narrative letters from other specialties. OSLOES. Subspeciatly sloes. Non-residency SLOEs. Whatever
If you can't get more than one SLOE by the end of app season, then I think you definitely would want an OSLOE, subspecialty sloe, or non-res sloe as well to make up for the lack of a 2nd eSLOE.
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How about 3 letters...2 SLOES and 1 OSLOE? Do they want to see a non-SLOE? I assumed they would prefer the standardized OSLOE from all letter writers rather than a traditional letter. Also, I see you said 4 letters...I have 3. Is this a red flag or totally fine?
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Yeah thats fine. Again, you need 2 eSLOEs, and anything you get after that to hit the programs number of letters (3 or 4) to be complete is fine. Doesn't matter what that 3rd and/or 4th letter are after you get 2 eSLOEs. If you can't get 2 eSLOEs, then I think it makes sense that one of those letters is an alternative SLOE.
Thanks, fingers crossed. My advisor has offered to view the SLOE and let me know his opinion on whether or not I should send it out.
One more question for you--how should applicants utilize the hometown section on ERAS? I was raised in/went to college in place A, spouse is from place B, we lived in place C after getting married/before medical school and have 75% of our family there, and currently very established in place D (medical school location). If I only list place A as my hometown, how can I show ties to both B and C, and does my medical school location show enough commitment to place D?
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I think you are overthinking the hometown. Just put your hometown, whatever you'd consider that to be. Doesn't have to be where you were born, but where do you consider "home" when not in med school. Most places are going to filter based on current address or permanent address anyways; it's much more difficult to filter based on hometown with the way ERAS is set up. You have to build a filter that searches for keywords if you want to use that.
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A little bit of a different question as I’m already a happily matched PGY2.
As a PD of an academic ED, what factors go into your department Hiring academic faculty? What credentials do you look for in core or clinical faculty? What roll do clinical vs core faculty play in resident education? And how often do these types of openings come along?
I ask because I love academic EM, but after discussing with some faculty the impression I’ve gotten is that it’s virtually impossible to break into the market these days.
As a PD of an academic ED, what factors go into your department Hiring academic faculty? What credentials do you look for in core or clinical faculty? What roll do clinical vs core faculty play in resident education? And how often do these types of openings come along?
I ask because I love academic EM, but after discussing with some faculty the impression I’ve gotten is that it’s virtually impossible to break into the market these days.
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I think my area is unique in the sense that its a more rural location, which is traditionally harder to recruit to. So its never been too hard to get a job there, we usually have a resident or two that stays for a year or two after to work as clinical faculty, some longer. But few people come from the outside, maybe one every three years, and its usually someone with ties to the area or their spouse does. They often times seek out us about an opportunity.
As for what you are looking for, it doesn't matter core vs clinical. You want a team player who is interested in teaching, not just someone who is looking for an easier clinical experience. Being an attending can actually be a difficult job if you make it do be. It can also be easy if you are one of those people who doesn't see the patients and barely supervises. We have zero of the those types on staff. Then the difference in terms of what you are looking for with core vs clinical is just about scholarly output.
Clinical faculty just work clinically, they have no academic requirements. They work their 16 9's, supervise residents and students clinically, but don't have to come to conference, take on other roles/responsibilities in the dept and residency, do QI, publish, etc. Core faculty have to have scholarly output, but work less shifts, and attend weekly conference.
Cracking core faculty is harder, we usually only have an opening every so many years, that's been that way for awhile. Our core group is fairly young, many have ties to our geographic region, so not many looking to move on. Which leads to little room to add more core faculty. Our core gig is a good one, core work 4 less shifts a month than clinical, so when one opens, everyone wants one. But when that happens, honestly, I'd rather find someone from the outside if one is available if none of the clinical faculty are qualified. I mean that mainly because most people that decide to stay as clinical faculty don't have to do any scholarly work, so they don't do any to advance their career. And then when a core spot opens, no one has the qualifications. Ideally, you would do SOME scholarship as clinical faculty for your own benefit so if a spot opens there, you are the obvious hire. But that's just not how people think. Few are out there padding their academic resumes in non-academic positions I don't think.
As for what you are looking for, it doesn't matter core vs clinical. You want a team player who is interested in teaching, not just someone who is looking for an easier clinical experience. Being an attending can actually be a difficult job if you make it do be. It can also be easy if you are one of those people who doesn't see the patients and barely supervises. We have zero of the those types on staff. Then the difference in terms of what you are looking for with core vs clinical is just about scholarly output.
Clinical faculty just work clinically, they have no academic requirements. They work their 16 9's, supervise residents and students clinically, but don't have to come to conference, take on other roles/responsibilities in the dept and residency, do QI, publish, etc. Core faculty have to have scholarly output, but work less shifts, and attend weekly conference.
Cracking core faculty is harder, we usually only have an opening every so many years, that's been that way for awhile. Our core group is fairly young, many have ties to our geographic region, so not many looking to move on. Which leads to little room to add more core faculty. Our core gig is a good one, core work 4 less shifts a month than clinical, so when one opens, everyone wants one. But when that happens, honestly, I'd rather find someone from the outside if one is available if none of the clinical faculty are qualified. I mean that mainly because most people that decide to stay as clinical faculty don't have to do any scholarly work, so they don't do any to advance their career. And then when a core spot opens, no one has the qualifications. Ideally, you would do SOME scholarship as clinical faculty for your own benefit so if a spot opens there, you are the obvious hire. But that's just not how people think. Few are out there padding their academic resumes in non-academic positions I don't think.
Got the green light on my SLOE so I was probably over analyzing the interaction with the APD. My advisor gave me the impression that I likely have two top 1/3rd SLOEs and no negative comments, possibly one of them is a top 10 but really unsure about that. I applied to 50 programs and about 20 of them are huge reaches. Is that pretty reasonable or should I target more as a DO?
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I think 50 programs personally is enough if you've applied to programs you are competitive for. And if you have good sloes, you should be fine.
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@gamerEMdoc
Really appreciate you answering all these questions. Also, not sure if you'll even see and reply to this since this threads so old. But hoping for just an advising question.
My school PD and APDs say O-SLOEs and SS-SLOEs dont really matter, so maybe im stressing. But in addition to my 2 eSLOEs, I will likely have 3 additional SLOEs. One O-SLOE from the MICU (2 weeks, home), one SS-SLOE from Ultrasound (2 weeks, away), one SS-SLOE from Peds EM (2 weeks, home).
It seems like we can only submit up to 4 total letters, but i'll have 5. I know my MICU O-SLOE will be great because I saw my course evaluations, and my O-SLOE will be based off of those. I have a feeling my SS-SLOE will be strong because of my interest and skills in ultrasound (faculty often say as strong as most residents) + it is an away. my peds EM i think will be good, currently rotating on it and have one more shift, and I'll probably ask for a feedback session to get an idea of how strong that ss-sloe will be...
My interests lie in critical care and ultrasound, so i was leaning toward using those (MICU, US) for my other 2 sloe's since i feel they represent me better. But my hesitation is whether the peds EM ss-SLOE has more of an impact than the MICU o-SLOE because its subspecialty and not off-service.
Thank you for your time
Really appreciate you answering all these questions. Also, not sure if you'll even see and reply to this since this threads so old. But hoping for just an advising question.
My school PD and APDs say O-SLOEs and SS-SLOEs dont really matter, so maybe im stressing. But in addition to my 2 eSLOEs, I will likely have 3 additional SLOEs. One O-SLOE from the MICU (2 weeks, home), one SS-SLOE from Ultrasound (2 weeks, away), one SS-SLOE from Peds EM (2 weeks, home).
It seems like we can only submit up to 4 total letters, but i'll have 5. I know my MICU O-SLOE will be great because I saw my course evaluations, and my O-SLOE will be based off of those. I have a feeling my SS-SLOE will be strong because of my interest and skills in ultrasound (faculty often say as strong as most residents) + it is an away. my peds EM i think will be good, currently rotating on it and have one more shift, and I'll probably ask for a feedback session to get an idea of how strong that ss-sloe will be...
My interests lie in critical care and ultrasound, so i was leaning toward using those (MICU, US) for my other 2 sloe's since i feel they represent me better. But my hesitation is whether the peds EM ss-SLOE has more of an impact than the MICU o-SLOE because its subspecialty and not off-service.
Thank you for your time
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Osloes and subsp sloes carry about the same impact, in that both are better than general letters but otherwise really dont matter much if you have 2 esloes bc those are what people will pay attention to. So dont sweat the decision. Just use the 2 that you think will be the best.
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How do these program directors get off requiring 2 SLOEs and away rotations in 2023?
At least when I was applying 10 years ago, there was the guarantee of making $250/hr minimum. Now you're telling competitive allopathic seniors that they still have to jump through this hoop? For what? 170/hr to work in a 2pph USACS sweat shop? A 3 year partner track w an SDG working all nights?
Smart and savvy seniors will continue to gravitate towards fields w stronger short and long term outlooks
At least when I was applying 10 years ago, there was the guarantee of making $250/hr minimum. Now you're telling competitive allopathic seniors that they still have to jump through this hoop? For what? 170/hr to work in a 2pph USACS sweat shop? A 3 year partner track w an SDG working all nights?
Smart and savvy seniors will continue to gravitate towards fields w stronger short and long term outlooks
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Hell, you don't need to. It looks like around 500 people matched into EM this year without having done any EM rotations of any kind. You just need to "apply" via the SOAP.
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Yes, but seems like the powerhouseeeee places will still require it. Why not make barrier to entry lower to at least to have a chance to match high quality students? Otherwise why wouldn't they just go to radiology where the only thing that matters is your numbers?
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The barrier of entry is low. You have to do an EM rotation. Maybe. No one said you have to get great letters/sloes these days. Most places would accept just one sloe even 10 years ago (80% or so according to PD surveys) though they prefered two. You can match with zero. But if your dream is to go to a place that still matches competitively, you’d probably want to get 2 sloes.
So why recommend 2 sloes when you can just match with one or zero? Bc no one is recommending “just matchibg”. I want students to go to the best places they can get in. It would be poor advice to say that your goal should be to just shoot for the places no one wants to end up bc they’ll still have spots.
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Or maybe recommend caution when considering a specialty where the leaders are selling our future out from under us.
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I understand the frustration with corporate influence within medicine and EM in particular and certainly understand the workforce concerns within the future of the specialty. However, that was never really the point of this thread and honestly, this thread died off quite awhile ago as I largely stepped away from posting much here on SDN. I'm always available for students to ask questions, I've answered every question and DM here and elsewhere for years for both non-EM and EM-interested students to help with understanding the match and will always do so. But I've largely chosen to step away from SDN because the community here has largely lost all hope and just seems like a echo chamber for burnout. I get it. I get where its coming from. I'm not blind to the problems within the specialty currently. And I truly hope those that haven't found professional satisfaction within the field eventually do so, or are able to pivot their careers to something different that brings them happiness within medicine, though that seems hard to come by these days in the current healthcare environment. Anyways, I've asked the mods to lock this thread, but I appreciate all the students over the years that asked for advice and hope I made even a small difference in their success along the way.
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