EM PD - Ask Me Anything

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@gamerEMdoc This may have been answered previously, but what're some things a DO student can do beginning in M1-M2 to strengthen chances of eventually matching EM besides doing well in classes? I understand research isn't that important for matching EM?
 
Coltuna said:
@gamerEMdoc This may have been answered previously, but what're some things a DO student can do beginning in M1-M2 to strengthen chances of eventually matching EM besides doing well in classes? I understand research isn't that important for matching EM?
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Try learning/doing something interesting. I was asked more about skiing and fishing in my interviews than my grades, research, or board scores combined.
 
Coltuna said:
@gamerEMdoc This may have been answered previously, but what're some things a DO student can do beginning in M1-M2 to strengthen chances of eventually matching EM besides doing well in classes? I understand research isn't that important for matching EM?
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EMRAs website has great links and resources for what you should do each year. ALIEM and the PD from Northwestern have great videos. Joining EMRA gives you a survival guide handbook

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Coltuna said:
@gamerEMdoc This may have been answered previously, but what're some things a DO student can do beginning in M1-M2 to strengthen chances of eventually matching EM besides doing well in classes? I understand research isn't that important for matching EM?
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I totally agree with the two posts above. Most of the first two years probably aren't going to matter critically outside of doing well enough on your boards to open doors for interviews/rotations. Research isn't that big of a deal. You will get asked in every EM interview what you do outside of medicine, so if your entire life revolves around medical school, I'd start developing some hobbies as AlgernonMed suggested. I'd start looking at the info that EMRA and ALIEM has for students planning for EM. They are good. I think I posted links to some of that stuff somewhere in this thread a long while back, but you can easily find it. There won't be much for you to do now, but really just getting a timeline and familiarizing yourself with the important part of the process like timing your away rotations, getting SLOEs, etc. If your school has an EM interest group, join it. See if your school has any access to EM advisors/mentors, too early probably to contact one but may be a good idea to know if they exist and get some contact info to contact early in your 3rd year. Otherwise, I wouldn't really worry much in the M1-2 year.... med school is a grind, enjoy life a bit, 3/4th year will get here soon enough.
 
What are your thoughts on subspecialty or non-faculty SLOE's? I did an EMS rotation and never thought to get one for it, for my initial application. Right now I'm planning for the SOAP contingency and looking for anything that might give me a boost.
 
CajunMedic said:
What are your thoughts on subspecialty or non-faculty SLOE's? I did an EMS rotation and never thought to get one for it, for my initial application. Right now I'm planning for the SOAP contingency and looking for anything that might give me a boost.
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My thoughts on subspecialty sloes and non-residency sloes are that they carry less weight than a SLOE, but more than a generic written LOR. If you a;ready have 2-3 sloes at this point, I doubt an EMS subspecialty SLOE is going to make a huge difference.
 
Anything you would be looking for for someone coming out of a TRI? Decided the ACGME Match/SOAP was going to be too risky, and the TRI connected to my home EM program was filling and not holding any spots until after the SOAP. I've done some pretty serious self-analysis, plus gotten some feedback and I believe I know where I went wrong this match.
 
Generally, if you can figure out what was wrong with your app (especially if its a single SLOE) that’s easier to fix. You take out the bad SLOE and insert a LOR from your TRI PD. If its something you can’t change... well, you can’t change it. If you are doing at TRI at a place with an EM residency, it would be great if you could rotate in their ED early on and get a SLOE from their department.
 
Business-Analyst-Certification-Fotolia_32083818_XS.jpg


Congrats to everyone that certified their list. To those that didn't, seriously, you should probably do that, you have 45 minutes. Huge step, and a huge relief. At this point, you are in the hands of the match gods at the NRMP and can do no more. Best of luck all.
 
Going to be a loooooong weekend...

That being said, if anyone out there had contacted me privately for advice this past year, if you wouldn’t mind dropping me a message next week and letting me know how you did in the match, and whether not you felt it helped or not. I would greatly appreciate it!

Best of luck everyone!
 
gamerEMdoc said:
Going to be a loooooong weekend...

That being said, if anyone out there had contacted me privately for advice this past year, if you wouldn’t mind dropping me a message next week and letting me know how you did in the match, and whether not you felt it helped or not. I would greatly appreciate it!

Best of luck everyone!
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Dude, you are srsly a cool guy.

I wouldn’t be surprised if your program gets a measurable uptick on apps due to your presence here.

You’ve been a great help over the last few years.
 
AlgernonMed said:
Try learning/doing something interesting. I was asked more about skiing and fishing in my interviews than my grades, research, or board scores combined.
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And I was told my research was heavily covetted at top programs, including all county ones--it was the focus of most of my interviews. I think how much research matters depends on the program, but I've noticed that the culture of EM and its perspective on research is definitely changing.
 
gamerEMdoc said:
Going to be a loooooong weekend...

That being said, if anyone out there had contacted me privately for advice this past year, if you wouldn’t mind dropping me a message next week and letting me know how you did in the match, and whether not you felt it helped or not. I would greatly appreciate it!

Best of luck everyone!
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I think you might be the most beloved anonymous APD in human history. You definitely elevate the brand of your program and reflect the best of EM Med Ed. I hope I interviewed at your shop, and wish you only the best for the your Match.
 
Gray Fox said:
I think you might be the most beloved anonymous APD in human history.
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Doubtful, but I'll take the complement 🙂. And I've remained anonymous? Seems like every student that browses SDN that has interviewed with me over the last 2 years has said "you are gameremdoc, right!" Lol.

Gray Fox said:
You definitely elevate the brand of your program and reflect the best of EM Med Ed
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Probably not, there's many many many educators out there putting more effort than me in reaching a mass audience. EM is truly a field of the best and the brightest using technology to teach and reach out to others across a wide audience. I'll just settle for doing my small part in this small corner of the internet on SDN. But once again, I appreciate it.

Gray Fox said:
I hope I interviewed at your shop, and wish you only the best for the your Match.
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Best of luck! And thank you!
 
Gray Fox said:
And I was told my research was heavily covetted at top programs, including all county ones--it was the focus of most of my interviews. I think how much research matters depends on the program, but I've noticed that the culture of EM and its perspective on research is definitely changing.
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Gray Fox, I think you are right to point this out. I've said before that research doesn't really matter much in the application process, and I standby that to an extent, but there are exceptions. I don't think a single token project carries a lot of weight. But when a candidate actually has a decent research background, its definitely intriguing. Every program, University or community, has to have their faculty publish. So getting residents who you know will help towards that goal is definitely a plus.
 
TeddyBoomBoom said:
Dude, you are srsly a cool guy.

I wouldn’t be surprised if your program gets a measurable uptick on apps due to your presence here.

You’ve been a great help over the last few years.
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Couldn't agree more. Reaching out to this guy was by far the best move I made in this whole process.
 
I don't know if you'll be able to answer this question, but you did say "anything!" You actually had some very helpful replies to my post 2 years ago when I first failed to match into EM, but I know a lot changes in 2 years...

I am a current FM PGY-2 and feeling very lost as to the path ahead. I've always wanted to do EM, but I had 2 major red flags: 1. Step scores with a Step 1 failure, and mediocre Step 1 and Step 2 and 2. Taking an LOA shortly after starting med school because I wasn't prepared academically.

I'm not sure if any of those hurdles can be overcome, or what the best way is of doing that and I am looking for some advice going forward.

Mainly, when is the ideal time to apply to EM, and what should I be doing until then?

Really, I see two paths forward here:

1) Apply to open PGY-2 spots as they come available in the coming months potentially for a PGY-2 spot July 2018
2) Rematch in the fall for a PGY-1 spot July 2019 (at which point I should probably also apply to all the open PGY-2 spots for July 2019 as well).

I'm not really sure what is the better option for me. I know you have said in the past that I wouldn't be an attractive candidate from a FM residency to take a PGY-2 spot. I am guessing that is still the case. While my program is unopposed and full-spectrum, I'm guessing my numbers in terms of patient encounters and procedures just don't match up well with an EM-1 trying to change programs into an open EM-2 spot. I am actually not as worried about procedures as based on the ACGME's "Emergency Medicine Defined Key Index Procedure Minimums" I am doing pretty well and have either already met minimums or are very close to what other EM rotators through our ED have in their logs at the start of PGY-2, but with only 4 months of EM time, I'm sure my overall encounters numbers are much lower than the EM rotators.

If option 1 isn't really viable, then I would need to look at rematching this coming fall. If that's the case, how does a grad of an FM program stand out to a residency admissions committee? Other than continuing to do well on my EM electives (both the Department Chair and the Assistant Chair I've worked with extensively and will be willing to write me a letter whenever I am at the stage of needing one), doing an away elective at a program with a EM residency (to try and capture a letter from current faculty in an EM program), and continuing to post In-Training Exam scores above the average (to show that my test-taking woes are behind me), what else do I need to be doing?

And when the time comes, is there any way of knowing which programs are more friendly to those looking to switch specialties? I presume that with 191 EM programs in the Match last year, without further contact from an interested applicant, a lot of those programs will throw out any applications from someone who failed step 1 and I can't realistically apply to all 191 programs and contact them to explain my situation and interest--at least, not in a meaningful way!

Thank you for any thoughts you might be able to offer me!
 
The issue with getting a PGY2 spot if one comes open is, most want someone who has a year of EM experience. Most are looking to fill with another EM resident who is trying to leave their current program. Not saying its not completely impossible, its just going to be very very difficult. First an opening has to happen. Then it has to be a place willing to take someone outside of the specialty. Then you have to compete for it. That's a lot of ifs. I think the odds are definitely against it.

If applying for the match, I'd definitely focus on community EM programs, newer programs, programs that recently transitioned AOA to ACGME, and programs that are within a geographic radius of where you are training, if there are any. And you may want to try and network. You will get filtered out of programs lists because of your failure/scores, so you may benefit from contacting programs or hitting up a residency fair to try and get your foot in the door for interviews.
 
Hi, thanks for doing this. What easy to read EM study resources would you recommend for someone who wants to make a study plan for intern year?
 
Gamer can likely recommend other content, but do yourself a favor and learn how to read an EKG.

Amazon product ASIN 0763773514
I read this after match MS4 year. Full 12-lead EKGs and great explanations. Starts off relatively easy and progresses through basically Cards fellow material. Expensive but totally worth it. That other ekg book everyone reads during med school is pure garbage.
 
My other 2 cents:

EM is nice cause if you come into residency with a strong general medicine knowledge base (like you killed your USMLEs) you will likely be well equipped for intern year. If not, I'd find a text that you jive with (probably Tintinali or Rosen) and start going through that. Once you get the basics, you can then branch into the podcasts / blogosphere (ie EMCrit, EMRAP, life in the fast lane, etc, etc).

To be honest, I didn't read many text books. I found them very boring and put me to sleep. I came in with a strong base knowledge. I read a lot on UpToDate about diagnoses I saw during shifts. This was a surprising shift in learning style for me because in medical school I could pound away at a text book for 5 hrs no problem, but 2 pages a textbook in residency put me to sleep.

I would sign up for Step 3 for the first half of your intern year. The USMLE q-bank is great and will reinforce all that general medical knowledge you need for EM anyway.

Get the basics down please. Nothing was more irritating for me as a senior resident than when a junior whipped out some nugget they learned on EMRAP, but in the resus bay they didn't know basic RSI med dosing.
 
GonnaBeADoc2222 said:
My other 2 cents:

EM is nice cause if you come into residency with a strong general medicine knowledge base (like you killed your USMLEs) you will likely be well equipped for intern year. If not, I'd find a text that you jive with (probably Tintinali or Rosen) and start going through that. Once you get the basics, you can then branch into the podcasts / blogosphere (ie EMCrit, EMRAP, life in the fast lane, etc, etc).

To be honest, I didn't read many text books. I found them very boring and put me to sleep. I came in with a strong base knowledge. I read a lot on UpToDate about diagnoses I saw during shifts. This was a surprising shift in learning style for me because in medical school I could pound away at a text book for 5 hrs no problem, but 2 pages a textbook in residency put me to sleep.

I would sign up for Step 3 for the first half of your intern year. The USMLE q-bank is great and will reinforce all that general medical knowledge you need for EM anyway.

Get the basics down please. Nothing was more irritating for me as a senior resident than when a junior whipped out some nugget they learned on EMRAP, but in the resus bay they didn't know basic RSI med dosing.
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I'll also defer to @gamerEMdoc but as an attending:
- Your attention span gets worse and worse through residency, so use reference materials you can read/tolerate but actually use (something is better than nothing);
- Step 3 early to get it out of the way is nice, although matters less for EM given wide scope of specialty;
- Agree with getting basics down. And please be humble. The interns I trust least, and hate working with most, are those who seem to have this chip on their shoulder and/or seem a bit arrogant and hyper-defensive. We've all been there. Intern year is a little tumultuous, and it's stressful in unique ways, but just learn and be easy to work with, and it'll be just fine.
 
Totally agree with getting Step 3 done ASAP. There is little reason to wait. I've never had a resident fail Step 3. That would be very uncommon for an EM resident. The didactics and patients you see are so broad, its a perfect field for prepping you to take Step 3.
 
GonnaBeADoc2222 said:
Gamer can likely recommend other content, but do yourself a favor and learn how to read an EKG.

Amazon product ASIN 0763773514
I read this after match MS4 year. Full 12-lead EKGs and great explanations. Starts off relatively easy and progresses through basically Cards fellow material. Expensive but totally worth it. That other ekg book everyone reads during med school is pure garbage.
Click to expand...

I actually like the Dubin book (the one you are referring to I believe that people read in med school). But only for teaching the basics. It will teach you a systematic approach to reading an ecg. But its not filled with examples or nuanced findings. Its just a starting point, it certainly can't be the only thing you read to learn ECG interpretation. For the rest I really like Amal Mattus two ECG books ECG for the EM physician. Just hundreds of ECGs, one after another, randomly arranged (which is how you will see them on shift) with long detailed answers. I'm not sure it really matters what you read as long as you get the basics from somewhere, then have a book of tons of examples to test yourself and hone your systematic method of reading an ecg while at the same time developing quick pattern recognition.
 
As a DO, is there anything BESIDES RESEARCH that you can do between M1 and M2 summer to make yourself more competitive? Thanks.
 
sdhere1234 said:
As a DO, is there anything BESIDES RESEARCH that you can do between M1 and M2 summer to make yourself more competitive? Thanks.
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I would just go on emras page. There are papers somewhere on there on what to do each year of medical school to prepare. Basically just learn how to interact in the hospital environment and formulate a plan for away rotations. Focus step 2

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sdhere1234 said:
As a DO, is there anything BESIDES RESEARCH that you can do between M1 and M2 summer to make yourself more competitive? Thanks.
Click to expand...

Honestly, Id just try to enjoy the time off if you get some. Lifes too short and med school is a grind. I mean that honestly. I mean, reading EMRAs guides for applying EM to familiarize yourself with a path to a successful match is a great suggestion in the post above. But honestly, if I were a first year student, Id just be happy to take some time off.
 
gamerEMdoc said:
Honestly, Id just try to enjoy the time off if you get some. Lifes too short and med school is a grind. I mean that honestly. I mean, reading EMRAs guides for applying EM to familiarize yourself with a path to a successful match is a great suggestion in the post above. But honestly, if I were a first year student, Id just be happy to take some time off.
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Oh yeah I misread that as between years 2 and 3. Agreed. Relax that summer and work on your golf game. Don't burn yourself out before the second year of death by PowerPoint

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"Secure an open PGY-1 position sometime during the year through a residency vacancy".

Does that happen? I thought that if you don't start July 1 then you don't start until next year. Are there really PGY-1 spots that open up mid-year that you can apply to and start in say December?

Advising the Unmatched Applicant
 
theSmurfette said:
"Secure an open PGY-1 position sometime during the year through a residency vacancy".

Does that happen? I thought that if you don't start July 1 then you don't start until next year. Are there really PGY-1 spots that open up mid-year that you can apply to and start in say December?


Advising the Unmatched Applicant
Click to expand...

Last year there was a PGY-1 spot that opened during the fall, I think at Wisconsin? But you can count on those filling pretty quickly, usually from within.
 
gamerEMdoc said:
Alright. Now that that is finally over, who out there is ready to start preparing for next years match?
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I am!

Graduation from business school - q 7 wk.
Senior schedule - check.
Reset UWorld - check.
Step 2 CK - pending.
Step 2 CS - pending.
Schedule away rotation - check.

2019 lets git er done!!!!
 
Do you think that the increasing number of residencies will glut the ER market, or are fears overblown? Why do so few students from top medical schools choose EM?
 
slurpy15 said:
Do you think that the increasing number of residencies will glut the ER market, or are fears overblown? Why do so few students from top medical schools choose EM?
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In regards to "top" medical schools, here's a brief breakdown from 2017:
12 from U of Pittsburgh
8 from U Chicago (typically smaller classes compared to other medical schools)
13 from WashU
19 from Case Western
11 from Hopkins
4 from Stanford (they have a much smaller class in general, so smaller numbers)
7 from Cornell

I would definitely disagree that medical students from top programs are not choosing EM.
 
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