EM PD - Ask Me Anything

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gamerEMdoc said:
I agree that both sides should take what each says with a grain of salt. There are definitely honest people on both sides in this process, but the ones that lie make it so no one can believe what anyone says.

However, in this example, the program may not have lied. Sending a Christmas card is hardly a lie. Even if it said we’ll be ranking you highly. Sometimes you just match higher than usual. Sometimes lower. The match is unpredictable. So if you on average always go to the middle of your list, and you have someone in the top 1/3, you are in fact ranking that person high on your list and they should match. But if the stars align and you match much higher than typical in a given year, the program wasn’t lying, they just matched better than anticipated.

Unfortunately, no one ever knows what actually happened in these situations. The only way you know if a program or student lied is if they told you “you are ranked to match” or a student says “I’m ranking you #1” and there isn’t a match. And this definitely happens. It’s usually 1-2 people a year that contact us to say they are ranking us #1 that don’t show up on our list. Hell I had a student last year that probably emailed and said this at least 5 times or more, and we went below his spot on our list and didn’t match him. You just have to take these comments with a grain of salt, and not change what you do based on them. My frustration with this post-interview emails is that there is real fear that if you don’t send out emails as a program/student, that it will hurt you because the other side will take that as disinterest. There isn’t any data that I know of to back that up. But the one year we didn’t send out any, we had our lowest match statistically. It may not have had anything to do with it, but it gives you a fear as a program that by not reaching out, students will take that as disinterest. I know students feel the same way. It’s all silly, and while its not a match violation, its not in the spirit of the intent of the match IMO.
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This is what is making it difficult for me as an applicant to understand who genuinely wants me at their program. I had an interview a few weeks ago where the PD was very forward about being interested in me matching there, but would probably be a program I rank lower. Then I had an interview this past week at a place I am very interested in, great interview day, but no comments made on their interest of me. Its hard when you leave a place you are interested in and not sure if they are interested in you. I feel like these situations are why people do crazy things during rank list time haha
 
wh2k13 said:
Just had the PD of a program I'm currently rotating at (and from which I have not yet received an interview) tell me that it's still early...is this really the case, or is he/she just trying to be nice? FWIW the program has already interviewed at least 1-2 rounds of applicants...it's kinda awkward working in the ED and seeing a tour group of interviewees come through.
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Just trying to be nice.
 
Drdan007 said:
This is what is making it difficult for me as an applicant to understand who genuinely wants me at their program. I had an interview a few weeks ago where the PD was very forward about being interested in me matching there, but would probably be a program I rank lower. Then I had an interview this past week at a place I am very interested in, great interview day, but no comments made on their interest of me. Its hard when you leave a place you are interested in and not sure if they are interested in you. I feel like these situations are why people do crazy things during rank list time haha
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Nope. Don't go crazy about this. Rank the programs in the order you want them.
 
How has this process changed since you've been doing it?

Most of us will only go through this once. We'll see parts of it as residents, but I'm curious as the person on the other side of the table. What anecdotal things do you see from cycle to cycle?
 
Do people match at places that give them a middle 1/3 SLOE, or does that pretty much mean they don't want you?
 
EMikate said:
Do people match at places that give them a middle 1/3 SLOE, or does that pretty much mean they don't want you?
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Absolutely. Programs match on average 6.5 x spots. Meaning if they have 10 spots to fill, they go down to about 65 on their list to fill the 10th spot.

That means programs on average go beyond the midpoint of their list to about the 2/3rd point.
 
gamerEMdoc said:
Absolutely. Programs match on average 6.5 x spots. Meaning if they have 10 spots to fill, they go down to about 65 on their list to fill the 10th spot.

That means programs on average go beyond the midpoint of their list to about the 2/3rd point.
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Ok that makes sense. Thank you!!
 
nedkelly said:
How has this process changed since you've been doing it?

Most of us will only go through this once. We'll see parts of it as residents, but I'm curious as the person on the other side of the table. What anecdotal things do you see from cycle to cycle?
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Great question!

Not much changes cycle to cycle, but I've been part of the interview process dating back to my residency over a decade ago. As a resident, I went to nearly every interview dinner, interviewed in my 2/3 years, and went to all the rank list meetings. When I got into my current job, I got the scoring system my residency used and adapted it based on my own thoughts into what I use today.

I'd say that the things in the process as a whole that have changed in the past decade include:

1. It was rare to see more than 2 SLOEs a decade ago.
2. SLOEs were often written by one persons opinion; "the group SLOE" concept definitely carries more weight and now seems like its most SLOEs these days
3. Students are doing way more rotations now. Most people just did a home/away rotation a decade ago.
4. There seems to be way more anxiety about the whole process now. Maybe I was just oblivious to it when I was a student/resident though.
5. One match. Finally!

On a personal level a ton has changed for me. When I took my current job, we were still an AOA program. Many AOA programs didn't even write SLOEs, so it wasn't atypical to get applicants without any SLOEs, which was a huge annoyance for me trying to judge candidates. The non-SLOE LORs were mostly garbage, I actually interviewed two candidates the same day that word for word had the same LOR other than their name being changed. I don't think I ever saw a LOR that ever said anything negative/constructive. So now, with DO's mostly all having several SLOEs with the migration through the merger, its much simpler to evaluate DO candidates.

Back when I first got into program leadership, faculty at our program would mostly would write SLOEs, though some would still write regular letters when asked way back then. It was a bit of a crap shoot and the individual SLOEs often were too top heavy on the top 10 / top 1/3 side. My first year or two as APD, I really tried to help standardize things, and eventually I realized it would just be easier if I took over writing them all. We eventually landed on a system of a group SLOE where we meet several times during "SLOE season" to discuss the rankings then I write all the SLOEs.

Other than that, my scoring system gets tweaked from time to time. I tweak how I do our rank list before we take in resident input and change it around. I changed how I interview quite a bit. And I've tried more and more every year to be a resource for advising if students need it when they come through.
 
gamerEMdoc said:
Great question!

Not much changes cycle to cycle, but I've been part of the interview process dating back to my residency over a decade ago. As a resident, I went to nearly every interview dinner, interviewed in my 2/3 years, and went to all the rank list meetings. When I got into my current job, I got the scoring system my residency used and adapted it based on my own thoughts into what I use today.

I'd say that the things in the process as a whole that have changed in the past decade include:

1. It was rare to see more than 2 SLOEs a decade ago.
2. SLOEs were often written by one persons opinion; "the group SLOE" concept definitely carries more weight and now seems like its most SLOEs these days
3. Students are doing way more rotations now. Most people just did a home/away rotation a decade ago.
4. There seems to be way more anxiety about the whole process now. Maybe I was just oblivious to it when I was a student/resident though.
5. One match. Finally!

On a personal level a ton has changed for me. When I took my current job, we were still an AOA program. Many AOA programs didn't even write SLOEs, so it wasn't atypical to get applicants without any SLOEs, which was a huge annoyance for me trying to judge candidates. The non-SLOE LORs were mostly garbage, I actually interviewed two candidates the same day that word for word had the same LOR other than their name being changed. I don't think I ever saw a LOR that ever said anything negative/constructive. So now, with DO's mostly all having several SLOEs with the migration through the merger, its much simpler to evaluate DO candidates.

Back when I first got into program leadership, faculty at our program would mostly would write SLOEs, though some would still write regular letters when asked way back then. It was a bit of a crap shoot and the individual SLOEs often were too top heavy on the top 10 / top 1/3 side. My first year or two as APD, I really tried to help standardize things, and eventually I realized it would just be easier if I took over writing them all. We eventually landed on a system of a group SLOE where we meet several times during "SLOE season" to discuss the rankings then I write all the SLOEs.

Other than that, my scoring system gets tweaked from time to time. I tweak how I do our rank list before we take in resident input and change it around. I changed how I interview quite a bit. And I've tried more and more every year to be a resource for advising if students need it when they come through.
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Do you fault students for not knowing enough or being deficient in certain procedural skills, maybe the more straightforward ones like a lac repair? Really, I'm trying to understand what goes into a student receiving a bottom 1/3 SLOE (I'm sure there are a multitude of reasons) and if that is like a death sentence as far matching into EM? It would seem from my vantage point that most SLOEs would tend to skew more positively unless a student did something egregious like do an unauthorized procedure or significantly stepped out of line with a resident or attending (ie tell pt or family something wrong/inappropriate, be unprofessional with ancillary staff).

Thanks!
 
gamerEMdoc said:
Absolutely. Programs match on average 6.5 x spots. Meaning if they have 10 spots to fill, they go down to about 65 on their list to fill the 10th spot.

That means programs on average go beyond the midpoint of their list to about the 2/3rd point.
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so what you're saying is...if im at an interview, sitting next to two chaps, I just have to beat 1 of them?
 
Our residents/attendings are coached to take experience into account. So a student rotating in July on their first EM rotation is not judged the same as a student in October on their 3rd EM rotation. The expectation is that students continue to improve, get more efficient, learn to present a case succinctly, learn to build differentials/plans, etc as time goes on.

In terms of low 1/3, oftentimes its one of two things. Either the student is very inefficient, is in the room forever, and can't present/formulate a ddx/plan to save their life, or its the student who is way too overeager. That's not only the case with our place, nearly every low 1/3 SLOE I read mentions one of those two issues. A student that is clinically way behind their peers, or a student that is so overeager they are obtrusive and very difficult to work with. I don't mean excited or trying hard. I mean like tripping over you, not taking feedback well, arguing with you, etc. Like there are some students that take the intensity way up to 11.
 
Listen2Savage said:
so what you're saying is...if im at an interview, sitting next to two chaps, I just have to beat 1 of them?
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Ever watch "The Price is Right"? (If you haven't, what kind of communist are you??) There are 4 people on contestant row. There will be nine total selected for any show. 6 of them will get up on the stage to play a game. So, just like TPIR, you just have to beat 1 of them!
 
Apollyon said:
Ever watch "The Price is Right"? (If you haven't, what kind of communist are you??) There are 4 people on contestant row. There will be nine total selected for any show. 6 of them will get up on the stage to play a game. So, just like TPIR, you just have to beat 1 of them!
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Apollyon said:
Ever watch "The Price is Right"? (If you haven't, what kind of communist are you??) There are 4 people on contestant row. There will be nine total selected for any show. 6 of them will get up on the stage to play a game. So, just like TPIR, you just have to beat 1 of them!
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Wait, unless you are the last one chosen from the audience. Does this mean late interviews count less than early interviews?!?!
 
@gamerEMdoc,

I'll be applying EM next year, and apologies if this SLOE question has been beaten to death already but I haven't been able to find a clear-cut answer on my specific school schedule.

My school recommends us to do July as a "paper month" to knock out Step 2 CS/CK. So, that would leave my EM auditions during August, and September. So, ideally timing wise I'd have 1 non-SLOE letter and 2 SLOE's in by October 1st (assuming that second SLOE would come in on time/a week or two after Oct 1st).

Does this timeline work for applicants or is it considered late since I'd be risking only 1 SLOE in by Oct 1st? Would it be advisable to do an audition in October to get a 3rd SLOE that would come in around November?

Thanks in advance!
 
camtheram1815 said:
My school recommends us to do July as a "paper month" to knock out Step 2 CS/CK. So, that would leave my EM auditions during August, and September. So, ideally timing wise I'd have 1 non-SLOE letter and 2 SLOE's in by October 1st (assuming that second SLOE would come in on time/a week or two after Oct 1st).
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If you can get an EM rotation in July, do EM in July. You would still be fine if you get rotations in August and September, but what if you can't get scheduled somewhere. What if the rotation fell through. App season opens Sept 15, and you will want at least one SLOE by then. You are assuming the August rotation SLOE will be there by Sept 15, and that's not a safe assumption. Some places just drag their feet on writing SLOEs. The earlier you can knock out two 4th year auditions at EM programs and get 2 SLOEs the better.

That being said, if you couldn't rotate in EM in July, you'd probably still be fine. It's just not an ideal timeline. And it's silly to forgo a July rotation for step 2 IMO. SLOEs are the most important part of your application, not Step 2. Why prioritize something that is far less important? Depending on what your study schedule is, I agree with taking it as early as possible, I just wouldn't forgo an EM rotation to do so.

Hopefully more students who are closer to this timeline can shed some light on this and how they timed taking Step 2 while fitting in their rotations.


camtheram1815 said:
Does this timeline work for applicants or is it considered late since I'd be risking only 1 SLOE in by Oct 1st? Would it be advisable to do an audition in October to get a 3rd SLOE that would come in around November?
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You don't need a 3rd SLOE, though in some circumstances it can help. It doesn't hurt to have a SLOE that comes later in the application season, but its not going to net you a bunch of interviews. Most programs are making a decision on your app early and based on your first 2 SLOEs.

It is a risk mainly because you are banking on your August SLOE being actually written by the time ERAS opens. And you are banking on your Sept rotation SLOE being done by early October when programs are looking at apps and deciding on the bulk of interviews. Those aren't always safe assumptions to make IMO.
 
gamerEMdoc said:
If you can get an EM rotation in July, do EM in July. You would still be fine if you get rotations in August and September, but what if you can't get scheduled somewhere. What if the rotation fell through. App season opens Sept 15, and you will want at least one SLOE by then. You are assuming the August rotation SLOE will be there by Sept 15, and that's not a safe assumption. Some places just drag their feet on writing SLOEs. The earlier you can knock out two 4th year auditions at EM programs and get 2 SLOEs the better.

That being said, if you couldn't rotate in EM in July, you'd probably still be fine. It's just not an ideal timeline. And it's silly to forgo a July rotation for step 2 IMO. SLOEs are the most important part of your application, not Step 2. Why prioritize something that is far less important? Depending on what your study schedule is, I agree with taking it as early as possible, I just wouldn't forgo an EM rotation to do so.

Hopefully more students who are closer to this timeline can shed some light on this and how they timed taking Step 2 while fitting in their rotations.




You don't need a 3rd SLOE, though in some circumstances it can help. It doesn't hurt to have a SLOE that comes later in the application season, but its not going to net you a bunch of interviews. Most programs are making a decision on your app early and based on your first 2 SLOEs.

It is a risk mainly because you are banking on your August SLOE being actually written by the time ERAS opens. And you are banking on your Sept rotation SLOE being done by early October when programs are looking at apps and deciding on the bulk of interviews. Those aren't always safe assumptions to make IMO.
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Gotcha, thank you!

So to be clear, July/August auditions is preferred to get those 2 SLOEs... My school's M3 ends in June, so that means I'd likely take both Step 2's in September (unless I could squeeze it in June but would risk a lower score)? Is that also a risk receiving scores in October?
 
camtheram1815 said:
Gotcha, thank you!

So to be clear, July/August auditions is preferred to get those 2 SLOEs... My school's M3 ends in June, so that means I'd likely take both Step 2's in September (unless I could squeeze it in June but would risk a lower score)? Is that also a risk receiving scores in October?
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Depends on how you want to bet on yourself, and how much you are studying throughout 3rd year for the individual shelf exams. When in June does your school year end? Is it June 30th? What is your rotation that month, how much time will you have to study/prepare? Cramming all your studying in a month may improve your score a little, but it doesn't make that HUGE of a difference in overalll performance. Its far better to longitudinally prepare throughout the year if possible. Taking one of the two most valuable months to study for step 2 seems like a big mistake to me personally.

I think the optimum strategy, personally, is to not cram for step 2. You should be studying in the winter and spring longitudinally for it. You should try to take it in June or early July if you need to improve on your Step 1 (so results are back before interviews go out). If you did great on Step 1, you can afford to take step 2 later because most programs will send you an invite based on your great step 1 and sloes. You should never prioritize boards over SLOEs. One is the most powerful aspect of your ability to get interviews and match in EM. The other is boards.

But by all means, hopefully some students from this year can weigh in to say when they took step 2, if they took a month off to prepare for it, and whether it would have been worth giving up a July EM month to do so.

This is all just my perspective which is one strictly coming from someone looking at applications and deciding who to interview. When I see an app with no sloes in late Sept, I ignore it and mark it incomplete. I may or may not ever come back to it a month or two later. When I see one with 1 sloe, and its not a good one, I ignore it. And I may or may not come back to that app a month or two later. I have to look at 50-100 or so apps at a time when I sit down to review. I don't have time to constantly be going back.

And this is not far off of what CORD advises as well. Directly from the application guide:

- "Prioritize getting your first SLOE over taking Step 2 CK early.
Both are important, but studies show the SLOE is more important in offering
interviews"

- "For those who feel a dedicated study month (or 2 weeks) is needed this should
be done only if timing allows for scheduling at least one EM rotation over the
summer months. Remember your goal is to have at least 1 SLOE, but preferably
2, uploaded to ERAS by opening day."
 
gamerEMdoc said:
Depends on how you want to bet on yourself, and how much you are studying throughout 3rd year for the individual shelf exams. When in June does your school year end? Is it June 30th? What is your rotation that month, how much time will you have to study/prepare? Cramming all your studying in a month may improve your score a little, but it doesn't make that HUGE of a difference in overalll performance. Its far better to longitudinally prepare throughout the year if possible. Taking one of the two most valuable months to study for step 2 seems like a big mistake to me personally.

I think the optimum strategy, personally, is to not cram for step 2. You should be studying in the winter and spring longitudinally for it. You should try to take it in June or early July if you need to improve on your Step 1 (so results are back before interviews go out). If you did great on Step 1, you can afford to take step 2 later because most programs will send you an invite based on your great step 1 and sloes. You should never prioritize boards over SLOEs. One is the most powerful aspect of your ability to get interviews and match in EM. The other is boards.

But by all means, hopefully some students from this year can weigh in to say when they took step 2, if they took a month off to prepare for it, and whether it would have been worth giving up a July EM month to do so.

This is all just my perspective which is one strictly coming from someone looking at applications and deciding who to interview. When I see an app with no sloes in late Sept, I ignore it and mark it incomplete. I may or may not ever come back to it a month or two later. When I see one with 1 sloe, and its not a good one, I ignore it. And I may or may not come back to that app a month or two later. I have to look at 50-100 or so apps at a time when I sit down to review. I don't have time to constantly be going back.

And this is not far off of what CORD advises as well. Directly from the application guide:

- "Prioritize getting your first SLOE over taking Step 2 CK early.
Both are important, but studies show the SLOE is more important in offering
interviews"

- "For those who feel a dedicated study month (or 2 weeks) is needed this should
be done only if timing allows for scheduling at least one EM rotation over the
summer months. Remember your goal is to have at least 1 SLOE, but preferably
2, uploaded to ERAS by opening day."
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Thanks again.

And agreed, I think boards studying should be a longitudinal process and am planning on that. Like I said, our schools recommended this and didn't add up to me which is why I asked. Seems like I have some logistical things to take care of, but definitely invaluable advice. Thanks!
 
@gamerEMdoc , since we are on the topic of betting one oneself in regards to Step 2/SLOE strategizing, I have a related dilemma. I did reasonable well on Step 1 (243) and based off my NBME shelf scores so far I expect to perform average (ie below 243) and maybe even below average for all I know on Step 2. My "study month" is from May 22 - June ~21st, which can be utilized to any degree (eg 2 weeks only, 2 week rotation) Knowing this possibility, I'm not sure what is most optimal for me. -- utilize the study month to ensure a good score or delay until end of audition season to maybe let my Step 1/SLOEs carry me to the interview? FWIW, I asked one of our clinical deans, and since my last three months of third year are IM, he suggested I will have peak Step 2 knowledge at the end of May (end of my third year) and so taking the exam sometime in June would appear ideal. However, reading the blurb from CORD that you posted is making me even more unsure! I'm a DO student as well, and also not sure if relevant, but I've been able to do about 13 shifts at a local ED w/ an adjunct faculty and likely will do 5-7 more before auditions begin.

Ultimately I gotta make a decision and stick w/ it, but looking for any advice you think I should keep in mind as well!

Thanks!

Edit: The other thing is that, since I am still slightly interested in possibly pursuing anesthesiology, I have also been advised to do an anesthesiology rotation early on in 4th year to see if I can rule it in or out and go from there for the rest of 4th year, but I still am more inclined to go for EM.
 
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I did my medicine AI and my home EM rotation before my study month and thought that worked well. I had a good step 1 score (250+) and didn't need to do step 2 early, but the combination of taking it just after high yield rotations and getting it out of the way early was worth it to me.

And along the lines of what gamer was saying, you can get a ton of step 2 review done longitudinally during your 3 months of medicine at the end of 3rd year. I took a month off to study after because I'm slow at studying. A lot of people take the whole month, and a lot of people decide they are ready early and push the test forwards.

My school starts 4th year earlier than most though. Whatever you decide, make sure you have your home sloe and an away sloe by the time eras opens in September.

.
Doctor_Strange said:
@gamerEMdoc , since we are on the topic of betting one oneself in regards to Step 2/SLOE strategizing, I have a related dilemma. I did reasonable well on Step 1 (243) and based off my NBME shelf scores so far I expect to perform average (ie below 243) and maybe even below average for all I know on Step 2. My "study month" is from May 22 - June ~21st, which can be utilized to any degree (eg 2 weeks only, 2 week rotation) Knowing this possibility, I'm not sure what is most optimal for me. -- utilize the study month to ensure a good score or delay until end of audition season to maybe let my Step 1/SLOEs carry me to the interview? FWIW, I asked one of our clinical deans, and since my last three months of third year are IM, he suggested I will have peak Step 2 knowledge at the end of May (end of my third year) and so taking the exam sometime in June would appear ideal. However, reading the blurb from CORD that you posted is making me even more unsure! I'm a DO student as well, and also not sure if relevant, but I've been able to do about 13 shifts at a local ED w/ an adjunct faculty and likely will do 5-7 more before auditions begin.

Ultimately I gotta make a decision and stick w/ it, but looking for any advice you think I should keep in mind as well!

Thanks!

Edit: The other thing is that, since I am still slightly interested in possibly pursuing anesthesiology, I have also been advised to do an anesthesiology rotation early on in 4th year to see if I can rule it in or out and go from there for the rest of 4th year, but I still am more inclined to go for EM.
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Doctor_Strange said:
@gamerEMdoc , since we are on the topic of betting one oneself in regards to Step 2/SLOE strategizing, I have a related dilemma. I did reasonable well on Step 1 (243) and based off my NBME shelf scores so far I expect to perform average (ie below 243) and maybe even below average for all I know on Step 2. My "study month" is from May 22 - June ~21st, which can be utilized to any degree (eg 2 weeks only, 2 week rotation) Knowing this possibility, I'm not sure what is most optimal for me. -- utilize the study month to ensure a good score or delay until end of audition season to maybe let my Step 1/SLOEs carry me to the interview? FWIW, I asked one of our clinical deans, and since my last three months of third year are IM, he suggested I will have peak Step 2 knowledge at the end of May (end of my third year) and so taking the exam sometime in June would appear ideal. However, reading the blurb from CORD that you posted is making me even more unsure! I'm a DO student as well, and also not sure if relevant, but I've been able to do about 13 shifts at a local ED w/ an adjunct faculty and likely will do 5-7 more before auditions begin.

Ultimately I gotta make a decision and stick w/ it, but looking for any advice you think I should keep in mind as well!

Thanks!

Edit: The other thing is that, since I am still slightly interested in possibly pursuing anesthesiology, I have also been advised to do an anesthesiology rotation early on in 4th year to see if I can rule it in or out and go from there for the rest of 4th year, but I still am more inclined to go for EM.
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So CORD claims 50% require step 2 to interview and 50% dont. So a good step 1 and good sloes will be more than enough at about 1/2 the programs. Is that enough? Depends on where you are applying.

Personally I like the idea of getting step 2 out of the way, I just dont like the idea of sacrificing a July-Sept EM month to do that. I’d much rather see someone study for 3 months than cram it all in a month anyways. So personally Id say study all spring and take it at the end of June. But some people cant be disciplined enough to study longitudinal and need that time pressure to of a study month to hunker down. So it kind of depends on how disciplined you are.
 
@gamerEMdoc How do you handle 2 SLOES from the same institution? Bc of how my school's coursework is we end up getting a SLOE from a required EM rotation and an EM sub-I so while the SLOES are written by different people (course director vs program director), they are both from my home institution. Do both of these count for SLOES or should I only use one of them bc they are from the same institution? Thanks for making this thread, its been incredibly informative!
 
I consider them one SLOE, usually they agree with eachother anyways. Personally, I don't think any institution should write two SLOEs. If you rotate there two months, they should write one SLOE at the end. There's a section on how many months you rotated at the place. The intent of the SLOE is to be a summary of the programs opinion of you. Not any one individuals opinion.
 
I think you answered this before but ... What exactly are all y'all talking about in the meeting after the interviews? how long do they usually last?
 
Hey gamerEMdoc, I know it varies by program but generally, would you categorize top 1/3 as honors, middle 1/3 = HP, bottom 1/3 = P?
 
attitudeofgratitude said:
I think you answered this before but ... What exactly are all y'all talking about in the meeting after the interviews? how long do they usually last?
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I obviously can’t speak for everyone, but our meeting afterwards is all the people that interviewed discussing the candidates then blindly giving an interview score (1-10) that is a subjective assessment of the applicant and how much you would like to work with them based on their interview and application. The average score (which strikingly nearly always is within one point of eachother for all the interviewers) then gets added to the overall much more extensive objective application score.

What everyone else does, who knows. That’s just my system, which I completely ripped off and adapted from the system my residency used to evaluate candidates years ago. I liked their scoring algorithm and interview scoring system, but I had a different take on the mathmatical weight I’d give to different parts of the app, so I took it and adapted it quite a bit. I still change it from time to time over the years. But all in all, I think its a solid scoring system, and I know of at least one PD that used to be faculty that utilizes my scoring system at his program.
 
CharChar12 said:
Hey gamerEMdoc, I know it varies by program but generally, would you categorize top 1/3 as honors, middle 1/3 = HP, bottom 1/3 = P?
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You’d like to think that “Honors” means either top 10 or top 1/3; HP means top 1/3 or mid 1/3; and pass is mid 1/3 or low 1/3. And at many places that probably holds true. But its so variable. Some places give 90% honors, so some of their honors are then given middle 1/3 SLOEs and their “top 1/3” which are really their bottom 10% are basically their low 1/3’s. So it can be really variable. But as a generalization, it often fits the pattern I laid out.
 
hopefulgasman said:
While difficult to speak for the way someone else does things, what is the point of some programs giving out 90% honors? Doesn’t that affect their credibility in terms of being able to adequately evaluate applicants in a distribution that the world is accustomed to seeing?

Other than the obvious of being nice to the student, I’m trying to see the point of giving out almost all honors grades when they can give out top 1/3 without truly pissing people off I would think.
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Correct, its strictly because they are terrified of giving negative feedback to students. And its sometimes ivory tower places too. Two in state University MD programs come to mind that give an insane amount of Honors.

In terms of credibility, most of the time, such programs have a more reasonable/less top heavy sloe distribution. Which is why SLOEs are blinded. Because otherwise you'd have everyone getting "top 10%" SLOEs at a 90% rate at some places because they are terrified to tell students they are average. Its unfortunate.
 
@gamerEMdoc again thanks for taking the time.

Have you heard of applicants who interviewed at really great places and still ended up far down their list or had to SOAP? Obviously, you could just interview horribly but are there any other factors?
 
takeurmeds02 said:
@gamerEMdoc again thanks for taking the time.

Have you heard of applicants who interviewed at really great places and still ended up far down their list or had to SOAP? Obviously, you could just interview horribly but are there any other factors?
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I know of one case, through SDN. Good applicant, very good student. Had outstanding boards and went to a great school. They had two sloes that probably sandbagged his chances, I think its because they were both from pretty competitive places and they were a very quiet person. So they probably didn't stand out on rotation much and their SLOEs suffered because they were rotating with some of the best of the best people unfortunately. Still should have matched in my opinion, they had like 14 interviews at great places. So it can happen, its just highly highly unlikely.
 
southerndoc said:
I know of one program that was told that they were too harsh and didn't give enough honors and high pass. Now every student that rotates there gets honors.
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One time during an interview I had a student who told me my student grading was too harsh because I gave him an 85% on the rotation and he'd never heard of anyone getting a score that low on any rotation at his school. He was a good solid middle of the road candidate, one I would have liked to match, but it clearly ticked him off and I'm sure he didn't rank us high.
 
hopefulgasman said:
In that same vein, how likely is it that a place who gives a student an honors grade would then give them a bottom 1/3 SLOE?

would programs who give out 90% honors do that as well, even though doing that would make the SLOE look ridiculously juxtaposed with honors and bottom 1/3 written not far from each other?
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Pretty unlikely. Though I've seen SLOEs that gave Honors and then selected "do not rank" and then justified it in the comments saying they don't rank non-US grads. Pretty BS thing to do IMO. My personal bias is, unless someone does something horrible, you shouldn't check the DNR box. Even if you don't rank IMGs, if that person was otherwise a top 1/3 or mid 1/3 candidate compared to others, they should be rated as such.
 
Just a quick note... 35 students so far on rotation this year so far with their evals all written. 22 SLOEs written. I personally reviewed hundreds of applicants to decide on interviews. 97 total candidates applications picked apart in insane detail. I just finished scoring the 97th and last app for the year yesterday in preparation for the last week of interviews. I can't believe its already over. Hope you all had as much fun as I did! Good luck with formulating your rank lists!
 
I’m sure you’ve probably posted about this but any advice on making rank lists? I have a list of programs in cities across the country and I want to hopefully do some work in social EM (specifically violence intervention). Some programs I loved the people and location but just due to patient population doing violence intervention wouldn’t be as applicable. Others I would have a wealth of opportunities to complete my academic goals but felt my “fit” with the residents was just okay. I’m very torn on what to prioritize and any advice would be so appreciated!
 
smalls0331 said:
I’m sure you’ve probably posted about this but any advice on making rank lists? I have a list of programs in cities across the country and I want to hopefully do some work in social EM (specifically violence intervention). Some programs I loved the people and location but just due to patient population doing violence intervention wouldn’t be as applicable. Others I would have a wealth of opportunities to complete my academic goals but felt my “fit” with the residents was just okay. I’m very torn on what to prioritize and any advice would be so appreciated!
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First and foremost, your rank list is yours. You should rank it based on what you value, not what anyone else tells you to value. Nor should you rank places based on your perceived chances of matching there. Rank your list how YOU want it based on what YOU want out of your residency.

That being said, some general advise. I think you first need to sit down and think about in order what is most important to you. Is it location? Is the chance to do this violence intervention social work? Is it the resident camaraderie? For sure, they all may be important to you, but you are going to have to decide what is more important. And no one can answer that but you.

Also, realize that no matter how you rank them, the ultimate decision isn't yours, its the match algorithm. So your fate isn't entirely your choice. Which means no matter how much you stress about it, it may not matter. So don't lose too much sleep over this, because there's another factor in this whole process you just can't control.

Lastly, realize that no matter where you train, its for a very small part of your career. So if you match somewhere with great camaraderie and have a great 3 years but can't pursue your side interests, you have 20-30 years to pursue that when you are done. If you match somewhere where you perceive the camaraderie isn't as good, you'll still almost certainly make friends there, and again, it's a short time in the grand scheme of things.

I hope that helps, I know its not a direct answer as to how you should prioritize your list, but ultimately, that's something you need to reflect on, figure out what is most important to you ultimately, then use that to rank them. Ultimately, there are no wrong answers. Just rank them how you want them and let the match figure the rest out.
 
gamerEMdoc said:
First and foremost, your rank list is yours. You should rank it based on what you value, not what anyone else tells you to value. Nor should you rank places based on your perceived chances of matching there. Rank your list how YOU want it based on what YOU want out of your residency.

That being said, some general advise. I think you first need to sit down and think about in order what is most important to you. Is it location? Is the chance to do this violence intervention social work? Is it the resident camaraderie? For sure, they all may be important to you, but you are going to have to decide what is more important. And no one can answer that but you.

Also, realize that no matter how you rank them, the ultimate decision isn't yours, its the match algorithm. So your fate isn't entirely your choice. Which means no matter how much you stress about it, it may not matter. So don't lose too much sleep over this, because there's another factor in this whole process you just can't control.

Lastly, realize that no matter where you train, its for a very small part of your career. So if you match somewhere with great camaraderie and have a great 3 years but can't pursue your side interests, you have 20-30 years to pursue that when you are done. If you match somewhere where you perceive the camaraderie isn't as good, you'll still almost certainly make friends there, and again, it's a short time in the grand scheme of things.

I hope that helps, I know its not a direct answer as to how you should prioritize your list, but ultimately, that's something you need to reflect on, figure out what is most important to you ultimately, then use that to rank them. Ultimately, there are no wrong answers. Just rank them how you want them and let the match figure the rest out.
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It does! Thank you for that and all the other advice on here. Can’t tell you how many times during the past six months I’ve come back to this thread to look for something you had said earlier.


Sent from my iPhone using SDN mobile
 
smalls0331 said:
It does! Thank you for that and all the other advice on here. Can’t tell you how many times during the past six months I’ve come back to this thread to look for something you had said earlier.


Sent from my iPhone using SDN mobile
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I mean hopefully in retrospect what I said when you looked back was correct!
 
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