EM post-scramble advice?

[ama33]

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Can someone please give me some advice? I graduated from a US med school in 2007. I've tried the match and scramble without success. I didn't do an EM rotation as a med student. I shadowed for a couple months to get letters, but I was warned it would most likely not be enough. For 2009, I'm debating between EM and anesthesia. I'm a suboptimal candidate for these highly competitive fields. I need clinical exposure. What do you suggest is the best method to do that? Where can I find average USMLE scores for people who've matched into these specialties?
Please help me.

 

[theCamel]

http://www.nrmp.org/

go to the advance data tables

 

[ama33]

thanks, theCamel. will do.

 

[CorpusERdoc]

Can someone please give me some advice? I graduated from a US med school in 2007. I've tried the match and scramble without success. I didn't do an EM rotation as a med student. I shadowed for a couple months to get letters, but I was warned it would most likely not be enough. For 2009, I'm debating between EM and anesthesia. I'm a suboptimal candidate for these highly competitive fields. I need clinical exposure. What do you suggest is the best method to do that? Where can I find average USMLE scores for people who've matched into these specialties?
Please help me.

Scramble into a transitional year, and do an elective in anesthesia and EM.

 

[zinjanthropus]

Can someone please give me some advice? I graduated from a US med school in 2007. I've tried the match and scramble without success. I didn't do an EM rotation as a med student. I shadowed for a couple months to get letters, but I was warned it would most likely not be enough. For 2009, I'm debating between EM and anesthesia. I'm a suboptimal candidate for these highly competitive fields. I need clinical exposure. What do you suggest is the best method to do that? Where can I find average USMLE scores for people who've matched into these specialties?
Please help me.

what do you think is the current deficiency that is giving you so much trouble with your application?

google -"charting outcomes of the match" and you will get the pdf of all the USMLE data for different specialties.

 

[tv12345]

I also graduated from a US med school in 2007. I scrambled into a surgical internship year, and matched for an EM position 2009. My board scores are not below average. I think it helps having an internship year under your belt, especially surgery as it makes you look "rough and tough". Just understand that if your board scores are marginal, you should try your best to get a surgical internship vs medicine due to funding issues. I was told that had I scrambled into a medicine position, a lot of EM programs would not have looked at my application as they would not be funded for the full 3 years...but that's another story in itself.

 

[Apollyon]

I was told that had I scrambled into a medicine position, a lot of EM programs would not have looked at my application as they would not be funded for the full 3 years...but that's another story in itself.

Once again, wrong, wrong, wrong. Unless you scramble into a categorical spot, it doesn't affect your funding. Preliminary and transitional spots do NOT start the clock, because they do NOT lead to residency completion. The only ones who get screwed like that are people that start an FM program, then go somewhere else, and use the FM1 year as a prelim year. Their clock is going on the 3 year cycle.

Who told you this? Whomever said it was 100% wrong. And I can point you towards multiple PDs in multiple specialties (and two former EM PDs that are now deans) who will support what I said.

 

[ama33]

Thanks, everybody. Hopefully, a prelim vacancy will open up soon....I was thinking I'd even try FM openings until i read Apollyon's post.

 

[tv12345]

Once again, wrong, wrong, wrong. Unless you scramble into a categorical spot, it doesn't affect your funding. Preliminary and transitional spots do NOT start the clock, because they do NOT lead to residency completion. The only ones who get screwed like that are people that start an FM program, then go somewhere else, and use the FM1 year as a prelim year. Their clock is going on the 3 year cycle.

Who told you this? Whomever said it was 100% wrong. And I can point you towards multiple PDs in multiple specialties (and two former EM PDs that are now deans) who will support what I said.

MAN! YOU SURE ARE FEISTY!!

Anyways OP: U should carefully research funding options, because I have talked to multiple DME's (Directors of Medical Education) -> Who work with funding, and know these things...There is nothing really in black and white in regards to GME funding of residencies...the closest thing I found were JAMA articles from 1999. The websites are posted below:

http://jama.ama-assn.org/cgi/content/full/282/23/2268-a

http://jama.ama-assn.org/cgi/content/full/282/24/2366

Can't believe hearsay. Always best to have something in black and white...and this is quoted directly out of one of the JAMA articles:

"The initial residency period is set when a physician enters residency, and it does not change. Hospitals with training programs will receive slightly less when a resident is beyond the initial residency period. Some hospitals are using this cut in funding to eliminate applicants to their programs. "

"Medicare makes an allowance for residents who enter transitional year programs. In this case, if a resident switches to a specialty that requires a year of general medical training as a prerequisite, Medicare will fully fund the resident for that specialty and for 1 year of general training. However, if the new program does not require 1 year of general training, that transitional year will be counted as 1 year of the initial residency period. "

 

[Apollyon]

"There is nothing really in black and white in regards to GME funding of residencies"

"The initial residency period is set when a physician enters residency, and it does not change. Hospitals with training programs will receive slightly less when a resident is beyond the initial residency period. Some hospitals are using this cut in funding to eliminate applicants to their programs. "

"Medicare makes an allowance for residents who enter transitional year programs. In this case, if a resident switches to a specialty that requires a year of general medical training as a prerequisite, Medicare will fully fund the resident for that specialty and for 1 year of general training. However, if the new program does not require 1 year of general training, that transitional year will be counted as 1 year of the initial residency period. "

Umm...as far as Medicare GME funding goes, yes it IS "black and white" - go to the library and ask to see the "green book", and it's in the front, how many years are funded. The "initial residency period" is the "initial residency period leading to board certification". Prelim programs, by definition, do NOT lead to board certification - ergo, they do NOT start the clock.

http://www.aamc.org/advocacy/library/gme/dgmebroc.pdf

This is a big file, but has exactly what you need. To whit:

"What is considered an initial residency period, and when does it begin?

The initial residency period is the minimum number of years in which a resident is eligible for specialty certification. It is based on the minimum accredited length listed for each specialty in the Graduate Medical Education Directory (sometimes called the Green Book), published by the American Medical Association (AMA). The initial residency period is determined at the time the resident first enters a training program and does not change, even if the resident later changes specialties.

For this reason, it is very important that you understand that the residency program in which you begin training determines the number of years in which Medicare will make full direct graduate medical education payment to the hospital for your training. The Medicare program has published a list of specialties and initial residency periods, which may be found in the Appendix. Except for geriatrics and preventive medicine, all subspecialty training is beyond the initial residency period, and each FTE is counted as a 0.5 FTE."