EM Programs that don't require more than 1 SLOE?

[Perfect Hair Day]

Hello,

I would prefer not to discuss my personal circumstances publicly, but September 15 may arrive without me having been able to do an externship in Emergency Medicine. Does anyone know which programs only require one SLOE? I have heard (anecdotally) that these programs exist, and I will be forward in saying I am not vying for the DenverHealths or LACs of the world for my residency. Thanks folks 🙂

I remain,

ButteredLobster

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[CliveStaples]

Are you referring to only having one SLOE to get an interview and you will have done an externahip and received a second SLOE later? Or do you not think you'll be able to get a second SLOE in at all?

 

[gutonc]

It doesn't matter what specialty you are going for, you need at least 2 specialty specific LORs. Since EM only cares about SLOEs, you need 2 of them...at least.

Figure out how to make that happen, or go visit the SOAP thread for a reality check.

 

[jessk2015]

I matched with 2 "SLOEs" but only one was departmental, the other was an individual one from the same institution (not really considered a SLOE I don't think). I'm guessing most programs would say that doesn't satisfy a 2 SLOE requirement? Anyway, I'll let you know where I matched once I know!

ETA: this was a very stressful process and I would have felt much more secure with another true SLOE, so I'm certainly not advocating for my approach!

Sent from my iPhone using SDN mobile

 

[gamerEMdoc]

Most programs will extend interviews with only one sloe, but you will be hurting your chances if you cant get a second one later on. If you get one by Sept, and a second sometime in Oct or early Nov, that should still be ok.

 

[Perfect Hair Day]

Most programs will extend interviews with only one sloe, but you will be hurting your chances if you cant get a second one later on. If you get one by Sept, and a second sometime in Oct or early Nov, that should still be ok.

I'm suggesting I won't be able to do an away rotation.

 

[KinesiologyNerd]

I'm suggesting I won't be able to do an away rotation.

Only a home SLOE? Yeah you need to change that.

 

[dadaddadaBATMAN]

I'm suggesting I won't be able to do an away rotation.

Trust me when I say that life will be more than stressful enough next year without wondering whether the most fundamental part of your application was f'ed up.

I know there are people who have matched with one sloe, but you don't want to have to be one of them.

Is your school being ridiculously obtuse about this or something? One away rotation seems reasonable no matter where you're going, unless you're trying to max vacations or take an international month. If that's the case, save that crap for later and make sure you match.

 

[CliveStaples]

You will likely receive interviews with 1 SLOE but I don't think you'll technically be "complete" at a program without a second SLOE coming in later.

I'm sure there are exceptions and perhaps there are programs that would rank you with 1 SLOE but this is not really an advertised policy and would be too inconsistent to bank on calling this a winning strategy.

I know you don't want to discuss your specific situation as to why you cannot do an away rotation and maybe at the interviews you receive you can explain your unique situation and get ranked, but I'm not sure that this is going to yield enough success to give you a great shot at matching.

 

[gamerEMdoc]

I'm suggesting I won't be able to do an away rotation.

Your initial post made it sound like you could only do one rotation in EM before Sept 15. So you are saying you can only do one rotation in EM, period? If so, that's going to hurt you. There's no way around it. Almost every field in medicine is going to expect you to do at least two rotations in the specialty you are applying to. I'm not saying its impossible to match with only one EM rotation and one SLOE, but you better be a great candidate otherwise.

 

[EMapplicant2017]

Hello,

I would prefer not to discuss my personal circumstances publicly, but September 15 may arrive without me having been able to do an externship in Emergency Medicine. Does anyone know which programs only require one SLOE? I have heard (anecdotally) that these programs exist, and I will be forward in saying I I'm not vying for the DenverHealths or LACs of the world for my residency. Thanks folks 🙂

I remain,

ButteredLobster

If your personal circumstances are related to those you previously made public, you might be given some leniency on SLOEs -- provided you are able to articulate your reasons and note the deficiency in your personal statement.

It's a tough call though. Your SLOEs are honestly the most significant portion of your entire EM application. As stated above, by more important opinions than mine, you'll essentially have an incomplete application.

 

[Trail Blazer]

Reading back through one of your old posts you alluded to not being able to afford to do an away rotation. I think the majority of us understand this completely, most of us are broke college students living frugally on loans. Doing away rotations made my budget even tighter last year, so I can empathize with your position.

However, this is absolutely not the time to be stingy with money as long as it is to further your career goals. Cornell is a private medical school, so I am assuming you've racked up ~200k+ in debt already, and that is without the interest you've accrued on those loans + not factoring in college debt. If you are truly interested in EM, and want to pick it as your career vs a career in cardiology, then find a private loan with a much lower interest rate than you are accruing from the federal loans and use that to fund your away. A 2k loan is literally less than 1/100 of your current debt. That is nothing.

I'd also suggest you look at doing an away in an area where you can find cheap rent for a month. Hop on rotatingroom.com and find a resident subletting a private room. A month away from NY is not going to hurt your application if you're dying to stay there, and if you are looking to leave then an away somewhere else will most certainly help you. Indiana, Alabama, North Carolina, Arizona, New Mexico all have places to rent for <600/mo. Some places, like UNC, have free public transportation to the hospital.

Big takeaway: if you're really, truly interested in EM, don't hurt your chances by skimping on aways solely due to a lack of funds. You'll look back on it in 30 years and will have many a face-palm.

 

[LostinLift]

my program as a policy does not interview incomplete candidates (anyone with less than 2 SLORs). I can't speak for other programs, but I assume there are at least a few others who operate similarly. I'm situated in California, however. Not sure if it's a Cali thing.

When will they look at apps? ACEP this year is at the end of October so I'm guessing there will be a big wave before then. Say you don't get a second SLOE until early/mid October, will they still give your application a look at this point?

 

[gamerEMdoc]

When will they look at apps? ACEP this year is at the end of October so I'm guessing there will be a big wave before then. Say you don't get a second SLOE until early/mid October, will they still give your application a look at this point?

PD survey via CORD awhile back said 80% will extend interviews with just one SLOE. That means you need one SLOE by mid Sept. Most though then would expect you to get a second SLOE sometime during interview season.

I personally ask anyone coming through in the first month or two of interviews if they have any other SLOEs that I need to watch out for. If they do, I make a note and add it to a followup list, then I go back and look for it later in the interview season to add it to the candidates score.

 

[Status Sciaticus]

PD survey via CORD awhile back said 80% will extend interviews with just one SLOE. That means you need one SLOE by mid Sept. Most though then would expect you to get a second SLOE sometime during interview season.

I personally ask anyone coming through in the first month or two of interviews if they have any other SLOEs that I need to watch out for. If they do, I make a note and add it to a followup list, then I go back and look for it later in the interview season to add it to the candidates score.

Does it matter if the second rotation is done in OCT vs NOV as long as its in this semester? From what I recall, the second sloe is primarily to rank applicants?
Also, do our planned courses for the year matter in getting interviews? Say I had EM, Ortho, EM Away, Rads, Ortho, ENT/Optho scheduled, would it seem weird or random? I figured since Ortho/ENT/Optho/Rads are all EM related in the sense you see those types of patients, it would look normal

 

[CliveStaples]

Does it matter if the second rotation is done in OCT vs NOV as long as its in this semester? From what I recall, the second sloe is primarily to rank applicants?
Also, do our planned courses for the year matter in getting interviews? Say I had EM, Ortho, EM Away, Rads, Ortho, ENT/Optho scheduled, would it seem weird or random? I figured since Ortho/ENT/Optho/Rads are all EM related in the sense you see those types of patients, it would look normal

Earlier is always better - that second letter could be your ticket to getting more interviews. A second SLOE is not just to influence your final rank position - it'll still strengthen your chances of getting interviews.

Nobody really looks/analyzes your 4th your schedule. Take an elective in underwater basket weaving palliative care and nobody would notice.

 

[Status Sciaticus]

Earlier is always better - that second letter could be your ticket to getting more interviews. A second SLOE is not just to influence your final rank position - it'll still strengthen your chances of getting interviews.

Nobody really looks/analyzes your 4th your schedule. Take an elective in underwater basket weaving palliative care and nobody would notice.

Well its not really up to me, considering many aways now pick and choose who they let into their away rotations based on grades and such, so I was going to weigh taking an indy or carolinas rotation in oct or nov compared to say a less attractive one like orlando or wisconsin in sept or oct.

 

[KinesiologyNerd]

less attractive one like orlando or wisconsin in sept or oct.

.........

E: I'll expand. UW and ORMC are not chump change programs. We're not talking about Brookdale. Escaping the SDN echo chamber they're near lateral moves.

Now, if IU or CMC is your prohibitive #1 and you're willing to not have a second SLOE until close to Christmas... IDK I still wouldn't risk it actually.

 

[CliveStaples]

Well its not really up to me, considering many aways now pick and choose who they let into their away rotations based on grades and such, so I was going to weigh taking an indy or carolinas rotation in oct or nov compared to say a less attractive one like orlando or wisconsin in sept or oct.

You'll catch some fire for the "less attractive" statement. These kinds of decisions are relative and I know that I personally would disagree with your assessment of at least one of those programs. Doesn't make me right and you wrong, except for me making my own decision. I also don't fall into the typical SDN hegemony when it comes to how I made my final rank list. To each their own.

I'll say that you have to do what you think is best for you. Going on a more preferred rotation later is definitely going to help open a door to that program (most of the time). In return, you might get fewer interviews overall by not having a second SLOE in by the time most interviews go out. You just have to weigh those risks yourself based on your perceived strength of application. I would caution you that in the world of EM it can be very difficult to gauge your competitiveness until the SLOEs come in.

 

[Status Sciaticus]

.........

You'll catch some fire for the "less attractive" statement. These kinds of decisions are relative and I know that I personally would disagree with your assessment of at least one of those programs. Doesn't make me right and you wrong, except for me making my own decision. I also don't fall into the typical SDN hegemony when it comes to how I made my final rank list. To each their own.

I'll say that you have to do what you think is best for you. Going on a more preferred rotation later is definitely going to help open a door to that program (most of the time). In return, you might get fewer interviews overall by not having a second SLOE in by the time most interviews go out. You just have to weigh those risks yourself based on your perceived strength of application. I would caution you that in the world of EM it can be very difficult to gauge your competitiveness until the SLOEs come in.

LOL let me rephrase. Less attractive to me in the sense that I would prefer to match at the two i mentioned over the two I said were less attractive. Theyre all fine programs in that I would go to any of them.

 

[KinesiologyNerd]

LOL let me rephrase. Less attractive to me in the sense that I would prefer to match at the two i mentioned over the two I said were less attractive. Theyre all fine programs in that I would go to any of them.

See my edit above. I still wouldn't risk having a second SLOE that late.

 

[SpacemanSpifff]

See my edit above. I still wouldn't risk having a second SLOE that late.

Agreed. Having a second SLOE in prior to applications also covers your bases, just in case you have a less glowing eval from your initial rotation.

 

[EMedGrrl]

I'm suggesting I won't be able to do an away rotation.

If this is the case, then you should a) get two SLOEs from your home school (a departmental one and an individual) - not ideal, but it's something; b) explain in your personal statement why you are unable to do an away rotation (presuming these same factors would not preclude you from matching in a location other than your home school)

 

[Status Sciaticus]

See my edit above. I still wouldn't risk having a second SLOE that late.

Agreed. I didnt mean to offend anyone with that comment. It was just my personal ranking scale out of 4 really good schools.

Agreed. Having a second SLOE in prior to applications also covers your bases, just in case you have a less glowing eval from your initial rotation.

Unfortunately my electives are all in 4th year which starts in july for us, at the earliest. I was going to take a month off to do dedicated S2 studying. So effectively it leaves me August for home, and sept or oct for an away, if I can secure one during those months. If I get sept approved, then great. Alternatively, I could always do 2 SLOEs from Home (departmental through the elective and 1 faculty eval from the department chair who I am doing research for). Thoughts?

 

[KinesiologyNerd]

Unfortunately my electives are all in 4th year which starts in july for us, at the earliest. I was going to take a month off to do dedicated S2 studying. So effectively it leaves me August for home, and sept or oct for an away, if I can secure one during those months. If I get sept approved, then great. Alternatively, I could always do 2 SLOEs from Home (departmental through the elective and 1 faculty eval from the department chair who I am doing research for). Thoughts?

No offense taken, I was a little harsh.

You've got to find an early away. I had aways July and September (had a 3rd year SLOE). I struck out on an August away necessitating the July rotation. PD floated the idea of a second home rotation to get a letter before applications, but that was a worst case scenario.

 

[doggydog]

Agreed. I didnt mean to offend anyone with that comment. It was just my personal ranking scale out of 4 really good schools.



Unfortunately my electives are all in 4th year which starts in july for us, at the earliest. I was going to take a month off to do dedicated S2 studying. So effectively it leaves me August for home, and sept or oct for an away, if I can secure one during those months. If I get sept approved, then great. Alternatively, I could always do 2 SLOEs from Home (departmental through the elective and 1 faculty eval from the department chair who I am doing research for). Thoughts?

I know someone said that you could use two SLOEs from your home program, and I'm sure it was done successfully by someone in this cycle, but please don't. You really need SLOEs from two different programs in order to optimize your competitiveness.

If anyone needs any extra motivation to not take the easy way out here, go read the SOAP thread on the NRMP subforum. You don't want to be in their situation next year.

At least two SLOEs from two different programs is what you need and I would never advise anyone to do anything different.

 

[Perfect Hair Day]

This thread has become quite a reality check. I am hopeful that my situation will change, and that I will be in a position where I can do an away rotation. For the time being, however, I was hoping people could still chime in and share what programs they are aware of that state a minimum requirement of one (1) SLOE.

 

[brabbit2222]

This thread has become quite a reality check. I am hopeful that my situation will change, and that I will be in a position where I can do an away rotation. For the time being, however, I was hoping people could still chime in and share what programs they are aware of that state a minimum requirement of one (1) SLOE.

In general, the best applicants can do things like no away rotations. Get 260+ on Steps, AOA, Honors third year, strong leadership/extracurriculars/EM research, rock your home EM rotation, and the vast majority of the EM programs in the country will extend you an interview invitation. Just like a poor Step score, no away rotations is a red flag, but prove yourself in other categories, and you'll be fine.

 

[Perfect Hair Day]

In general, the best applicants can do things like no away rotations. Get 260+ on Steps, AOA, Honors third year, strong leadership/extracurriculars/EM research, rock your home EM rotation, and the vast majority of the EM programs in the country will extend you an interview invitation. Just like a poor Step score, no away rotations is a red flag, but prove yourself in other categories, and you'll be fine.

Hmm, no AOA. Step 1 is 247. Will obviously need to take 2CK before I apply. I hear the trend (in general) is upward from Step 1. Strong leadership, meh research (I have a number of experiences but no publications - currently working on a pedi EM paper though). Interesting personal story - I was diagnosed with cancer my first year of medical school, and I just stayed and went through hell while studying for classes and boards (2nd Quartile). That's my application, in a nutshell. 3rd year very much middle of the road. So, reality check me - where on the spectrum of applicant quality do I fall in this scenario? The insight is much appreciated 🙂

 

[brabbit2222]

Hmm, no AOA. Step 1 is 247. Will obviously need to take 2CK before I apply. I hear the trend (in general) is upward from Step 1. Strong leadership, meh research (I have a number of experiences but no publications - currently working on a pedi EM paper though). Interesting personal story - I was diagnosed with cancer my first year of medical school, and I just stayed and went through hell while studying for classes and boards (2nd Quartile). That's my application, in a nutshell. 3rd year very much middle of the road. So, reality check me - where on the spectrum of applicant quality do I fall in this scenario? The insight is much appreciated 🙂

A major factor in your competitiveness will be your performance on your home EM rotation. Get honors and amazing comments, get at least mid 250s on Step 2, get a couple publications, and I think it's reasonable to expect to get a decent number of interview invites. If this were me, I would try my hardest to do an away, though. Aways in the geographic area of interest really do unlock the invites from that region.

 

[dadaddadaBATMAN]

Hmm, no AOA. Step 1 is 247. Will obviously need to take 2CK before I apply. I hear the trend (in general) is upward from Step 1. Strong leadership, meh research (I have a number of experiences but no publications - currently working on a pedi EM paper though). Interesting personal story - I was diagnosed with cancer my first year of medical school, and I just stayed and went through hell while studying for classes and boards (2nd Quartile). That's my application, in a nutshell. 3rd year very much middle of the road. So, reality check me - where on the spectrum of applicant quality do I fall in this scenario? The insight is much appreciated 🙂

Where you fall on the academic scale is beyond my purview, but I can tell you I had a similar app (minus the cancer, sorry about that and keep kicking its ass) and I heard a lot more after my second sloe came in. And all of the interviews I got with one were interested in when my second one would come back.

I'm not aware of a list of programs where one sloe is cool. Even if you find that list though you'll always be better off with two strong ones than one strong one, or even two pretty good ones vs one strong

 

[Perfect Hair Day]

.........

E: I'll expand. UW and ORMC are not chump change programs. We're not talking about Brookdale. Escaping the SDN echo chamber they're near lateral moves.

Now, if IU or CMC is your prohibitive #1 and you're willing to not have a second SLOE until close to Christmas... IDK I still wouldn't risk it actually.

Out of curiosity, what can you tell me about Brookdale?

 

[Barker Posey]

Can't you do a local away? Mine was in the same city and cost me zero. Maybe saved me money because the parking and cafeteria were cheaper. Even if a school accepts one SLOE, you will be competing for interviews with students who have up to four. Ultimately, it's a job. No matter how compelling your personal story is, things, like SLOEs, that give evidence as to the type of worker you will be are the only things that matter.

 

[Istaretoomuch]

Can't you do a local away? Mine was in the same city and cost me zero. Maybe saved me money because the parking and cafeteria were cheaper. Even if a school accepts one SLOE, you will be competing for interviews with students who have up to four. Ultimately, it's a job. No matter how compelling your personal story is, things, like SLOEs, that give evidence as to the type of worker you will be are the only things that matter.

I'll second this. I did my away at a different program in the same city and got great interviews in and out of my region. There is also like 4 other programs < hour drive (not ideal) but just an example of ways to save some cash.

 

[LovesBikes]

I'm suggesting I won't be able to do an away rotation.

Long set of circumstances, but I matched this year with one SLOE that came in November. I believe that it hurt my app a lot to have only one (late) SLOE and I'm very happy and grateful that I matched since I only had 8 interviews. Do your best to do at least one away, the SLOE is king and you need to prove you can hack it in the ED when compared to other students.

 

[EMapplicant2017]

Out of curiosity, what can you tell me about Brookdale?

It was tongue and cheek.

He was taking a jab at a poor interaction their PD had on the rank list thread. It had to do with a competitive applicant ranking the program low.

 

[Mad Jack]

Can't you do a local away? Mine was in the same city and cost me zero. Maybe saved me money because the parking and cafeteria were cheaper. Even if a school accepts one SLOE, you will be competing for interviews with students who have up to four. Ultimately, it's a job. No matter how compelling your personal story is, things, like SLOEs, that give evidence as to the type of worker you will be are the only things that matter.

Damn, we only get one away rotation before September 15th, makes getting more than one SLOE impossible early on. Glad I chose not to do EM...

 

[em2017plz]

We have no EM advising at my school--so I'm turning to you guys for advice. I'll be an EM reapplicant this coming cycle. I just SOAPed into a surgery prelim, which doesn't have an EM program, but the PD said he would be able to set up an EM away for me to get a new SLOE, given we can work out the financial aspects of it. That sounded very promising, but would also like to take a little more control over it to make sure I actually end up with at least one new SLOE. Does anyone know if an MD graduate is allowed to do an away rotation prior to starting a surgery prelim? I'm thinking of doing a rotation in June before we start...or a 2-week rotation somewhere if that is something that exists.

 

[racerwad]

We have no EM advising at my school--so I'm turning to you guys for advice. I'll be an EM reapplicant this coming cycle. I just SOAPed into a surgery prelim, which doesn't have an EM program, but the PD said he would be able to set up an EM away for me to get a new SLOE, given we can work out the financial aspects of it. That sounded very promising, but would also like to take a little more control over it to make sure I actually end up with at least one new SLOE. Does anyone know if an MD graduate is allowed to do an away rotation prior to starting a surgery prelim? I'm thinking of doing a rotation in June before we start...or a 2-week rotation somewhere if that is something that exists.

So you want to do a 2 week rotation as a 4th year medical student? You'll have to arrange that through your school because of insurance issues. If you happen to graduation in May, no one is going to take "some guy" who has a degree but no insurance or license of their own. If this is the case, you are probably out of luck.

 

[em2017plz]

So you want to do a 2 week rotation as a 4th year medical student? You'll have to arrange that through your school because of insurance issues. If you happen to graduation in May, no one is going to take "some guy" who has a degree but no insurance or license of their own. If this is the case, you are probably out of luck.

What if it's "some GIRL" instead? lol.

I could possibly do a 2 week rotation before graduation (at the end of May). I'm not aware of any 2-week EM rotations though....if you know any, please let me know. Otherwise I'll do some research on it. I had to get additional third-party malpractice insurance for all my away rotations, so I'm wondering if there's something similar for a graduate?

 

[KinesiologyNerd]

I could possibly do a 2 week rotation before graduation (at the end of May). I'm not aware of any 2-week EM rotations though....if you know any, please let me know. Otherwise I'll do some research on it.

Just start cold calling people

 

[racerwad]

What if it's "some GIRL" instead? lol.

I could possibly do a 2 week rotation before graduation (at the end of May). I'm not aware of any 2-week EM rotations though....if you know any, please let me know. Otherwise I'll do some research on it. I had to get additional third-party malpractice insurance for all my away rotations, so I'm wondering if there's something similar for a graduate?

Even if you could get the malpractice, no institution's GME office is going to let "some girl" who is not in medical school rotate and do clinical work. Also, most places don't do 2 weeks. Even if you could find a place, that SLOE would be pretty weakly written and received. I think you're going to have to let it go and wait until you start your prelim.

 

[em2017plz]

Even if you could get the malpractice, no institution's GME office is going to let "some girl" who is not in medical school rotate and do clinical work. Also, most places don't do 2 weeks. Even if you could find a place, that SLOE would be pretty weakly written and received. I think you're going to have to let it go and wait until you start your prelim.

Yeah, kind of looking like it might not be very feasible, unless I can get a month-long rotation before graduation. It's possible, as I'm done with rotations this week, but leaving for a trip all through April that I could skip part of if I'm able to work something out. We'll see.

Appreciate the input!

 

[racerwad]

Yeah, kind of looking like it might not be very feasible, unless I can get a month-long rotation before graduation. It's possible, as I'm done with rotations this week, but leaving for a trip all through April that I could skip part of if I'm able to work something out. We'll see.

Appreciate the input!

I would've cancelled the trip yesterday if it meant I could do a rotation to get a SLOE. You are unmatched; if you are really serious about EM, you should consider reordering your priorities.

 

[em2017plz]

I would've cancelled the trip yesterday if it meant I could do a rotation to get a SLOE. You are unmatched; if you are really serious about EM, you should consider reordering your priorities.

I'm already working with someone at school to see if it can work out. Obviously I'll do what I need to to make it work, even if it means skipping the trip.

Appreciate the input, not so much the tone.

Thanks again.

 

[racerwad]

I'm already working with someone at school to see if it can work out. Obviously I'll do what I need to to make it work, even if it means skipping the trip.

Appreciate the input, not so much the tone.

Thanks again.

What was wrong with the tone of my response?

 

[em2017plz]

What was wrong with the tone of my response?

Sounded somewhat condescending, but maybe I'm overly sensitive after an unexpectedly emotional week. Apologies if the tone was unintentional. Interpreting text is hard.

Off to figure things out now.

 

[pandahunter]

When will they look at apps? ACEP this year is at the end of October so I'm guessing there will be a big wave before then. Say you don't get a second SLOE until early/mid October, will they still give your application a look at this point?

They'll still read the app. But at best, the app will go to the maybe pile and won't get an invite until a second SLOE comes in. But by the time that happens, we may have already exhausted our interview invites.