EM residency

[IdontTakeCall]

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whats competitive score on the COMLEX for a DO student looking for allopathic EM residency? Is it necessary to take the USMLE too?

 

[lord_jeebus]

moving to emergency medicine forum

 

[zinjanthropus]

whats competitive score on the COMLEX for a DO student looking for allopathic EM residency? Is it necessary to take the USMLE too?

Any time you are applying for a position, it is in your best interest to maximize the factors you can control in your favor. Board scores are one of those factors and taking the USMLE can only increase your competitiveness at allopathic programs. In addition, it may be a baseline requirement with some programs.

When I see DO applicants who have taken the USMLE, it gives me an objective criteria for evaluation I am familiar with and also shows me the candidate is quite serious and motivated about matching into an allopathic spot.

 

[tkim]

When I see DO applicants who have taken the USMLE, it gives me an objective criteria for evaluation I am familiar with and also shows me the candidate is quite serious and motivated about matching into an allopathic spot.

Didn't you just match this year? Your sound like you get to evaluate applicants already. Is this true at USF?

 

[IdontTakeCall]

thanks for the reply. The top 2 residency programs that i want to go to, though both allopathic, dont require the USMLE. Im not sure if thats kind of a trick though, implying i should still take the exam. 5 of the 10 first year residents at the one program are D.O.'s so i know theyre osteopathic friendly, just curious if i should still take them anyway.

 

[Old_Mil]

whats competitive score on the COMLEX for a DO student looking for allopathic EM residency? Is it necessary to take the USMLE too?

If you want one of the ROADE residencies or a competitive IM program, you should take it. FM and less competitive community IM programs, you won't need it.

 

[IdontTakeCall]

Im not sure what ROADE means but i have 0 interest in IM or FM. I strictly and 100% want to do emergency medicine.

 

[tkim]

Im not sure what ROADE means but i have 0 interest in IM or FM. I strictly and 100% want to do emergency medicine.

Radiology
Ortho/Ophtho
Anesthesia
Derm
EM

Used to be the 'ROAD' to riches, but now it's "ROADE" - 'roadie'?

 

[Dr Roboto]

Radiology
Ortho/Ophtho
Anesthesia
Derm
EM

Used to be the 'ROAD' to riches, but now it's "ROADE" - 'roadie'?

No way...since when?

 

[tkim]

No way...since when?

Since two posts up I guess. There are better-paying specialties than EM.

 

[Dr Roboto]

Since two posts up I guess. There are better-paying specialties than EM.

I was referring to the E in ROADE. Haven't heard that yet.

 

[IdontTakeCall]

I was unaware that EM had become as competetive as ortho derm and rads...Like 3-4 D.O's a year match rads, ortho and derm combined...we had 14 go into EM last year. And the pay for Em isnt bad at all, add to that the hourly pay and lack of call and its wonderful for being home for the kids softball game.

 

[tkim]

I was unaware that EM had become as competetive as ortho derm and rads...Like 3-4 D.O's a year match rads, ortho and derm combined...we had 14 go into EM last year. And the pay for Em isnt bad at all, add to that the hourly pay and lack of call and its wonderful for being home for the kids softball game.

Honestly, I don't think it is. Although anesthesia and EM are pretty close.

 

[domer621]

Anesthesia and EM are equal in competitiveness by the nrmp stats. "ROAD" is Rads, Ophtho, Anes, Derm. EM isn't nearly as competitive as Rads, Derm, or Ophtho.

 

[Hercules]

Since two posts up I guess. There are better-paying specialties than EM.

The orginial ROAD specialties (referred to in House of God if I remember correctly) were more for lifestyle than paycheck. That's why EM got added on. Great lifestyle with a decent paycheck.

 

[tkim]

The orginial ROAD specialties (referred to in House of God if I remember correctly) were more for lifestyle than paycheck. That's why EM got added on. Great lifestyle with a decent paycheck.

Nights, weekends, holidays. Working those doesn't seem like a great lifestyle.

Doesn't matter. You do what you love.

 

[VALSALVA]

Nights, weekends, holidays. Working those doesn't seem like a great lifestyle.

Doesn't matter. You do what you love.

I'll work EVERY Holiday and my fair share of nights in exchange for 250,000K/year and a 36 hr work-week. That's an amazing lifestyle!

 

[enfuegoEP]

I was unaware that EM had become as competetive as ortho derm and rads...Like 3-4 D.O's a year match rads, ortho and derm combined...we had 14 go into EM last year. And the pay for Em isnt bad at all, add to that the hourly pay and lack of call and its wonderful for being home for the kids softball game.

Our program is getting bombed with applications. There's an upward trend in the number of applicants.

As to your original post: at least take usmle step II. Not taking it won't exclude you, but taking it will greatly enhance your chances.

Don't forget to apply to the number one emergency medicine program in the country: USF 😀

 

[enfuegoEP]

Didn't you just match this year? Your sound like you get to evaluate applicants already. Is this true at USF?

We can review apps and make suggestions, although most of the time we're so busy we don't have time.

 

[diphenyl]

The e in ROADE stands for ENT which, with the exception of neurosurg is the most competitive surgical specialty.

 

[VALSALVA]

The e in ROADE stands for ENT which, with the exception of neurosurg is the most competitive surgical specialty.

More competitive than Plastics??

 

[Drawing Dead]

Whoa, wait a minute here. First of all, as proud as I am to be in the EM field, I would never extend ROAD (Rads, Optho, Anesthesia, and Derm) to include EM. Yes, EM affords great lifestyle and good pay, but it also includes holidays, weekends, high stress, and lower pay than those four. It really has NOTHING to do with the competitiveness of getting a residency in that field, because that waxes and wanes (Anesthesia was about as competitve as FP until a few years ago, and judging from what I saw last year, may be on the decline).

As far as the House of God reference, I don't think thats accurate. He named 6 fields, and I remember them as Gas, Pysch, Derm, Path, Rad, and Optho, or PRODAP (need some help on this because I lent my copy to a friend and never got it back). Those were only named due to the ability in those fields to basically go to work, do your job, and leave your work there without taking call, lifestyle basically. Had nothing to do with pay, or competitiveness of getting the residency. And, when the book was written, EM didn't even exist. And, seriously, how many people are fighting for Psych and Path?

There is no E in ROAD, and one can make the arguement that if they wanted to include "E"NT, they could say the O is Otorhinolaryngolgy.

Finally, to steer back to the point of this post, to the OP, don't worry about board scores and grades and all that crap. The worst thing I ever did was listen to the people around me. Case in point, there was a program 30 minutes from where I'm from that was AOA/ACGME until the year I applied. They lost their AOA accreditation, and became fully ACGME. I didn't apply there because I didn't take the USMLE. My friend did apply there without the USMLE, and who I am pretty sure had an inferior application (based on the fact that I got interviews where he didn't, not that my application was spectacular) and got the spot. Is EM getting more and more competitve? Of course. But there is no magic formula to getting a residency spot. The best advice I can tell you is to showcase where you want to go, impress the program director, and impress the RESIDENTS. When push comes to shove, they won't care what kind of grades you got, as long as you are competent in the environment and someone they want to work with.

 

[southerndoc]

At the hospitals where I work, attending radiologists work night shifts to read CT's and ultrasounds.

Radiology isn't that much of a lifestyle specialty anymore. It's moving to shift work with nights and holidays now a requirement at many places.

 

[Drawing Dead]

At the hospitals where I work, attending radiologists work night shifts to read CT's and ultrasounds.

Radiology isn't that much of a lifestyle specialty anymore. It's moving to shift work with nights and holidays now a requirement at many places.

Attendings? That's a pretty new concept to me, after spending 4 years on the east coast, and now in the midwest. Everywhere I've been, the night/weekend/holiday readings have been done by A: Residents, B: Nighthawk, or C: The ER (yes, the EM attendings). I would like to know where this is though, because that would be a great place to work. No more waiting for 3 hours to find out a "STAT" CT reading by the resident that is just going to be contradicted by the radiology attending the next day. (And yes, I do read them myself, but my attendings prefer the "official" radiology resident read as confirmation before dispo.)

P.S. Sucks for all the rads guys who thought it was bankers hours for half a mil a year after residency.

 

[southerndoc]

Attendings? That's a pretty new concept to me, after spending 4 years on the east coast, and now in the midwest. Everywhere I've been, the night/weekend/holiday readings have been done by A: Residents, B: Nighthawk, or C: The ER (yes, the EM attendings). I would like to know where this is though, because that would be a great place to work. No more waiting for 3 hours to find out a "STAT" CT reading by the resident that is just going to be contradicted by the radiology attending the next day. (And yes, I do read them myself, but my attendings prefer the "official" radiology resident read as confirmation before dispo.)

P.S. Sucks for all the rads guys who thought it was bankers hours for half a mil a year after residency.

Just PM'd you the facility name. Quadruple attending reading during most of the day (usually get plain film readings within 15 minutes), 1 attending from 2a-7a (only reads CT's and ultrasounds).

 

[IdontTakeCall]

well thanks for all the replies. Im planning on taking the USMLE step 1 atleast. second question, about how many residecies should i send apps too? theres 2 that are at the top of the list and after them i could care less as to which i go..so like a round number 5, 10, 15?

 

[pseudoknot]

As far as the House of God reference, I don't think thats accurate. He named 6 fields, and I remember them as Gas, Pysch, Derm, Path, Rad, and Optho, or PRODAP (need some help on this because I lent my copy to a friend and never got it back). Those were only named due to the ability in those fields to basically go to work, do your job, and leave your work there without taking call, lifestyle basically. Had nothing to do with pay, or competitiveness of getting the residency.

I believe the discussion in House of God concerned what he called the "NPC" specialties, for No Patient Care. In the book getting away from patient care was considered much more important than money, lifestyle, or competitiveness of training 🙂

 

[domer621]

second question, about how many residecies should i send apps too? theres 2 that are at the top of the list and after them i could care less as to which i go..so like a round number 5, 10, 15?

If you want to go to an allopathic residency as a DO, you'll need to apply to a lot more than that. It's impossible to give you a number right now, since you haven't taken the Step 1 yet.

Just to give you an idea, a DO I knew who had >230 on the USMLE Step 1 applied to around 40 allopathic programs after talking with his advisors.

 

[Drawing Dead]

If you want to go to an allopathic residency as a DO, you'll need to apply to a lot more than that. It's impossible to give you a number right now, since you haven't taken the Step 1 yet.

Just to give you an idea, a DO I knew who had >230 on the USMLE Step 1 applied to around 40 allopathic programs after talking with his advisors.

OP, this is the crap that I'm warning you about. Don't listen to this clown, or anyone else who gives you advice like this. There is no "good" number of apps to send out. My advice to you is to send out apps to places you want to train that look like what you want on paper. If that number turns out to be 40, thats fine, but I'm sure it will be smaller. And if there are 2 programs you really want, set them up early to showcase like September/October. Someone who sends out 40 apps just for numbers sake isn't a good applicant, they are just neurotic.

Just remember, a spot you don't want that you apply to may interview you. Then a 6 dollar app can turn into a 300 dollar plane ticket and 100 dollar hotel room. Then you may say "how many programs should I rank?" and you get more great anecdotal advice like "I heard my cousin's friend's brother's former roomate ranked like 20 programs and didn't match" and you include that program, and what do you know, you're humpin it out in the middle of no where, hating life, and hating the field. Only apply to places you are willing to go, regardless of numbers. I can't stress that enough.

 

[domer621]

OP, this is the crap that I'm warning you about. Don't listen to this clown, or anyone else who gives you advice like this. There is no "good" number of apps to send out.

No need to be immature and insulting. I was giving an example of a DO applicant I knew.

So you're saying that the competitiveness of an applicant shouldn't influence the amount of programs he/she applies to? That's hilarious.

 

[Drawing Dead]

You can take it as an insult and being immature, but it's people like you that make the application process that much more stressful. It's people like you that make other applicants say "I'll never get an allopathic spot" or I'll never match EM because it's too competitive.

And no, the competitiveness of an applicant should not dictate how many programs they apply to. The same person can apply to 5 programs and get 5 interviews, or they can apply to 40 programs and get none. No two programs have the same inclusion criteria for offering interviews. Board scores and grades are only the tip of the iceberg. Do you know what I look at first when I look at apps? (And yes, we the residents review applications) First I look to see if it's someone I've worked with before, ie they rotated with me. Then I go to the personal statement. Then I glance over research. Finally I will look at board scores. Transcript I don't even bother with, becuase its comparing apples to oranges between schools.

I can't stress enough how much showcasing is the most important thing you can do at a program you want. It really is more about who you know than what you know.

 

[domer621]

I can't stress enough how much showcasing is the most important thing you can do at a program you want. It really is more about who you know than what you know.

I agree with this, but it's never good to put all your eggs in one basket. Applying to more programs covers you. I'm perplexed as to how you fail to understand this concept. When I say "competitiveness," that includes everything about the applicant, including their academics, letters, etc. I don't know of a single person who applied to only 5 EM programs, even if they were incredibly competitive academically and "show-cased" at a few of the programs they applied to... it's just not worth the risk.

 

[vtucci]

I agree with domer.

Drawing Dead-- You cannot divorce your level of competitiveness from the number of programs to which you apply. If a person applies to 5 programs and gets 5 interviews and another applies to 40 and gets none, I guarantee you that the applications are not equal.

Even the most competitive applicants would be foolish to apply to only 5 programs (not that this doesn't happen as some people are locked into specific geographic regions but they are also taking a calculated risk that they may not match when the time comes).

If you apply to more and get interviews everywhere you apply, congrats. There is no written rule that you have to interview everywhere and for most applicants, we do not have a crystal ball and know in advance who will grant us an interview and who will not.

I do agree with you that the most important thing is working with the applicant when possible. Many programs also value SLORs, Dean's letter, research and lower down transcripts and board scores. However, many students do not know absolutely where they want to go for residency (other than possibly their home program) and away rotations can be extremely eye-opening for both the program and the applicant.

 

[IdontTakeCall]

the reason i ask i that ive completed the first 2 years of medical school 300 miles away from my wife and 11 month old daughter and its really stressing my family and marriage. both of our families are in the same geographical area as is the place where she works and where i intend to work as an attending. There is only so far i can conceivably move my family if i were not get into my top choice residency which is 45 minutes from our house where she and my daughter currently live. Theres another residency about 90 miles away and after that its 300 miles to NYC or Boston or furthur. As i cant move my family any further than say south to NJ or NE to maine/boston, im very landlocked...so do i aqpply to every residency program within that 300 mile radius?

 

[domer621]

the reason i ask i that ive completed the first 2 years of medical school 300 miles away from my wife and 11 month old daughter and its really stressing my family and marriage. both of our families are in the same geographical area as is the place where she works and where i intend to work as an attending. There is only so far i can conceivably move my family if i were not get into my top choice residency which is 45 minutes from our house where she and my daughter currently live. Theres another residency about 90 miles away and after that its 300 miles to NYC or Boston or furthur. As i cant move my family any further than say south to NJ or NE to maine/boston, im very landlocked...so do i aqpply to every residency program within that 300 mile radius?

I didn't know about your family situation. If the family stress would be too much, then no way should you apply to a residency program too far away, man. You'd be miserable. The most important thing for you to do is schedule away rotations at those top 2 programs you mentioned, to increase your chances of getting in. I still would not recommend applying to so few programs, though. I don't know how many residencies are within the radius you mentioned, but I would apply to the ones that would be possible for you and your family to not be miserable (although I'm not sure what number that would be).

 

[Drawing Dead]

I'm sorry, but where did you guys match???? Oh yeah, that's right, you're still medical students. And, yes, maybe because you're 4th years, you might think you know everything, but trust me you don't. And once match day arrives, every single one of you will look back and say "I could have done this differently" whether is was apply to other programs, not have applied to certain ones, taken certain interviews, passed on others, etc.

Yes it's nice to be able to pick and choose from interviews, but guess what, they don't all come at once like it's some alla carte menu. You might apply to 40 programs, and get interview offers from 31-40 first, once you get back from those, programs from your top 10 may offer. Now what, you're broke and out of days that you can get excused from rotations to interview.

Vtucci, you completely missed my point. I was talking about the same applicant. The same applicant can apply to the 5 percieved "weakest" programs in the country or the 40 "strongest" and have different results, with the same app. I left those descriptive words out so I didn't spark a totally new topic.

OP, you have obviously decided to stay in what I can guess is New England, judging from your Red Sox icon. In that case, I would look at all the programs in the geographical area you are willing to go to, and apply to the ones that you would be willing to train at. Don't worry about a number. And hey, if you don't match, it's not the end of the road. You can always scramble, and I know for a fact that there were a few allopathic as well as osteopathic programs that didn't fill last year. You can also do a traditional year, and re-apply as a PGY-2. This is the most stressful time of med school, and the last thing you need is people stressing you out even more.

And finally domer. What's with the arrogance dude? I fail to understand your shotgunning concept? Here's my thought on the same applicant taking my advice and yours:

My advice: Applicant applies to 15 programs (arbitrary number, but smaller than 40) and gets 5 interviews. Match day comes, and doesn't match. Initially freaks out until he realizes that there are programs that were a little too selective and didn't fill (like a certain one in New Haven that hasn't filled in 2 years on match day), and is free to scramble without compromising his desire to keep his family close to home.

Your advice: Applicant applies to 25 additional programs for the sake of numbers and gets 20 interviews. Match day comes, and matches 1000 miles away from home and has to uproot his family to a foreign place to a program that he is not at all excited about. Sees that a program much closer to home didn't fill. Calls program director there and is told "We would love to take you, but you matched. If you can get out of your obligation, we can talk, but I can't guarantee the spot will still be here." And now the applicant can burn his bridge with his current program, with no guarantee he will be released from his match obligation, or that the spot will still be there, or he can take his medicine like a man, break the news to his family, and friends and move them away all for the sake of "matching" because we all know that is much more prestigious than scrambling, right?

And I say this because I was the person in scenario B. Now don't get me wrong, I love my program, and it's been a blessing in disguise. And yes, I could have scrambled into a program much closer to home if I hadn't matched, but I did. And I did uproot my girlfriend, who was a tenured NYC teacher with 5 years of pension, made her quit her job so she could restart her life out here with me. And Thanksgiving, I'll be suturing turkey carving lacs and putting Silvadine on deep fried turkey accidents. And why? Because my family is 1000 miles away, and the other residents scheduled with me are from the area. I volunteered for the shift knowing I won't see my family so they could. And I know I sound bitter, but I'm not. I'm only saying this because you mentioned you have a family. Sometimes we take for granted how this affects other people in our lives until it happens. Not everyone is so willing to start their lives over.

So, I cannot stress enough to ONLY APPLY TO WHERE YOU (and your family) ARE WILLING TO GO.

 

[domer621]

I'm way too lazy to respond to everything you just posted. There's an obvious miscommunication here, and I think it's here:

You might apply to 40 programs, and get interview offers from 31-40 first, once you get back from those, programs from your top 10 may offer. Now what, you're broke and out of days that you can get excused from rotations to interview.

Let me just clarify that I'm not telling him to go on 31-40 interviews, but just to apply to that many programs. Of course you wouldn't go on that many interviews.

I re-read what I posted, and I don't see how I came across as arrogant. If I did, I apologize.

I honestly don't know what to say about your advice on scrambling, man. I don't think anyone should take that risk.

So, I cannot stress enough to ONLY APPLY TO WHERE YOU (and your family) ARE WILLING TO GO.

This is basically what I said in my post right above yours, so the OP would not be matching anywhere that would make his family situation miserable. He also would probably not be scrambling, either.

 

[kungfufishing]

but ultimately, wouldn't you be willing to go to a lot places for a few years if it offered you the opportunity to train and board in your chosen specialty? You are portable when you finish..

 

[IdontTakeCall]

selling a house, buying a new one and moving wife from her job and 11 month old infant isnt as easy as it sounds mate so no i wouldnt consider it a "portable" situation

 

[vtucci]

Having a house definitely complicates the picture. I know and absolutely understand where you are coming from OP. Also, if you family is not portable, that makes it tough.

Drawing Dead- wow- being a little harsh? It is true that Domer and I are 4th year medical students but that does not mean that we have not held jobs/careers in other professions just as competitive as medicine and have not dealt with similar things before. Nor does it mean that we do not understand the process. Undoubtedly, many applicants will regret something about the way they applied, interviewed or ranked their lists. It is hard to know in advance whether you will be offered an interview or whether you will gel with a program if you are (if we knew this, we would not have to go and check it out). However, most of us would be much more concerned that we had to scramble for a slot who knows where than if we applied to too many places. There is no guarantee that a scramble slot will be in an area good for the OP.

Also, as there is tremendous disagreement in our field about what programs are the best, most competitive etc., most students tend to be cautious and cast a wide net. Even the most competitive applicants may not know what a particular program is looking for as the process often seems nebulous to us. Lot of times it seems like a crap shoot as to why one program granted an interview to a student and why another (arguably the same level of competitiveness per conventional wisdom) does not. This is why Domer and I were suggesting the OP might want to apply more broadly. That being said, a candidate should not apply to programs that they have no intention of ever going to. If OP is truly locked in New England for personal reasons, it would be foolish for him to apply to Ariz, Missouri, Florida etc. or outside the area he can reasonably travel. The best recipe would be to go to the program of interest, work his butt off and make a great impression on the team.

As Domer mentioned, 40 applications does not mean that you have to take (in the unlikely event you are offered all) 40 interviews (as a practical matter, it is virtually impossible for most students to attend more than 20 (even if they had limitless funds due to scheduling). Also, even if you went to 20 interviews, we are not required to rank all 20 programs if we don't like a program, we may make a calculated risk that we will match elsewhere or have to scramble if our rank list is not long enough.

It is truly frustrating for many of us that interviews come in on a rolling basis. As a result, we may be unable to change our plans and interview at programs we otherwise would have been interested in but that can happen with students' schedules whether you apply to 5 programs only or 20. However, for those of us who can plan in advance to do an interview month or independent study or a light rotation during December and January, it will usually work out ok.