Army Emergency medicine—Do I have a shot at a residency?

[Stormin']

I’m hoping to get some advice from Army EM Residents/Physicians.

All throughout undergrad and the pre-clinical years of medical school, I couldn’t see myself doing anything other than Emergency Medicine. When I have shadowed (both before and during medical school) I have loved the specialty and what an EM physician does.

I just got my COMLEX Level-1 score back, and it was not as good as I thought I did. I got just below a 500. I’ve heard that the NBOME thought that the averages last year were too high (around 550) and corrected that in this testing cycle with a lower/more normal average. We won’t get the average data until next July, so I have no idea what percentile I ended up in. Between that and one other thing, I probably don’t look fantastic on paper. I do believe that I’m a good clinical learner, I’m able to get along with people well and believe that I would do well as an EM resident/future physician.

Emergency medicine is a competitive specialty in the Army. I get that. I’m wondering if I should even bother pursing it as a residency. I’m early in my rotations, so I still have time to decide and think about this.

I was hoping to get some advice/thoughts. Thanks in advance!

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[HighPriest]

What's the one other thing? If you can't be within 200 yards of a school, then discussing this is a moot point. If you got a bad grade on a math test in the second grade, then there's a discussion to be had.

I would recommend contacting a program director at any of the service-specific training programs, and laying out your specific situation. Be as honest as possible, it's in your best interest. He'll let you know what he thinks. Even then, it's not set in stone. A lot of factors come in to play, and while grades are very important they're not everything. That being said, he may tell you that they don't even consider applications with scores below some number "X." Just be ready for whatever he tells you.

 

[Stormin']

No legal issues or anything like that.

It was an academic issue

 

[HighPriest]

Yeah, I hear you. My point is: was it a big issue? Was it "you failed to turn in a few assignments and it reflected in your grade" or was it "you plagiarized a midterm and went before a board review to see if you should be suspended?" I'm not saying that you need to share, but keep in mind that "one other issue" could be small fries or it could be enough to sink an application regardless of your scores.

 

[Stormin']

I’d say somewhere inbetween. I failed a course by 0.5% and ended up having to repeat my first year. I came back and rocked the course next time around, but I can’t imagine that looks too great on an application....

 

[HighPriest]

Well, to be honest, that may end up being an issue in-and-of itself. Not insurmountable, I don't think, but the more competitive of a specialty you're looking at, the easier it is to be "bottom-stacked."
I'm not an ER doc. I can only speculate. I know that would be a major red flag in my field. It's not that you're not a good applicant, per say. it's just how you measure up compared with the other applicants. And in some cases, if it's very competitive with a lot of applications turned in every year, you can have a program not look at your application at all if it doesn't meet certain requirements.

The best thing you can do is to speak with an ER program director. Call the ER office (not the ER. Find out what their office number is, or call the GME coordinator at a MEDCEN and let them know your situation. They may have to take your contact information and pass it on, and you may have to wait for someone to contact you. If so, keep in mind that most GS employees take great pride in doing their job poorly, and so you may need to contact the GME coordinator again in 2-3 weeks if you haven't heard anything. Be persistent, but not pushy.) I'd recommend not contacting the ER director at your first choice program. I'd start with your last choice. Maybe that doesn't matter, but if I were you I'd probably not try to draw immediate attention to your deficiencies from your program-of-choice.

 

[armytrainingsir]

HighPriest has given you excellent advice. To expand on that a bit… Physicians are incredibly risk-averse. Program directors more so. The last thing they want to do is pick a resident that turns out to be a dud. Trying to recycle or fire resident is a royal pita. And unfortunately, having to repeat a year of medical school puts you in a very rare group of applicants. The best way to fight looking bad on paper is to look good in person. I can’t really recall anyone ever overcoming a bad impression on paper with more paper.Although I’m sure it happens. Your personality and work ethic on clinical rotations is what is going to save you and give you a chance at doing what you want. So you need to figure out a way to maximize your face time with ER program directors.

Good luck.

 

[Stormin']

I appreciate advice from both of you! I will contact program directors to talk to them.

It's obviously something that I worry about. I know that I don't look great on paper. But I also know how important it is to perform well in an audition rotation. Between improving my 2nd time around (which carried onto my 2nd and what 3rd year I've completed) and off paper stuff (which I believe is a strength), how much of the 'on paper' can I overcome?

 

[HighPriest]

I appreciate advice from both of you! I will contact program directors to talk to them.

It's obviously something that I worry about. I know that I don't look great on paper. But I also know how important it is to perform well in an audition rotation. Between improving my 2nd time around (which carried onto my 2nd and what 3rd year I've completed) and off paper stuff (which I believe is a strength), how much of the 'on paper' can I overcome?

Potentially a lot. But, this is milmed. EM is very popular, and there are only so many training spots. I’m the civilian side, I think you could overcome this stuff. The only way to know in the military is to ask the guys who make those calls.

 

[armytrainingsir]

Programs pick who they want first, and the most qualified second. Too late for #2, so be #1 !

I knew a total goofball that looked horrible on paper get picked up for neurosurgery. (civilian).


I really miss the good old days of military medicine. Because in the 80s & 90s, a solid candidate could do his time in GMO land, come back, and be picked up pretty much in any specially of his choice.

Sadly, I don’t see those days ever returning.

 

[HighPriest]

To be fair, I'd rather have some of the residents I knew who were great people but not the best academically than I would the many of the guys who were great academically, but just boring or $#!tty people.