Emergency Medicine Class Matching in 2013

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EPtoB said:
Haven't sent my "you're #1" e-mail yet, as I still have one more interview left.

But was wondering if anyone else got an invite from Palmetto/USC to a basketball game/second look for applicants? Anyone know what this is about? Is everyone invited?
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Didn't get an invite
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FSU2013 said:
No "ranked to match" emails. Got a few generic "liked your app" or "you'd be a good fit" in response to TY emails, but I don't make too much out of those.

When I consider my wife's salary, we're looking at a difference of well over 25k take home between a few places, but with drastically different COL. There is however a combined 10k difference in take home pay for two of the programs in my top 3 right now that have very similar COL.
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Yeah, that's basically all I got too. EM handles this whole process slightly differently.
 
EPtoB said:
Haven't sent my "you're #1" e-mail yet, as I still have one more interview left.

But was wondering if anyone else got an invite from Palmetto/USC to a basketball game/second look for applicants? Anyone know what this is about? Is everyone invited?
Click to expand...

No invite for me. I interviewed there a while ago
 
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EPtoB said:
Haven't sent my "you're #1" e-mail yet, as I still have one more interview left.

But was wondering if anyone else got an invite from Palmetto/USC to a basketball game/second look for applicants? Anyone know what this is about? Is everyone invited?
Click to expand...

I did.
 
I'm sure these Program A vs B things get annoying but I just wanted to throw this out there. I want to be a community doc and am having a hard time figuring out which program to rank higher.

Program A: Better fit with residents and faculty. More of a community/academic focus. Residents get PG surveys and education in patient satisfaction and administration. Busy with decent acuity but nowhere close to a knife-and-gun club setting. Newer program with <10 years of graduates. So far grads have gone to every region with some in desirable locations. Better location than Program B.

Program B: Well established big name county program. High volume, high acuity. Felt like doing residency here would let me step in a war zone and be comfortable. Seeing some of the traumas come in on the tour gave me a rush I'm not sure I'll ever get at Program A. No real curriculum for transitioning to a community practice. Had a hard time jiving with residents and faculty to the point that I'm really questioning if I'd enjoy working with them. Location isn't terrible but less desirable than Program A.

I'm torn because I feel like Program B gives me the better training and CV but Program B let's me be happier for 3 years.
 
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DB2013EM said:
whichever makes you happier is where you should be.
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I feel like one program makes me happier in the short term and another makes me happier in the long term. Go for long term?
 
Akail said:
I'm sure these Program A vs B things get annoying but I just wanted to throw this out there. I want to be a community doc and am having a hard time figuring out which program to rank higher.

Program A: Better fit with residents and faculty. More of a community/academic focus. Residents get PG surveys and education in patient satisfaction and administration. Busy with decent acuity but nowhere close to a knife-and-gun club setting. Newer program with <10 years of graduates. So far grads have gone to every region with some in desirable locations. Better location than Program B.

Program B: Well established big name county program. High volume, high acuity. Felt like doing residency here would let me step in a war zone and be comfortable. Seeing some of the traumas come in on the tour gave me a rush I'm not sure I'll ever get at Program A. No real curriculum for transitioning to a community practice. Had a hard time jiving with residents and faculty to the point that I'm really questioning if I'd enjoy working with them. Location isn't terrible but less desirable than Program A.

I'm torn because I feel like Program B gives me the better training and CV but Program B let's me be happier for 3 years.
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I have the exact same question; almost the same two types of programs you described. I am also unsure but am leaning towards A. However, this changes almost every day :laugh:
 
cheasus said:
I have the exact same question; almost the same two types of programs you described. I am also unsure but am leaning towards A. However, this changes almost every day :laugh:
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SO annoying! Leaning towards A tonight too...we'll see how I feel tomorrow!
 
Akail said:
I'm sure these Program A vs B things get annoying but I just wanted to throw this out there. I want to be a community doc and am having a hard time figuring out which program to rank higher.

Program A: Better fit with residents and faculty. More of a community/academic focus. Residents get PG surveys and education in patient satisfaction and administration. Busy with decent acuity but nowhere close to a knife-and-gun club setting. Newer program with <10 years of graduates. So far grads have gone to every region with some in desirable locations. Better location than Program B.

Program B: Well established big name county program. High volume, high acuity. Felt like doing residency here would let me step in a war zone and be comfortable. Seeing some of the traumas come in on the tour gave me a rush I'm not sure I'll ever get at Program A. No real curriculum for transitioning to a community practice. Had a hard time jiving with residents and faculty to the point that I'm really questioning if I'd enjoy working with them. Location isn't terrible but less desirable than Program A.

I'm torn because I feel like Program B gives me the better training and CV but Program B let's me be happier for 3 years.
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Okay, so it seems like you have already talked yourself into program A. Your biggest concerns seem to be the "big name" and the higher acuity, but you admit that you get along better with the residents and there is a better location for A. The bottom line is that you will get good training at any program. You will be spending a lot of time with your fellow residents over the next few years and if you can't really "jive" with them it will be tough to work together on a daily basis. Volume and acuity don't necessarily equal good training, in fact it may be detrimental to some extent because there is a fine line between managing multiple patients and learning from pathology and just moving meat.

Just some food for thought.
 
Peace everyone. I'm just trying to stay more thankful for the opportunities than anxious about the outcome; I know y'all probably are feeling a little anxious too so I wanted to send good vibes. What an exciting time! :)
 
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Anonymous M4 said:
Peace everyone. I'm just trying to stay more thankful for the opportunities than anxious about the outcome; I know y'all probably are feeling a little anxious too so I wanted to send good vibes. What an exciting time! :)
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I can't believe we have another 2 months til match day! I'm not so much nervous or anxious, just eager to have this whole thing over with and go apartment hunting :D
 
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pianoman511 said:
Okay, so it seems like you have already talked yourself into program A. Your biggest concerns seem to be the "big name" and the higher acuity, but you admit that you get along better with the residents and there is a better location for A. The bottom line is that you will get good training at any program. You will be spending a lot of time with your fellow residents over the next few years and if you can't really "jive" with them it will be tough to work together on a daily basis. Volume and acuity don't necessarily equal good training, in fact it may be detrimental to some extent because there is a fine line between managing multiple patients and learning from pathology and just moving meat.

Just some food for thought.
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Thanks for for the input, A>B to stay! :cool:
 
after a long week of traveling, so very happy to have found my #1
 
migm said:
after a long week of traveling, so very happy to have found my #1
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Nice! It's a fantastic feeling, no? I've identified several possible #1's. Left each feeling like.....:love:
 
Anyone else feeling a little bit of a panic committing to #1? My #1 is my #1 for MANY reasons and my gut is telling me it's where I belong, but all of a sudden I'm just worried that somehow I could be wrong. It seemed like such a great match for me that it almost seems too good to be true. There really isn't another program I'm even toying with placing in that #1 spot, but all of a sudden I'm anxious about it. I think part of this comes from the fact that there were several programs I thought would end up higher on my rank list than this program initially. I have also been told repeatedly that I'm really a "top tier" applicant and could go anywhere... somehow I feel like I'm "supposed to" end up at a big name program. My #1 seems well-respected (and people have said great things about it in the reviews here), but it's not one of the heavy hitters within EM.

I'm sure this is just stupid butterflies and it will be fine. *Sigh*
 
go with your gut. go with your gut. go with your gut. go with your gut. go with your gut. go with your gut.
 
DoctorTinyCat said:
Anyone else feeling a little bit of a panic committing to #1? My #1 is my #1 for MANY reasons and my gut is telling me it's where I belong, but all of a sudden I'm just worried that somehow I could be wrong. It seemed like such a great match for me that it almost seems too good to be true. There really isn't another program I'm even toying with placing in that #1 spot, but all of a sudden I'm anxious about it. I think part of this comes from the fact that there were several programs I thought would end up higher on my rank list than this program initially. I have also been told repeatedly that I'm really a "top tier" applicant and could go anywhere... somehow I feel like I'm "supposed to" end up at a big name program. My #1 seems well-respected (and people have said great things about it in the reviews here), but it's not one of the heavy hitters within EM.

I'm sure this is just stupid butterflies and it will be fine. *Sigh*
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Follow that gut. Worrying about what others say or how they feel about where you are going is a recipe for disaster. Stay true to yourself, and go where you will be happy, not where others tell you that you will be happy.
 
Woo Hoo! One interview left. Wow, this process has flown by. In a few days I will have seen all of my options. No more "any questions?" questions. It's time to get nasty with my ROL and establish dominance.
 
DreamingTheLive said:
Woo Hoo! One interview left. Wow, this process has flown by. In a few days I will have seen all of my options. No more "any questions?" questions. It's time to get nasty with my ROL and establish dominance.
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Yay! Just finished my last one. It's been one hell of a ride that I'm glad is ending! Hope it all works out for us!
 
What's everyone doing til May besides finishing up with school? Anyone have cool vacation plans they want to share?
 
Do people generally wait until after their ROL to post reviews on programs? It would be nice to read what people thought about programs.
 
You can certify your list as many times as you want, si? I have my preliminary ranking done and want to certify it just to get rid of the nightmare where I forget the deadline. Figure there is no harm in certifying it once just to have something in while I make my final decisions...
 
DeadCactus said:
You can certify your list as many times as you want, si? I have my preliminary ranking done and want to certify it just to get rid of the nightmare where I forget the deadline. Figure there is no harm in certifying it once just to have something in while I make my final decisions...
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That is correct. I've changed mine appx 5 times already.
 
mine is certified platinum! Holla!

Okay, that was dumb. certified...fresh?
 
Just heard about the results of the urology match...about 65% landed a spot this year. Yikes.
 
As I’m thinking about wrapping up residency, I had a few random musings about applying for residency, doing well as a resident, and the OHSU Emergency Medicine program. Like all things on SDN, buyer beware.

Applying for residency

First, this sucks. I think it’s worse than applying to med school (at least you know where you have been accepted for med school). EM is more and more competitive and this doesn’t help either. Ask for help. EM attendings, students who just matched, EMRA website tips – whatever. Also, don’t skimp on any steps. One little thing can really hose your application, such as not doing an away rotation. There are lots of tips already out there, I won’t go on and on. There is one thing that I do think is important. When you interview at a location, it’s great to mention your ties to the area but don’t make that your main selling point to the program. I can’t tell you how many applicants have told me how much they loved Portland, grew up here, want to live here, etc. I know this. That is why you are applying to OHSU. Tell me something that you like about our program. Then I know you have done your research and are interested in the residency, not being on a Portlandia episode. Lastly, be ready for match day. Lots of people don’t get their first choices. Think hard about your top three. Fortunately, the statistics say you should wind up in one of these.

Choosing a residency

I think it’s important to think about what you want when to do you for a career when are applying. Do you see yourself practicing in an inner city, underserved, hard core trauma ED for your career? If so, apply to those programs. Are you into academics? Go to a place with good fellowships. Most people stay where they are for fellowship and it’s a great view of the program. If you choose to leave to another fellowship location, you’ll get great tips and recommendations. Are you into something outside of residency? Make sure your locations have this. I would go nuts if I couldn’t go hiking, skiing, or kayaking so I went somewhere where I could do this. If you are a dead set of a location to live in, it helps to do residency there. Most of the local EDs will have grads from your program and networking is that much easier. The best jobs aren’t advertised and you’ll need an “in” to get them. If you have no idea what you want, go with your gut.

Do think about the work ethic of the program. If they have 12 hour shifts, how many do you do a month? Make sure the place won’t grind you into the ground. Everyone stays an hour or two after a shift to finish charting. Six 10 hour days in a row are tough but six 14 hour days in a row will crush you. Finally, know that you will get a great training and love your program no matter where you go. To my knowledge, all EM programs will get you what you need. You will make great friends and have a life changing experience.

In residency

Congratulations. Now you can focus on learning what you want to do. Two recommendations:

Get involved in the program outside of your shifts. Pick a committee, start a project, whatever. Don’t say yes to everything but try and find a niche your intern year. You can always change if you don’t like it. By doing this, you will set up good relationships with a few attendings and expand your EM knowledge outside of clinical work

Second, get your financial life in order. Find a financial planner (one who isn’t tied to a particular insurance company) and take their advice. Usually they are free in residency. They can help you with the tips below.

A couple things to think about:

Consider Income Based Repayment for your loans. I poo-pooed this because I am in a three year program and most EM community practices are not non-profit. What I didn’t realize is that your yearly payment is based off last year’s income. Meaning, during my intern year I would have essentially payed nothing and had one less year of loans to pay off. Your second year will be based off six months of a resident salary. Still a low payment. Since I didn’t do this, I have 10 years of super high monthly payments instead of seven. If you are in a four year program, do a fellowship, or go into academics, you will save even more money.

Get personal disability insurance. You will get a killer rate and likely can set up to increase your coverage before graduating without going through underwriting again. This is a big topic but super important. You are at highest debt load, lowest income, and greatest opportunity for income lost. Don’t let one needle stick prevent you from not qualifying later in residency. This is worth the money/time investment!

Consider life insurance, particularly if you have dependents. Term insurance is cheap, you are young and healthy, and you can lock in a cheap rate for many years.
Set up an emergency fund. If your car breaks down, you’ll need to fix it and don’t want to get stuck with even more credit card debt.

Make a budget. The residency salary only goes so far so don’t push yourself further into debt. It also helps to start saving money for step 3, licenses, etc.

OHSU
In my intern year, I put up several posts to counter the OHSU bashing that I saw on SDN. That’s all pretty much old news at this point but those posts keep on popping up when you search for OHSU. I’ve had a great experience at this program. The program is very receptive to resident input and the program has significantly improved the three years I’ve been here. A few examples:

The peds experience is much improved. An additional dedicated month has been added. Now there are two months of dedicated peds ED and 2-3 shifts during every OHSU EM month. This adds up to about 4 peds ED months plus the PICU month. The RRC requirement is only two months and most programs still sit at that.

Interns now work on only one team in the OHSU ED. They used to spread between two attendings which made staffing kind of a pain. Also you now work closely with the third year resident who can give tips and steer your towards some good procedures.

A few things that OHSU isn’t great at: First, we aren’t a high volume penetrating trauma center. This is probably obvious. You will see enough trauma to feel comfortable. I’ve put in plenty of chest tubes. I think we average about a thoracotomy a month so will see the gory stuff. Next, a problem plaguing all academic residences is competing services. This is mostly an issue with orthopedics. If the patient is a trauma entry or followed by the ortho service we have to give them a call. Sometimes they will let us do the reduction but not always. We still get plenty of ortho procedures – usually at the community sites or the patients that aren’t trauma entries/followed by ortho. Lastly our hospital has a lot of ICU beds. We certainly stabilize the sick patients but they don’t linger in the ED for days. This both a blessing and a curse. It allows us to see more patients but we aren’t doing extended critical care. If you want to be managing pressors and vent settings every ED shift, we aren’t doing that. Some places have ED critical care pods. OHSU is not one of them.

In regards to all the digs about OHSU being low volume. One comment – it doesn’t matter. You’ll see plenty of patients. I’ve had shifts where I have seen over three an hour. We have only two teams and both teams see high acuity patients. One perk is that you won’t get stuck in a fast track or low acuity shift. At those big EDs, you can be darn sure you won’t be working the resusc bay every shift. I like the fact I get a variety of patients every time I go to work. At the community EDs, we only work the high acuity pods and can pretty much cherry pick the sick patients.

Good luck with your career!
 
emoregon said:
As I’m thinking about wrapping up residency, I had a few random musings about applying for residency ... One little thing can really hose your application, such as not doing an away rotation ... Think hard about your top three. Fortunately, the statistics say you should wind up in one of these.
Click to expand...

Really appreciate the post.

Curious as to how much you think an away is crucial to a happy match day. I did not do an away for reasons which seemed generally accepted when I explained them during interviews, interviewed at just under 10 programs, and have gotten good feedback from a few places to date -- but am still nervous for (a) being under 10 and (b) having not done an away.
 
exi said:
Really appreciate the post.

Curious as to how much you think an away is crucial to a happy match day. I did not do an away for reasons which seemed generally accepted when I explained them during interviews, interviewed at just under 10 programs, and have gotten good feedback from a few places to date -- but am still nervous for (a) being under 10 and (b) having not done an away.
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Idk man, I think it all depends. I know a few people who didnt do aways and both matched number 1 on their list and are super happy. I think an away is good for 3 reasons. 1) can help you figure out what types of programs you want to apply to. 2) LORs from them are probably more reputable than at your home. 3) Can help you get in at that particular program.
 
48-nyc-logo.jpg


Too soon?
 
winkleweizen said:
Idk man, I think it all depends. I know a few people who didnt do aways and both matched number 1 on their list and are super happy. I think an away is good for 3 reasons. 1) can help you figure out what types of programs you want to apply to. 2) LORs from them are probably more reputable than at your home. 3) Can help you get in at that particular program.
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All good points. If you're not able to do an away rotation then make sure you have a good reason for it!
 
emoregon said:
There is one thing that I do think is important. When you interview at a location, it's great to mention your ties to the area but don't make that your main selling point to the program. I can't tell you how many applicants have told me how much they loved Portland, grew up here, want to live here, etc. I know this. That is why you are applying to OHSU. Tell me something that you like about our program. Then I know you have done your research and are interested in the residency, not being on a Portlandia episode.

Are you into something outside of residency? Make sure your locations have this. I would go nuts if I couldn't go hiking, skiing, or kayaking so I went somewhere where I could do this. If you are a dead set of a location to live in, it helps to do residency there. !
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I've never really understood this argument. There are plenty of people on here who say that all the programs in the country are very good quality and will train the residents there very well. With that in mind, why is it so frowned upon for an applicant to really be attracted to a program b/c of the city that it is in or the environment that surrounds it? If you took OHSU and placed it in Fargo, ND it would attract a completely different group of applicant and residents.

I would venture to guess that the #1 factor for most of the applicants who choose to rank OHSU, UW, Denver, Utah, etc as their top choice did so b/c of the city that the program is in. After interviewing at all of these programs, I can honestly say that they all attract great residents and seem to put out great graduates.

I think the city and the "vibe" of the program are the two most important factors for me when deciding how I rank the programs that I have interviewed it. Maybe that's just me, but I think that is the secret recipe for me to be happy and achieve balance during residency (as you said, you would go nuts if you couldn't ski, hike, kayak, etc with such convenience!).

:D
 
Lanolin said:
I've never really understood this argument. There are plenty of people on here who say that all the programs in the country are very good quality and will train the residents there very well. With that in mind, why is it so frowned upon for an applicant to really be attracted to a program b/c of the city that it is in or the environment that surrounds it? If you took OHSU and placed it in Fargo, ND it would attract a completely different group of applicant and residents.

I would venture to guess that the #1 factor for most of the applicants who choose to rank OHSU, UW, Denver, Utah, etc as their top choice did so b/c of the city that the program is in. After interviewing at all of these programs, I can honestly say that they all attract great residents and seem to put out great graduates.

I think the city and the "vibe" of the program are the two most important factors for me when deciding how I rank the programs that I have interviewed it. Maybe that's just me, but I think that is the secret recipe for me to be happy and achieve balance during residency (as you said, you would go nuts if you couldn't ski, hike, kayak, etc with such convenience!).

:D
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Sometimes you just have to play the game. I mean, when asked why I wanted to go to program x? I would always mention the region that the program was in. I would also talk up the program mentioning things like the acuity, diversity, volume, curriculum, teaching, or anything unique about that given program.
 
winkleweizen said:
Sometimes you just have to play the game. I mean, when asked why I wanted to go to program x? I would always mention the region that the program was in. I would also talk up the program mentioning things like the acuity, diversity, volume, curriculum, teaching, or anything unique about that given program.
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There really aren't huge difference between the "top" programs around the country. While county programs may have a more diverse patient population or the 'underserved" patient, when you look at academic places I don't think there is a huge difference in what you mentioned above between places like OHSU, Davis, Stanford, Denver, UCLA, Vandy, UTSW, etc.

But I do agree with you that it's good to have some reason other than the outdoor activities or city activities for liking a program, and at the same time I do think it's a shame that you can't just be totally honest and say that you are happiest in x, y, z due to the environment, city, and COL in the area. After all, most of the faculty stayed in the area or migrated there after training for one main reason....

If I had to go to residency in NYC I would be depressed beyond all belief. Same with U of Nebraska. Some places offer great training, diversity, teaching, etc and aren't even on my radar b/c of where they are.
 
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