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Definitely a lot harder than for a US grad. But its not impossible. If you look at SGU's match list, you will find some grads who matched into emergency medicine. Make sure you rock Step 1 and Step 2, impress your attendings on clinical rotations, and get awesome letters of recommendation, especially one from an ER attending.
 
I second what Top Gun said with the addition of getting at least one EM SLOR (standardized letter of recommendation) from an academic EM department. You can download a copy of the SLOR form here.

Joining ACEP/EMRA is also a good idea and more power to you if you're involved. SAEM and AAEM are other EM organizations that you can join, too. At the least, I would join ACEP since it's the largest EM organization. (EMRA is free once you join ACEP but you still have to sign up for it.) At the least, through these organizations you'll get an idea of the issues and research in emergency medicine.

Getting involved in extra-curricular activities and/or leadership could help you out as well. EM-related research certainly can't hurt either. Although, I will have to admit that I never did any research.
 
Need gooooood scores step 1, 2, pass CS ....personality means alot...I know of a buddy that got an EM residency and he was the first AUC student this school ever accepted as a resident...in the setion that says "welcome our 2007 incoming class", he's listed as AUC, then there is UNC-Chapel Hill, Unv. of Cinn, Georgetown....again, rocking scores is the answer!!🙂
 
Residency appointments last year:

AUC:
Emergency Medicine - (8)

Earl K Long Medical Center, LA
Louisiana State University Health Sciences Center, LA - 2
LSU- New Orleans, LA
University of Mississippi Medical Center, MS - 2
St. John Hospital and Medical Center, MI
St. Vincent Mercy Medical Center, OH

Ross:

Emergency Medicine
Albert Einstein Medical Center – Philadelphia, PA
Brooklyn Hospital Center – Brooklyn, NY
Earl K. Long Medical Center – Baton Rouge, LA
Saint John Hospital – Detroit, MI
Stony Brook Teaching Hospitals – Stony Brook, NY
Synergy Medical Education Alliance – Saginaw, MI
University Hospital – Jackson, MS
University of Connecticut Health Center – Farmington, CT
University of Medicine and Dentistry of New Jersey - New Jersey Medical Center – Newark, NJ
University of Puerto Rico – San Juan, Puerto Rico
University of South Florida College of Medicine – Tampa, FL
Wayne State University/Detroit Medical Center – Detroit, MI

SGU had 18 people match: http://www.sgu.edu/ERD/ResidPost.nsf/BYPGY?OpenView&RestrictToCategory=PGY1&Count=-1

Saba had 2 people match:
http://saba.edu/residency_match.php

It is important to remember to keep perspective.
Saba and AUC accept less people than SGU and Ross per year.
 
....personality means alot...

This is particularly true of EM. Unlike other specialties where the attending may only see you for two or three hours in the day. EM residents work with EM attendings, nurses, and other staff side-by-side day or night. Naturally, programs are going to want to bring in people who they think they will like working with.

And you may notice that EM residents and attendings (and even with the nurses at some programs) get together outside of work more often than in most other specialties. Helps if you play well with others.🙂
 
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