For any DOs applying EM: Here my experience/advice (recently matched)

[Dr.Bruh]

Posting an update on my season bc I think future applicants (particularly those who feel like underdogs) can hopefully learn from it to strategize for next year.

Specialty: EM

Bio: DO 22x/23x 55x/59x. Bottom half pre-clinical class rank (top 1/3 clinical rank tho). Honored 2 Shelfs (Psych, Surg)

Letters: 1 eSLOE, 1 Subspecialty SLOE (ultrasound), 2 non residency SLOEs (community EDs my home program lets us rotate at).

Applied: 78 (too many. Was gunna apply 50 but with COVID I got spooked increased)

Invites/Rejections/Waitlist/Cancelled: 27 invites, 11 rejections, 2 waitlists, 38 ghosts

• 15 Community
• 12 University/County (mostly mid-tier, 1 Top 5 program)
• 4 of these were former DO programs (didn't apply too many of these bc I didn't want to do 4 years)
• 2 From the programs I rotated at.
• 8 Invites from programs I networked with(Attending socials, Contacting residents, EMRA Residency fair etc).

Letters of Interest:

• Sent 10 (Sent to any program that if I was offered an invite I would rank in top 1-5)
• 3 invites post LOI
• 2 Waitlists post LOI, ghosted by the rest.

Invite Timeline:

• I got the majority (17) in Oct/November, another 6 in December and 4 in January.

Cancelled: 11. ranks = 16 (Feel bad bc I planned to rank 12-15 but I got 2-3 invites in Jan that were in my top 5 and already went on my other interviews. I would have cancelled a few more if I got those ones earlier)

Interview distribution:

• 14 Midwest/North (included Chicago/Michigan/Minnesota in this)
• 4 Northeast (NY/NJ) (I got the least amount of love here relative to the number of apps I applied to in this region)
• 8 South/Southeast (literally never even stepped foot in most of these states so was surprised to get any offers from here)
• 1 West coast/PNW (only applied to 2-3 programs here)

Application Strategy:

• So going in a was just praying to get at least 10-12 invites and wasn't feeling confident as I felt very average/below average stat-wise. So I applied to 10-15ish programs I considered safeties. Obvi there is no formal definition of a "safety" program, but I considered any brand new program former DO program in my geographic region a safety . I tried to make close to 1/2 of them in my region (Midwest/South/North), and did not apply to very many coast programs (mainly bc I didn't want to go there). I also didn't apply to any program that didn't have at least on DO in each class (or if they had a class without a DO they at least had one in all others). I also identified programs i had a "good shot" at based on geography, number of DOs, etc. Here's my interview yield based on those classifications I made based on my app:

- Safety programs (9): 6/9
- Good shot programs (14): 7/14
- Top choices (10): 4/10
- All others (45): 10/45

• - As you can see its kind of a crapshoot but I definitely think being able to accurately understand your competitiveness and identify programs that fit with that is crucial to getting a comfortable enough amount of invites.
• In hindsight I would have applied to more "top" programs. As I knew many DOs in just my class who got interviews at top places (even places that have never taken a DO), and now that its post match Im seeing DOs in many top/Ivy EM programs this year. So for those applying this year shoot your shot!

MATCHED: My number 1!

• So this program I knew before the cycle if I was lucky enough to get an interview it would be my number 1.
• I interviewed on the last day the had interviews which was not even a date they had originally but later added in the interview cycle. Got my invite in early jan. I had basically given up hope on this program until then
• I did send them a Letter of Intent saying im ranking them number 1. NO RESPONSE
• Basically, don't let when you interview or response to an email mess with your head.

What I think worked/helped me:
1.) SLOEs

• This was by far the biggest and most obvious factor. My letters were mentioned in every single interview I had. Was told by one that by SLOE and Subspecialty SLOEs were both Honors.
• Idk what was all in my SLOEs but I think being likeable and someone who everyone at the programs thinks is nice/fun and would want to work with is much more important that knowledge base. I dont' think I crushed my auditions in terms of nailing every pimp question, but based on my interviews the letters seem to focus on my personality, being well likely by faculty and staff, and looking eager to be there and that I enjoyed all my shifts.

2.) Perceived commitment to the specialty and ED experience

• This also came up on most of my interviews. I worked in the ED for 3 years in undergrad.
• Was involved with EM leadership (EMRA, ACEP etc), Attending a national EM conference, published articles for EM magazines/websites.
• I was lucky enough that despite COVID I was able to go into the application cycle having 5 EM rotations (3 non-residency electives I did 3rd year, my audition, and US rotation). This helped me feel pretty comfortable in the ED.

3.) Networking

• My school did not have a home EM program/department so I used EMRA to assign me an EM resident mentor as an M1 (who was a grad from my school/DO) and I used him periodically throughout med school for advise etc.
• Once auditions were cancelled I realized that I was not going to be able to rotate at my top places and as an average DO I knew I had to get noticed somehow. So I was pretty active on social media, zoom stuff, contacted DO residents at programs I was interested in (literally just asking them If based on my app if I would even have a shot). This seemed to pay off pretty big for me.
• I literally got my US rotation from twitter so I recommend making a professional med student twitter account. EM programs are very active on there and with likely virtual interviews again this year they are using social media a lot more as a recruitment tool.

4.) Other things that came in clutch

• My hobbies and interest section
  
  • DO NOT SKIMP ON THIS. This was talked about in every interview. I do have other hobbies (guitar, music on spotify, did improv comedy etc).
  • I literally listed all of my fav Netflix/Hulu shows and it was a talking point a lot. I'd be quoting Arrested Development, The Office, or talking Star Trek with random interviewers. (know your audience tho, I put things on there that I knew would seem "normal" to 99% of people)
• Working in the service industry
  
  • I worked at bar for 4 years (and I maintain that the skills from this job translated better to me working in the ED than any other job I had).
  • I was told by multiple interviews that they either try to find applicants who have worked in the service/food industry. 2 programs told me its an extra point they have on their app scoring system.
  • I knew a few friends who left out their service jobs on their apps. If you're applying EM DO NOT DO THIS. Its valued.

TLDR:

- Building an accurate understanding of your true competitiveness (which I think many people miscalculate) and identify programs who typically interview/rank applicants of similar competitiveness is key in my opinion. SLOEs, networking, and being well rounded very important.

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[Cath Up]

Posting an update on my season bc I think future applicants (particularly those who feel like underdogs) can hopefully learn from it to strategize for next year.

Specialty: EM

Bio: DO 22x/23x 55x/59x. Bottom half pre-clinical class rank (top 1/3 clinical rank tho). Honored 2 Shelfs (Psych, Surg)

Letters: 1 eSLOE, 1 Subspecialty SLOE (ultrasound), 2 non residency SLOEs (community EDs my home program lets us rotate at).

Applied: 78 (too many. Was gunna apply 50 but with COVID I got spooked increased)

Invites/Rejections/Waitlist/Cancelled: 27 invites, 11 rejections, 2 waitlists, 38 ghosts

• 15 Community
• 12 University/County (mostly mid-tier, 1 Top 5 program)
• 4 of these were former DO programs (didn't apply too many of these bc I didn't want to do 4 years)
• 2 From the programs I rotated at.
• 8 Invites from programs I networked with(Attending socials, Contacting residents, EMRA Residency fair etc).

Letters of Interest:

• Sent 10 (Sent to any program that if I was offered an invite I would rank in top 1-5)
• 3 invites post LOI
• 2 Waitlists post LOI, ghosted by the rest.

Invite Timeline:

• I got the majority (17) in Oct/November, another 6 in December and 4 in January.

Cancelled: 11. ranks = 16 (Feel bad bc I planned to rank 12-15 but I got 2-3 invites in Jan that were in my top 5 and already went on my other interviews. I would have cancelled a few more if I got those ones earlier)

Interview distribution:

• 14 Midwest/North (included Chicago/Michigan/Minnesota in this)
• 4 Northeast (NY/NJ) (I got the least amount of love here relative to the number of apps I applied to in this region)
• 8 South/Southeast (literally never even stepped foot in most of these states so was surprised to get any offers from here)
• 1 West coast/PNW (only applied to 2-3 programs here)

Application Strategy:

• So going in a was just praying to get at least 10-12 invites and wasn't feeling confident as I felt very average/below average stat-wise. So I applied to 10-15ish programs I considered safeties. Obvi there is no formal definition of a "safety" program, but I considered any brand new program former DO program in my geographic region a safety . I tried to make close to 1/2 of them in my region (Midwest/South/North), and did not apply to very many coast programs (mainly bc I didn't want to go there). I also didn't apply to any program that didn't have at least on DO in each class (or if they had a class without a DO they at least had one in all others). I also identified programs i had a "good shot" at based on geography, number of DOs, etc. Here's my interview yield based on those classifications I made based on my app:

- Safety programs (9): 6/9
- Good shot programs (14): 7/14
- Top choices (10): 4/10
- All others (45): 10/45

• - As you can see its kind of a crapshoot but I definitely think being able to accurately understand your competitiveness and identify programs that fit with that is crucial to getting a comfortable enough amount of invites.
• In hindsight I would have applied to more "top" programs. As I knew many DOs in just my class who got interviews at top places (even places that have never taken a DO), and now that its post match Im seeing DOs in many top/Ivy EM programs this year. So for those applying this year shoot your shot!

MATCHED: My number 1!

• So this program I knew before the cycle if I was lucky enough to get an interview it would be my number 1.
• I interviewed on the last day the had interviews which was not even a date they had originally but later added in the interview cycle. Got my invite in early jan. I had basically given up hope on this program until then
• I did send them a Letter of Intent saying im ranking them number 1. NO RESPONSE
• Basically, don't let when you interview or response to an email mess with your head.

What I think worked/helped me:
1.) SLOEs

• This was by far the biggest and most obvious factor. My letters were mentioned in every single interview I had. Was told by one that by SLOE and Subspecialty SLOEs were both Honors.
• Idk what was all in my SLOEs but I think being likeable and someone who everyone at the programs thinks is nice/fun and would want to work with is much more important that knowledge base. I dont' think I crushed my auditions in terms of nailing every pimp question, but based on my interviews the letters seem to focus on my personality, being well likely by faculty and staff, and looking eager to be there and that I enjoyed all my shifts.

2.) Perceived commitment to the specialty and ED experience

• This also came up on most of my interviews. I worked in the ED for 3 years in undergrad.
• Was involved with EM leadership (EMRA, ACEP etc), Attending a national EM conference, published articles for EM magazines/websites.
• I was lucky enough that despite COVID I was able to go into the application cycle having 5 EM rotations (3 non-residency electives I did 3rd year, my audition, and US rotation). This helped me feel pretty comfortable in the ED.

3.) Networking

• My school did not have a home EM program/department so I used EMRA to assign me an EM resident mentor as an M1 (who was a grad from my school/DO) and I used him periodically throughout med school for advise etc.
• Once auditions were cancelled I realized that I was not going to be able to rotate at my top places and as an average DO I knew I had to get noticed somehow. So I was pretty active on social media, zoom stuff, contacted DO residents at programs I was interested in (literally just asking them If based on my app if I would even have a shot). This seemed to pay off pretty big for me.
• I literally got my US rotation from twitter so I recommend making a professional med student twitter account. EM programs are very active on there and with likely virtual interviews again this year they are using social media a lot more as a recruitment tool.

4.) Other things that came in clutch

• My hobbies and interest section
  
  • DO NOT SKIMP ON THIS. This was talked about in every interview. I do have other hobbies (guitar, music on spotify, did improv comedy etc).
  • I literally listed all of my fav Netflix/Hulu shows and it was a talking point a lot. I'd be quoting Arrested Development, The Office, or talking Star Trek with random interviewers. (know your audience tho, I put things on there that I knew would seem "normal" to 99% of people)
• Working in the service industry
  
  • I worked at bar for 4 years (and I maintain that the skills from this job translated better to me working in the ED than any other job I had).
  • I was told by multiple interviews that they either try to find applicants who have worked in the service/food industry. 2 programs told me its an extra point they have on their app scoring system.
  • I knew a few friends who left out their service jobs on their apps. If you're applying EM DO NOT DO THIS. Its valued.

TLDR:

- Building an accurate understanding of your true competitiveness (which I think many people miscalculate) and identify programs who typically interview/rank applicants of similar competitiveness is key in my opinion. SLOEs, networking, and being well rounded very important.

How many hobbies and interests did you list? For example, on my CV I have 3. Feel it is probably overkill to list more. Is that not the case with ERAS?

 

[Dr.Bruh]

How many hobbies and interests did you list? For example, on my CV I have 3. Feel it is probably overkill to list more. Is that not the case with ERAS?

For ERAS is just an open text box for "Hobbies/Interest" with not a large character limit. I think I put like 5-6 things and 1-2 sentence description for each. The description is important IMO bc for EM most of your interview convo starters are going to come from this portion of your app. I had 1 author pubs and case reports etc and not once did anything research related come up lol. Not even at the bigger academic programs. But if you only have 3 thats fine! Dont just list stuff just to list it. But take those three things and put effort into describing them and being able to discuss them during interviews bc they will ask.

 

[Sardonix]

Did you or did you not list an IPA as your favorite microbrew? Is a membership in a rock climbing gym still a vital requirement or do you think proof of Soul Cycle attendance before school each AM will do it? Is Parkour still controversial or now a mainstay for EM activities?

Okay, I'll stop kidding. Congrats on the success and your #1. For real though, what's the atmosphere like with EM this year? I have friends in EM residencies and there are some DARK clouds on the horizon. Did programs talk about job outlooks and current trends or did they gloss over that?

 

[Rekt]

Echoing what Sardonix said. There was a large summit between all of the EM organizations yesterday and this Friday. A brief leak of preliminary data shows a 7600 oversupply of EM physicians by 2030. You can bet they tried to make these numbers look as good as possible. (staffing every micro/rural hospital with ABEM). I'd be on the lookout for what happens after this Friday before anyone considers EM.

 

[Darrow O'Lykos]

• I did send them a Letter of Intent saying im ranking them number 1. NO RESPONSE

pain


In all seriousness, congratulations and thank you for this helpful post! As someone likely going the EM route, I appreciate this!

 

[Dr.Bruh]

Did you or did you not list an IPA as your favorite microbrew? Is a membership in a rock climbing gym still a vital requirement or do you think proof of Soul Cycle attendance before school each AM will do it? Is Parkour still controversial or now a mainstay for EM activities?

Okay, I'll stop kidding. Congrats on the success and your #1. For real though, what's the atmosphere like with EM this year? I have friends in EM residencies and there are some DARK clouds on the horizon. Did programs talk about job outlooks and current trends or did they gloss over that?

Everyone has their deal breakers and reasons/motivations that guide what they want in life. For me, even if the salary for ED was 200k you’d bet your ass I’d still do it. You couldn’t pay me enough to take a non-shift work based job with call or rounds. I literally would rather leave medicine than do anything like that haha. Also, idk what happened in Rekts life but he/she literally infiltrates any thread on this site where the term “EM” is even tangentially referenced to just flood it with doomsday talk. If anybody has been on this site long enough you’ll realize there is one thing that is certain. SDN doomsayers are almost ALWAYS wrong. Literally almost 100% of the time. When I was premed I remember with the merger it was “DO is the new primary care degree” and “no more DOs will match specialties now”. Literally the exact opposite happened lol. No doubt EM is in a rough place and I’m gunna be keeping an eye on the data. It’s not roses. I doubt it apocalyptic like Rekt suggest. The truth is likely somewhere in the middle. As is the case with most things in life. But for me I know I would be miserable doing anything else. Be very cautious altering the trajectory of your life based on anonymous SDN doomsayers lol.

but to answer your question. Every interview this was discussed. N=1 but every program I interviewed with the residents all echoes that the job market was right and difficult bc covid decreasing volumes but they all had secured jobs or taken a fellowship. There was 1-2 programs I think that has 1 grad or so still looking but it was early in the interview cycle (nov) so maybe they did find jobs idk.

 

[Rekt]

Everyone has their deal breakers and reasons/motivations that guide what they want in life. For me, even if the salary for ED was 200k you’d bet your ass I’d still do it. You couldn’t pay me enough to take a non-shift work based job with call or rounds. I literally would rather leave medicine than do anything like that haha. Also, idk what happened in Rekts life but he/she literally infiltrates any thread on this site where the term “EM” is even tangentially referenced to just flood it with doomsday talk. If anybody has been on this site long enough you’ll realize there is one thing that is certain. SDN doomsayers are almost ALWAYS wrong. Literally almost 100% of the time. When I was premed I remember with the merger it was “DO is the new primary care degree” and “no more DOs will match specialties now”. Literally the exact opposite happened lol. No doubt EM is in a rough place and I’m gunna be keeping an eye on the data. It’s not roses. I doubt it apocalyptic like Rekt suggest. The truth is likely somewhere in the middle. As is the case with most things in life. But for me I know I would be miserable doing anything else. Be very cautious altering the trajectory of your life based on anonymous SDN doomsayers lol.

but to answer your question. Every interview this was discussed. N=1 but every program I interviewed with the residents all echoes that the job market was right and difficult bc covid decreasing volumes but they all had secured jobs or taken a fellowship. There was 1-2 programs I think that has 1 grad or so still looking but it was early in the interview cycle (nov) so maybe they did find jobs idk.

Lol we'll see man. Don't forget you have 3-4 years before you find a job. And you know nothing about EM yet. Med students are shielded from 90% of true EM. I say this as someone who did five aways. You haven't even worked a real shift. Come back 3-4 years from now saying you'll take 100k a yr to do EM. That's only a harmful thought to the entire field of medicine. I love EM but would not do it for mid level pay.

 

[Dr.Bruh]

Lol we'll see man. Don't forget you have 3-4 years before you find a job. And you know nothing about EM yet. Med students are shielded from 90% of true EM. I say this as someone who did five aways. You haven't even worked a real shift. Come back 3-4 years from now saying you'll take 100k a yr to do EM. That's only a harmful thought to the entire field of medicine. I love EM but would not do it for mid level pay.

Bro I worked in the ED for 3.5 years prior to med school. Also I did 5 EM rotations in med school (currently on my 6th). My DO school has community ED rotations ( no residency) and I was able to do 3 of those as a 3rd year (on another one currently), one audtion, and one ultrasound rotation. Also you’re out of your mind if you think EM salary is going to 100k in 3-4 years. You instantly lose all credibility with crazy statements like that. Lol

 

[FutureDoctor5000]

Lol we'll see man. Don't forget you have 3-4 years before you find a job. And you know nothing about EM yet. Med students are shielded from 90% of true EM. I say this as someone who did five aways. You haven't even worked a real shift. Come back 3-4 years from now saying you'll take 100k a yr to do EM. That's only a harmful thought to the entire field of medicine. I love EM but would not do it for mid level pay.

wth are you talking about? THERE IS NO doctor in this world who is working for 100k let alone in the ED, average salary is like 350k...... lol sure it will go down in the short term due to covid and residency expansion but you are engaging in some serious hyperbole.... there are still jobs out in the boonies that pay very very well..

 

[Dr.Bruh]

Is EM even competitive?

Historically (like within the last 10 years) its been considered “moderately competitive”. More competitive than primary care, but not competitive as surgical sub specialties. Somewhere in between (think like Rads, anesthesia, OB) based on step scores averages and match rates.

 

[Dr.Bruh]

Congrats man! Other than scores and number of SLOEs it looks like we both had pretty similar experiences with scribing and restaurant work, even down to number of invites and ranks haha. Unfortunately unlike you I fell down my list, even past the two programs I did subIs at, which was wild because at all my interviews atleast one person commented about how much one of the programs loved me and read some of the great comments on the SLOE.

To add to the EM (and more broadly tbh) advice, treat every program you interview at as if they’re your #1, and LIE LIE LIE about what your career goals are and the kind of practice environment you want to go to, and come up with 3-4 bull**** reasons related to the area about why that program is just perfect for you. I made the mistake of opening up to programs about being nervous about my relationship with my SO during residency because they were x distance away at another program, so in retrospect I think it came off as me not really being committed to their specific program. I also told them all, regardless of whether they were community, academic, or county, that I wanted to practice in a semirural environment with a primarily community-focused career and part-time academics.

I thought being open would win me points since it’s always been positive in real life, but I was so wrong. Tell the interviewers what they want to hear.

First off congrats on the match. It was a tough year and making it to this point is an accomplishment. That is a tough situation tho for sure. Luckily I was a single dude trying to go to a brand new place (not really close with my family) and I was honestly stuck between wanting to do community vs academic. So I was honest on interviews but it worked bc I I could just talk up the city and then say I’m not sure what I want to do. I do agree in a way. There’s so many applicants you don’t want to give your dream program any reason at all to doubt your app or reasons for coming there. I really did treat each program like my number Bc I was scared I wouldn’t get many interviews in the first place and was just happy any of these places wanted to interview me.

 

[sylvanthus]

Welcome to the sinking ship.

 

[Prehealth1011]

I’m an incoming IM resident and really enjoyed reading this. Congrats on your interviews that’s an incredible yield

 

[getfat]

Just want to emphasize the "hobbies" section on your ERAS application. If interviewers ran out of questions to ask they used it as talking points every-time.

If you are going to list a sports team, please at least know how the team is doing haha. Maybe know a couple players.

 

[Postictal Raiden]

I scratch my head at the EM attendings/residents who keep discouraging students from pursuing the field. Are they too oblivious to realize that the spots will continue to fill regardless of how bad the job market gets?

The only thing that will change is that the spots will be filled by a lower caliber applicants instead of attracting the smart ones, who can potentially rescue the field and help it evolve.

 

[Cath Up]

I scratch my head at the EM attendings/residents who keep discouraging students from pursuing the field. Are they too oblivious to realize that the spots will continue to fill regardless of how bad the job market gets?

The only thing that will change is that the spots will be filled by a lower caliber applicants instead of attracting the smart ones, who can potentially rescue the field and help it evolve.

If you were an attending and saw a field where a student would likely have difficulty finding a job that they would be happy in, wouldn't you bring that up?

 

[Lawpy]

Welcome to the sinking ship.

Lmao, that was blunt

 

[Lawpy]

I scratch my head at the EM attendings/residents who keep discouraging students from pursuing the field. Are they too oblivious to realize that the spots will continue to fill regardless of how bad the job market gets?

The only thing that will change is that the spots will be filled by a lower caliber applicants instead of attracting the smart ones, who can potentially rescue the field and help it evolve.

They discourage because they don't want their students to waste few years of SLOE hassle/aways and torturous residency only to end up unemployed

 

[Lexdiamondz]

I scratch my head at the EM attendings/residents who keep discouraging students from pursuing the field. Are they too oblivious to realize that the spots will continue to fill regardless of how bad the job market gets?

The only thing that will change is that the spots will be filled by a lower caliber applicants instead of attracting the smart ones, who can potentially rescue the field and help it evolve.

If I know a building is rigged to blow w dynamite and I don't tell you & you get blown up, that's on me.

If I warn you and you end up a pile of charcoal anyway, that's on you.

Giving med students the unfiltered truth is the right thing to do. What yall do with that information is your business, but yall cant say nobody warned you

 

[Postictal Raiden]

If I know a building is rigged to blow w dynamite and I don't tell you & you get blown up, that's on me.

If I warn you and you end up a pile of charcoal anyway, that's on you.

Giving med students the unfiltered truth is the right thing to do. What yall do with that information is your business, but yall cant say nobody warned you

Hyperbole much?

 

[Lexdiamondz]

Hyperbole much?

a quarter of EM seniors don’t have jobs lined up and it’s mid-April...

no, this isn’t hyperbole. Not when you have a quarter million dollars of loans and still need to make rent and feed yourself/your family

 

[Dr.Bruh]

a quarter of EM seniors don’t have jobs lined up and it’s mid-April...

no, this isn’t hyperbole. Not when you have a quarter million dollars of loans and still need to make rent and feed yourself/your family

Gunna need a source for that? Bc on all my interviews there was only one program where seniors still had people looking and that was back in Nov.

 

[Lexdiamondz]

Gunna need a source for that? Bc on all my interviews there was only one program where seniors still had people looking and that was back in Nov.

They served on the COVID-19 front lines. Now these emergency medicine doctors can't find jobs.

Usually, emergency medicine residents fend off recruiters. This year, they’re barely getting calls back. Here's how COVID-19 has upended EM job prospects.

www.aamc.org

also remember that "employment" also includes people finding fellowships & part time gigs.

frankly, what you experienced on the interview trail is irrelevant - no program is going to be 100% up front on their grads having to take part time gigs or delaying graduation for fellowships to try and ride out the bad economy.

by all means, believe what you want. for both our sakes I hope it actually isnt as bad as projected but ACEP (which is notoriously head in the sand about these things) is projecting a 9k EM physician surplus by 2030 and thats only 5-6 years after you graduate.

 

[Rekt]

They served on the COVID-19 front lines. Now these emergency medicine doctors can't find jobs.

Usually, emergency medicine residents fend off recruiters. This year, they’re barely getting calls back. Here's how COVID-19 has upended EM job prospects.

www.aamc.org

also remember that "employment" also includes people finding fellowships & part time gigs.

frankly, what you experienced on the interview trail is irrelevant - no program is going to be 100% up front on their grads having to take part time gigs or delaying graduation for fellowships to try and ride out the bad economy.

by all means, believe what you want. for both our sakes I hope it actually isnt as bad as projected but ACEP (which is notoriously head in the sand about these things) is projecting a 9k EM physician surplus by 2030 and thats only 5-6 years after you graduate.

Also keep in mind it's not going zero to 10k from 2029 to 2030. Honestly with a 10k number that surplus means essentially anyone starting residency this July is will be entering a completely full market.

 

[AlbinoHawk DO]

Don't worry, soon all you'll need to match is a pulse as there will be no jobs for you

 

[getfat]

Gunna need a source for that? Bc on all my interviews there was only one program where seniors still had people looking and that was back in Nov.

Completed my EM core in jan at a community EM program. There was a significant portion of upcoming grads that still didn't have a job. 4-5 out of a 10-resident class were still unemployed.

Of note, I do remember that some of these residents restricted their job search to specific states or east coast. Apparently theres jobs but not in areas that new grads wanted. Didn't apply EM so i have no idea where but i'm gonna assume somewhere midwest.

 

[Dr.Bruh]

Completed my EM core in jan at a community EM program. There was a significant portion of upcoming grads that still didn't have a job. 4-5 out of a 10-resident class were still unemployed.

Of note, I do remember that some of these residents restricted their job search to specific states or east coast. Apparently theres jobs but not in areas that new grads wanted. Didn't apply EM so i have no idea where but i'm gonna assume somewhere midwest.

Yeah I’m from rural Midwest and have no problem returning. Currently know of a position open near my home time for 450k and 12 shift a month. Lots of people just unwilling to go to these places. Which is understandable but for me if lived here my whole life so if that’s all that’s available when I’m out bet your ass I’m going.

luckily my program was able to get all their grads jobs (some went fellowship) and alternative for me is to go as hard as I can in residency and try to land a faculty position after graduation (2 grads at my program able to snag faculty spots this year).

 

[zero0]

I hate to rain on your parade and your accomplishments thus far but honestly this thread is just so tone-deaf it's infuriating. The one and only advice we should be passing along to future residents is stay the hell away from EM.

Even those few jobs in rural nowhere will be gone in the next few years. EM is in dire straits already and the future looks even worse, and that's per the ACEP. I just don't see it turning around anytime. You'd have to convince dozens of HCA residencies to close down and stop profiting off cheap resident labor. Never gonna happen. Take a look around these boards and you'll see one story after another of recent grads struggling. Feel free to live in denial but do not come on here telling people everything is okay.

 

[Dr.Bruh]

I hate to rain on your parade and your accomplishments thus far but honestly this thread is just so tone-deaf it's infuriating. The one and only advice we should be passing along to future residents is stay the hell away from EM.

Even those few jobs in rural nowhere will be gone in the next few years. EM is in dire straits already and the future looks even worse, and that's per the ACEP. I just don't see it turning around anytime. You'd have to convince dozens of HCA residencies to close down and stop profiting off cheap resident labor. Never gonna happen. Take a look around these boards and you'll see one story after another of recent grads struggling. Feel free to live in denial but do not come on here telling people everything is okay.

Listen to yourself for a second tho. The specialty is in crisis (which I agree) so instead of offering solution you think having everyone abandon it is the answer? Here's the reality: those HCA places arent just opening EM residencies they are opening Gen surg, anesthesia, psych, peds etc. None of these specialties are safe and in 10 years it will be one of them that everybody says to run away from. If every time this happens you convince the medical community to abandon the specialty you back all doc into a corner of the most narrow scope of practice we have ever seen. This itself will perpetuate midlevel encroachment. Where med students and docs leave midlevels will fill in the gaps. Literally its people like you who will make scope creep worse.

Also you just kinda made up everything you based your argument on. Who said everything was ok? Nobody is saying that who are you even talking to? I gave my reasons for staying bc I literally would rather quit medicine than do anything else (especially IM or surg). If you can see yourself happy in another field you should seriously consider it.

 

[FrkyBgStok]

I gave my reasons for staying bc I literally would rather quit medicine than do anything else (especially IM or surg). If you can see yourself happy in another field you should seriously consider it.

This comment right here is the crux of the problem. Every single med student says "I would rather leave" or "I couldn't do anything else" as justification for choosing EM despite all the evidence that you shouldn't, but you aren't listening to all your EM predecessors that say that they were the same and they were lying to themselves. I am in peds EM and it is completely a different job, but I have a monthly conversation with a different EM resident who said they convinced themselves they couldn't love anything else and they regret not doing something else. And year after year after year after year after year there is another crop of medical students saying that they are different.

and they aren't. now you have an entire specialty filled with residents looking to get out of their specialty in one way or another. not attendings jaded by years of practice and who have grown tired of the shift changes, residents. I do believe that some people really are those lifelong EM people, but they are extraordinarily rare. but, like all the jaded residents and attendings that said the same thing you are saying now, I am sure you are the one that is different.

all in all, it doesn't matter what people say, people are going to do what they want and listen to the things that reinforce their ideas. that's fine and I am sure I am no different. it is what it is.

 

[Dr.Bruh]

This comment right here is the crux of the problem. Every single med student says "I would rather leave" or "I couldn't do anything else" as justification for choosing EM despite all the evidence that you shouldn't, but you aren't listening to all your EM predecessors that say that they were the same and they were lying to themselves. I am in peds EM and it is completely a different job, but I have a monthly conversation with a different EM resident who said they convinced themselves they couldn't love anything else and they regret not doing something else. And year after year after year after year after year there is another crop of medical students saying that they are different.

and they aren't. now you have an entire specialty filled with residents looking to get out of their specialty in one way or another. not attendings jaded by years of practice and who have grown tired of the shift changes, residents. I do believe that some people really are those lifelong EM people, but they are extraordinarily rare. but, like all the jaded residents and attendings that said the same thing you are saying now, I am sure you are the one that is different.

all in all, it doesn't matter what people say, people are going to do what they want and listen to the things that reinforce their ideas. that's fine and I am sure I am no different. it is what it is.

It’s wild how much casual hyperbole people get away with in SDN comments. I understand what you’re saying but you’re anecdote doesn’t translate. At least people I know going EM (my class had 51 EM matches this year) decided late or switched from originally wanting surgery or have some delusion that EM is 90% trauma etc. many many of them considered other things. Also despite the specialty being in crisis the majority are not trying to find a way out. That’s just such hyperbole you lose credibility. The loudest minority shouts on SDN and attending forums and represents a fraction. I’ve been in 3-4 different EDs the past few months and while there is legit concern nobody is trying to get out. None of my classmate or the many income interns i know are looking for exit plans. We are reevaulating what our long term goals are and ready to adapt and ready to advocate for the specialty to prevent this problem from getting worse. The way you try to make it seem like the majority of residents are looking to get out is disingenuous.

Wow, had no clue rural EM pays that well.

i mean with the market these jobs are going to be exceedingly rare if not non existed. But where I was a scribe (rural Midwest) every Ear doc I worked for make 500k

 

[Steve_Zissou]

It’s wild how much casual hyperbole people get away with in SDN comments. I understand what you’re saying but you’re anecdote doesn’t translate. At least people I know going EM (my class had 51 EM matches this year) decided late or switched from originally wanting surgery or have some delusion that EM is 90% trauma etc. many many of them considered other things. Also despite the specialty being in crisis the majority are not trying to find a way out. That’s just such hyperbole you lose credibility. The loudest minority shouts on SDN and attending forums and represents a fraction. I’ve been in 3-4 different EDs the past few months and while there is legit concern nobody is trying to get out. None of my classmate or the many income interns i know are looking for exit plans. We are reevaulating what our long term goals are and ready to adapt and ready to advocate for the specialty to prevent this problem from getting worse. The way you try to make it seem like the majority of residents are looking to get out is disingenuous.

i mean with the market these jobs are going to be exceedingly rare if not non existed. But where I was a scribe (rural Midwest) every Ear doc I worked for make 500k

I wonder if this means that they are correct in not looking for exit plans, or if they are willingly blind to the writing on the wall. Time will tell, I suppose.

 

[DO2015CA]

It’s wild how much casual hyperbole people get away with in SDN comments. I understand what you’re saying but you’re anecdote doesn’t translate. At least people I know going EM (my class had 51 EM matches this year) decided late or switched from originally wanting surgery or have some delusion that EM is 90% trauma etc. many many of them considered other things. Also despite the specialty being in crisis the majority are not trying to find a way out. That’s just such hyperbole you lose credibility. The loudest minority shouts on SDN and attending forums and represents a fraction. I’ve been in 3-4 different EDs the past few months and while there is legit concern nobody is trying to get out. None of my classmate or the many income interns i know are looking for exit plans. We are reevaulating what our long term goals are and ready to adapt and ready to advocate for the specialty to prevent this problem from getting worse. The way you try to make it seem like the majority of residents are looking to get out is disingenuous.

i mean with the market these jobs are going to be exceedingly rare if not non existed. But where I was a scribe (rural Midwest) every Ear doc I worked for make 500k

With all due respect, I frankly don’t care what incoming interns think a job market is. I care what the 3rd years, attendings, and current 2nd years think. They are the ones that have spent a significant time looking into job options. It may well be hyperbole, but they are the ones with real experience. They are the ones looking for jobs.

 

[Ho0v-man]

It’s wild how much casual hyperbole people get away with in SDN comments. I understand what you’re saying but you’re anecdote doesn’t translate. At least people I know going EM (my class had 51 EM matches this year) decided late or switched from originally wanting surgery or have some delusion that EM is 90% trauma etc. many many of them considered other things. Also despite the specialty being in crisis the majority are not trying to find a way out. That’s just such hyperbole you lose credibility. The loudest minority shouts on SDN and attending forums and represents a fraction. I’ve been in 3-4 different EDs the past few months and while there is legit concern nobody is trying to get out. None of my classmate or the many income interns i know are looking for exit plans. We are reevaulating what our long term goals are and ready to adapt and ready to advocate for the specialty to prevent this problem from getting worse. The way you try to make it seem like the majority of residents are looking to get out is disingenuous.

i mean with the market these jobs are going to be exceedingly rare if not non existed. But where I was a scribe (rural Midwest) every Ear doc I worked for make 500k

Dude I’m really happy that you’re happy with your decision. But the outlook for EM is awful. Saying anything else is just at best naive and at worst dishonest. It’s deceptive to those coming after you to be optimistic about EM and that’s a disservice to them.

You were in a thread on the EM forum asking for ways to make yourself marketable in the future and both residents and attendings told you to pick another field. Now you’re acting like you’ve got some insider knowledge they don’t have? A surplus of 9,000 in 2030 is a surplus of ~6-7,000 in 2029. This isn’t a matter of not being able to get a job in a top 10 city or whatever. This field will be a real life hunger games scenario very soon.

I’m not trying to be a jerk. I’m very sorry you and so many others got screwed like this. It’s total BS. But there’s still options for future classes. Don’t mislead them.

 

[DO2015CA]

Dude I’m really happy that you’re happy with your decision. But the outlook for EM is awful. Saying anything else is just at best naive and at worst dishonest. It’s deceptive to those coming after you to be optimistic about EM and that’s a disservice to them.

You were in a thread on the EM forum asking for ways to make yourself marketable in the future and both residents and attendings told you to pick another field. Now you’re acting like you’ve got some insider knowledge they don’t have? A surplus of 9,000 in 2030 is a surplus of ~6-7,000 in 2029. This isn’t a matter of not being able to get a job in a top 10 city or whatever. This field will be a real life hunger games scenario very soon.

I’m not trying to be a jerk. I’m very sorry you and so many others got screwed like this. It’s total BS. But there’s still options for future classes. Don’t mislead them.

Exacty, it’s not like 6-7k EM doctors in 2029 would rather be unemployed than take the small town middle America jobs that you are currently seeing. It’s 9k surplus in the US, not in the coastal cities, its nationwide.

 

[sylvanthus]

No point arguing, anyone that says "I can't see myself doing anything else" is not the type of person who has an open mind, has an imagination, or can be reasoned with. Let him/her crash and burn, the warnings have already been given and are being ignored.

 

[FrkyBgStok]

It’s wild how much casual hyperbole people get away with in SDN comments.

With all due respect, I frankly don’t care what incoming interns think a job market is. I care what the 3rd years, attendings, and current 2nd years think. They are the ones that have spent a significant time looking into job options. It may well be hyperbole, but they are the ones with real experience. They are the ones looking for jobs.

Read this post again. Just because you want to believe it isn’t hyperbole doesn’t mean anything. Your sample is MS4s and attendings who currently have jobs? My sample is 2nd and 3rd year residents applying for and signing to jobs they hate because there is literally nothing else available. Your sample is people who keep saying “nothing else for me” and my sample is 1st and 2nd year residents who say “I am burned out and I wish I chose something else.” And then post after post in your thread and in the EM forums says you are wrong.

Do you honestly think it is hyperbole, or do you just wish it was?

 

[zero0]

Listen to yourself for a second tho. The specialty is in crisis (which I agree) so instead of offering solution you think having everyone abandon it is the answer? Here's the reality: those HCA places arent just opening EM residencies they are opening Gen surg, anesthesia, psych, peds etc. None of these specialties are safe and in 10 years it will be one of them that everybody says to run away from. If every time this happens you convince the medical community to abandon the specialty you back all doc into a corner of the most narrow scope of practice we have ever seen. This itself will perpetuate midlevel encroachment. Where med students and docs leave midlevels will fill in the gaps. Literally its people like you who will make scope creep worse.

Also you just kinda made up everything you based your argument on. Who said everything was ok? Nobody is saying that who are you even talking to? I gave my reasons for staying bc I literally would rather quit medicine than do anything else (especially IM or surg). If you can see yourself happy in another field you should seriously consider it.

I'm not here to argue. I just want to make sure future residents are adequately informed. There will NOT always be jobs in rural America like you keep saying. Your n=1 of that one ED you went to one time where everyone was happy doesn't change the fact that most EM physicians around the country are desperately looking to jump ship to literally anything else. Things most definitely are not ok or ever going to be, no matter how much you like to argue otherwise without saying it in so many words.

I never said I had a solution. There likely is no realistic one. Unfortunately, in healthcare once things swing in the wrong direction they rarely if ever swing back. Simply put EM is dead. Bury it with pathology, rad onc, peds, and nephro, and move on with your lives as best as you can. You have been warned.

 

[DO2015CA]

I'm not here to argue. I just want to make sure future residents are adequately informed. There will NOT always be jobs in rural America like you keep saying. Your n=1 of that one ED you went to one time where everyone was happy doesn't change the fact that most EM physicians around the country are desperately looking to jump ship to literally anything else. Things most definitely are not ok or ever going to be, no matter how much you like to argue otherwise without saying it in so many words.

I never said I had a solution. There likely is no realistic one. Unfortunately, in healthcare once things swing in the wrong direction they rarely if ever swing back. Simply put EM is dead. Bury it with pathology, rad onc, peds, and nephro, and move on with your lives as best as you can. You have been warned.

Except peds and nephro aren’t dead. There are still jobs they’re just poor reimbursement. Their problem is different than rad onc, path, and no EM.

 

[RapidEyeMovementLearning]

Is FM the safer route if someone wants to do some ER work? Some states allow FM trained docs to work in their ER (Arkansas)

 

[DO2015CA]

Is FM the safer route if someone wants to do some ER work? Some states allow FM trained docs to work in their ER (Arkansas)

Absolutely not.. if you want to do ER. With a >9k surplus all ERs will be staffed by BC EM docs. It will be the safer option for a job though. You will be getting clinic jobs though.

 

[Doc Doc Doc Goose]

I hate to rain on your parade and your accomplishments thus far but honestly this thread is just so tone-deaf it's infuriating. The one and only advice we should be passing along to future residents is stay the hell away from EM.

Even those few jobs in rural nowhere will be gone in the next few years. EM is in dire straits already and the future looks even worse, and that's per the ACEP. I just don't see it turning around anytime. You'd have to convince dozens of HCA residencies to close down and stop profiting off cheap resident labor. Never gonna happen. Take a look around these boards and you'll see one story after another of recent grads struggling. Feel free to live in denial but do not come on here telling people everything is okay.

Thank God we have you to enter the thread and save the day and restore our hearing. You’re the first person in this entire thread to comment on the bleak job outlook.

 

[hallowmann]

Clinical faculty at my medical school is ~80 percent young EM trained docs, and I always wondered why : /

Yeah. Its crazy, I'm in the midwest and we have had a significant influx of new EM attendings virtually all from in-house graduating classes, some after having to do a fellowship. People who would normally go out and get jobs with EM practices, now they are working the grind at the University system.

That all said, I honestly don't know what EM is going to look like in 15-20 yrs. Anyone who claims they do is probably wrong. Things change in medicine every 15-20 yrs or so anyway. There was a time when Rad Onc was literally one of the most competitive residencies, you couldn't beg people to go into psych, and EM was the flavor of the decade.

Is the 10-yr outlook for EM bad, yeah, but I'm honestly worried about the 20-30 yr outlook in basically all of medicine. We are flooding the market not just with more residents, but also with tons more midlevels. They are basically exceeding medical graduates every year now when they were a small fraction of them just 10 yrs ago, despite huge expansion (>30%) of US med schools in that same time.

There is an insane demand for bedside nursing, because we are basically burning through people in their early 20s with associates or bachelors degrees, so that the average career length is <5 yrs. We're also telling them that the only way they can not "sell themselves short" is to become NPs.

All these private practices and small community hospitals are floundering (like a lot of smaller businesses) in the setting of COVID, and many docs, nurses, healthcare workers of all stripes are literally burning out and shifting fields, retiring early, or worse. In fact, maybe the thing that makes EM thrive again in the future is the early retirement of a lot of burnt out EM docs.

I don't know what the future of medicine holds but all this stuff scares me sufficiently to be thinking of an exit strategy even early on in my career. Maybe when COVID finally calms down in 2-3 yrs, things will come back, and maybe I'm just burned out, but it looks pretty grim from where I'm standing.

#Medicineisover!!! #sleepdeprivedrant #burnout #doomandgloom #sortakindaalittlebithyperbolic