Getting into EM Residencies - No Sugar coat

[mrmedico]

USMLE Step 1: avg 215
USMLE Step 2: avg 220

GPA/Class rank varies
Have excellent LoRs of course. If you want at shot at a more competitive program and don't have the best scores, rotate there. Make sure if you want to rotate in August, contact them January. Don't take the chance.

For the less competitive applicant who is in the bottom quarter of the class:

USMLE 190-200 (no failed attempts, no step2 score): Apply 40, expect 5-8 interview offers by Dec 1.

USMLE 200-210 (no failed attempts, no step2 score): Apply 40, expect 7-12 interview offers by Dec 1.

USMLE 210-220 (no failed attempts, no step2 score): Apply 40, expect 9-15 interview offers by Dec 1.

-------------------

USMLE 190-200 (no failed attempts, Step2 >220): Apply 40, expect >8 interview offers by Dec 1.

USMLE 200-210 (no failed attempts, Step2 >220): Apply 40, expect >10 interview offers by Dec 1.

USMLE 210-220 (no failed attempts, Step2 >220): Apply 40, expect >15 interview offers by Dec 1.


This is assuming you apply to less competitive programs if you have lower socres and assuming there are no red flags in your application. The data above is solely personal opinion and does not reflect any scientific study or official result. So take it with a grain of salt and use common sense.

---------------

Use SAEM website to eval programs, and look at how many years they got approval for their program.

---------------

The red flag applicant. (Failes Step1 or 2, failed courses, etc.)

Must have strong LoR, strong personal statment, and an explanation for the red flags.

Apply >50 programs

Apply to newer programs, and less "attractive" cities, whatever you take it to be.
(Please note: There are many newer programs out there that are excellent and are enforcing increasingly rigorous standards.)

A home school with an EM residency program is a plus.

Apply as early as possible (when eras opens!)

Have a back up: i.e. internal, family etc. Have both personal statements ready, and LoR from both specialties ready. Make sure you will be happy with your back up.

Do not apply to an EM and say... IM program in the same hospital or to near as programs talk to each other.

Keep your attitude positive. For whatever reason you struggled a bit but now you are ready to move forward. Yes... it will cost a lot more money and a lot more writing but it is much better than the uncertain abyss of scrambling eggs. Have tuff skin as most programs will weed you out. That's just the nature of it. I told you... no sugar coat but it is definetley possible.

If you rotate at a visiting program, be a work-a-holic! Come in early - stay late. Do not give them an excuse to sweep you away. Read 1-2 hours every night on cases you saw. Have pocket books ready to look up cases before presenting. Excuse yourself to the bathroom if you have to and look up something you know you will be pimped on.

When seeing a patient... please find out why are they in the ER and what brought them there, why now, who brought them. Also know that you can not solve all their medical problems in the ER. Don't give a huge long presentation on their OB hystory if they came in for fractured wrist.

When you see the cheif complaint, write down a differential. Make sure to cover lethal things. You need to address these things during your history and physical. If you don't your attending will but it will make you look better. Think of bedside tests, imaging, labs, disposition, etc.

Remember, patient saftey first. Be responsible about the information you present. If they are in distress and you're not sure, get help. If you're in there more than 10-15 minutes, then usually you are taking too long. Be aware that some patients will require more time but generally as a student 10-15 minutes will suffice.

Again, these are only my personal views. Take it with a grain of salt or pepper.

---

Members don't see this ad.

 

[BerkeleyMD]

great post! is it fair to say 230+ on step 1 is competitive for most community based programs or are they all about the same? (i am thinking of smaller california programs)

also, given that EM/IM are so similar is it really that bad if you apply to both at the same place? its not like applying to surgery/psych at the same place.

any advise for the interview day itself?

 

[mrmedico]

In my opinion, a 230+ on step 1 is a competitive score and will allow you to pass the primary elimination round on many programs that have cut offs of 220. Either because they get a lot of applicants, are very competitive, etc... Many programs out there do not have this cut off.

So yes, 230+ is competitive in both academic and community programs. I would emphasize however, that they look at the whole package. But yes, that score will open many doors.

In regards to applying to EM and IM at same program... I would not suggest this in the scenario that you have one as a back up to the other. I think it shows that you are not fully committed to either at the particular hospital/med center you are applying to.

Interview day... This is another can of beans. I'll start with... be yourself. Really... it's ok. Programs will appreciate your honesty. Trying to force yourself into fitting there personality type may fool them for 30 seconds but these folks are very experienced. They take your applications seriously and are genuine about what they have to offer. I would offer the same genuine look of yourself back.

Take time to research what kind of emergency physician you want to be.
- Academic track?
- Clinical track?
- A little of both?
- Looking into doing fellowship?
- Am I the researcher type?
- Could I be a leader in the field?
- etc etc.

Research the programs by design and personal interest first. What fits best with your career goals as an emergency physician? Considering geography or other factors (personal ties to a state, city, etc).

If you research well before hand, you will likely apply to programs that like you more as an applicant thus increasing your odds of getting an interview. I would also note the faculty and where they trained. Again, there are more things to it. Totally new thread.

 

[quideam]

I'm in the midst of the interview season right now, and I just wanted to chime in and completely disagree with the inital poster. I think that the numbers he posted are WAY off - you don't need a 230 (or even a 220) to get a lot of great interviews, including at competitive places. It's true there are a few programs out there who seem very focused on the numbers, but the vast majority aren't. Of course, every application is different - but I would say that your Step 1 score and clinical grades are truly just part of your application, and can't predict interviews offered very well. From my experience so far, what seems to be most important is being well-rounded: show early interest in EM (EMT, etc), do research/ projects/ international work, etc, and have at least decent grades and scores (and EM rotation and other clinical grades are definitely more important than USMLE scores). This is all assuming you don't have red flags, but otherwise I think there's a lot of reason to be more optimistic about interview chances than the OP deliniated.

 

[mrmedico]

Sounds good. Thanks for keeping the post alive!

 

[Freakingzooming]

I'm in the midst of the interview season right now, and I just wanted to chime in and completely disagree with the inital poster. I think that the numbers he posted are WAY off - you don't need a 230 (or even a 220) to get a lot of great interviews, including at competitive places. It's true there are a few programs out there who seem very focused on the numbers, but the vast majority aren't. Of course, every application is different - but I would say that your Step 1 score and clinical grades are truly just part of your application, and can't predict interviews offered very well. From my experience so far, what seems to be most important is being well-rounded: show early interest in EM (EMT, etc), do research/ projects/ international work, etc, and have at least decent grades and scores (and EM rotation and other clinical grades are definitely more important than USMLE scores). This is all assuming you don't have red flags, but otherwise I think there's a lot of reason to be more optimistic about interview chances than the OP deliniated.

Can't whole heartedly agree- EM is not like applying to medical school or to rad-oncology. Sure, you probably need a basic minimum for scores on step 1- I would say at least 210+. But the more competitive programs will look at your application as a whole. I have been pleasantly surprised by some of the interviews I have gotten and I didn't imagine myself to be here.

I have talked to some PDs and asked them point blank what they look for in a MS4's app and they don't sugar coat it. They tell me that they have a couple cut-offs (like a filter formula) but for the most part, after you clear a basic number like 210 for step 1, you get a heavy screen where they read your PS and your activities and your LORs. I wouldn't make this process a numbers game. I would be sincere in your interest in EM- try to explore it early. Do well on your EM electives, get good LORs, take time with your personal statement and try to be enthusiastic in your interview. Good things will happen.

 

[tybalt]

Can't whole heartedly agree- EM is not like applying to medical school or to rad-oncology. Sure, you probably need a basic minimum for scores on step 1- I would say at least 210+. But the more competitive programs will look at your application as a whole. I have been pleasantly surprised by some of the interviews I have gotten and I didn't imagine myself to be here.

I have talked to some PDs and asked them point blank what they look for in a MS4's app and they don't sugar coat it. They tell me that they have a couple cut-offs (like a filter formula) but for the most part, after you clear a basic number like 210 for step 1, you get a heavy screen where they read your PS and your activities and your LORs. I wouldn't make this process a numbers game. I would be sincere in your interest in EM- try to explore it early. Do well on your EM electives, get good LORs, take time with your personal statement and try to be enthusiastic in your interview. Good things will happen.

I think that's what quideam said...

 

[willow18]

Can't whole heartedly agree-

I think that's what quideam said...

I think he meant to say "can't but whole heartedly agree"

 

[tybalt]

I think he meant to say "can't but whole heartedly agree"

I think it's more likely that he meant to quote the OP.

 

[GoBuckeyes913]

I had a nightmare last night that I didn't match. IT SUCKED. Anyone else's dreams haunting them?

 

[MeBeAnEP]

I had a dream a few nights ago that I matched at a program I didn't even apply to, and certainly didn't want to be at. But at least I matched!

 

[Freakingzooming]

I think it's more likely that he meant to quote the OP.

whoopsie- yeah- it was "can't but more wholeheartedly agree."

 

[ccfccp]

I had a nightmare last night that I didn't match. IT SUCKED. Anyone else's dreams haunting them?

I had my first "Holy Crap... My alarm didn't go off an I'm late for my interview!" dream a few nights ago. I literally sprang like 4 feet of the bed and land standing and heading for the shower when I noticed my hotel room clock said... 3:27.

 

[GoBuckeyes913]

I had my first "Holy Crap... My alarm didn't go off an I'm late for my interview!" dream a few nights ago. I literally sprang like 4 feet of the bed and land standing and heading for the shower when I noticed my hotel room clock said... 3:27.

Hahaha, I ALWAYS have this feeling the night before an interview! Then, I go to sleep and it eventually pops up in a dream overnight, and I wake up freaking out until I look at the clock. I feel like I'm being messed with.... by me! Just haven't figured out how to stop it yet

 

[domer621]

Hahaha, I ALWAYS have this feeling the night before an interview! Then, I go to sleep and it eventually pops up in a dream overnight, and I wake up freaking out until I look at the clock. I feel like I'm being messed with.... by me! Just haven't figured out how to stop it yet

haha yep, I even had that experience the night before my very last interview... it didn't go away!

 

[DaveinDallas]

Thanks for the info.....

Question: Is there a reference page for programs that will take COMLEX Level I vs. USMLE Step 1? or do I need to check the individual program websites?

 

[LadyGrey]

You need to just take the USMLE.

Unless you already know exactly where you want to apply, and are willing to contact every program individually, because the info is not on most websites.

I just had this debate in another forum (Osteopathic, I think) so I don't know if it's worth starting up again here, but my strongly held position is that if you think you might want to go allopathic, there is no good reason to avoid the USMLE. Of course if you're already a third or fourth year and didn't take Step 1 of the USMLE, it would probably be a bad idea to do it now.

 

[GoBuckeyes913]

Thanks for the info.....

Question: Is there a reference page for programs that will take COMLEX Level I vs. USMLE Step 1? or do I need to check the individual program websites?

I havent' found a ref page on this, just contacted programs I was interested in to see who accepted COMLEX. (A ton surprisingly do) This was sometime during my 3rd year when taking step 1 was out of the question. My opinion is different from most... everyone will tell you to take the USMLE, I didn't and got plenty of interviews at great places.. . BUT, i'm also a great applicant with great COMLEX scores (I'm not bragging, just giving you an idea) If your floating in the 500's, and are hoping to end up with interviews from like, Yale or Pitt.. then I would take USMLE. You don't HAVE to take it in order to be considered by great allo EM progs, but if you're an average run of the mill student I prob would. I hate to say it, but there's just some programs that won't even grant you an interview cause your DO.. .it sucks, but very true.

 

[NPEMTIV]

You need to just take the USMLE.

Unless you already know exactly where you want to apply, and are willing to contact every program individually, because the info is not on most websites.

I just had this debate in another forum (Osteopathic, I think) so I don't know if it's worth starting up again here, but my strongly held position is that if you think you might want to go allopathic, there is no good reason to avoid the USMLE. Of course if you're already a third or fourth year and didn't take Step 1 of the USMLE, it would probably be a bad idea to do it now.

I agree here. From everyone I've spoken too you should probably take the USMLE. I've signed up for both. I would prefer to do an osteopathic EM Residency, but realistically there aren't enough for me to hang my hat on and I would rather have the USMLE available for the allo programs to look at. Just me opinion though.

 

[EM2BE]

I will say that if you are even thinking about considering allopathic programs in certain areas of the country, take the USMLE. I myself didn't take it and still don't regret not taking it because I made that decision due to other reasons. Everyone has their own personal aspect on the issue, but if you are looking at applying in places like Cali or the east coast, I would seriously consider taking the USMLE. Granted I haven't gone through the application process yet, but this is advice I have received and I'm just passing it on.

 

[NPEMTIV]

I will say that if you are even thinking about considering allopathic programs in certain areas of the country, take the USMLE. I myself didn't take it and still don't regret not taking it because I made that decision due to other reasons. Everyone has their own personal aspect on the issue, but if you are looking at applying in places like Cali or the east coast, I would seriously consider taking the USMLE. Granted I haven't gone through the application process yet, but this is advice I have received and I'm just passing it on.

I admit I have heard similar advice. The problem I've personally run into is that I hear both arguments pretty regularly. From a personal standpoint I decided to pursue the better-safe-than-sorry philosophy, but I do see the other side. It's a calculated decision either way, and like the EM2BE (and others) have said, it depends a lot on where one intends to apply. Maybe if I had more of an idea I'd be willing to forgo the USMLE. Who knows...