How competitive really is EM residency these days? There is all this talk of backup specialties and people worried about not matching. Has it really become that competitive? Are people with avg scores and grades really having a tough time matching? Or is this all just hype?
How Competitive is EM?
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I dunno but I sure would like this question answered. I keep hearing differing opinions and there's no recent NRMP data to prove either one. This last week I had emergency medicine lectures given by a clerkship director/attending at one of the Florida residencies. He said last year they had 200 people apply per available spot and that now they were looking for 250 or greater for both step 1 and step 2 and research experience as the weeding out factors.
I was thrown aback...basically the same CV for ophtha and all other competitive residencies. He said there were exceptions to the 250s but not many.
I asked him what would be considered safety programs so I could narrow my list and at least apply strategically. He said he didnt know of any???? I dunno if hes just on some egotrip or if this is the real deal in EM right now.
I was thrown aback...basically the same CV for ophtha and all other competitive residencies. He said there were exceptions to the 250s but not many.
I asked him what would be considered safety programs so I could narrow my list and at least apply strategically. He said he didnt know of any???? I dunno if hes just on some egotrip or if this is the real deal in EM right now.
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WTF? - Egotrip. Fear and loathing in Las Vegas trip.
Look at last year's "Charting Outcomes in the Match". This year's projections wont change radically from last year's outcomes.
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Yes this is right two years ago the avg was 223 so at best the avg might be in the low 230s/high 220s
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Yes, the average keeps creeping up, but for someone to say "250+ or GTFO, LOLZ" is ridiculous.
If I scored in the high 250 range, I'd be thinking about ophtho/derm, but I'd also hate myself because... ophtho/derm.
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Apparently they don't publish charting outcomes anymore.
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deleted547339
I interviewed at 3 of the programs in FL - none of them struck me as having residents that were all AOA, 250+. I'm not saying they were dumb, but they all seemed average among EM residents.
I scored very well, as did many of my friends that went into EM - but rashes all-day, every-day? Ok, more like 10-3 Monday through Thursday.....but still. That'd be awful.
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quite a few in the 250's and higher choose to go into EM. Better to be happy than be uber rich and bored on a daily basis.
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I agree, 250 step 1 awaiting step 2 results, will be applying EM. I can also attest to the fact that everywhere you look people have different opinions and ideas as far as how competitive it is. I have heard of people talking about 220-230 range is the average to match, and the other end saying people with 240s-250s not matching after ranking 5+ spots.
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Florida Hosp in Orlando = 6 spots
Orlando Health = 14
UF = 15
Shands = 8
USF= 10
The only one here that could have had 200 people apply/spot would be Florida hosp. in Orlando, which is a program that wouldn't match a single person if they only interviewed people with a 250+ step 1 and step 2. For some reason I feel like you are stirring the waters with your bad effort at trolling.
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To which people are you referring? 220-230 is the average. Look at last year's Charting Outcomes. Ask PDs. There is no reason why this would dramatically change in 1-2 years. There are folks with 250+ Step 1 scores who think other people look like shoes. Why? Because they stare at their own feet rather than make eye contact when speaking. Perhaps it is okay they don't match into Emergency Customer Service Medicine.
I was recently told by a PD/chair at a program in... well, we'll say the Southeast... that his program was "A 250+ Step 1, from a top 10 medical school type of program. Simply put, people with a score below 235 will not flourish here at _____ and will have significant problems".
As if said program taught on some different level that required a 250+ board score just to be able to comprehend what they are dishing out. It definitely seems to be getting more competitive but part of it is a number of programs are starting to think of themselves a little higher than they perhaps should and perpetuating that feel. I personally think that your higher end residencies (and I mean higher end by way of competitiveness) are not always a first choice for someone initially until they score in the range that makes them "eligible" for that specialty. I seriously doubt there are tons of people out there just drooling to be dermatologists but when that 255-260 step 1 comes back, sure they entertain the notion of an easy life and good pay. I don't think EM is like that... you want it and you go for it... it's not one of the "default" programs of people with higher scores so for PDs to think that they are consistently going to attract 250+ scorers with stellar apps and stellar personalities/attitudes... they are dreaming. Most people know (and not speaking of anyone in this thread or otherwise) that a person who scores that highly often thinks their score will open the door for them and that they don't have to try as hard so the effort or attitude might not be in place. There are exceptions and THOSE are the true superstars we sometimes run across but if you're making a cutoff of 250 essentially you are saying "I don't care what kind of person they are, what their attitude is like, or how hard they work... just as long as they have the right numbers". To me (and I hope others as well), those are the programs that I'd rather just say "fine, take em and have fun... not a fit for me". I don't think all programs are like this and think (maybe hope, lol) that there are still a large number of programs out there that look more at the person than the numbers. That's the kind of place I want to be... where the attitude is right and the work ethic is there rather than a giant group of egghead *****holes who know a lot but can't carry a conversation. I know many people who score 250+ probably do not fit that mold, but if you're going to populate your program based on the score criteria alone you better bet you're going to get your fair share of the socially awkward geniuses or the great score/poor work ethic kind of people. There is still plenty of other programs for the rest of us...
While I do not doubt that the specialty will become more competitive, it is #4 in terms of number of residency positions (if you exclude prelim spots) and there are more residencies opening. It will never be as competative as dermo, plastic, rad/onc, etc., which have only a few hundred spots as opposed to nearly 2000 for EM. Will some EM programs attract folks with high scores? Sure, but so do certain IM programs.
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deleted547339
Do you mean ORMC? I'm from FL - didn't interview at FL because I heard it was very average. Friends rotated there and interviewed there. Interviewed at ORMC and was quite impressed.
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I don't know much about the Florida programs in general, except that there isn't one in Miami. I'm not sure how your reasoning skills led you to Florida Hospital but you managed to peg it right on the head. I purposely said 200 per spot so as not to disclose the exact residency but I have to give you credit you guessed right. So yea it was Florida Hospital in Orlando that gave me those stats. Why do you say they wouldn't match anyone with those stats?
btw: you and many other on this forum need to get over this trolling complex you have. I'm not sure why, but so many people assume everyone is trolling. Has it ever occurred to you that not everyone has time to waste by going online to start **** with random strangers?
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I think they guessed florida hospital because they have the least number of spots 6 x 200 = 800 apps (when you take into account the number of people who apply to EM each year it was probably the obvious choice considering a little over 2400 applied to EM in 2012).
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deleted547339
I'd guess egotrip.
I totally don't buy that. Fl Hosp isn't even the best EM program in the city.....much less the state. If FL Hosp was honestly using 250 step 1 and step 2 as a cut off, not only would they probably not match anyone, they wouldn't be interviewing very many people. 2 years ago the charting the outcome showed fewer than 100 people with Step 1 >250. Geographically, you were looking at what? 20-40 people with those numbers applying in the SE? People with >250 on step 1, step 2 and research and applying to programs in the SE? What? 30 - tops.
Is it tougher now than 2 years ago? Yes. Was there magically a jump of over 30 points in the average in 2 years? No. Is a program that has only been around for 5 years that isn't even a level 1 trauma center somehow recruiting all AOA, 250+, multiple pubs caliber students away other programs in the South like Carolinas, Vandy, Emory, UAB, UNC, ORMC etc? No.
Mind you, I have nothing against Fl Hosp, I'm just calling BS on them recruiting 250+ Step 1/Step 2 with research.
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Glad I'm not alone in feeling that what I was told is a bit unrealistic...egotrip it is then.
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I used to think like that too as a naive med student, before I did any investigation into derm.
Thank god I was proven wrong, and haven't looked back since.
Thought I'd chime in:
-Scored >250 >270 on steps & top 10% of class and didn't feel like I was guaranteed a spot of my choice. Did not even get every interview i applied to (more like 1/2?). Don't over-estimate the value of scores in EM. If you have SLORS and above averagey scores you'll do fine if you put the effort into doing enough interviews >10.
-Rotated at ORMC and FH. ORMC Is fantastic, and I do think it is on the competitive side. When I rotated we had a *ton* of auditioners from all over and they were *gunning.* FH east, not so much on the competitive side is my impression. New program. Level 3 trauma center. IT is TRUE community though which is rare (meaning ortho will NOT come and do your splints-cuz they aren't there) and wow you would learn spanish like crazy.
-Scored >250 >270 on steps & top 10% of class and didn't feel like I was guaranteed a spot of my choice. Did not even get every interview i applied to (more like 1/2?). Don't over-estimate the value of scores in EM. If you have SLORS and above averagey scores you'll do fine if you put the effort into doing enough interviews >10.
-Rotated at ORMC and FH. ORMC Is fantastic, and I do think it is on the competitive side. When I rotated we had a *ton* of auditioners from all over and they were *gunning.* FH east, not so much on the competitive side is my impression. New program. Level 3 trauma center. IT is TRUE community though which is rare (meaning ortho will NOT come and do your splints-cuz they aren't there) and wow you would learn spanish like crazy.
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I think you may have misunderstood me, I am saying I have also seen many people talk about how EM has gotten to the point that people with 240s-250s are not matching, but I have also heard the other end, and seem to see it factually whenever the match statistics are posted. So i'm not sure what to believe. I do believe it's getting more and more competitive, however I wouldn't go as far to say 250+ or bust...
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Ok I think it's fair to say we established that 250+ is desirable but not an absolute requirement. So the question becomes.....which programs are the ones that have these high requirements?
What would be considered safety programs for the average applicant? How can one figure this out since there is not really any consensus on how EM programs are ranked in competitiveness.
What would be considered safety programs for the average applicant? How can one figure this out since there is not really any consensus on how EM programs are ranked in competitiveness.
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I have a friend who matched with a ~200 step I score last year who had a good amount of interviews and ended up matching to a pretty solid program while another who had a 250+ didn't get nearly as many interviews as anticipated (still matched to a great program as well), so as everyone's sort of mentioned before, numbers aren't everything.
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There aren't "safety programs". Deciding to apply to a program based on perceived competitiveness is a fool's errand. So apply broadly to places that make sense for you geographically or that you may have some connection you can speak to on the interview trail. And look at it this way, if there was a list of "safety programs" then they wouldn't be safety programs since everyone would be applying to them to try and ensure matching into EM and thus they'd become competitive just from scarcity of interview spots.
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Although some programs probably do use board scores as the sole screening criteria, most do not. Screening is based on multiple factors with the Dean's letter playing a much more critical role then board scores. Each program uses different screening criteria so it is a mistake not to apply to program that you're interested in since you can't present the results. If you don't apply you certainly won't get an interview so give it a shot.
Board scores have no predictive value whatsoever in terms of how someone will do in residency other than to predict higher scores at in-service examinations. Admittedly poor board scores may tip the balance when screening an application since there are a limited number of interviews spots, but screening applicants based on very high board scores is not a sign that a program is competitive. It is a sign of program is uninformed and that the program director needs to spend a little more time thinking about what they're trying to do.
It is a competitive specialty in that applicants failing to get into emergency medicine (even after trying many times) will easily find spots in many other specialties. But a lot more goes in to being unable to match than board scores.
Board scores have no predictive value whatsoever in terms of how someone will do in residency other than to predict higher scores at in-service examinations. Admittedly poor board scores may tip the balance when screening an application since there are a limited number of interviews spots, but screening applicants based on very high board scores is not a sign that a program is competitive. It is a sign of program is uninformed and that the program director needs to spend a little more time thinking about what they're trying to do.
It is a competitive specialty in that applicants failing to get into emergency medicine (even after trying many times) will easily find spots in many other specialties. But a lot more goes in to being unable to match than board scores.
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Source?
Our PD said he glances at the Deans Letter and uses it mostly to look for red flags.
EM is moderately competitive. Many are more competitive and many are less.
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deleted480308
Ormc (now orlando health) is the only lvl 1 trauma in town. I shadowed there and everyone was really nice and helpful.
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Source: Me
I've studied it, communicated my findings, and built and overseen the process at 3 pretty good programs.
IMNSHO, I'd qualify as an expert witness. But if I need a second source, Peter Rosen and I have discussed and agreed on this more than once.
Red flags in the Dean's letter *are* key, but to find them, sometimes you need a careful read. Most Dean's Letter use Dean's code where good is bad and worked hard is worse.
Your program director has an approach, so does mine, and they are almost certainly not identical. And that's my point. Just as there is not a rank of best to worst program, there is not a rank of best to worse applicants based on Board Scores. The selection for interviews will play out differently from one program to the next and the match lists are not mirror images of each other.
One should also not be spooked by the applicant to position ratio. First everyone today applies to a large number of programs so the numbers have inflated dramatically without really changing the chance of matching. The number of applicants tends to be driven mostly by location so a 6 resident spot program in an attractive location will have very high applicant to position ratios. But I hardly ever see Orlando snagging the leaders on my match list up here in the North East.
I've studied it, communicated my findings, and built and overseen the process at 3 pretty good programs.
IMNSHO, I'd qualify as an expert witness. But if I need a second source, Peter Rosen and I have discussed and agreed on this more than once.
Red flags in the Dean's letter *are* key, but to find them, sometimes you need a careful read. Most Dean's Letter use Dean's code where good is bad and worked hard is worse.
Your program director has an approach, so does mine, and they are almost certainly not identical. And that's my point. Just as there is not a rank of best to worst program, there is not a rank of best to worse applicants based on Board Scores. The selection for interviews will play out differently from one program to the next and the match lists are not mirror images of each other.
One should also not be spooked by the applicant to position ratio. First everyone today applies to a large number of programs so the numbers have inflated dramatically without really changing the chance of matching. The number of applicants tends to be driven mostly by location so a 6 resident spot program in an attractive location will have very high applicant to position ratios. But I hardly ever see Orlando snagging the leaders on my match list up here in the North East.
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deleted547339
Do PDs look to see where their top few ranked that matched elsewhere end up? I've been curious about this for a while.
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You bet. Not just their top few. The entire list.
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deleted547339
Interesting....so the PDs are as neurotic as us. Good to know. Lol.
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Where I trained (which is getting some serious love in this thread), the residents actually get a huge say in the rank list - it's not just the PD and some little committee. And yes, the programs are as neurotic as you are. But my program is one were you really have to be on the ball the whole time - if you piss off one resident, you could very well screw your rotation. Similarly, you kick ass and everyone loves you, they will overlook not-quite-as-awesome scores.
You the applicant, want a good fit as much as the programs do.
But the match is definitely more competitive now than it was when I matched!
You the applicant, want a good fit as much as the programs do.
But the match is definitely more competitive now than it was when I matched!
Haha, if only we could mention this when they tell us "don't worry, you'll do fine" as we sweat during auditions, interviews, and creating lists, lol!
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From what I have gathered from some folks, around 230 is the new number for Step 1.
But, EM is still not a number's game. yet.....completely.
But, EM is still not a number's game. yet.....completely.
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Mean was ~226 I believe (2013). I don't know how anyone knows the EM mean without the 2011 charting outcomes data (223) - other than that, it's a arbitrary guessing game of 1500 Step 1 scores. Unless someone has identified a bellwether residency program that represents the entire nation.
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I have heard from high 220's to low 230's. There is no way to know for sure, but I think the real number can be safely figured around 225-230.
Def not 250+
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Wait... whats the average for the high caliber schools? I'm in NC and would like to stay here for residency if I can... I keep hearing that Carolinas and UNC are extremely competitive but I have never heard what kind of step 1 and step 2 scores would be competitive at those places?
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deleted547339
You're not going to be able to get a good number, because no-one publicizes it. I scored high 240s on step1 and high 260s on step2 and got invites at all of those places.
I was impressed by both of those programs. No matter what your scores are: apply broadly and go into your interviews with an open mind. An interview I almost cancelled (only didn't because my advisor told me not to) ended up being my favorite program where I subsequently matched.
Good luck.
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What does it matter? If you like the place and wouldn't mind living there, then go ahead and apply. The worst that will happen is you won't get an interview.
It's like knowing the day you are going to die. Are you suddenly only going to sit in bed all day, eat ice cream, and watch Seinfeld? No, you want to be an EM physician, so you are going to wade into the morass and start taking names. The application process is a 2-way street. You have to want them and they have to want you. You cripple your chances by only applying to 'safe' places that you think you have a decent chance of getting accepted. Knowing the average board scores of a residency does nothing except tempt you to give up applying to that place. For every resident with a 250 there was someone with a 210.
Every PD would love to have a class of all 250+, but that isn't happening.
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deleted547339
Yes, and no. If a program is notorious for being a "numbers program" and you would be happy living there, you should certainly apply regardless of your scores. But it may not be wise to know which programs tend to overemphasize numbers if you have average to below average scores when scheduling externships. If you only have time to do 1-2 externships and you have a 210 on step 1, you would probably be better served at a program that has less emphasis on boards.
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Well I plan on applying regardless... and I'm right at 250 anyway for step 1 at least... I asked more out of curiosity than anything since I've heard from several people about CMC's great reputation in EM (I'm from right outside of Charlotte)
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I interviewed a lot of 270s last year. They weren't necessarily people we ranked at the top.
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Of course there are people with tremendous scores who didn't match. I don't pick you because you're super smart, I pick you because you're the kind of person I want in my program. You can be a genius but if you're sitting across from me acting superior because your scores were better than mine then please don't let the door hit you on the way out. Now, some of you are going to protest that not everyone who scores 250+ acts like a douche and you are 100% correct. But I'm willing to bet those kids matched. If there's a student out there with a stellar application and amazing scores who didn't match then that student needs to look in a mirror and ask what they did wrong.
Long story short - if you want to do EM then apply to EM. If your overall application impresses me then you will be invited for an interview.
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+1
2011 charting outcomes is the last one that is going to be published.
Nobody knows the average. I'd suspect it increased slightly only because the average step 1 score for all med students increases every year. But that is a complete guess.
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Where did you hear this?
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I probably would as a DO and if your Step 1 is on the low end.
