How to be a Good EM Candidate Starting in M1

[djtallahassee]

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Hello all, M1 here that is pretty sure I want to do EM and am researching how to become a good candidate. We have 1.5 curriculum so even though it seems like awhile away, its not that far. I want to have a good idea of how to be a good candidate, the optimized order of rotations, how many aways, how to improve clinically etc.. Any thoughts?

Also, my school doesn't have a home residency program. I realize this puts me at a disadvantage but how much of a disadvantage is it? Whats the best way to overcome this? From my prelim research it looks like I will need at least 3 away rotations if not more. Any thoughts on how to get aways that I want and actually would like to What could I possibly be doing with my home hospital (level 1 trauma center) to get ahead of the game.

We dont really have physician mentors, so I'm here looking for answers

 

[GonnaBeADoc2222]

Don't fail any preclinical courses.
Kill step 1.
Get honors in as many clinical rotations as possible.
Kill step 2.
Do 2 or 3 SLOE eligible EM rotations and never be late to a shift, show initiative, act interested.
Don't say anything racist/sexist, etc. at the interview.

 

[Lawpy]

Don't fail any preclinical courses.
Kill step 1.
Get honors in as many clinical rotations as possible.
Kill step 2.
Do 2 or 3 SLOE eligible EM rotations and never be late to a shift, show initiative, act interested.
Don't say anything racist/sexist, etc. at the interview.

Seems like strong Step scores + strong clinical grades (best case: all or near-all honors) + strong letters + research + strong interview skills = strong matching success anywhere, including EM. AOA probably helps too

 

[GonnaBeADoc2222]

I'm sure high quality research and AOA status helps but I didn't have either of these and got interviews at all the "top" programs and matched at one. At least at my school AOA was about how well you sucked up to the dean in charge of the selection committee and less about actual merit.

 

[Tenk]

In addition to all of the above, EM is a pretty small community when you compare it to other fields, and we are a pretty social bunch, so it’s very advantageous to network as much as possible. Since you don’t have a program, do you have a home rotation? If you have that, start there and talk to whichever doc is in charge of that.

 

[djtallahassee]

Don't fail any preclinical courses.
Kill step 1.
Get honors in as many clinical rotations as possible.
Kill step 2.
Do 2 or 3 SLOE eligible EM rotations and never be late to a shift, show initiative, act interested.
Don't say anything racist/sexist, etc. at the interview.

Haha I agree good advice for all and workin toward the step now.

In addition to all of the above, EM is a pretty small community when you compare it to other fields, and we are a pretty social bunch, so it’s very advantageous to network as much as possible. Since you don’t have a program, do you have a home rotation? If you have that, start there and talk to whichever doc is in charge of that.

We do have a home rotation. Luckily I've already shadowed them and things went pretty well and should be welcome to observe anytime. Considering going in some more and eventually asking if I can do the pt interview/learn and try to guess which tests to order. Not sure if that would be annoying.

One thing that seems a little less clear is how I find EM research. From what I asked around there weren't too many active projects although there may be in the future. What I don't want to do is be doing bench scale chemistry like I was doing in undergrad. Our place has some more clinicalish research but not a ton. Maybe something like Case studies would be a good place to start while I look for other research?

 

[gamerEMdoc]

Haha I agree good advice for all and workin toward the step now.



We do have a home rotation. Luckily I've already shadowed them and things went pretty well and should be welcome to observe anytime. Considering going in some more and eventually asking if I can do the pt interview/learn and try to guess which tests to order. Not sure if that would be annoying.

One thing that seems a little less clear is how I find EM research. From what I asked around there weren't too many active projects although there may be in the future. What I don't want to do is be doing bench scale chemistry like I was doing in undergrad. Our place has some more clinicalish research but not a ton. Maybe something like Case studies would be a good place to start while I look for other research?

Find a resident or attending that has an interesting case and help them write a case report. You can write one in a day, and it should help everyone get a publication.

 

[8741empls]

We do have a home rotation. Luckily I've already shadowed them and things went pretty well and should be welcome to observe anytime. Considering going in some more and eventually asking if I can do the pt interview/learn and try to guess which tests to order. Not sure if that would be annoying.

Just an M4 and this may be semantics so take this however you will, but if you want to learn how to to perform well in the ED I would not focus on “guessing what test to order.” I would approach time in the ED by trying to determine an ED appropriate differential for each case/complaint you see (catastrophic to most likely), and think through how you would rule out/in each of those things and how the results of each of those tests will affect their disposition. I know this seems like the same thing, but I have seen a lot of students struggle to articulate their diagnostic pathway and disposition to their attending and I suspect it comes from observing patterns/looking up the work up for complaints (which you can do in 5 seconds on any number of apps) rather than really trying to learn EM. You will know the test to order if you are thinking of the right pathology, learn what to do with that information. This will do two things, it will help you not update residents and attendings on information that is not actionable (read: not be annoying) and will help you stand out as the student who reports information while simultaneously suggesting the next step, whether that be discharge, calling consultants, or beginning a treatment. This may seem like it’s easy, but it isn’t.

But the very most important thing you can do other than crushing exams and doing well third year is learning how to give a focused, organized ED presentation. Attendings have very little time to see you in action and to be honest, smooth is probably noticed more than good. Learn to be focused, concise, and smooth with an ED presentation. Having the perfect plan and all the answers means nothing if you get cut off or they check out before you get to physical exam. Learn from my mistakes. Practice this early and perfect it and you stand out.

Edit: this is advice I probably wouldn’t worry about until 3rd year. I need to learn to read. Ignore me.

 

[gamerEMdoc]

Just an M4 and this may be semantics so take this however you will, but if you want to learn how to to perform well in the ED I would not focus on “guessing what test to order.” I would approach time in the ED by trying to determine an ED appropriate differential for each case/complaint you see (catastrophic to most likely), and think through how you would rule out/in each of those things and how the results of each of those tests will affect their disposition. I know this seems like the same thing, but I have seen a lot of students struggle to articulate their diagnostic pathway and disposition to their attending and I suspect it comes from observing patterns/looking up the work up for complaints (which you can do in 5 seconds on any number of apps) rather than really trying to learn EM. You will know the test to order if you are thinking of the right pathology, learn what to do with that information. This will do two things, it will help you not update residents and attendings on information that is not actionable (read: not be annoying) and will help you stand out as the student who reports information while simultaneously suggesting the next step, whether that be discharge, calling consultants, or beginning a treatment. This may seem like it’s easy, but it isn’t.

But the very most important thing you can do other than crushing exams and doing well third year is learning how to give a focused, organized ED presentation. Attendings have very little time to see you in action and to be honest, smooth is probably noticed more than good. Learn to be focused, concise, and smooth with an ED presentation. Having the perfect plan and all the answers means nothing if you get cut off or they check out before you get to physical exam. Learn from my mistakes. Practice this early and perfect it and you stand out.

Edit: this is advice I probably wouldn’t worry about until 3rd year. I need to learn to read. Ignore me.

Excellent advise

 

[Perfect Hair Day]

Get involved with AAEM/RSA, EMRA, and/or RAMS. Some charge for membership, others are free - but the benefits are well worth it. Half of the activities on my ERAS CV are directly from leadership roles in organized emergency medicine or projects and papers that I was able to get through being involved and networking and being offered those opportunities. I am interviewing with 3 programs that I met PDs at conferences. The intangibles are intangible but good to have.

 

[boomshaketheroom]

The intangibles are intangible but good to have.

The schnozzberries taste like schnozzberries!

But yeah getting involved and finding leadership roles where you actually do something is a nice way to set yourself apart on top of the other things mentioned.

 

[Rekt]

Hello all, M1 here that is pretty sure I want to do EM and am researching how to become a good candidate. We have 1.5 curriculum so even though it seems like awhile away, its not that far. I want to have a good idea of how to be a good candidate, the optimized order of rotations, how many aways, how to improve clinically etc.. Any thoughts?

Also, my school doesn't have a home residency program. I realize this puts me at a disadvantage but how much of a disadvantage is it? Whats the best way to overcome this? From my prelim research it looks like I will need at least 3 away rotations if not more. Any thoughts on how to get aways that I want and actually would like to What could I possibly be doing with my home hospital (level 1 trauma center) to get ahead of the game.

We dont really have physician mentors, so I'm here looking for answers

Make sure you put "EM Candidate 2022" in your school e-mail signature.

 

[Perfect Hair Day]

Make sure you put "EM Candidate 2022" in your school e-mail signature.

Do NOT do this.

 

[GonnaBeADoc2222]

Get involved with AAEM/RSA, EMRA, and/or RAMS. Some charge for membership, others are free - but the benefits are well worth it. Half of the activities on my ERAS CV are directly from leadership roles in organized emergency medicine or projects and papers that I was able to get through being involved and networking and being offered those opportunities. I am interviewing with 3 programs that I met PDs at conferences. The intangibles are intangible but good to have.

Had none of this. No quasi "EM leadership". No EM research. My half a**ed "research was in GI and another surgical field.

Still matched at a top program.

My point is, do what you like to do. If you actually like this stuff, sure do it. If you like martial arts or running or immersive board games, do that. Be a person. Have an original thought. Be able to appear interesting when an interviewer asks "What do you like to do for fun?"

I talked about brewing beer at one interview.

I talked about playing xbox with the PD of the program I matched at.

Just be real. And do well in school.

 

[djtallahassee]

All good advice, Definitely gives me stuff to think about next time I go shadow/our clinic so I can focus on the presentations and get a good sense of differentials. Also checking out EMRA now.

Get involved with AAEM/RSA, EMRA, and/or RAMS. Some charge for membership, others are free - but the benefits are well worth it. Half of the activities on my ERAS CV are directly from leadership roles in organized emergency medicine or projects and papers that I was able to get through being involved and networking and being offered those opportunities. I am interviewing with 3 programs that I met PDs at conferences. The intangibles are intangible but good to have.

Did you get these projects/papers through EMRA? How does one go about networking outside of their school system to find active research?

 

[Perfect Hair Day]

All good advice, Definitely gives me stuff to think about next time I go shadow/our clinic so I can focus on the presentations and get a good sense of differentials. Also checking out EMRA now.



Did you get these projects/papers through EMRA? How does one go about networking outside of their school system to find active research?

I personally am not involved with EMRA in any capacity. AAEM has a rep council that if you sign-up for it, you're in. You can connect with people through that, work on special projects. Join one of AAEM/RSA committee's and you can work on special projects with luminary faculty in the field of EM - I had Reuben Strayer's (from EMupdates) undivided attention for 40 minutes while we worked on a painkiller FOAMed thing. I interviewed a PD for a podcast. Go to conferences and put yourself out there - I sat in on a committee meeting just out of pure interest and they asked if anyone was interested in working on a specific thing and I volunteered to help out - now I'm on that committee and I'm writing an article. Opportunities abound in this field, and being present is 90% of what it takes.