How to match EM from transitional year?

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darkknight15

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I am a DO student who applied to both DO and MD programs. I believe that my application is pretty strong (3rd year all H, H on EM aways, EM research) except for my Level 1 score (420s). I went up to 520s on Level 2. Obviously, I probably did not meet the cutoff for many programs Level 1 score, so my application was never even looked at to see my strengths, like my SLOEs. As a result, I got 0 DO interviews, and 4 MD interviews (3 of which I rotated at, and 1 family connection). I think my interviews were definitely very strong, and I'm hoping this will be my saving grace. I am obviously preparing for the possibility that I don't match. I've been doing some research and it appears that scrambling into a transitional year or prelim medicine is the way to go if there are no or few EM spots available. My question is this- for people who have successfully matched into EM after a transitional or prelim year, how did you improve your application to get more interviews?

My main fear is that I clearly can't improve my Level 1 score, so I will run into the same issue when I reapply that I will not meet the score cutoff, and my application will not even get looked at. Thanks for any help/advice.

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-Definitely take Step 1 and 2.
-If you have to scramble try to be at a place with an EM program and one that will let you do an elective rotation.
-Where ever you end up, talk to your program director about your situation.
 
I kind of thought about taking Step 1 and 2, but how would I have time to efficiently study for them and do well as an intern?
 
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I kind of thought about taking Step 1 and 2, but how would I have time to efficiently study for them and do well as an intern?

I would recommend you not taking step 1. A low 400s comlex is probably failing(or close to it) for the USMLE.
 
Yeah while it is not a good score, I was going through a death in the family at the time. I am certain I could do better given the proper study time. But like I said, how would I do that as an intern? Have you every heard of an intern taking Step 1 and doing well?
 
Yeah while it is not a good score, I was going through a death in the family at the time. I am certain I could do better given the proper study time. But like I said, how would I do that as an intern? Have you every heard of an intern taking Step 1 and doing well?

Nope. You are two years out from the basic sciences so it would be rough. If I had to pick which one to take it would be step 3. Intern year is hard so you will have little to study for a basic sciences exam
 
Agree with above advice about taking both USMLEs and finding a great advisor (ideally, an EM clerkship director or program director at a major residency). Passing Step 3 would be good but not half as helpful as a great Step 1 and 2 score. Step 3 also has a basic science component, now.

Scrambling into TY is not easy; you have a much better shot at Prelim IM or Surg.

Additional consideration: Doing an extra intern year will take away a year of your funding - this may be a problem for smaller EM programs not willing to toy with their "cap."
 
Like I mentioned above, is it even realistic to think I could effectively for Step 1 and 2 as an intern? When I took COMLEX, I had at least 2 months of uninterrupted study time. Working an intern schedule, I just don't see how it would be possible. Ideas?
 
I am a DO student who applied to both DO and MD programs. I believe that my application is pretty strong (3rd year all H, H on EM aways, EM research) except for my Level 1 score (420s). I went up to 520s on Level 2. Obviously, I probably did not meet the cutoff for many programs Level 1 score, so my application was never even looked at to see my strengths, like my SLOEs. As a result, I got 0 DO interviews, and 4 MD interviews (3 of which I rotated at, and 1 family connection). I think my interviews were definitely very strong, and I'm hoping this will be my saving grace. I am obviously preparing for the possibility that I don't match. I've been doing some research and it appears that scrambling into a transitional year or prelim medicine is the way to go if there are no or few EM spots available. My question is this- for people who have successfully matched into EM after a transitional or prelim year, how did you improve your application to get more interviews?

My main fear is that I clearly can't improve my Level 1 score, so I will run into the same issue when I reapply that I will not meet the score cutoff, and my application will not even get looked at. Thanks for any help/advice.

Wait so you are in SOAP right now? Don't take step 1 or 2 you won't have enough time to study for it. Just focus on Step 3. Prelim med is pretty competitive to get and most spots are saved for students at that institution who didn't match. 1 year of residency will not stop you from getting full funding at programs.
 
It's funny you mention that because I was reading some previous threads and basically everyone recommended NOT to do a surgery preliminary year. Would you mind explaining further?
 
It's funny you mention that because I was reading some previous threads and basically everyone recommended NOT to do a surgery preliminary year. Would you mind explaining further?

Surgery prelim sucks and you should avoid it if you can but with SOAP prelim med is going to be hard to get because you have all the people doing rads and anesthisa who want to go. Since so many prelim surg spots go unfilled use that to your advantage and apply to the ones that have an EM program get in well with the residents and PD so that they want you to be a resident. The key thing is having residents vouch for you because they have a big say in ranking. Also there are two new EM programs in Tennessee with surgery prelim programs that shouldn't be too hard to get a spot in. You gotta work with what you got.
 
Additional consideration: Doing an extra intern year will take away a year of your funding - this may be a problem for smaller EM programs not willing to toy with their "cap."
Not according to the "green book" - if it doesn't lead to board eligibility, it doesn't go against the clock.
 
Funding wasn't an issue when I went from TY to a 3-year EM spot.

There is always some turnover and/or opportunity. Might help to go somewhere with a large or less-competitive EM program and do your best to make friends.
 
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A number of DO programs keep some spots open for folks who have to scramble after the MD match. You need to be on these like a hawk. I would suggest trying to a DO intern year, I think that a DO EM residency is probably your best chance at this point. It will afford you some connections hopefully, you might have the opportunity to rotate in the ED and impress people, it's less competitive in general and is a better pathway to your specialty of choice than a surg prelim year while still maintaining your sanity and not costing you a year. Don't take USMLE steps, that would be a nightmare. You don't have time to study, and you have better things to spend your time on, like learning medicine well so that you can be impressive when you get the chance to work with people who matters. More than anything, chill out, handle your business without putting TOO much stress on yourself. If this is meant to be your path, it will all work out.
 
Does it really matter if I do a DO or MD intern year? I will check but I'm not sure how many DO transitional/prelim programs still have spots. If I can get an MD one, I figure I can still apply for DO and MD EM next cycle.
 
A number of DO programs keep some spots open for folks who have to scramble after the MD match. You need to be on these like a hawk. I would suggest trying to a DO intern year, I think that a DO EM residency is probably your best chance at this point. It will afford you some connections hopefully, you might have the opportunity to rotate in the ED and impress people, it's less competitive in general and is a better pathway to your specialty of choice than a surg prelim year while still maintaining your sanity and not costing you a year. Don't take USMLE steps, that would be a nightmare. You don't have time to study, and you have better things to spend your time on, like learning medicine well so that you can be impressive when you get the chance to work with people who matters. More than anything, chill out, handle your business without putting TOO much stress on yourself. If this is meant to be your path, it will all work out.

I agree that a DO residency will be his best bet. Most TRI in the DO world are worthless and it requires connections and/or luck to match EM. I know of two people that matched EM after a transitional year but their scores were higher. Personally I would recommend attempting EM for DO again(most MD places won't touch you and if they use the conversion factor to calculate a projected USMLE you would have failed step 1.)
 
Does it really matter if I do a DO or MD intern year? I will check but I'm not sure how many DO transitional/prelim programs still have spots. If I can get an MD one, I figure I can still apply for DO and MD EM next cycle.

In the DO match, which I think is your best option for next year. I remember the program director at our home program saying "I don't care what their COMLEX is so long as they pass and I like them," which seems to be par for the course. You need to angle for a DO spot, so much of which is based on connections and getting to know the people involved in the process, massaging egos, etc. I think this would be easier to accomplish from a DO intern year, if they have an EM residency, as well as the fact that you're also not giving up an entire year with a prelim year vs an Osteo TRI. By doing an MD prelim and applying DO or MD EM residencies, you're essentially doing little to improve your application other than throwing in a Step/Level 3 score for whatever that's worth. If you're doing your MD medicine, or god forbid, surgical prelim year at somewhere that has an EM residency, you can rotate in the ED and demonstrate you would do well there, that might work, but I think this is a riskier course. If you do this, the DO EM programs will probably ignore you completely. You're in a tight, but not impossible spot, you need to maximize your chances anyway you can.
 
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Anyone have any experience with this situation as a US-IMG? I matched a TY this year and didn't match EM. Will my IMG status still hurt me in the 2016 match when I will be applying as a TY intern?
 
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