Is EM really this hard to get into?

[Caltechstud]

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I am applying to EM next cycle - and I don't have stellar stats - 230 Step 1, 240 Step 2, all Pass in third year clerkships. Red flags include 2 LoAs - one due to family, one due to step 1. Should I pick a back up specialty at this point or go all in for EM?

According to Charting the Outcome 2016 - people with my step scores have about a 95% chance of matching - but it seems people with superior stats than mine aren't even getting interviews. What gives?

 

[Mad Jack]

I am applying to EM next cycle - and I don't have stellar stats - 230 Step 1, 240 Step 2, all Pass in third year clerkships. Red flags include 2 LoAs - one due to family, one due to step 1. Should I pick a back up specialty at this point or go all in for EM?

According to Charting the Outcome 2016 - people with my step scores have about a 95% chance of matching - but it seems people with superior stats than mine aren't even getting interviews. What gives?

There's a group of people with any given stat profile that will interview poorly or that have red flags despite their high stats. You have to just be honest with yourself- are you one of those people?

 

[Caltechstud]

I am talking about people who are not even getting interviews with scores and grades stronger than mine - looking at this year's application thread.

I have LoAs for legitimate reasons - I was sick during step 1 studying period and needed to postpone the test. I had an immediate family member that was dying of cancer, and I took a semester LoA for family obligations. Are those red flags to you?

 

[CliveStaples]

I think that getting everybody's perspective smack dab in the middle of the interview cycle is going to give you a skewed perspective. I would wait until the end of the cycle to start drawing conclusions - there are many people with few interviews now who I expect will get many more in the coming weeks.

I think what you're seeing is that EM seems to be screening heavily based on SLOEs and not as heavily based on Step scores, so I wouldn't interpret the difficulty that some people have had with interviews and take that to mean that they needed better Step scores - that is almost assuredly the wrong conclusion to draw. What it does mean is that you should give a lot of thought and preparation into planning your 4th year EM rotations and to put yourself in the best position to succeed. Finally, you'll need to be willing to apply broadly. It seems that more people than ever are applying to EM and whether it's true or not, you'll be able to find out when Charting the Outcomes comes out next year.

As far as your LOAs, that will be up to each program to decide. Generally a single LOA for a good reason is not considered a negative. Given that you have two, I think you'll need to make sure that they are explained well. Even if both were for good reasons, you will have a greater challenge overcoming them than if it were just a single LOA. I do not think it needs to derail your career aspirations, but it's something you will need to take seriously in explaining.

 

[gman33]

Don't be an ahole.
Apply broadly so you don't get screened out.
If you get plenty of interviews, only go to the 10-15 that you like best.

You will be fine.

 

[Mad Jack]

I am talking about people who are not even getting interviews with scores and grades stronger than mine - looking at this year's application thread.

I have LoAs for legitimate reasons - I was sick during step 1 studying period and needed to postpone the test. I had an immediate family member that was dying of cancer, and I took a semester LoA for family obligations. Are those red flags to you?

I can't say, I'm not a PD. There's some who err on the side of "if there's more than one LoA, there's probably some bull**** in one or all of them" because they're cynical, but there's also ones that have "oh, what a kind soul, caring for their family etc" look on the bright side personalities. But the point of my post was that numbers aren't what breaks candidates that fail to match with high stats- it's something else. They applies to too selective of programs, didn't apply broadly enough, didn't interview well, had red flags, etc. Honestly evaluate your app and its strength, apply to a decent number of programs, and you'll probably match unless there's something else in your file (which was my point- you know you better than anyone else, so give your app a good 'ol honest self evaluation and think if there's any reason you wouldn't hire you over some guy with your stats but without that same issue). If there's nothing wrong with your app other than the LoAs, cast a broad net and you'll match. Chill out.

 

[Frazier]

Having step 2 done is a big thing these days for EM... so that's good for you

 

[Psai]

Having step 2 done is a big thing these days for EM... so that's good for you

I dunno why people think step 2 is the shizzle
Compared to step 1 I studied for half the days, half the hours and half the effort
Barely read anything, just did uworld
Did better on step 2 with 1/8 the effort

 

[doggydog]

I dunno why people think step 2 is the shizzle
Compared to step 1 I studied for half the days, half the hours and half the effort
Barely read anything, just did uworld
Did better on step 2 with 1/8 the effort

Congrats?

 

[Goose Egg]

.

 

[Psai]

Congrats?

dont hate me cause u aint me

 

[deleted547339]

I dunno why people think step 2 is the shizzle
Compared to step 1 I studied for half the days, half the hours and half the effort
Barely read anything, just did uworld
Did better on step 2 with 1/8 the effort

Seriously? You don't know why? It is about 1,000x more related to clinical medicine.

Anyways, OP - if you address the LOA directly in your PS and apply broadly, you'll probably be fine.

 

[gman33]

The problem with loa is the PD has concern you may need it again during residency.

Unlike med school, if this occurs, it causes a big problem.

 

[Psai]

Seriously? You don't know why? It is about 1,000x more related to clinical medicine.

Anyways, OP - if you address the LOA directly in your PS and apply broadly, you'll probably be fine.

Not really.

 

[canigetawhatwhat]

stop being uptight.
Your stats are fine.
Be a normal person on interview day. When they ask you about basketball, talk about it.
When they ask what you like to do? Its ok to say whatever you want.

EM = normal people

 

[Apollyon]

I dunno why people think step 2 is the shizzle
Compared to step 1 I studied for half the days, half the hours and half the effort
Barely read anything, just did uworld
Did better on step 2 with 1/8 the effort

Back in the old days (when it was on paper), the saw about studying was "Step I, 2 weeks, Step II, 2 days, Step III, a #2 pencil". If you are studying more as you go further, you're doing it wrong (or, at least, not the most efficiently).

 

[carbonizedeyesockets]

I am applying to EM next cycle - and I don't have stellar stats - 230 Step 1, 240 Step 2, all Pass in third year clerkships. Red flags include 2 LoAs - one due to family, one due to step 1. Should I pick a back up specialty at this point or go all in for EM?

According to Charting the Outcome 2016 - people with my step scores have about a 95% chance of matching - but it seems people with superior stats than mine aren't even getting interviews. What gives?

EM isn't THAT competitive. Hundreds of programs and over 1800 positions. Only FM, IM, and peds have more spots available. SOme programs and regions are more competetive. But if you apply broadly and aren't a slug, you'll get in somewhere (probably in your top 3).

 

[KarlPilkington]

I am talking about people who are not even getting interviews with scores and grades stronger than mine - looking at this year's application thread.

I have LoAs for legitimate reasons - I was sick during step 1 studying period and needed to postpone the test. I had an immediate family member that was dying of cancer, and I took a semester LoA for family obligations. Are those red flags to you?

I'm a PD, and am also someone who took a medical LOA in residency so I see both sides.
Are two LOAs a red flag: Yes
Are two LOAs going to keep you from matching in EM: No

As others have said, I would go out of my way to address the two LOAs in my personal statement and in person during interviews. Life happens, sometimes we have to take time off. I'm happy to match an applicant who has been through some stuff and come out the other side stronger. I would be less excited to take someone who came off as defensive or wasn't totally forthcoming about what happened in the past and why it wasn't likely to happen again. Remember that in residency and life beyond, if you take a leave of absence, you are asking one of your colleagues to step up and work for you. We never close, we can't cancel our clinic schedules, there are no make up rotations. In EM the possibility of having a provider take a leave can be really difficult to handle as a group or department.