Just how big of a net should I cast?

[Helen Scott]

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I'll be applying next year to EM, with crappy board scores (low 200s on Step 1--currently working my pants off in hopes of greatly improving come Step 2), and high passes across the board for clinicals. I really wish I weren't so sold on such a competitive field, but alas, here we are. So, I know that I've got my work cut out for me, and that I'm certainly not going to be able to be picky about my residency options.

I am planning on applying to probably around 45 programs. Let's just assume that none of them are scared away by my application, and all offer me an interview. How many interviews should I be planning to go on to feel a little more secure in my position? I've seen people on here mention going to 10 or less, but they inevitably have better stats than I do. I'm okay with spending the $$ to interview to try to avoid not ending up with a match next year, but at the same time I don't think it's feasible to go on 30 interviews. Thoughts?

As a side note, if anyone has any information about which programs out there might be less competitive and more open to someone like me, feel free to send it my way! It seems fairly hard to judge which programs are less competitive by their websites, etc.

Thank you in advance!

 

[RustedFox]

I
How many interviews should I be planning to go on to feel a little more secure in my position?

Thank you in advance!

Go to all of them. No joke. EM is going to become even more competitive next year if current trends continue. If you don't have a horse in the race, you can't win it.

 

[NERDY]

Take step 2 CK early and do well!
Schedule CS as soon as you can since there are only 5 locations in the country.
Schedule home + away rotations and honor them.
Make sure you are getting strong SLORs
Apply broad.
Make sure you check your email often and have a smart phone, some interview dates fill very fast.

 

[Transmogrifier]

If you have an EM program at your school, you should definitely sit down with the program director or assistant program director to go over your application in depth. They can help you figure out where you sit as far as competitiveness and which programs in your area are more likely to take you.

Forty-five applications should be quite sufficient for just about any applicant out there. Fifteen interviews will probably be around the upper limit of what is feasible (with regards to time, money, and stamina).

For now, you need to prepare well for Step 2 and take it early enough during 4th year so the score will be available when your application goes out.

Starting looking at where you might want to do an away rotation so you can get another SLOR and round out your application.

 

[winkleweizen]

I'll be applying next year to EM, with crappy board scores (low 200s on Step 1--currently working my pants off in hopes of greatly improving come Step 2), and high passes across the board for clinicals. I really wish I weren't so sold on such a competitive field, but alas, here we are. So, I know that I've got my work cut out for me, and that I'm certainly not going to be able to be picky about my residency options.

I am planning on applying to probably around 45 programs. Let's just assume that none of them are scared away by my application, and all offer me an interview. How many interviews should I be planning to go on to feel a little more secure in my position? I've seen people on here mention going to 10 or less, but they inevitably have better stats than I do. I'm okay with spending the $$ to interview to try to avoid not ending up with a match next year, but at the same time I don't think it's feasible to go on 30 interviews. Thoughts?

As a side note, if anyone has any information about which programs out there might be less competitive and more open to someone like me, feel free to send it my way! It seems fairly hard to judge which programs are less competitive by their websites, etc.

Thank you in advance!

I agree...as many as you can, but with that said 12-14 would suffice for almost anyone. As far as less competitive programs. Look for newer programs and programs in the middle of nowhere or the midwest (outside of Chicago, Indy, and Cinci).

 

[DreamingTheLive]

Agree with a lot of above, here's a bullet-point recap:

-Take Step 2 early enough so score is in BEFORE they download apps and really do your best to significantly increase your score. There are some programs that don't look as much at board scores (I have zero idea which programs these are and I'm sure they're shrinking as we speak).

-Schedule at least 2 aways and rock them. This could be huge for you and there is literally nothing to lose. For applicants with really good scores/grades I don't think Aways are as important and can be a double-edged sword...but for you...a must.

-start trying to beef up the rest of your app w/ other EM-related things, volunteering, EM research, etc...

-talk to school/advisors and attempt to cultivate a list of what they feel are less "competitive" or desirable programs.

-apply to more than 45, especially judging by some of the stories from this year, way more...

If you really want to be an EM physician, I really believe you can achieve this dream no matter the current state of your app (within reason). It might take a little extra work or time, but it's possible.....then again, I'm simply a 4th year med student who hasn't even matched yet, so take what I say with a grain of salt.

GL and don't stress too much yet, it's only January, you could still potentially fall in love w/ another specialty (happened to me in the spring of my 3rd year).

 

[eastcoastEM]

One man's 45 is another's 20. What I mean is, 45 programs in your region, not including big names or reach programs, might be fine. If you apply to 45 and 20 are the other coast, and 10 are denver, cinci, etc, then your chances aren't as good.
If you think your app is lacking, apply for an away early, at a less competitive program, so you have a decent level of protection from scrambling or not matching.
The other advice above is good, too.

 

[Helen Scott]

Thank you for the replies, everyone! They give me hope that this still might be an attainable goal...

I do have plans to take Step 2 early (well, late July, but at least scores will be out in time), and my Step 2 CS is scheduled for next month, when I'm on an easy psych rotation. I am hoping to be accepted for 2 aways, and someone told me that it was a good idea to do one at a less competitive program that I'd like to attend, and one at a competitive program that I would never get into anyway, in hopes of getting a good LOR on their impressive letterhead. Does anyone have any thoughts on that?

Also, I do technically have a home EM program, but it's on the other side of the state, even though it's associated with my home school. So sadly, I don't really have many opportunities to get super involved with it in person until 4th year, when I do my home EM rotation with them.

While I'm at it, can anyone comment on whether it's a good idea to rank a couple of transitional year programs at the bottom of my list, in case I don't match? I realize that I could just end up doing a transitional year and then still not matching, which would leave me with nothing, but at the same time it seems like just about the biggest crisis in the world to me right now to not match at all.

Thank you all for putting up with my paranoia-based questions!

 

[NERDY]

I think having a plan B is a good idea: ty/prelim, research, year off, MPH, etc. Talk to your home program advisers to get suggestions. Apply to prelim programs that have EM residencies so you can get SLORs and do EM rotations as a prelim. I met some prelim year applicants on the interview trail. However, I know it was tough for them to get time off to interview.

 

[goodoldalky]

Would not bother w transitional year. They are competitive and won't help you. Worst case scenario should probably involve EM research or something along those lines. Rock step 2 and an away rotation or two instead and you won't have to think about that.

 

[UW med student]

I'm in a similar position to the OP and was wondering how you handle scheduling step 2 early to make up for a less than ideal step 1 score while still fitting in EM rotations. At least at my med school I'll have 2 weeks at the end of June free between M3 and start of M4, and then I'm trying to do a rotation at my home institution and 2 away rotations. That would take up July, Aug, and Sept. So unless I take step 2 CK during those 2 weeks in June I would otherwise be taking it in Oct which I believe is too late for results to be on my app when I first submit it. Do other schools have different schedules that allow you more study time or do most people only study for 2 weeks? I feel like this isn't enough time especially for someone who needs to do stellar to make up for step 1 but maybe I'm wrong. Thanks in advance.

 

[The White Coat Investor]

I'll be applying next year to EM, with crappy board scores (low 200s on Step 1--currently working my pants off in hopes of greatly improving come Step 2), and high passes across the board for clinicals. I really wish I weren't so sold on such a competitive field, but alas, here we are. So, I know that I've got my work cut out for me, and that I'm certainly not going to be able to be picky about my residency options.

I am planning on applying to probably around 45 programs. Let's just assume that none of them are scared away by my application, and all offer me an interview. How many interviews should I be planning to go on to feel a little more secure in my position? I've seen people on here mention going to 10 or less, but they inevitably have better stats than I do. I'm okay with spending the $$ to interview to try to avoid not ending up with a match next year, but at the same time I don't think it's feasible to go on 30 interviews. Thoughts?

As a side note, if anyone has any information about which programs out there might be less competitive and more open to someone like me, feel free to send it my way! It seems fairly hard to judge which programs are less competitive by their websites, etc.

Thank you in advance!

I would apply to as many as it took to get at least 10 interviews. Then I'd go to 10-15. 45 may not be enough for you to get 10 interviews. Spend your money on more applications (60? 75?) and fewer interviews. Worst case scenario you spent $1000 too much on applications. Do you know how long it takes me to make $1000 in the ED? About 4 hours. Hardly worth putting your life off for another year because you didn't apply to enough. Screw plan B. Just do plan A right, even if you have to apply to every program in the country. EM research for a year? Give me a break.

If I bombed step I, I'd take Step II as early as possible. The good news is if you actually study for step II it's possible to do really well on it, especially for someone with an EM mindset. I had to study for it because I had to take it early for the military match. Many of my classmates took it late in their 4th year and didn't study at all. So with far less studying than step I, I had a much higher score. In fact, STEP II was my highest of the three, by far.

Lastly, to the OP, I don't think your stats are that bad. > 200 step I, high passes in your clinicals...nothing wrong with that. As long as you get honors on your EM rotations that is.

 

[Helen Scott]

I would apply to as many as it took to get at least 10 interviews. Then I'd go to 10-15. 45 may not be enough for you to get 10 interviews. Spend your money on more applications (60? 75?) and fewer interviews. Worst case scenario you spent $1000 too much on applications. Do you know how long it takes me to make $1000 in the ED? About 4 hours. Hardly worth putting your life off for another year because you didn't apply to enough. Screw plan B. Just do plan A right, even if you have to apply to every program in the country. EM research for a year? Give me a break.

If I bombed step I, I'd take Step II as early as possible. The good news is if you actually study for step II it's possible to do really well on it, especially for someone with an EM mindset. I had to study for it because I had to take it early for the military match. Many of my classmates took it late in their 4th year and didn't study at all. So with far less studying than step I, I had a much higher score. In fact, STEP II was my highest of the three, by far.

Lastly, to the OP, I don't think your stats are that bad. > 200 step I, high passes in your clinicals...nothing wrong with that. As long as you get honors on your EM rotations that is.

Thank you. All of this is what I needed to hear.

 

[NERDY]

I'm in a similar position to the OP and was wondering how you handle scheduling step 2 early to make up for a less than ideal step 1 score while still fitting in EM rotations. At least at my med school I'll have 2 weeks at the end of June free between M3 and start of M4, and then I'm trying to do a rotation at my home institution and 2 away rotations. That would take up July, Aug, and Sept. So unless I take step 2 CK during those 2 weeks in June I would otherwise be taking it in Oct which I believe is too late for results to be on my app when I first submit it. Do other schools have different schedules that allow you more study time or do most people only study for 2 weeks? I feel like this isn't enough time especially for someone who needs to do stellar to make up for step 1 but maybe I'm wrong. Thanks in advance.

Often rotations are flexible with start/end dates, so perhaps you could start July 15 (giving you a month to study)? If you did July OR August, Sept and the October (with 1 month off to study), I think you will be ok. However, I started having interviews is October so you want to be careful asking for days off of an away. Also, remember these months will be busy!

 

[manny99]

When is the latest you can take step II and still have your score ready when applications open?

 

[NERDY]

When is the latest you can take step II and still have your score ready when applications open?

I would say a month is usually a safe estimate for score release (step 2 scores come out on Wednesdays) so around Aug 15. However, this cycle, CS and CK had score delays, so scores came out later. Also, step 1 scores have also been delayed in the past. I think the summer months are busy with so many US students taking exams, which may be a reason for the delay. MSPE comes out earlier now too.

 

[QuackaDO]

Similar situation for me as well... barely cleared the 200 Step 1 and average pre clinical grades but on the bright side I do have honors in all my clinical rotations so far and worked as a Paramedic for 10 yrs+ before medical school including a couple of years in Iraq (non military though). My other "downside" is that I am DO sooooo... not sure I should even dip my toe in and try the MD EM pool. My plan is to do at least 4 away "audition" rotations at DO programs and apply at several others and try to kill Step 2 early. Not sure if I should even consider MD programs at all... with my situation what do you all think? (sorry to hijack but similar story/problem)

 

[dav86]

Similar situation for me as well... barely cleared the 200 Step 1 and average pre clinical grades but on the bright side I do have honors in all my clinical rotations so far and worked as a Paramedic for 10 yrs+ before medical school including a couple of years in Iraq (non military though). My other "downside" is that I am DO sooooo... not sure I should even dip my toe in and try the MD EM pool. My plan is to do at least 4 away "audition" rotations at DO programs and apply at several others and try to kill Step 2 early. Not sure if I should even consider MD programs at all... with my situation what do you all think? (sorry to hijack but similar story/problem)

I think you will have a long uphill battle with a step 1 score in the low 200s being a DO. Does not mean it is impossible, but it will be very difficult. The top half of our rank list mainly had scores 220-260s with the majority above 240 and we don't even look at step scores as much as other programs. Being a DO will make it tougher because there are so many good MD applicants available and each year they all seem to be getting better. Auditions will help and a killer step 2 score 240+ might get a couple interviews, but I would focus on the DO match and rotating well. IF you have money to burn then apply to most MD programs and see what happens, but I would not count on getting many interviews with that score. GL

 

[DreamingTheLive]

Similar situation for me as well... barely cleared the 200 Step 1 and average pre clinical grades but on the bright side I do have honors in all my clinical rotations so far and worked as a Paramedic for 10 yrs+ before medical school including a couple of years in Iraq (non military though). My other "downside" is that I am DO sooooo... not sure I should even dip my toe in and try the MD EM pool. My plan is to do at least 4 away "audition" rotations at DO programs and apply at several others and try to kill Step 2 early. Not sure if I should even consider MD programs at all... with my situation what do you all think? (sorry to hijack but similar story/problem)

wait, you're a med student in Iraq now?

Crush Step 2 CK (do well). Take it mid-July at latest, just in case score delay (fairly common)
4 Aways seems like overkill. Honestly, I've never even heard of 4 EM Aways. I'd shoot for 3 and go all out
Whether or not you apply DO or MD or both is really your call, I know jack squat about the DO process so I really can't say.

Hang in there, try to keep strengthening your app in other ways, make contacts, enjoy life.

 

[TheBlueBlazer]

Be careful with aways. They're definitely a double-edged sword. Everyone here always says "be a rockstar at your aways" and "crush step 2" and things of the like which is encouraging but not always realistic. This is easier said than done. I'm sure you were trying to do well on step 1 too, which was not successful, and unless there is some sort of drastic change, don't expect step 2 to be magically easier just because you want it to be. Other people want it as well, and are going to be trying to impress as well, and well, when everyone is bringing their A-game, it's hard to stand out. I agree you should work hard, but also temper your expectations, and realize that aways magnify your faults as well as your strengths, and being in a pressure-cooker situation at your top choice programs isn't always the ideal situation.

In short, do the things you can to improve your status, but don't assume it's going to happen. Apply broadly, invest time in searching for the diamond-in-the-rough programs and realize that they're all good enough to meet RRC requirements, so aside from geography, some creature comforts and "reputation" fwiw, you're dealing with programs that are all going to get you to the same place.

 

[QuackaDO]

wait, you're a med student in Iraq now?

Haha... no, not in Iraq anymore but see why you said that. I haven't posted in quite awhile and apparently haven't updated my location info recently either, lol!

As to the other comments... there are reasons for my step 1 score and like every low scorer I have my own sob story. I was scoring in the mid 70s on USMLEWorld consistently for several weeks, got a mid 220 on my first couple of assessments, and was cruising along fine until one day I hit the proverbial "wall" and inexplicably 2 weeks before my tests my scores dropped to 55-60% and I took a hit on my next assessment and got a 200ish. Destroyed me mentally I guess but I pushed on and in the final 2 weeks leading up to Step 1 and level 1 (COMLEX) I also proceeded to go through a rough breakup, my car breaking down, and also breaking my leg. Despite all this I convinced myself I was strong mentally and I could still take the tests and achieve at the level I was supposed to. Of course, I was wrong, and looking in hindsight I wish I could redo that who month-6 weeks of my life cuz it's totally screwed me but hey... what's happened has happened and now I move forward. With all that said I do realize that for ever low score everyone has a sob story to tell and likely mine won't be heard or considered but for the few that do hear it maybe it will garner some understanding about the lone score in the face of all honors in clinicals (to this point), a high step 2 (which I know I can achieve sufficed to say that similar events don't happen again next time and I learned my lesson, lol), and my EMS experience (and Iraq) which I have been told is looked favorably upon.

I don't think I have score competetive enough to put any faith in the MD match... that's why I've kinda set most (maybe all) my eggs in the DO match basket. The reason for 4 aways is because in the DO match a number (not all) of the programs won't interview you unless you do a rotation with them. Not a fan of that idea but doing a rotation gets my foot in the door and gets me a chance to show them what I'm capable of and let THEM say "huh... I guess his Step 1/Level 1 scores really WERE an abberation". Who knows... maybe I'm kidding myself but that's the mentality I'm working under at this point and just hoping someone will want to judge the person, not the score...