Last minute EM decision

[corpsmanUP]

Hey guys, I need some honest advice. Just listen to what I have to say and don't flame me if you feel the need. Just give me some critical thought process.

I am a 4th year DO student who has always wanted to do full spectrum family medicine with an EM twist in a rural setting. The problem is, I have just recently decided that I cannot and will not put my family through the terrible lifestyle of rural practice where you have to not only run the ED but also your practice, along with OB if you can do it all. I just don't think I have the energy for that any longer, nor the desire. The thing I like the most is the ED. I had done my darned best to avoid the ED because I thought I had enough of it in my past.

Here is the problem though. I am now considering changing paths and applying to EM. But all my LOR's are directed toward family medicine. And my 4th year EM rotation, although honored, is not on my transcript because it was early 4th year. So, I am not sure what the PD's are going to say when they see all these stellar letters saying that I will make the best full spectrum FP in the world! I mean don't get me wrong, these letters are the kind that say "this guy already functions at a PGY2 level", and things of that nature.

My stats are hopefully good enough to help them overlook these strange FP letters of rec, and my personal statement for EM explains a lot of this away. Here are my stats if it helps you to advise me.

Masters degree as a PA, practicing urgent care since 98 even in med school
Will graduate number 2 out of 124
USMLE I 232/94, USMLE II 262/99, COMLEX I 715/99, COMLEX II pending
Shelf exams- all between 95-99
Former EMT-Paramedic with several years field experience
Former Navy Corpsman-(medic)
combat medical experience Gulf War

I am really looking at UT Houston very closely, but I am wondering if applying with these strange LOR's will be a deal breaker. Does anyone really know? Would you send an email to the PD to explain the situation or what?

Okay, let me have it!!

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[pinbor1]

Hey guys, I need some honest advice. Just listen to what I have to say and don't flame me if you feel the need. Just give me some critical thought process.

I am a 4th year DO student who has always wanted to do full spectrum family medicine with an EM twist in a rural setting. The problem is, I have just recently decided that I cannot and will not put my family through the terrible lifestyle of rural practice where you have to not only run the ED but also your practice, along with OB if you can do it all. I just don't think I have the energy for that any longer, nor the desire. The thing I like the most is the ED. I had done my darned best to avoid the ED because I thought I had enough of it in my past.

Here is the problem though. I am now considering changing paths and applying to EM. But all my LOR's are directed toward family medicine. And my 4th year EM rotation, although honored, is not on my transcript because it was early 4th year. So, I am not sure what the PD's are going to say when they see all these stellar letters saying that I will make the best full spectrum FP in the world! I mean don't get me wrong, these letters are the kind that say "this guy already functions at a PGY2 level", and things of that nature.

My stats are hopefully good enough to help them overlook these strange FP letters of rec, and my personal statement for EM explains a lot of this away. Here are my stats if it helps you to advise me.

Masters degree as a PA, practicing urgent care since 98 even in med school
Will graduate number 2 out of 124
USMLE I 232/94, USMLE II 262/99, COMLEX I 715/99, COMLEX II pending
Shelf exams- all between 95-99
Former EMT-Paramedic with several years field experience
Former Navy Corpsman-(medic)
combat medical experience Gulf War

I am really looking at UT Houston very closely, but I am wondering if applying with these strange LOR's will be a deal breaker. Does anyone really know? Would you send an email to the PD to explain the situation or what?

Okay, let me have it!!

You look like a strong candidate. I would immediately get new LORs. Explain to them that you have decided to go into Emergency Medicine. They can be pretty understanding. Have your transcript updated and rewrite your personal statement. Then send off the above to a wide range of EM programs. You seem like a strong candidate, and their is still time to get your applications out. I know our program hasn't started downloading. Good luck, and PM me if you have questions.

 

[corpsmanUP]

So do you really think I would not get interviews just because the LOR has a focus other than EM? I mean isn't it common for some LOR's to basically not say anything about whay you are going into? If I had to get new LOR's I think it would be virtually impossible at my school. These guys are so bad here about letters, it took 3 months to get these done after dozens of follow ups. One guy made me write it in the end! Seriously though, if these letters were simply some of the best you had ever read, along with an incredible Dean's Letter, with my stats would it just be unrealistic to expect an interview? My personal statement is already re-written with a good EM focus. It explains away the fact that I was initially looking to do full spectrum FM with an EM focus. What about doing a rotation at UT Houston for instance if that is where I am most interested and getting a letter from someone while I am there? Any ideas?

 

[pinbor1]

So do you really think I would not get interviews just because the LOR has a focus other than EM? I mean isn't it common for some LOR's to basically not say anything about whay you are going into? If I had to get new LOR's I think it would be virtually impossible at my school. These guys are so bad here about letters, it took 3 months to get these done after dozens of follow ups. One guy made me write it in the end! Seriously though, if these letters were simply some of the best you had ever read, along with an incredible Dean's Letter, with my stats would it just be unrealistic to expect an interview? My personal statement is already re-written with a good EM focus. It explains away the fact that I was initially looking to do full spectrum FM with an EM focus. What about doing a rotation at UT Houston for instance if that is where I am most interested and getting a letter from someone while I am there? Any ideas?

I would ask if they could just modify their letters, just to put an EM spin on it. I would also get atleast one LOR from an EM attending that you have worked with they can fill it out on a Standardized form (SLOR), I think it is at cordem.org. If you are interested in UT houston, I would definitely make the effort to do a rotation out there.

You sound like a solid candidate but you can get "screwed" if you don't know what your doing.

 

[DeLaughterDO]

MM,

'sup? Decided to come over to the dark side, eh? Or, I guess, back to this side

I don't think it will be a problem. You'll probably get some questions about why you made the last minute decision - but believe me, you're not the first person in this situation!

Knowing how hard it is to get letters from these people in the first place, I'd just try to get one or two from the EM faculty on your EM rotation (I don't know where you did yours), preferably in the "standard letter of recommendation" (SLOR) for EM format. You can find it on the CORD website (I think www.cordem.org or something like that).

So do you really think I would not get interviews just because the LOR has a focus other than EM? I mean isn't it common for some LOR's to basically not say anything about whay you are going into? If I had to get new LOR's I think it would be virtually impossible at my school. These guys are so bad here about letters, it took 3 months to get these done after dozens of follow ups. One guy made me write it in the end! Seriously though, if these letters were simply some of the best you had ever read, along with an incredible Dean's Letter, with my stats would it just be unrealistic to expect an interview? My personal statement is already re-written with a good EM focus. It explains away the fact that I was initially looking to do full spectrum FM with an EM focus. What about doing a rotation at UT Houston for instance if that is where I am most interested and getting a letter from someone while I am there? Any ideas?

A rotation at UTH would be an EXCELLENT idea if you can get in - you're practically guaranteed an interview then, and they can see your work firsthand. Just don't blow it while you're down there!

Give me a call if you have any other specific questions - I'm in Pa right now, but I'll help you any way I can.

jd

 

[DrQuinn]

I would change your personal statement, and IMMEDIATELY say to them:

I wanted to do rural medicine withi EM but now realize I want to do straight EM, I didn't realize it until late.

That way there is no question in the PDs mind when he sees your LORs are towards FP.

Submit your stuff NOW.

Q

 

[corpsmanUP]

I would change your personal statement, and IMMEDIATELY say to them:

I wanted to do rural medicine withi EM but now realize I want to do straight EM, I didn't realize it until late.

That way there is no question in the PDs mind when he sees your LORs are towards FP.

Submit your stuff NOW.

Q

Thanks Quinn!!

That is exactly what I did. I changed my PS to reflect exactly what you stated yesterday. I know the LOR thing stinks but I am really in a bad situation to get more. The EM rotation I did was at a community hospital where they don't have an EM residency. I am afraid to ask for a letter from them because they are recruiting me for their FM program. Word will spread fast and I will be seen as wishy washy for their FM program which is my next best choice if I can't get EM.

Quinn, do you think with my stats and a PS explaining the facts, that I will get an interview at some EM programs? I promise you when you see my CV and stuff you will see that very few applicants have the kind of history in EMS that I have. How many applicants can say they were tubing people and doing cut downs at age 19 in a combat zone?

Tell you what Quinn, I am not looking to come to Florida, but if you give me a PM I will submit my ERAS stuff to you if you are still affilliated with the program where you are. You can take a look at my letters and stuff and tell me what realistic chance I have. I still have a few freebies since I only applied to a few EM programs.

Thanks Quinn, and thanks JD.

 

[margaritaboy]

FYI - You can submit as many personal statements as you want. Just choose the appropriate version to send to the EM programs.

 

[corpsmanUP]

FYI - You can submit as many personal statements as you want. Just choose the appropriate version to send to the EM programs.

Thanks a bunch! I did just this very thing and submitted my info yesterday to EM programs. The PS was definitely able to explain why I had originally been wanting to do rural FP with EM potentially as a fellowship (you know, the cheesy FP version). I explained though that I no longer wanted to put my family through the rigor of the lifestyle that comes with trying to do rural FP, OB, EM, and hospital work all in one package. I explained that it was truly the EM that has been the most exciting for me and what I have liked the most. My EM grade was a 97 for my clerkship, but my clerkship was not done until early 4th year and I don't know if it got transmitted with transcript. Can you get your school to re-transmit your transcript to update the grades or is what got sent final?

Even my Dean's Letter was sent before my EM grade was back. Perhaps I will just have to bite the bullet and ask my EM preceptor to write me a letter explaining what grade I was given and include it with a good LOR. The problem as I said is that my EM preceptor knows I was at their hospital looking at the FM program and he spent the entire month trying to talk me into coming there. So if I tell him I need a letter for EM, he may spill the beans and get me unranked at the FP program I love the most should the EM thing not work out. Sucks to be me!!

 

[EM Junkie]

I am an MS4, and just finished the month rotation at UT-Houston. You interview at the end of the month here, so if you rotate you are guaranteed an interview.

I can tell you from working with the faculty in the ED here that you MUST have at least one SLOR letter from EM faculty. The rest might be able to be explained away, but no EM faculty that I know of will let you in based on an FP letter that says you functioned at the level of a PGY-2; they just don't care that much what an FP has to say.

Anyways, good luck! Feel free to PM me with any questions about UT-Houston.

-Scott, MS4

 

[corpsmanUP]

I am an MS4, and just finished the month rotation at UT-Houston. You interview at the end of the month here, so if you rotate you are guaranteed an interview.

I can tell you from working with the faculty in the ED here that you MUST have at least one SLOR letter from EM faculty. The rest might be able to be explained away, but no EM faculty that I know of will let you in based on an FP letter that says you functioned at the level of a PGY-2; they just don't care that much what an FP has to say.

Anyways, good luck! Feel free to PM me with any questions about UT-Houston.

-Scott, MS4

The only problem I see with the SLOR is that it looks like it is assumed to be coming from an EM faculty at an EM program. Its specifically asks how the candidate did in comparrison to others who were accepted and such like that. I did not do my EM at a residency program. So can the EM doc do a SLOR anyway? Any ideas?

Matt

 

[corpsmanUP]

As luck would have it, I took a chance and called my old EM preceptor at the hospital where I am considering FM. She said she would not only be happy to provide me with a letter, but also be willing to keep it hush hush that I was now considering EM. I think she was happy to see someone had been influenced by her and she was very nice about it. If she writes me a nice LOR do I still have to have the SLOR? I still say that the SLOR looks like it has to have someone from an EM program filling it out.

 

[DeLaughterDO]

As luck would have it, I took a chance and called my old EM preceptor at the hospital where I am considering FM. She said she would not only be happy to provide me with a letter, but also be willing to keep it hush hush that I was now considering EM. I think she was happy to see someone had been influenced by her and she was very nice about it. If she writes me a nice LOR do I still have to have the SLOR? I still say that the SLOR looks like it has to have someone from an EM program filling it out.

MM,

I was at the EMRA meeting in DC this past weekend and went to the EMRA Med Student Forum. They had the PD from Maryland there who said that it is expected that the SLOR come from an EM faculty, preferably another PD or someone affiliated fairly high up in the ED program ladder. There are several questions on the SLOR to control for something like what you are asking - having any EP fill out a SLOR for you.. stuff like how does this student compare to others you've written letters for in the past year, how many letters have you written in the past year, how do they compare to other students you've ranked in the past year. He said if the answer to these questions are #1, 1, and #1 respectively, the SLOR is basically thrown in the vertical file..

Basically you need a SLOR from a program, or to do a rotation at a program you're interested in and kick @$$...

l8r,

jd