Less Competitive Programs

[wadigga33]

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Hi. I am posting this question and have checked other threads to avoid duplicate posts..I scored below average/average on my Step 1(had some personal family issues going on) and am looking at EM programs that are not highly competitive. Most of the posts here have been about the best programs or the most competitive but I am trying to be realistic and knowing that i may not be the best candidate, i need to target programs that i might have a greater chance of getting in..any suggestions for programs? I have looked at programs that didnt fill last year and will do again this year..any help would be great. thanks

 

[USCDiver]

Jack in the Box

 

[BeerIsGood2Me]

Fear not wadigga, there is always hope.

First off, I wouldn't ask the question "what residency is the least competitive?" I think the better question you should ask yourself is how to improve your chances of landing a quality residency. One fallacy I have found in my medical infancy is that everyone assumes that the big name programs offer big time training. I think the main point is to find a residency that fits you (gut feeling, how the residents get along with each other, curriculum, location, career options, etc).

Second, from what I am told board scores are only a piece of the puzzle. However, there are programs that get thousands of applications and use board scores as cut offs to sift through the applications. If you choose to apply to go to a place that is popular, I would highly reccommend doing a rotation there, do well in your third year rotations and taking step 2 early with the hope that you will kill step 2. After glancing on these forums, I hardly see board scores less than 220 (responder bias). Yet, there are people who match with less than average board scores. Take a look at the NRMP match outcomes for 2005.

Also, there is an article that was published that ranked the important factors program directors look for in applicants. If I recall correctly, one of the top points in that article is to do well in your clerkship rotations, especially your Emergency Medicine rotation. I have personally known some people who did average to sub average on their board scores but rocked their EM rotation to get honors. They put their appilcation in early and now are interviewing at some pretty darn good places.

Hope you and your family are ok now and that you all had a great holiday seson.

 

[monkeyarms]

i would second the above advice, but would add that i think you should try to identify a couple of things in your residency search:
1) some sort of faculty guidance, either from your home school, a place that you rotate, or a virtual advisor from saem.org. hunting around here is likely to get you the same old tired jokes in response to your queries.
2) which regions of the country you are considering. competition is pretty variable based on where you want to go. no question there is a spot for you as a us grad with your head screwed on straight. i know plenty of people who landed their requisite 8-10 interviews at programs they liked in cities they liked with below avg step scores.

 

[Dr.Evil1]

Above advice is great. When you are looking at choosing a residency one of the main factors is often location. There are plenty of GREAT residencies in areas of the country that are less apealing to many people. When casting your wide net (which is the other part of the plan) try to focus on residencies that are well established and have a good reputation but are not in popular cities like NY, Chicago or virtually anywhere out west. Cities like Detroit (where I was born, raised and now train) are excellent places to train but do not have the national apeal to applicants that can make a similar program in a more popular city out of your academic reach. I won't name any other cities that are less apealing for fear of offending others, but you get my drift.

That is my two cents. Also remember that you haven't finished with the portfolio that you are presenting to programs when you are applying to residency. Your step 1 score only repersents a small portion of your overall package. I have a great friend who actually failed a couple of classes and had to repeat a year of medical school that ended up matching at his #1. As said before there is likely a spot that is out there waiting for you. Good luck.

 

[membsr-8890]

Apply to a variety of schools no matter how competitive you think you are. Your choice should be based on location, experience, advisors, voodoo, etc. Just make sure they are not all in California, and not all "top-tier" (Denver, Cinci, Indy, Carolinas, etc.).

Apply to enough programs to get at least 8-12 interview offers. This (safely, albeit) means about 20 programs if you're very competitive, 30 programs if you're about average, and 40 programs if your application has some problams.

That being said, EM, in my humble estimation, is not as board-score-batty as some other specialties so don't leave highly desired programs off your list just because you think they won't be iterested - you never know, and it's only a few extra bucks.

It is almost more impossible to determine which programs are bottom-tier than which ones are top-tier. Hennepin, for instance, is on my personal bottom-tier just because of location but probably most of the other readers on this site would leap to disagree. Some of the newer programs might be less competitive because not everybody is willing to go with an unknown, but even this is widely debatable. MUSC, for example, is brand new this year but for all I know it could end up being super-competitive - what if everybody they interview has a pioneering spirit and is dying to live in Charleston?

Oh yeah, and read all the excellent stuff everybody else already said.

 

[EM_Rebuilder]

For us with less than stellar scores, the key factor is to apply broadly!!! Apply to 60+ programs, and only nix the places you are certain you just could not even stand living (for me that was places like CA and NYC). You will probably be pleasently surprised with the number of interviews you end up getting, and chances are much in your favor to match at one of your top 3.

As mentioned, pick two places to do an away rotations. Avoid going to a place that might be highly desirable as they are more likely to see many super stars, and even if you are awesome, they might have a hard time taking someone with mediocore scores. You need to go somewhere with at least a decent name and allows you to stand out from the crowd. Be Mr dependable and the cool guy to have on a shift, arrive early and stay late!! Get a SLOR from the PD.

I think the biggest take home message is to NOT sale yourself short, even though you do not have 250+, you are a hot commodity to much of the EM market.... do not automatically think you will have to settle for something you really do not want.. chances are you will find a decent program that fits well.

Good luck and PM if I can be any other help.

I always like to add the disclaimer that I am a MSIV going through the process and am just relaying the information I have learned/gathered from this board and other sources...

 

[CueDoc]

all great points... i disagree with one thing... do an away at a highly competitive school and another at a place that is good but not "top-tier". Even if a place sees super-stars and it is tough to match there, a good letter from a well known PD ups your stock tremendously.

 

[beyond all hope]

Tend to be in out-of-the-way places.

Most candidates apply to programs based on geography. The programs in desirable areas get more applications and therefore are more competitive regardless of merit. There are lots of exceptional programs which are not as competitive simply because they're not in sexy cities like NY, LA, etc.

Also agree boost your resume with a letter from a well-known faculty member and Honors on an EM rotation.

 

[beyond all hope]

Tend to be in out-of-the-way places.

Most candidates apply to programs based on geography. The programs in desirable areas get more applications and therefore are more competitive regardless of merit. There are lots of exceptional programs which are not as competitive simply because they're not in sexy cities like NY, LA, etc.

Also agree boost your resume with a letter from a well-known faculty member and Honors on an EM rotation.

 

[deleted109597]

Also, for reasons that are fairly obvious to most, the 2-3-4 programs are, as a whole, less competitive from a numbers standpoint simply because there is a huge block of students who don't want to put up with an intern year.
That's not to say there aren't some out there that attract big score people, but we are speaking in general.