SDSU EB

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Oct 11, 2009
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Alright, so I'm applying the military match this year as an MS4. I liked the idea of EM, especially after urgent care and trauma calls. So I asked to rotate EM, my school wouldn't allow me to rotate the specialty until I was interviewing. So my first EM rotation was as an interview rotation. Short of it: I LOVED the specialty, it was awesome, the people were awesome, I felt like I had found my niche in medicine. I was challenged, and excited about the challenge! My interview rotation felt like a very positive experience, good rapport with residents, worked well with several attendings, made more than a couple peritoneal patients giggle in pain. Good stuff.

However, I got a peek at some of my resident evals, and it seems that of the 3 I was allowed to see (the residents I had the best rapport with had either already turned them in and they'd been sorted out, or hadn't turned them in yet). And 2 of the 3 were more or less stated, "middle of the road candidate," or, "there are better candidates." For the latter eval - that critique focused on commenting on an issue I had minimal control over (transportation on and off shift) amongst other things. Thing is - I wouldn't have had the opportunity to see this feedback had I not run into the program coordinator collecting the evals, and asked. It came as a surprise, since I make a point of asking for verbal feedback after every shift, to try and fix any issues or concerns, and to try and be more than just a "middle of the road," or underwhelming candidate. It's now too late for me to truly address the issues brought up, correct any discrepancies, or work to better myself in the view of those residents.

So here I am, academically, in the military system, I'm a middle of the road candidate. My step scores are nothing to write home about. My clinical grades have largely been heart-warmingly positive in the subjective portions, but average in the objective shelf portions (leading to a string of "P").

EM in the military match is probably the most numerically competitive internship (in terms of # applicants to #selected, 42 applicants this year to 20 in-service spots for the Navy), though it seems subjective evaluations carry the most weight in the decision. I've been told repeatedly, I answer the 3AM question very well. But I'm not standing out, and at least 1 resident has a negative personal view of me.

Suggestions to move out of the middle-of-the-road, underwhelming candidate area? Ways to approach career choices going forward? General advice and thoughts are welcome!

(and now I'm super self-conscious, because a great attending agreed to an LOR, as long as I wrote it; I sent it to him, he confirmed he'd received it, but no further action has been taken on it).
 
Nov 6, 2014
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Brother,

Wouldn't asking the veterans and attendings of the military medicine sub forum of SDN be a better place for this topic? I believe they might have better insight than the denizens of the allopathic forum.

Also, would it be possible for you to rotate through the other big two hospitals within the Navy system? Granted the PDs all talk to each other but perhaps you can show improvement after the last EM rotation you just did. That might help...maybe. Also, go do a GMO, add some points to your application. Bang out some peer reviewed clinical research in EM in the next few months and get some more points.

Of course take my advice with a grain of salt since I am no where near graduating.
 
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KettleCorn

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Brother,

Wouldn't asking the veterans and attendings of the military medicine sub forum of SDN be a better place for this topic? I believe they might have better insight than the denizens of the allopathic forum.

Also, would it be possible for you to rotate through the other big two hospitals within the Navy system? Granted the PDs all talk to each other but perhaps you can show improvement after the last EM rotation you just did. That might help...maybe. Also, go do a GMO, add some points to your application. Bang out some peer reviewed clinical research in EM in the next few months and get some more points.

Of course take my advice with a grain of salt since I am no where near graduating.
+1 to asking this in Military Med. They'll have better answers for your specific situation OP. @Red Lobster Actual Navy EM only has residency spots at Portsmouth and San Diego so idk if rotating at WRNMMC would help.
 
Jul 21, 2016
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Is it too late to apply for civilian deferment? If I am not mistaken, EM is one of the specialties w/ priority for this.

Also, take my input with a giant, Lot's wife size, slab of salt.
 

Warderino92

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Jun 30, 2014
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From what I understand about mil med, naval medical officers more often than not usually have to do a GMO tour before applying to more competitive residencies right? If you can't land anything in the military arena could you do your time as a GMO and do a civilian residency instead once your commitment is up?
 

Perrotfish

Has an MD in Horribleness
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Suggestions to move out of the middle-of-the-road, underwhelming candidate area? Ways to approach career choices going forward? General advice and thoughts are welcome!
I'm Navy.

Things you can do:

1) If the ER interview rotation works the same way that Peds/Medicine/Surgery dos you are going to have the opportunity to do a 20 minute presentation. Understand that this is considered critically important. Spend a lot of time on it. Give the presentation to the wall. Then give it to an attending you feel comfortable with in the department for review. Finally make sure that attending is at the presentation when you give. A good rotation will drown out a lot of doubts, and a sloppy one is seen in a very negative light.

2) Similarly there will likely be a night, or two, where you go out to dinner with the residents. Understand that this isn't actually optional and that you are actually being interviewed just like at a civilian interview dinner (except that you will pay for your own meal). No more than two drinks, be relaxed but not complaining. Just in case you need to be told this: this is not an opportunity to hit on anyone, get drunk, or insist that you would like to do something different than the residents would like to do.

3) Remember that while the residents make suggestions, the PD makes the decision about who gets the Intern year. Your Step 1, grades, and research experience have already partially made the decision. If they're good don't stress too much.

4) In terms of what to do to look good while you're actually on the rotation: there's nothing new here. Be helpful, be accurate in your histories, be competent and concise in your A/Ps, have notes that the residents don't really need to edit, and be full of a positive attitude and a good sense of humor.

5) Remember there are 3 sites, and they have very different personalities. I recommend rotating at all of them, even though you would need to pay out of pocket for the third rotation. FWIW I had a similar experience to the one you are having now when I rotated through Portsmouth, and I got dramatically better reviews and Bethesda and San Diego. I don't think I did anything differently, those Portsmouth residents just found my sense of humor very off-putting. Too much Air Force can ruin anything, I guess.

6) If you don't rotate at all three sites, understand that interviewing at all three isn't optional. It is an expected courtesy that you will at least set up a phone interview at the site you didn't visit, and if you don't it will be seen in a negative light.
 
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Perrotfish

Has an MD in Horribleness
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From what I understand about mil med, naval medical officers more often than not usually have to do a GMO tour before applying to more competitive residencies right? If you can't land anything in the military arena could you do your time as a GMO and do a civilian residency instead once your commitment is up?
Yes and no

1) A GMO happens after Intern year, which is what OP is applying to. If you don't match into your intern year of choice then you get shunted into a different Intern year that didn't have enough applicants, like family medicine or psych. Even if you do a GMO and get out that means that when you get to the civilian world you have 3 years of residency left, rather than 2

2) Most people don't want to do a 4 year GMO tour. 2 years is (arguably) an interesting life experience, though a little bit skill deadening, but 4 years is a long time to spend away from everything other than a very limited subset of adolescent and sports medicine. If OP gets the ED internship but then gets sent to a GMO after PGY-1 he could usually come back after 2 years of GMO, finish residency, and spend the last 2 years of your commitment as an ED doc, which isn't that bad. If he matched into an FM internship then at the end of your 2 year GMO he either has to go back to FM or do another 2 years of GMO and reapply to the match at the end of his commitment.
 
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SDSU EB

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Thank you all for the excellent suggestions! Unfortunately Portsmouth nixed the Med student department wide presentations while I was there. I have WR and SD rotations set up!

Just more fearful of getting shunted to IM if I don't place high enough on the list, since TY is now full of the rads, anesthesia, backup ortho kids, I don't even come close to the numerical high ground when it comes to the traditional backup intern year, lol.

It's been a number of years since I posted on SDN and didn't think about other forums, so I will repost this over to the mil Med forum and see what advice rolls in!

(As an aside for the curious - it is getting harder for people who did something besides EM to come back and join the residency, and there are fewer and fewer GMO's coming from EM and more and more straight throughs. Despite this - I really like the idea of doing a GMO, and currently planning on tryin to get flight)