My residency application experience and advice

[anxious3456]

I applied to 130 EM programs, not because I was told to, but because I thought it was a bad place to save money. I got 8 interviews. If you include home and away rotations, that's 10 interviews total. Still pretty confused about the number. AMG, MD school, step scores 230s both, Pass. EM rotations P/H, ok extracurriculars, interviewers commented on the strength of the second SLOE. No red flags.

I think the reason I got a poor return on my applications is the P from my home rotation, which is home to a probably top 3 program in the country. I'd never done shifts in the ED before my sub-I, which is partly my fault. The expectations there were very high and the doc in the ED I was assigned to made it obvious she wasn't a fan of me, and I ended up in the bottom 40% with a Pass. It was nothing personal, I think, but my guess is she just wasn't used to seeing students who hadn't rotated in the ED before, and had never even done a lac repair. I worked hard and learned a lot, but it was just not enough.

Anyway, I know that according to NRMP data I'm 95%+ likely to match, but a part of me thinks that this is very skewed by people who got 20+ invites and just chose to go on 10, not people like me, who got 8 legit invites total. Pretty worried about not matching, but trying to not think about it for the next 2 weeks.

To third years reading this, I think the lesson here is that little things like a biased advisor can really mess up your ok application, and busting your ass studying for the boards could make up for possible weaknesses that you might not be able to control. Also, I think there's something to be said about doing an away first, preferably at a noon-competitive institution/area, before doing a home sub-I if your home institution has a highly competitive, hardcore residency where you'll compete against some of the brightest students going into EM.

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[RainbowOtterz]

Sorry bud, you had a red flag that was your SLOE. So did I. If you are worried now and worried that you will not match I think it would be prudent to start thinking about your backup plans.

This advice is coming from someone who didn't match last year. I recommend you have a back up plan, just in case.

Future applicants, if you're in a similar situation and worried you won't match at least think of back up plans. Early rather than later. There are a few advising posts online which give some guidance. My personal advice is that PDs and APDs seemed to look favorably on surgery prelim years, plus they come with 5 years of funding.

 

[IH8ColdWeath3r]

Sorry bud, you had a red flag that was your SLOE. So did I. If you are worried now and worried that you will not match I think it would be prudent to start thinking about your backup plans.

This advice is coming from someone who didn't match last year. I recommend you have a back up plan, just in case.

Future applicants, if you're in a similar situation and worried you won't match at least think of back up plans. Early rather than later. There are a few advising posts online which give some guidance. My personal advice is that PDs and APDs seemed to look favorably on surgery prelim years, plus they come with 5 years of funding.

Did you apply to surgery pre-lim and then matched into EM the following year? would it be wise to apply to surgery pre-lim over a medicine pre-lim?

 

[Whiteshoes]

I applied to 130 EM programs, not because I was told to, but because I thought it was a bad place to save money. I got 8 interviews. If you include home and away rotations, that's 10 interviews total.

Don't sell yourself short.

I'd love to get a PD's perspective but in my opinion, getting interviews is an extremely competitive process.

Programs get 900 apps and most probably interview 120 for 12 spots. 8 programs thought you'd be within the top 120/900. So 9/10 of your ranks are willing to look past your "pass sloe" because of your overall application. Which means THAT PD does not think it was a red flag. Otherwise they would've invited one of the other 750 remaining applicants in their pool.

Just a random persons two cents

 

[gamerEMdoc]

I'd love to get a PD's perspective but in my opinion, getting interviews is an extremely competitive process.

Very true. It was our first year in the ACGME match (former AOA program) and we had a record # of applicants. You just cant scrutinize every application. It's hard enough to scrutinize 100 applications over a four-month period, it would be impossible to scrutinize 600 applications over a month to decide who interviews.

This is why programs have filters. Geographic filters, minimum board score cut off's, minimum number of SLOEs, etc. There has to be a way of cutting that number down to a reasonable number to extend interviews to, and unfortunately it's just not realistic to try to sort through hundreds of applications in a short period of time. I'm not suggesting all programs have the same filters. Those that have board cut off's may set the number at different levels, while others don't have a board cut off's. Some may choose to only look at US allopathic candidates. But Id imagine all have at least some geographic filtering in place, looking at students from schools in and around their region first.

 

[DokterMom]

I think the reason I got a poor return on my applications is the P from my home rotation, which is home to a probably top 3 program in the country. I'd never done shifts in the ED before my sub-I, which is partly my fault.
It was nothing personal, I think, but my guess is she just wasn't used to seeing students who hadn't rotated in the ED before, and had never even done a lac repair.

Don't minimize this. The other takeaway for med students is that if you think you might be interested in a certain field, start exploring early. Show an interest in the field before your performance will be evaluated officially in a career-limiting way. The time to learn is before it counts against you.

 

[David Mitchell]

.

 

[Status Sciaticus]

what about home programs that only have a P/F?

 

[gamerEMdoc]

P/F places don't do anyone favors, but if you are getting a SLOE from them, there will be some objective ranking of your performance that will essentially substitute for a grade for people out there looking at your evaluation.

 

[MelMcT2009]

Very true. It was our first year in the ACGME match (former AOA program) and we had a record # of applicants. You just cant scrutinize every application. It's hard enough to scrutinize 100 applications over a four-month period, it would be impossible to scrutinize 600 applications over a month to decide who interviews.

This is why programs have filters. Geographic filters, minimum board score cut off's, minimum number of SLOEs, etc. There has to be a way of cutting that number down to a reasonable number to extend interviews to, and unfortunately it's just not realistic to try to sort through hundreds of applications in a short period of time. I'm not suggesting all programs have the same filters. Those that have board cut off's may set the number at different levels, while others don't have a board cut off's. Some may choose to only look at US allopathic candidates. But Id imagine all have at least some geographic filtering in place, looking at students from schools in and around their region first.

For geographic region, is it location of your med school, or location where youve lived your entire life? I spent my whole life in texas (including college), but went to med school in another state. Hoping to get back to Texas for residency

 

[OnlyOneZlatan]

For geographic region, is it location of your med school, or location where youve lived your entire life? I spent my whole life in texas (including college), but went to med school in another state. Hoping to get back to Texas for residency

Anecdotally, I was offered interviews at programs in my home state and med school state without any problem, and I was not a strong candidate (DO w/below avg stats) by any means.

 

[gamerEMdoc]

For geographic region, is it location of your med school, or location where youve lived your entire life? I spent my whole life in texas (including college), but went to med school in another state. Hoping to get back to Texas for residency

Both.

 

[wook]

Very true. It was our first year in the ACGME match (former AOA program) and we had a record # of applicants. You just cant scrutinize every application. It's hard enough to scrutinize 100 applications over a four-month period, it would be impossible to scrutinize 600 applications over a month to decide who interviews.

This is why programs have filters. Geographic filters, minimum board score cut off's, minimum number of SLOEs, etc. There has to be a way of cutting that number down to a reasonable number to extend interviews to, and unfortunately it's just not realistic to try to sort through hundreds of applications in a short period of time. I'm not suggesting all programs have the same filters. Those that have board cut off's may set the number at different levels, while others don't have a board cut off's. Some may choose to only look at US allopathic candidates. But Id imagine all have at least some geographic filtering in place, looking at students from schools in and around their region first.

Great points! With lots of applications, you have to draw the line somewhere to reduce the number of applications.

 

[RainbowOtterz]

Did you apply to surgery pre-lim and then matched into EM the following year? would it be wise to apply to surgery pre-lim over a medicine pre-lim?

I applied to surgery prelims. It has been a very difficult journey even with a supportive surgical program. Programs seemed to be receptive to be doing surgery over medicine. The rigor and the applicability of surgery was greater in the eyes of programs compared to medicine. I can thankfully say that I matched this year unlike last year. I was able to fix portions of my applications that were lacking the first year around.

 

[IH8ColdWeath3r]

I applied to surgery prelims. It has been a very difficult journey even with a supportive surgical program. Programs seemed to be receptive to be doing surgery over medicine. The rigor and the applicability of surgery was greater in the eyes of programs compared to medicine. I can thankfully say that I matched this year unlike last year. I was able to fix portions of my applications that were lacking the first year around.

Congrats! That is awesome that you matched and your response is immensely helpful. Would you mind if I PM you?

 

[gamerEMdoc]

I applied to surgery prelims. It has been a very difficult journey even with a supportive surgical program. Programs seemed to be receptive to be doing surgery over medicine. The rigor and the applicability of surgery was greater in the eyes of programs compared to medicine. I can thankfully say that I matched this year unlike last year. I was able to fix portions of my applications that were lacking the first year around.

I do agree. First and foremost, I think a prelim spot (IM or surgery) in a place with an EM program is the most important if you are going prelim route. The firsthand experience at the institution is going to be your best bet, because, in general, you'll be less competitive the 2nd time around. If all else is equal, I do agree Gen Surg prelim is probably more impressive. Anyone willing to gut out a surgery PGY1 year for a chance to do EM the following year shows how badly they want to do EM. And Gen Surgery, being a harder PGY1 year, more than likely makes you more prepared as a PGY1.

 

[EMedGrrl]

@anxious3456 how did it go?

 

[Noisewater-TDX]

Ok, idiot here. What is a SLOE and how can it hurt you?

 

[anxious3456]

@anxious3456 how did it go?

I matched, thank you for asking! Will update when I know what number on my list I matched at.

 

[anxious3456]

Ok, idiot here. What is a SLOE and how can it hurt you?

SLOE-standardized letter of evaluation. Like any letter, it's subjective, even though it tries very hard not to be.

 

[tux4]

Ok, idiot here. What is a SLOE and how can it hurt you?

Pretty sure a "pass" SLOE I received really had an affect on how many interviews I received. I ended up matching so I don't care anymore but it definitely made me feel uneasy. It was stressful because other people with similar stats were scoring 20+ when I was not near that. Had no other red flags.


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[EMedGrrl]

I matched, thank you for asking! Will update when I know what number on my list I matched at.

Congrats!

 

[wook]

I applied to surgery prelims. It has been a very difficult journey even with a supportive surgical program. Programs seemed to be receptive to be doing surgery over medicine. The rigor and the applicability of surgery was greater in the eyes of programs compared to medicine. I can thankfully say that I matched this year unlike last year. I was able to fix portions of my applications that were lacking the first year around.

Well done and congratulations!

 

[deleted547339]

SLOE-standardized letter of evaluation. Like any letter, it's subjective, even though it tries very hard not to be.

You really missed a fun opportunity by answering this question seriously.....we're all very disappointed.

 

[anxious3456]

OP here, just wanted to follow up and let you all know that I matched at my #4, which is also where I had done an away rotation. A little curious now if I still would have matched here had I ranked it #10, but I guess we'll never know. Overall, happy it worked out. Looking forward to residency.