Need some advice (medical student)

[J.FARKS1001]

Hi guys,
I apologize if this is the wrong place to post this, and I know there are several other similar posts about "chances" but I'm looking for a little bit of more in depth advice if anyone could help me out.

3rd DO student in PA, 573 comlex 223 Step 1, Probably around middle of the pack in my class. I was an EMT for 3 years in college at a pretty busy fire dept., ER scribe for 1 year member of a few clubs in med school. Got a "P" on everything in med school so far (no honors but no failures). No research but trying to find a project.

My Questions:
-In your opinion, should I apply to the Osteopathic Match, Allopathic match, or both next year?
-Should I write my personal statement on my experiences as an EMT or is this kinda glanced over by EM Program Directors because its so common?
-Can/should I do an audition rotation before I go through my required EM rotation 4th year? (I want to start getting my letters and the school scheduled me for a september EM rotation)?
Anything else I should try to do to boost my application (Besides rocking Step 2)?

Thanks, I appreciate the advice. I know its annoying.

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[traitorman]

apply both matches and see where you get more interviews to determine which match to participate in. I didn't take USMLE and my Comlex scores were average so I didn't apply ACGME. From an osteopathic standpoint, your application is better than mine, and I was able to get multiple DO interviews. I was also a scribe, have no research, hardly honored any 3rd year rotations, and didn't honor any 4th year auditions (but my letters were apparently really good)

you want to get your SLOEs in asap. (I didn't get my second one until November and a lot of osteopathic programs already filled their interview spots by that point). Whether it's July or August, I felt you had a little bit of leeway if they knew it was your first EM rotation so I personally would try to do one early.

 

[dotcb]

Hi guys,

-In your opinion, should I apply to the Osteopathic Match, Allopathic match, or both next year?
-Should I write my personal statement on my experiences as an EMT or is this kinda glanced over by EM Program Directors because its so common?
-Can/should I do an audition rotation before I go through my required EM rotation 4th year? (I want to start getting my letters and the school scheduled me for a september EM rotation)?
Anything else I should try to do to boost my application (Besides rocking Step 2)?
\

-Both
-Write whatever you feel strongly about. Make it interesting and have a few people proofread it.
-Do your home rotation first, then aways.
-Rock Step 2. Try to get some Honors. Honor you Sub-I's.

 

[BoardingDoc]

-Both
-Write whatever you feel strongly about. Make it interesting and have a few people proofread it.
-Do your home rotation first, then aways.
-Rock Step 2. Try to get some Honors. Honor you Sub-I's.

Agree with all of this. Particularly the last line. If nothing else, you need to do well in your SubIs. Obvious ways to do that.
1: Work hard
2: Always be on time
3: Be friendly and eager to help whenever people need/want your help
4: Take good care of your patients. It's better to see 3 people in a shift and do a great job with all of them, than to see 7 and do a so-so job with them.

 

['murica]

-In your opinion, should I apply to the Osteopathic Match, Allopathic match, or both next year? can't hurt to apply to both
-Should I write my personal statement on my experiences as an EMT or is this kinda glanced over by EM Program Directors because its so common? I've been told by a PD that 90% are mundane, 5% terrible and 5% amazing, and that the EMT/EDtech thing is a very common topic. However, like mentioned above, write whatever you feel strongly about, the PS is not a huge deal unless you are a horrible writer or have multiple errors in it.
-Can/should I do an audition rotation before I go through my required EM rotation 4th year? (I want to start getting my letters and the school scheduled me for a september EM rotation)? I would absolutely do one. If you only have one EM letter in October you are going to have trouble getting interviews in the ACGME match. Ideally, you should have at least 2 EM letters when applications go out to maximize your chances. It's usually best to do a home rotation first though, see if you can schedule it earlier.
Anything else I should try to do to boost my application (Besides rocking Step 2)?
agreed with boarding doc 100%.

 

[littlejuan]

223 Step 1 is fine for the EM match. Just make sure to improve on Step 2. I would apply to both EM and DO. Apply broadly as well. I did an audition rotation before my home required EM rotation, but that was due to scheduling conflicts. It turned out just fine though, I completely rocked my audition rotation. That is the key here. Work hard, always be up for anything, get involved in codes, be proactive. You have to do very well on your EM rotations if you want to stand out. There is not much else to do in order to really stand out at this point. Make sure you have a very clear, concise personal statement that is not the generic "as I was doing compressions for the first time, I knew right then that EM was for me" or something to that extent. Try to tell a unique story if you can, and keep it to 3 overarching ideas/key points. It's okay if your personal statement is mundane really, very few of them stand out, just make sure it doesn't stand out for the wrong reasons. Like others have said, try to write about something you are passionate about.

 

[gman33]

The personal statement can only really hurt you. A generic concise letter is fine.
Everyone tells you to honor rotations, get 250+ on the steps, etc. Just do the best you can.

I would do your home rotation before any away.
They will likely be generous with your grading if they know you are going into EM.
The EM block is vastly different from floor medicine and such.
Most students have no idea what they are doing.
If the first time you experience this is at an away, it may lead to a poor grade and SLOE.
This will kill your chances.

If possible try to meet with one of the residents and get some info on excelling during the block.
I do this all the time with students and hopefully they find it helpful.

 

['murica]

while I agree with people that home rotation before an away would be ideal, as long as jfarks doesn't think he'll blow his first rotation, I think it's more important to have at least 1 SLOE in by the time the MSPE goes out in early October. In the comments section of this ALiEM video, multiple PDs state the same thing. http://www.aliem.com/em-match-advice-em-rotation-eras-competitive/#disqus_thread

 

[gman33]

No one thinks they will blow a first rotation.
The problem is that many have an average rotation, mainly because they don't understand how to evaluate and present in the ED.
Do the home rotation first if possible.
Get letters as soon as possible.

Being late is better than having a bad eval that was submitted on time.

 

[BoardingDoc]

The problem is that many have an average rotation, mainly because they don't understand how to evaluate and present in the ED.

Exactly this. If you do an away somewhere you should be doing your absolute best. If you do a decent job, don't make any major mistakes and test well, you'll do fine on the rotation, but you aren't likely to match there. Why? Because the away is literally designed to be your chance to shine and put your best foot forward. If your best work is merely average, that says something

 

[J.FARKS1001]

Thanks for all your replies, I really appreciate it. One more question, as far as SLOE's go, would rotating at 2 DO residency facilities and getting SLOE's from them hurt me for the MD match?

 

[WalkingCorpse]

Thanks for all your replies, I really appreciate it. One more question, as far as SLOE's go, would rotating at 2 DO residency facilities and getting SLOE's from them hurt me for the MD match?

Probably. I would try to get at least one from an MD or a dually accredited program.

 

[DarkHorse22]

Thanks for all your replies, I really appreciate it. One more question, as far as SLOE's go, would rotating at 2 DO residency facilities and getting SLOE's from them hurt me for the MD match?

PM me. I was in a very similar situation. If you want an honest chance at matching in the MD match, I would rotate at at least 1 MD program, if not 2.

 

[racerwad]

Thanks for all your replies, I really appreciate it. One more question, as far as SLOE's go, would rotating at 2 DO residency facilities and getting SLOE's from them hurt me for the MD match?

I'm a DO with similar stats that applied this year MD. I had a SLOE from an osteopathic program that generated questions - where is this place, what was it like (county, academic, etc) - but probably did not help or harm. I did also have enough MD SLOEs as well by the time ERAS was opened up in September. As everyone else has said, great SLOEs is key. Good luck.

 

[JimmyB123]

I'm a DO with similar stats that applied this year MD. I had a SLOE from an osteopathic program that generated questions - where is this place, what was it like (county, academic, etc) - but probably did not help or harm. I did also have enough MD SLOEs as well by the time ERAS was opened up in September. As everyone else has said, great SLOEs is key. Good luck.

Did you get a good number of interviews at MD programs?

 

[racerwad]

Did you get a good number of interviews at MD programs?

16 invites, 14 interviews; applied to ~65.

 

[J.FARKS1001]

I'm a DO with similar stats that applied this year MD. I had a SLOE from an osteopathic program that generated questions - where is this place, what was it like (county, academic, etc) - but probably did not help or harm. I did also have enough MD SLOEs as well by the time ERAS was opened up in September. As everyone else has said, great SLOEs is key. Good luck.

Any tips on how to get great SLOEs? (Besides the obvious get in early, stay late, volunteer for everything, know your stuff?) I may have covered everything, but maybe I'm missing something.

 

[Pons Asinorum]

Any tips on how to get great SLOEs? (Besides the obvious get in early, stay late, volunteer for everything, know your stuff?) I may have covered everything, but maybe I'm missing something.

Don't underestimate the power of getting in early, staying late, volunteering for everything and knowing your stuff. I would addend the "knowing your stuff" part to include making sure that after every assessment comes a plan and disposition, with a brief explanation for why you are proposing that plan and that disposition. It sounds easy when you type it. Adhering to that plan for 12 hours per shift x 16 straight shift (or whatever) on a Sub-I ain't easy. Remember, you're starting from a cold zero most shifts, working with different attendings and residents. Lots of people only work with you once. Don't let that once be the shift where you deviate from your handy dandy 4-step path to SLOE domination.

 

[racerwad]

Don't underestimate the power of getting in early, staying late, volunteering for everything and knowing your stuff. I would addend the "knowing your stuff" part to include making sure that after every assessment comes a plan and disposition, with a brief explanation for why you are proposing that plan and that disposition. It sounds easy when you type it. Adhering to that plan for 12 hours per shift x 16 straight shift (or whatever) on a Sub-I ain't easy. Remember, you're starting from a cold zero most shifts, working with different attendings and residents. Lots of people only work with you once. Don't let that once be the shift where you deviate from your handy dandy 4-step path to SLOE domination.

I agree. In addition, part of knowing your stuff is knowing where your knowledge gaps are in relation to both a specific patient and medicine in general. By and large, I am dumb as **** but I did ok by following the above advice and being confident about those few things I did know or could do well.

Most of the time, the faculty expect very little of you in terms of patients-per-hour productivity. Use that to your advantage and take a moment before going in to a chest painer's room to review all of the pertinent ROS stuff you'll want to cover, build a comprehensive differential and the tests/exams to explore those differentials and then put it all together into a coherent assessment and plan. Even if your A&P is totally off the wall, most of the faculty I've worked with were generous in their treatment of my plans and were careful to not confuse me with one of their residents.

It is helpful is to run your workup past a senior resident prior to your presentation. IMHO, the better programs out there are full of residents that are more than willing to help you buff your plan and make you look good for the attendings. It isn't cheating to ask for help - you're a student. Moreoever, many of the residents are there to become better educators themselves so they often will jump at the chance to help out.

To use a tired cliche: fake it till you make it. When it is time to present, do it like a competent, confident resident, rather than a terrified 4th year. Rehearse it in your head, don't say "uhhh", admit when you don't know, and say that you will do the things in your plan (intubate, LP, rectal, etc). Don't perseverate and hope they let you get the tube. Say you've calculated the Roc dose, your blade preference is X, and have lube and a hemoccult card in your pocket.

Good luck. Make it happen!

 

[res1cue]

Any tips on how to get great SLOEs? (Besides the obvious get in early, stay late, volunteer for everything, know your stuff?) I may have covered everything, but maybe I'm missing something.

I will also add that many places, the definition of Honors is performing on an intern level. One of the most important aspects of that is to make sure you take ownership of the patient, as if you really were the resident taking care of the patient. Always be up to date with results of labs/imaging and know how that changes your plan. Always be thinking about the disposition and how to progress towards it. Reassess the patient often, and see if they need more zofran, or recheck their vitals

 

[J.FARKS1001]

thanks for all the advice guys, I really appreciate it. wouldn't expect anything less from future/current Emergency Docs, you make SDN seem sane!