So here's the problem - due to rotation availability, I'm down to my last two shots at scheduling a 4th year ER rotation. I've had a bunch turned down already and it's starting to look like I might not actually be able to schedule a 4th year rotation. I have an SLOR that the director filled out with honors when I passed through the ER as a third year late in the previous fall. If I don't have a 4th year slor, is it pretty much over before it starts?
I believe a 4th yr SLOR is mandatory. I would look to other programs IMO you need one from somewhere. There are 130 or so residencies. They cant *all* be full from July thru September. EF
One SLOR from M3 is a poor thing with which to go into ERAS/interview season. Like EF said man, there have got to be places with spots. They may not be where you want to end up but you can't be picky now. If all else fails start calling places again, try to talk to clerkship directors and see if they can squeeze you in.
Yes, and in fact I can think of no specialty you can match in without doing a senior elective in it. You may have to bite the bullet and pay for a hotel for a month if you really want EM.
Old Mil, What region of the USA are you from and where are you looking to do your EM rotation? As everyone said, there are 130+ EM programs and so there's lots of places where you can do your 4th year elective. I'm only familiar with NY and NJ, but if you are willing to come to NY or NJ for electives I can suggest a few hospital that have EM programs and it's pretty easy to schedule EM electives there. In NY, Lincoln Hospital and Brooklyn Hospital have pretty good EM electives and their medical student coordinators are nice and helpful and so setting up an elective there will be no problem. In NJ, Newark Beth Israel has a good elective and it's also very easy to set up electives there. Beth Israel also supplies free housing in the hospital for students. Just a few suggestions if you willing to live in NY or Newark. There are lots of places in NY especially that have great EM electives, but many of these have home schools whose students take up most of the EM slots and so it's farely hard to secure an elective there. As others have mentioned, it's very important to have a 4th year SLOR as a 4th year student's responsibilities in an EM elective are very different from a 3rd year student. Good luck and I hope everything works out for you.
Thanks for the feedback everyone. My hands are a bit tied by the policies of our school which (1) requires 2 months of mandatory family medicine 4th year, (2) reads us the riot act if we contact rotation sites independently outside of the institution, and (3) only allows us to request one rotation at a time for any given month.
Someone should try to get those rules changed with information to back it up because if other schools allow you to schedule for the whole year, you are out of luck with finding any spots. Also, I'm pretty sure most hospitals want more than one month notice (or will already have that month full). Do you know why they made these rules?
I am just a student, but can you talk to previous year IV students from your school, especially those who matched in EM? Perhaps, they can share their knowledge and wisdom with you. Also, you will know which program(s) take students from your med school. good luck.
It's really unfortunate how schools use these rules and end up actually hurting their students' chances of obtaining the residency spot that they want. As others have mentioned, probably your best bet is to talk to the outgoing MS IVs from your schoo who have matched into EM and ask them where they did their 4th year EM elective. Good lucks with everything.
What school is this? I want to reiterate that you need to get aggressive -- this is your career. Meet with the Dean and discuss the situation: for whatever reason you are late in the game and don't have EM rotations set up. You should be professional but insistent. Like I said it is also time to to figure out a few places and get on the horn with the clerkship director. Most of the people that direct these things are incredibly cool and I'll bet you could find one to squeeze you in.
Old_Mil, there are still plenty of November and December spots available. Well maybe not "plenty" but they are still out there. I started a little late and I have two rotations lined up for October and November. Also, if you're really keen on a particular program you can contact the Course Director (MD) directly and ask if they can squeeze you in. I did that to get a rotation at Chicago in October, and they were going to put me at one of their satellite hospitals (Lutheran I believe) which is their only Trauma I hospital, working with their faculty attendings there. I ended up not signing up for that for various reasons, but the point is made I hope. You've got to be a bit aggressive cause it's your future, as others have said. As far as your home school's rules, that blows. Maybe it's better to beg for forgiveness then ask for permission? Best of luck!
For what it's worth - I just dropped my slot at Advocate Christ in Chicago for Sept 15 - Oct 14. They have a great ER program and their application is SHORT. I dropped because of scheduling conflicts and I already have two ED rotations under my belt. PM me if you want an email address for contacting them.
What state are you from? I think a SLOR from 3rd year will be okay to get the interview, but you will need a 4th year rotation by December to be taken seriously. Otherwise it looks like EM is not your first choice and you used elective time for something else; it would seem odd... If your 3rd year SLOR is from someone known in EM, it may be fine. Feel free to PM me if you want a rotation in the NYC area.
