That sounds reasonable Ectopic. I do agree that 2 is ideal. The main point of my thesis though was to keep the hopes high of the applicant who does not have the ability to schedule their EM rotations the way they would like. Benzo, lots of people don't have a home program. Think about people in the Dakotas, half the med schools in Texas, Montana, Oklahoma, Kansas, non-Vanderbilt-Tennessee territory, and many other med schools who simply don't have en EM rotation. There are also many med schools who don't have a required EM rotation. Worse than that, there are ones like mine who require it but at least half the class will not do the rotation until after Christmas in the Spring. I really think the term "commitment" is overrated at this juncture in a med student's career. We punish applicants who come late to the field in senior year because they are not "commited" but then when we run them off we tell them the next year that they aren't desired because they already have a year of post graduate training. So they are left to apply to the programs who don't care about this issue or to the 2-4 programs. Its a bad situation. It really is common I believe to do an EM rotation and then realize you have found your home when previously you wanted to do something else. I can tell you that as a hopeful PD in the year 2015 or later, if things are still as they are now, I'll make a concerted effort to NOT care if someone has 2 EM rotations before match, or even one if they can explain it away. The bottom line is that a lot of applicants know they want to do EM but just can't get their schedules to work to fit in 2 EM rotations. Some have a tough time with even 1. Show me some good board scores, and bring to the table a fundamental understanding of EM based on other scholarly activities, and to me that person is as competitive as the applicant who half the time stood around for a month at some academic powerhouse trying to get a letter. I bet a good 25% of applicants bring extra life experiences in EM to the table, and why should these people need 2 rotations? I chose to do ICU's and a sub-I medicine because I knew I could do more as a student. And these rotations were way more useful than being allowed to see some fast track or low acuity patients in the ED at a rate of 4 per shift!
And if you are a DO, your school likely does not encourage or assist your interest in EM. It can be an uphill battle trying to schedule even 1 EM elective, and there might not even be a core. Plus, as I said before, even though we have a core, we have pass/fail grading as MANY schools now do in 3rd and 4th year. So having a "pass" for a core EM does nothing to help the PD decided if you are worth something. Its the letters that matter, so if you can get them, I think thats what matters. I got letters from 2 docs I had worked with as a PA in the past.
So don't slit your wrist if you aren't able to come up with 2 EM rotations before match. Just prove yourself in other ways.
