Official WAMC thread for EM applicants

[Smiths11]

Hello all,

I posted a couple of times earlier this season in regards to my interest in EM, and just wanted to give an update and post a couple of more questions. I have low scores, and the only way I've been getting interviews is through auditions. I'm currently on my 4th audition. The good news is that not only am I absolutely loving EM, but I'm also noticing the change in my knowledge and skills. I can really feel the difference, and more importantly I can see the difference in attendings and residents when they respond to my presentations, and when I reply to their pimping sessions. I posted a thread a few months ago about my wariness towards night shifts for which I got a lot of heat, but I must say that I love nights now even more so than days. All in all, I know EM is "the one" for me.

My first 3 rotations I received 2 high passes and 1 honors. This month I'm averaging honors based on evals thus far. I have my interview at the end of this rotation, next week. Needless to say I am going to have my work cut out for me to defend myself challenging my abilities given that I suck on paper. I am not sure how to take this approach. Seems like EM is so competitive now, so there is no reason for them to take me over the all the 240s and 250s out there. But one thing I do have going for me, in addition to solid clinical performance, is that I have great personality (imo) in terms of getting along with others and making friends. I am really hoping to spin these abilities to compensate for my board scores. Essentially I want to send the message that "I acknowledge that I suck on paper, but you saw firsthand that clinically I've been great as a student, and I'm likeable". Any suggestions on how I can do this?

They're also going to ask me why I did so poorly on Steps and what I learned from my experience, and how I can ensure that I will pass Step 3, and become board certified. Obviously their chief concern is their stats, and they wouldn't want to take me in if they think I will **** up those stats. The truth is that I am a much better learner clinically than I am with the books. And being where I am happy, like in EM, will have a great positive impact on my future exams, as I am so much more motivated. I know myself, and that's just the way I operate, for better or worse. Contrarily, 1st/2nd years were a struggle for me, as I wasn't having fun and that resulted in bad scores, but this won't be the same going forward. Would it be okay for me to offer to take an SAEM exam, just to prove to them I know my stuff? Or would that be way too absurd?

Any suggestions, tips are appreciated. Thanks in advance.

---

Members don't see this ad.

 

[BoardingDoc]

Would it be okay for me to offer to take an SAEM exam, just to prove to them I know my stuff?

I don't foresee a program director taking you up on this offer. It seems awkward and desperate and if anything, only serves to highlight the fact that you have subpar board scores.

 

[Smiths11]

I don't foresee a program director taking you up on this offer. It seems awkward and desperate and if anything, only serves to highlight the fact that you have subpar board scores.

Another possibility, which I forgot to mention is: one of my rotations actually required us to take an end of month SAEM exam. I scored honors on it, and hopefully the grade was good. Would it also look bad if I try to retrieve the score report and email it to PDs as an "update" to my application?

 

[CliveStaples]

So are you saying that you have interviews and you want to know how to handle questions about your academic performance?

First, I would try and encourage you by saying that if you do have interviews, that it means that a program does think that you have a rankable academic record (yes, they are at places you have rotated, but you have to carry some confidence into an interview). You will likely get questions about your board exam scores and your job is to explain any reasons why your scores are low while not making excuses. After any explanation, your job is to demonstrate that you have the insight to see that you need a plan for improvement and offer some plan that you believe will prepare you for your boards as a resident (i.e. "I know that one thing that would have helped my Step performances would be to do more practice problems early, so in residency I plan on making a question bank schedule to do regularly and often").

Under no circumstances do you want to do things like offer to take exams or offer score reports for things like the SAEM exam. It's an odd thing to offer and only highlights the difficulties that you've had. Again, only allow the interview to focus on your academic record as much as the interviewer asks about it. Don't offer to take the interview in a direction which is a weakness for you - spend your time highlighting your positive attributes but be prepared for the eventual academic record question.

Literally the only way your good SAEM exam score should be conveyed on your application is if it somehow ends up in your SLOE from that institution. But I would caution you not to ask the program to add it to the letter; it will only serve to highlight your academic deficiencies to one of the programs most likely to rank you.

It sounds like you have done well on your rotations, so I hope that these institutions are willing to look past their academic concerns. Good luck!

 

[goodoldalky]

Another possibility, which I forgot to mention is: one of my rotations actually required us to take an end of month SAEM exam. I scored honors on it, and hopefully the grade was good. Would it also look bad if I try to retrieve the score report and email it to PDs as an "update" to my application?

Doubt that would be helpful at all (perhaps some PD's could chime in). The good news is it seems as though you are passionate, motivated, and doing well clinically.

 

[gamerEMdoc]

No emailing a random SAEM grade isn't going to make or break your application. They become part of a rotation grade for many rotations, but I don't think a random PD is going to care much about a mass emailing of an SAEM end of rotation score.

You are saying you are getting all HP and Honors. You are saying you have a great personality. Assuming these are both true, you have nothing to worry about. Board scores help you get interviews. EM grades, SLOEs, and the interview are what determine your rank list position for the most part. If you have plenty of interviews, you have nothing to worry about.

 

[The White Coat Investor]

You're not getting legitimate interviews. That's a very bad sign. You are super high risk to not match. I hope you applied very broadly. Now is the time to start calling/emailing program directors and residency directors and expressing how incredibly interested you are in their programs and emphasizing how willing you would be to fill an interview slot when someone drops out.

 

[WildcatS11]

You're not getting legitimate interviews. That's a very bad sign. You are super high risk to not match. I hope you applied very broadly. Now is the time to start calling/emailing program directors and residency directors and expressing how incredibly interested you are in their programs and emphasizing how willing you would be to fill an interview slot when someone drops out.

This is the most reasonable advice yet. Ask your home PD/APD's to make some calls on your behalf, if they are willing.

 

[gamerEMdoc]

You're not getting legitimate interviews. That's a very bad sign. You are super high risk to not match. I hope you applied very broadly. Now is the time to start calling/emailing program directors and residency directors and expressing how incredibly interested you are in their programs and emphasizing how willing you would be to fill an interview slot when someone drops out.

Maybe I missed it, but did the OP state how many interviews they got? Hard to judge their match chances without knowing how many interviews they got. I do agree though, if you don't have many interviews at this point, you better have a good backup plan. Time is running out...

 

[The White Coat Investor]

Maybe I missed it, but did the OP state how many interviews they got? Hard to judge their match chances without knowing how many interviews they got. I do agree though, if you don't have many interviews at this point, you better have a good backup plan. Time is running out...

He said he had four, and they were the four places he rotated at. i.e. programs interview everyone who rotates at their place whether they will rank them or not. It's a free interview. The fact that he hasn't been invited to an interview by December 14th is a very bad sign. I mean, a lot of people have already been to half their interviews and have probably been invited to all the interviews they're going to get.

 

[gamerEMdoc]

He said he had four, and they were the four places he rotated at. i.e. programs interview everyone who rotates at their place whether they will rank them or not. It's a free interview. The fact that he hasn't been invited to an interview by December 14th is a very bad sign. I mean, a lot of people have already been to half their interviews and have probably been invited to all the interviews they're going to get.

I see. I didn't read it that way, but now that I re-read it, I see what you are saying. Only interviews were at audition places. Yeah, at this point, I'd have a backup plan if there have only been 4 interviews. I doubt mass emailing places will help get many more interviews, if any at all, but there will be cancellations around the holidays, so maybe they'll get lucky if a program sees the email the same day they get a cancellation.

 

[The White Coat Investor]

This is the most reasonable advice yet. Ask your home PD/APD's to make some calls on your behalf, if they are willing.

Right. There's nothing to lose by making some personal calls and emails and asking everyone you know to do the same for you. You're not going to lose an interview you would have gotten anyway. You've probably already got all the interviews you're going to get by following the normal protocol of applying in September and waiting by the computer.

 

[Smiths11]

@gamerEMdoc @thewhitecoatinvestor

I tried the first round of cold calling a bit over a month ago. Unfortunately, about 20% of the time it results in a rejection letter, and 80% of the time the PD or PC don't answer repeated calls or emails. I hear they get hundreds of emails a day.

I will try again though, hoping for cancellations.

This is the most reasonable advice yet. Ask your home PD/APD's to make some calls on your behalf, if they are willing.

I don't have a home program. Would it make sense to talk to PD's of the programs I've rotated at, asking them if they can make some calls? Or is that unprofessional? They all know my lack of competitiveness as well, so maybe they would be willing to help?

If anything, what if I ask them to give a call to other programs associated with their schools? Like if X Medical School is associated with 2 different programs, and I rotated at one of them, can I ask the PD to call the other one?

 

[Makati2008]

@gamerEMdoc @thewhitecoatinvestor

I tried the first round of cold calling a bit over a month ago. Unfortunately, about 20% of the time it results in a rejection letter, and 80% of the time the PD or PC don't answer repeated calls or emails. I hear they get hundreds of emails a day.

I will try again though, hoping for cancellations.



I don't have a home program. Would it make sense to talk to PD's of the programs I've rotated at, asking them if they can make some calls? Or is that unprofessional? They all know my lack of competitiveness as well, so maybe they would be willing to help?

If anything, what if I ask them to give a call to other programs associated with their schools? Like if X Medical School is associated with 2 different programs, and I rotated at one of them, can I ask the PD to call the other one?

Are you osteopathic? If so you will have an uphill battle with low scores (moreso than your MD counterparts. Also how low are they?) . Also did you apply to any of the previous osteopathic places that went acgme?

Good luck man. You've seemed to have changed for the better.


Sent from my iPhone using SDN mobile app

 

[BoardingDoc]

I don't have a home program. Would it make sense to talk to PD's of the programs I've rotated at, asking them if they can make some calls? Or is that unprofessional? They all know my lack of competitiveness as well, so maybe they would be willing to help?

If anything, what if I ask them to give a call to other programs associated with their schools? Like if X Medical School is associated with 2 different programs, and I rotated at one of them, can I ask the PD to call the other one?

This makes literally no sense. You are asking if a program director, at a program where you're applying, would be willing to make a phone call on your behalf to help you get into a different program????

What?

 

[gamerEMdoc]

I have to agree. There are two scenarios:

#1. PD at the program really likes you. Then you ask them to call other programs to get you an interview. It would look to them, no matter how you phrase it, like you are trying to go elsewhere
#2. PD at the program sees you more as a mid to lower tier student. Then you ask them to call other programs to get you interviews. They will like you even less, and you jeopardize them just not ranking you altogether.

This is a lose, lose scenario IMO. If you had a close advisor or something at your school, I could see them reaching out to their contacts. I've written to a program before (candidate didn't know about it at the time) to an allopathic program back when we were AOA only, and not only did it get the candidate an interview, they matched there. EM's a small world, and sometimes someones word does matter. But it would have to be the right person, and I don't think a PD at one of the few places you got interviews is the right way to go. Too high of a risk of alienating one of your few chances.

I think, mid-Dec, at this point, you have to start preparing for the reality that you may not match in EM. You still have a chance, you have those 4 interviews, but statistics are not on your side. You are unlikely to dig up 6 more interviews in the next few weeks. You really need to start formulating a backup plan, whether thats applying to a second field, preparing to scramble into FP, applying to an osteopathic PGY1 year (if you are a DO), etc.

 

[pooperdooper]

Just trying to see what this year's cycle is bringing in terms of invites for people with scores that might be considered "low"

 

[CliveStaples]

I've gotten 20 interviews with a very low step one score with a significant step 2 score (up to average). My SLOEs were very good.

I would say SLOEs have had the most impact and having a step 2 score which makes my academic record not scream "he might struggle with his boards."

 

[supinationpronation]

What geographical area? Mix of tiers?

I've gotten 20 interviews with a very low step one score with a significant step 2 score (up to average). My SLOEs were very good.

I would say SLOEs have had the most impact and having a step 2 score which makes my academic record not scream "he might struggle with his boards."

 

[Thandyie]

I'm also on the 20 interview invite train with a low step 1 and average step 2. I've had several interviewers comment on the strength of my sloes so I guess that's my saving grace.

Mix of programs geographically. Some definite reaches as well.

My advice is to reach out to the programs that you are really interested in. I had some luck doing that.

Feel free to PM me with any questions.

 

[CliveStaples]

What geographical area? Mix of tiers?

Midwest, southeast, mid-Atlantic, and a couple in the northeast. Didn't apply west coast so I can't really comment on that region. Mix of academic and community programs. Can't really speak to "tiers" since I don't really know what that means (doximity is meaningless in EM) but there are a small group of programs that I was interested in that I'm sure I didn't get play with since I was screened out by my Step 1 score - but I've also gotten interviews from places who list a Step 1 cutoff on their website that I'm lower than.

 

[AlgernonMed]

Are your step 1 scores actually low or just SDN low?


Sent from my iPad using SDN mobile

 

[Thandyie]

Actually I thought about a backup low.

 

[alpinism]

You can get plenty of interviews with low scores but you have to be willing to apply broadly and to less desirable locations.

Unless you have some killer SLOEs or extracurriculars I wouldn't expect much love from places like Cincinnati and Denver.

 

[EMincognito]

Legitimately low Step 1 (<210). Below average Step 2. Average grades, no red flags, what I believe are good SLOEs. So far, 15 invites and 2 waitlists. Northeast/mid-Atlantic programs, about half in major cities, the rest in small cities/suburbia; and a couple of California surprises that my advisors had told me would not be worth applying to with my scores...

Interestingly, so far not one interviewer (estimating 4-5 interviewers per program, so n~40 at this point) has asked me about my step scores, but a number have mentioned liking my personal statement, which is opposite of what my advisors told me mattered in terms of getting an interview. So my take home is that this process is pretty unpredictable.

 

[CliveStaples]

Are your step 1 scores actually low or just SDN low?


Sent from my iPad using SDN mobile

Actually low. Low enough it has come up in maybe 3 interviews.

 

[DolFAN]

Step 1 220's
Step 2 230s
Decent SLOEs

14 interview invites in the North East (NYC/DC/Philly/NJ) and Florida.

 

[TachycardicMS]

Yup, another panicking 3rd year here at a crisis point given past mistakes and time crunch till applications are due in 8 months-would just like some realistic input on weather i should continue persuing EM or if im wasting my (and everyone elses) time:

Preclinical
-with mostly passes, 2 HP's
-remediated 1 class 1st yr BP->P

Step1 226
-took 4 weeks to study, still not great

Clinicals
-LOA after for family matters (resolved)
-P's in surg, peds, family
-remediated neuro (incomplete)
-remediating IM (failed shelf)
-excellent evals

Research
-4 papers, 5 abstracts, 1 presentations, 4 "experiences", in various fields

I Still have a few 3rd year rotations, step 2, and all of 4th year on the horizon....a few more opportunities to succeed

Briefly about me, non-trad af a state school here, i realy wanna do EM. I've been wanting to go into the specialty since starting but now more interested than ever. I honestly cant think of anythibg else id be happy doing given all the rotations, shadowing, meetings, and reading ive done so far. (A far second possibly being surge,which im guessin is just as unlikely if not more?)

I understand EM is increasingly competative and that these kinda red flags are notable for any applicant for any specialty- not just EM.

that said, im sort of at a pivital crisis point/reality check: should i give it up and start hedging my bets for something ill more likely match into or press-on and do what i can with what time and apportunities to succeede ive got left before applying?

Not matching into EM would be devistating to say the least, but i also understand the need to be rational here considerung every other more attractive candidate wanting to do EM as well...is it too late?

Thanks in advance for anyone's input (tough love or otherwise)

 

[SpacemanSpifff]

Looking at the information you've given, you would be considered an average to below average candidate for EM - remediating several courses would definitely be a point of concern for programs. That said, you have some key pieces of your application that could potentially boost your chances: your home EM rotation, away rotation(s), and the resulting letters.

Get in touch with an EM advisor at your home institution ASAP. Plan to apply for a few away rotations at locations that you could see yourself living for 3-4 years. Talk with your advisor, residents, and puruse threads on the forums to get a handle on what you need to do to impress on your rotations. Crushing step 2 would obviously help, but the biggest boon would come from doing well on your rotations and securing strong SLOE's.

 

[TachycardicMS]

thabks for the advice, will be scheduling a meeting with an EM advisor for thsi ASAP.

When doing this, should it be the program director, clearkship/rotation director, someone involved with the residency program...?

Also what kindo of info should i get into- should i just lay it all out there: "this is who i am and this is what id like to do"

 

[Got Em]

Sorry if this sounds harsh, but I'm going to give it to you straight.

No matter what anyone tells you, you are a below average EM applicant with multiple red flags. You're below average in Step 1, Passed most clerkships while needing 2 separate clerkship remediations. However, you can still match with the right guidance.

The most important thing for you to do is figure out why you're failing the shelf exams. If you have excellent clinical grades, this should transfer to at least average shelf scores. Are you not using UWorld to study during the clerkship? Find this out first before diving into other stuff. As the above poster stated, your SLOEs are the most important for EM, and your EM rotations will often include an end of rotation shelf exam. If you fail this, you'll end up with the same situation and even more red flags.

The one positive you have is your 226 Step 1 score. Even though this is below average, you have met almost ALL of the step 1 cut offs. In your personal statement, you can explain all of your red flags and some programs will give you a chance if you do pretty well on away rotations.

Here is my advice:

1) Get in the ED as much as possible; this will not only get you comfortable to working in the ED, it will help you during your future EM rotations
2) Study for NBME by using UWorld from the start of the rotation or find other ways to make sure you do well on the shelves for future clerkships
3) Step 2 - shoot for 240+ since you're an academic risk
4) Research and apply to less competitive away rotations in the Midwest or Northeast. There are TONS of programs in these regions and some are less competitive than others. Look only for away rotations that offer guaranteed interviews.
5) Apply to as many programs as you can afford; do NOT apply to programs like Denver, CMC, Mass Gen, Hopkins, Oregon. As you can see anything that's reputable, prestigious, or on the coasts will be competitive.
6) Do NOT focus on any research, work, volunteering, etc. None of that will matter for you. Only concentrate on EM rotations, Step 2, and doing as well as you can on your required clerkships.

P.S. - I'm also a non-trad med student. This will help you during interview season.

 

[SpacemanSpifff]

thabks for the advice, will be scheduling a meeting with an EM advisor for thsi ASAP.

When doing this, should it be the program director, clearkship/rotation director, someone involved with the residency program...?

Also what kindo of info should i get into- should i just lay it all out there: "this is who i am and this is what id like to do"

If your home institution has an EM rotation, email the clerkship director/coordinator inquiring about advising. If you don't have a home program, ask a general career advisor at your school how previous EM students have received advising. The first meeting should cover a lot of what @Got Em discussed - how to perform better academically, things you should be thinking about going into your 4th year, and getting things lined up for your away(s).

 

[TachycardicMS]

Thanks so much for the advice, ill move forward with this info in mind.

 

[SarahBellum1]

Step 1 215
Step 2 240
--scores haven't even come up. (Except once when I was asked what is one thing I would change on my app if I had a magic wand--I brought it up myself)

19 invites, 1 waitlist
Applied mostly south/southeast and Midwest. I applied to way too many places. 80+ (all the the "extra" places I applied to, I either didn't hear from or was rejected--so that was a waste of money.)
Every interview has commented on my great involvement in ECs or volunteering.
My SLOEs were pretty good from what I've gathered but I don't think they were necessarily amazing.

So it can be done if you have other redeeming qualities. Just be realistic in the programs you will be getting invites from. Don't be picky. If EM is what you want to do, then you'll go anywhere that allows you to do that.

 

[Smiths11]

Thanks for the replies everyone, I want to respond to some of the comments, as well as provide a couple of updates. First of, my grades are better than I thought (I was expecting a HP from one place but actually got an honors). So, thus far I have 1 high pass and 3 honors, from my 4 auditions. I also have an honors from my 3rd year EM rotation, although that wasn't an organized one at a program.

I do have a backup plan - I've applied to Family Medicine as well.

My latest interview at the current program I just rotated at, went well IMO. Remember, this is the program I felt I was at my best. I've had great evals from residents and attendings, including the PD and APD. I spoke with the PD and APD for my interview, and they had nothing but nice things to say about me. They both told me how everyone likes me from everything they've heard. They both told me they'd be more than happy to have me if I do match. The PD specifically said that my grades would have been concerning had they only seen me on paper, but now that I've rotated I've proven that I am qualified. The APD told me how she's had struggles in the past in Med School as well, mentioned how she failed some courses, for example. I asked her is there anything I can do to improve given that I am really interested in the program, and she flat out said no since I'm doing everything right. She also told me "hope to see you in the future".

I really don't know what to make of this, because they might just say this to all of their students. Any thoughts from you guys would be appreciated.

So out of these 4 programs, I'm going to have to tell one of them they are my #1 choice. Do I have to be strategic about this given my poor scores? The abovementioned program was my favorite one, but I'm afraid it's also the most competitive one out of the 4. Would it be better for me to make the least competitive one my #1 instead? My logic is that if I tell a program they are my #1, and not many people like the program, I would have a better chance of moving up the rank list, instead of telling the same thing to a program that many students feel the same way about.

Thanks again.

 

[CliveStaples]

Programs should not and most often do not adjust their rank lists based on applicants informing them that they're the applicant's first choice. Your promise to them is not binding and they'd frankly be foolish to change their rank list because of it.

Literally the only positive purpose I've heard to telling a program that they are your number one is that they may (but not necessarily) tell you that you'll match there if you're in their top X number of spots (X being the number of spots they have at their program). However, this also isn't binding and just because you don't hear that from a place doesn't mean you won't match. So again, useless.

The rank is designed to work based on everybody's favorite preference. Trying to "game" the system is only going to hurt you. Rank your preference - they'll be ranking theirs.

 

[gman33]

If all you want is em it's worth applying.
Apply to every program.
If you want to somewhat limit your applications, try to figure out what programs are more competitive and don't apply to those.

My honest opinion is that you won't match.

3 remediations and a loa are just too many red flags. I'd focus on a less competitive field.

 

[TachycardicMS]

Yup thats my gut feeling as well- appreciate the honest input.

 

[Smiths11]

Programs should not and most often do not adjust their rank lists based on applicants informing them that they're the applicant's first choice. Your promise to them is not binding and they'd frankly be foolish to change their rank list because of it.

Literally the only positive purpose I've heard to telling a program that they are your number one is that they may (but not necessarily) tell you that you'll match there if you're in their top X number of spots (X being the number of spots they have at their program). However, this also isn't binding and just because you don't hear that from a place doesn't mean you won't match. So again, useless.

The rank is designed to work based on everybody's favorite preference. Trying to "game" the system is only going to hurt you. Rank your preference - they'll be ranking theirs.

Maybe it's different at every program? Multiple attendings at the last program I was at, including the Chair of the ED, told me to specify to the PD if it is my first or top few choices, because the PD apparently likes to take in people who really want to be there specifically. I've also heard similar stories from other programs.

 

[racerwad]

Maybe it's different at every program? Multiple attendings at the last program I was at, including the Chair of the ED, told me to specify to the PD if it is my first or top few choices, because the PD apparently likes to take in people who really want to be there specifically. I've also heard similar stories from other programs.

Everyone likes being liked. Of course PDs want to match people who want to be there, but it is highly unlikely to affect your rank position in a meaningful way.

Rank programs based on the order you favor them. The only way you'll get to your favorite place is...to rank them #1. If you are competitive at all of your top programs and you end up ranking places based upon your perception of matching rather than which you actually like, you'll just end up someplace you didn't want to be at. Why open yourself up to that possibility?

You need to chill out. A career in the ED is filled with unknowns and uncertainty. At some point, you have to just let things happen and deal.

 

[SansaStarkMD]

For me personally, I can live with failure. I can't live with giving up. You owe it to yourself to at least try with realistic expectations of moving on if necessary.

 

[Tenk]

Unless you get buddy buddy with a PD, you will probably not match to EM. I would focus on this more than anything. Unfortunately, you look bad on paper. Your only real shot is getting personal with the only ppl that matter: PDs. Sorry.

 

[tux4]

Nobody knows what is going to happen, all that can be said is your chances are lower. If you want EM, still aim for it. Apply to every program and a backup specialty and see how many invites you get.


Sent from my iPhone using SDN mobile app

 

[TachycardicMS]

Hmmm as for backups- is it reasonable to shoot for em and perhaps plan to scramble into a prelim surg year if needed- or what is the relative competativeness of that kind of prelim spot? I dont really know off hand just that an advisor told me thwre may be 3-400 open spots after match where as EM would be like 1-2 spots.

 

[TachycardicMS]

I think my problem is i dont feel particularly good about matching into anything really (i mean would you as a PD be happy to see this kinda paperwork no matter what specialty you were in?) - moreover ive yet to be truely sold or even interested in anything i've been exposed to save EM and perhaps surgery (the latter i gather is a bad idea if considering it as an alternative)...really sucks, ive really messed up here and no one to blame but myself.

 

[gman33]

How poorly did you do on the Steps?

No matter how good you are clinically, programs don't want residents who do poorly on standardized tests.
The concern is that you will not do well on the in-service and board exams.
If this happens, the program may have problems and get put on probation or worse.

I have no idea if you will match and neither does anyone else.

You did everything you could and you picked a backup.

Good luck.

 

[Babycatsinabag]

Yup, another panicking 3rd year here at a crisis point given past mistakes and time crunch till applications are due in 8 months-would just like some realistic input on weather i should continue persuing EM or if im wasting my (and everyone elses) time:

Preclinical
-with mostly passes, 2 HP's
-remediated 1 class 1st yr BP->P

Step1 226
-took 4 weeks to study, still not great

Clinicals
-LOA after for family matters (resolved)
-P's in surg, peds, family
-remediated neuro (incomplete)
-remediating IM (failed shelf)
-excellent evals

Research
-4 papers, 5 abstracts, 1 presentations, 4 "experiences", in various fields

I Still have a few 3rd year rotations, step 2, and all of 4th year on the horizon....a few more opportunities to succeed

Briefly about me, non-trad af a state school here, i realy wanna do EM. I've been wanting to go into the specialty since starting but now more interested than ever. I honestly cant think of anythibg else id be happy doing given all the rotations, shadowing, meetings, and reading ive done so far. (A far second possibly being surge,which im guessin is just as unlikely if not more?)

I understand EM is increasingly competative and that these kinda red flags are notable for any applicant for any specialty- not just EM.

that said, im sort of at a pivital crisis point/reality check: should i give it up and start hedging my bets for something ill more likely match into or press-on and do what i can with what time and apportunities to succeede ive got left before applying?

Not matching into EM would be devistating to say the least, but i also understand the need to be rational here considerung every other more attractive candidate wanting to do EM as well...is it too late?

Thanks in advance for anyone's input (tough love or otherwise)

The only red flags I see is the fact you are/have remediated two courses. You should investigate whether that will show in your transcript (at my school you get two fail a shelf and noone will ever know if you pass it the second time). Step 1 is only a few points lower than mine and I got plenty of great interviews in very competitive locations. Now, what I did and what I think can help you and make a world of difference:

1. Need to kill step 2: I studied 3 weeks but had already finished uwolrd by the time dedicated time came around, so I did it a second time and did flashcards tru the year to make sure I did not forget basic **** from psych or ob. Also take it early, I had my 250s result before apps were due.
2. Aways. Apply early and secure two early aways (july, aug, SEP). Most places are first come first serve, so send those apps early. Most are through vsas, but not all. Some are due as early as 1-2 months from now, so get those health forms signed, request whatever extra stuff is needed. Work hard, be enthusiastic, and honestly that's what they care about the most. You should have 3 total sloes ideally (one from your school), but if you have two solid ones you should be good.
3. You need to show improvement, so make sure you work your ass of and honor whatever you have left. I also struggled to honor things first have of third year,. UT shelves get easier as you go. Do questions banks. Like the whole section for peds in UW before your shelf plus pretest for example. There is no way if you do all that and work your butt off in the hospital that uwont honor (in my school shelf is like 50-60% so I'm assuming yours is similar).
4. Apply broadly. I don't mean apply to 100 programs. I mean apply to maybe 40, but make them 10 reaches, 20 mid tiers, and 10 super safeties (undesirable location, new programs). I'm saying 40 assuming you at least hit average on step 2 and honors on aways. Also, out of state or across country places are hard to break into if you don't have any ties there so keep it in mind.
5. Find a couple advisors. Not like a real mentor, more like a couple faculty within admin/residency program who can give honest advice based on your numbers and school prestige and all that fluff.

You are not in a bad place. You aren't too different from average applicant except that you need to clear up and make up for the clinical remediations. Good luck. PM me if needed.

 

[The White Coat Investor]

I'd still apply. But you're one of those who should probably also be applying in your # 2 specialty choice (which is hopefully less competitive.) Remember there are back doors into EM (FP/IM particularly in rural areas.) If you don't get any interviews in EM, well, there you go. If you do, go to them and rock them. You only need one, right? There's a study bouncing around here somewhere showing your chances of matching ranked against your number of interviews. Every additional interview increases your chances dramatically up to about 10.

I agree that you need to take (and rock) Step 2 early to show you're brilliant on what really matters. You also need to get some high pass/honors on an EM rotation. It would be easier to overlook the red flags if you have that.

 

[deleted245139]

The only red flags I see is the fact you are/have remediated two courses. You should investigate whether that will show in your transcript (at my school you get two fail a shelf and noone will ever know if you pass it the second time). Step 1 is only a few points lower than mine and I got plenty of great interviews in very competitive locations. Now, what I did and what I think can help you and make a world of difference:

1. Need to kill step 2: I studied 3 weeks but had already finished uwolrd by the time dedicated time came around, so I did it a second time and did flashcards tru the year to make sure I did not forget basic **** from psych or ob. Also take it early, I had my 250s result before apps were due.
2. Aways. Apply early and secure two early aways (july, aug, SEP). Most places are first come first serve, so send those apps early. Most are through vsas, but not all. Some are due as early as 1-2 months from now, so get those health forms signed, request whatever extra stuff is needed. Work hard, be enthusiastic, and honestly that's what they care about the most. You should have 3 total sloes ideally (one from your school), but if you have two solid ones you should be good.
3. You need to show improvement, so make sure you work your ass of and honor whatever you have left. I also struggled to honor things first have of third year,. UT shelves get easier as you go. Do questions banks. Like the whole section for peds in UW before your shelf plus pretest for example. There is no way if you do all that and work your butt off in the hospital that uwont honor (in my school shelf is like 50-60% so I'm assuming yours is similar).
4. Apply broadly. I don't mean apply to 100 programs. I mean apply to maybe 40, but make them 10 reaches, 20 mid tiers, and 10 super safeties (undesirable location, new programs). I'm saying 40 assuming you at least hit average on step 2 and honors on aways. Also, out of state or across country places are hard to break into if you don't have any ties there so keep it in mind.
5. Find a couple advisors. Not like a real mentor, more like a couple faculty within admin/residency program who can give honest advice based on your numbers and school prestige and all that fluff.

You are not in a bad place. You aren't too different from average applicant except that you need to clear up and make up for the clinical remediations. Good luck. PM me if needed.

Agree with 99 percent of this, well said.

One thing- in your position, 40 programs is too few. Even brand new programs are seeing spots evaporate. And forget 'reaches'. An application to Vandy is a waste. Any reach program better have a strong geographic tie.

Two most important steps:
-an audition at a program you want to be at... If you kill it, they will want you to stay
- massive step 2 improvement

 

[HLxDrummer]

I had a 219 Step 1, one preclinical honors, all others pass including clerkships. Did a home EM and one away which were probably average. 240 on Step 2. I got around 9 EM interview and that was with me emailing/calling programs expressing interest. I would recommend doing this if you not getting enough interviews as it got me 1 or 2 extra (make your letter unique to why you like their program). I also applied to FM back up which I also highly recommend. You can back door into EM with this if needed and at least you have a residency spot if you don't match EM.

As others have said, focus on Step 2 and EM rotations. I would use the **** out of Uworld and start studying some EM stuff so you can impress on your EM rotations. Good luck!