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We won't hate you. We will just point out that you're wrong and that Doximity is literally useless.
Official WAMC thread for EM applicants
- Thread starter Smiths11
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This table comes from EMRA/CORD student advising guide. Also applying as student this year so I really have no idea if this is accurate, but it helped me not worry as much haha. It at least gives you a good place to start even though you don't know SLOE strength. With your step scores and good SLOEs I wouldn't worry about getting Interviews. Just be sure to nail the interview.
Did you have a sense that your SLOEs were going to be crappy? I am a PGY2 IM rotating at the ED and there are a couple of MS4 rotating there and I all they have to do is to see patients and present these patients to the attending and get asked a few questions about management... I don't think they get to write notes since their notes won't be part of the medical record anyway. Besides, they work with different attending every day since our ED is huge (over 100 beds).
I was told the attending will get together and write a 'departmental' SLOE but it seems weird to me how each attending will get a sense of these students when they interact with them for 2-3 days at most.
Some of these students don't even know how to read a basic EKG (axis deviation, LVH, PR/ST changes, RBBB/LBBB, atrial abnormalities etc...) and they come from good schools (nothing wrong with that since I didn't know all these things when I was a MS4). I am sure they are smart students but how can an attending gauge these students when they interact with them for just 2-3 days? Is the SLOE mostly based on how enthusiastic you are and how well you present patients, which these students are good at...
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The thing is, great students (high boards, great clinical grades) generally get great SLOEs. Because they are great students. Is it the SLOEs or the scores?
I generally believe its the SLOEs, because they reinforce what the rest of the application tells you. I think the PD survey data backs this up, as well as personal experience. I've talked with students with outstanding board scores who don't match because of low 1/3 SLOEs. I have seen many many students match with low board scores but good SLOEs. I have absolutely never seen a student not match in EM with top 1/3 or above SLOEs. Never. Not once. So to me, all of the data and my personal experience dictates that the SLOEs essentially will absolutely dictate competitiveness. But its to a point. Someone with middle 1/3 SLOEs with outstanding scores will still be competitive. Someone with middle 1/3 sloes with board failures won't. So the scores do matter. Its the SLOEs on the higher and lower ends that really seem to make up for bad scores or kill peoples chances regardless of scores.
So for people with high scores, ts really when there is a discrepancy (high boards but several low 1/3 SLOEs) that the SLOEs break the application chances. It's not common but it sometimes does happen. Why? Usually because of interpersonal issues, you see a lot of comments like "will be difficult to train" or "overbearing" on these SLOEs. Just be a normal person on rotation, don't act like you are gods gift to medicine, don't be defensive about feedback, etc. Also, don't try to sleep with someone in the department unless you are damn sure they #1 feel the say way and #2 aren't going to rat you out for trying to sexually harass them in the work place, which I can't believe I have to say but it happens. Have common sense, be normal, and if you are a high scoring, great grades student, you are going to be just fine.
I generally believe its the SLOEs, because they reinforce what the rest of the application tells you. I think the PD survey data backs this up, as well as personal experience. I've talked with students with outstanding board scores who don't match because of low 1/3 SLOEs. I have seen many many students match with low board scores but good SLOEs. I have absolutely never seen a student not match in EM with top 1/3 or above SLOEs. Never. Not once. So to me, all of the data and my personal experience dictates that the SLOEs essentially will absolutely dictate competitiveness. But its to a point. Someone with middle 1/3 SLOEs with outstanding scores will still be competitive. Someone with middle 1/3 sloes with board failures won't. So the scores do matter. Its the SLOEs on the higher and lower ends that really seem to make up for bad scores or kill peoples chances regardless of scores.
So for people with high scores, ts really when there is a discrepancy (high boards but several low 1/3 SLOEs) that the SLOEs break the application chances. It's not common but it sometimes does happen. Why? Usually because of interpersonal issues, you see a lot of comments like "will be difficult to train" or "overbearing" on these SLOEs. Just be a normal person on rotation, don't act like you are gods gift to medicine, don't be defensive about feedback, etc. Also, don't try to sleep with someone in the department unless you are damn sure they #1 feel the say way and #2 aren't going to rat you out for trying to sexually harass them in the work place, which I can't believe I have to say but it happens. Have common sense, be normal, and if you are a high scoring, great grades student, you are going to be just fine.
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deleted436726
No. Other than being able to say that my second EM rotation was better than my first one, I can't really point to any glaring shortcomings I demonstrated while in the ED, to the point that I fully expected a bad SLOE coming out of it. But given that I had competitive scores, no failures, some decent extracurricular accomplishments as well as some research credentials in the form of a first-author paper, it must have been a SLOE (or two) that was bad. There's just no other explanation.
How many invites you had? You probably applied only to top programs. I know one individual who only applied to top programs, got enough invites (13+) but did not match.
There are so many sh..ty EM programs in the country (just like IM by the way), so if one has no glaring red flags and applied strategically you should match as long as you have ok stats...
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deleted436726
10. I think that also played a part in my failure to match last year.
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Thanks for the great response. I was also wondering. For EM, how much does AOA or GHHS play a role in extending interviews/ranking or are they pretty low yield for EM?
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I'll anecdotally add that I'm a DO, currently EM PGY-2, with a 230/251 who matched at a solid tertiary academic center. SLOEs are king.
@Splenda88 I'm sure it's different everywhere, but from working with the rotating students, it's sort of easy to pick out the top performers early in a shift. Now it's challenging because we don't necessarily get to follow them and track their improvement over the course of their month, but we do feedback at the end of every shift and theoretically they should get better over the course of the month. While yes, most of what the students do is see patients and staff them, and occasionally answer some questions, it's the ones who make your life easier that are the most helpful. The best students I've worked with are the ones who will reevaluate our patients without being asked and report back, or update them on their labs and imaging (depending on how complicated, we'll talk about what they should tell them beforehand. Also this isn't a make-or-break it thing because sometimes you don't want the student to be the one to talk about the workup with the patient before running through it as a team.) A lot of it is- somewhat annoyingly- is this someone who I'm not going to want to pull my hair out at 3 AM working an overnight with? Some of it also comes down to medical knowledge- but moreso that solid M4s can usually see a patient, come up with a decent differential, and usually an ok basic workup. Where students really set themselves above is when they complete the treatment of the patient, meaning they pick an analgesic/appropriate medication for symptom control, and tell me what they think is going to happen to this patient. For example, this is an older lady with potentially cardiac chest pain and a HEART score of 6, so even if her workup is negative, I think we should obs her for stress test and chest pain rule out. Those are the students who absolutely crush it- the ones who are transitioning from data collection (med student) to synthesizer (intern) to planner (late intern/senior resident.) It's somewhat remarkable how quickly you can differentiate students in a short amount of time- I didn't really believe it until I was working more directly with them in the department. (disclaimer: I absolutely understand people have an off shift or presentation and do not fault you for that or even lack of medical knowledge because how are you supposed to know these things without actually doing them.)
@Splenda88 I'm sure it's different everywhere, but from working with the rotating students, it's sort of easy to pick out the top performers early in a shift. Now it's challenging because we don't necessarily get to follow them and track their improvement over the course of their month, but we do feedback at the end of every shift and theoretically they should get better over the course of the month. While yes, most of what the students do is see patients and staff them, and occasionally answer some questions, it's the ones who make your life easier that are the most helpful. The best students I've worked with are the ones who will reevaluate our patients without being asked and report back, or update them on their labs and imaging (depending on how complicated, we'll talk about what they should tell them beforehand. Also this isn't a make-or-break it thing because sometimes you don't want the student to be the one to talk about the workup with the patient before running through it as a team.) A lot of it is- somewhat annoyingly- is this someone who I'm not going to want to pull my hair out at 3 AM working an overnight with? Some of it also comes down to medical knowledge- but moreso that solid M4s can usually see a patient, come up with a decent differential, and usually an ok basic workup. Where students really set themselves above is when they complete the treatment of the patient, meaning they pick an analgesic/appropriate medication for symptom control, and tell me what they think is going to happen to this patient. For example, this is an older lady with potentially cardiac chest pain and a HEART score of 6, so even if her workup is negative, I think we should obs her for stress test and chest pain rule out. Those are the students who absolutely crush it- the ones who are transitioning from data collection (med student) to synthesizer (intern) to planner (late intern/senior resident.) It's somewhat remarkable how quickly you can differentiate students in a short amount of time- I didn't really believe it until I was working more directly with them in the department. (disclaimer: I absolutely understand people have an off shift or presentation and do not fault you for that or even lack of medical knowledge because how are you supposed to know these things without actually doing them.)
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If you believe the PD survey data, then it matters about just as much as every other part of the application, excluding SLOEs. Most parts of the app scored between a 3-4 on a 5 point scale of importance. SLOEs were at a 4.9. I attached a PDF of the PD survey data from 2016 which is as far as I know, the most recent one published.
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I've always wondered this. Those who do an EM fellowship after a FM residency, are they full fledged ER docs? Like can they call themselves emergency doctors and work full time at large tertiary care level 1 trauma center hospitals?
also, I wonder how competitive that fellowship is, I imagine most FM residents just wanna practice FM
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This was my backup, to my backup, to my backup if I hadn’t matched EM this year.
Short answer, as I understood it is No. You are not eligible to sit for the ABEM or AOBEM board exams. You can take the ABPS board exam, but it’s not widely accepted. Very few , if any level 1’s would even hire you. If they did, you’d be in the urgent care/fast track pod or at one of their satellite campuses. Many of them work in rural or Critical Access Hospitals.
A couple of the smaller staffing groups, Relias or Alteon come to mind. They feed into their contracted facilities, mostly AL or MS. They take anywhere from 4-8 per site (there’s at least 5 if I remember correctly ) Not sure of the competitiveness of them. U of Alabama only takes 2, one for Tuscaloosa and one for Meridian, that one is somewhat competitive.
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How many programs did you apply to and how many interviews did you net?
I’m DO. High 23x Step 1. Honored in 1st of 3 EM rotations and one other, all others high pass. No red flags. Assuming my sloes will be at least middle third as long as i didn’t do anything weird. How many would you apply to?
I’m DO. High 23x Step 1. Honored in 1st of 3 EM rotations and one other, all others high pass. No red flags. Assuming my sloes will be at least middle third as long as i didn’t do anything weird. How many would you apply to?
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You would probably be safe with under 40. It also depends a lot on the types of places you’re interested in and their perceived prestige or competitiveness. That said, I feel like it’s hard to predict this sort of stuff. I had friends with mediocre applications who crushed it with the number of interview offers while others with great scores got less than 5. It’s really hard to say though.
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There is a law of diminishing returns assuming you are applying smartly. If you apply to a geographic catch area around your school and permanent address. I'd apply to former AOA now ACGME programs you have interest in. Then I'd apply to any "dream programs". Most of your interviews will come within a geographic ring around you. Applying to non-DO friendly places clear accross the country is a waste of money. I always stick to the "apply smartly" approach. 40 programs should be enough if you are applying to the right places.
What are the geographic radii options for filtering in ERAS? Is it by miles or general states/areas? Neighboring states only?
Not trying to overthink it but TBH probably at least half of programs I'm most interested in are not geographically centric to home/school.. balancing applying smartly and where my hearts at. Not going to apply to many pipe dreams, if its outside of my geography I'm shooting where my stats are in the middle 50% of matched residents. Or according to the residency explorer at least.
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You can set it up to choose whatever states you want, based on permanent address or location of medical school. So for instance, a program in western PA may look at Ohio, MD, PA, WV. In eastern PA they may look at PA, NY, NJ. When you build the filter, you choose which states are included. It's program dependent, they can take as big or as little of a geographic net as they want. But in general, I'd guess most places that filter by geography (which I'd guess is probably the majority of programs) do so by looking in state and the nearest few surrounding states.
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As per the AAMC ERAS data, it showed for last year the average applicant applied to 54 programs.
In contrast to what Gamerdoc said, I think geography ended up being much less important than I thought. I received plenty of invites from places that I had no ties to, some of which are even considered competitive (Like CA). I also received less than expected invites for a state that I honored a SLOE in. I think it's an overall crapshoot.
I don't really see the point in limiting your applications heavily. I'm very poor and my family had no role in my medical education expenses and I still decided to apply to ~75 programs. In the end, once I met the threshold of almost guaranteeing a match (~12-14 interviews), I started to become very selective. This allowed me to interview at lots of places I was interested in and would not have experienced otherwise if I limited my apps. If you apply to a bunch then in the end, you either get excessive invites and become selective or you end up with 4-5/70+ and are happy as hell you didn't apply to 30-40. Win win in my opinion. Just cancel excess invites very quickly and professionally to allow other students to take the spot. I'm also a DO/23X to give some perspective.
In contrast to what Gamerdoc said, I think geography ended up being much less important than I thought. I received plenty of invites from places that I had no ties to, some of which are even considered competitive (Like CA). I also received less than expected invites for a state that I honored a SLOE in. I think it's an overall crapshoot.
I don't really see the point in limiting your applications heavily. I'm very poor and my family had no role in my medical education expenses and I still decided to apply to ~75 programs. In the end, once I met the threshold of almost guaranteeing a match (~12-14 interviews), I started to become very selective. This allowed me to interview at lots of places I was interested in and would not have experienced otherwise if I limited my apps. If you apply to a bunch then in the end, you either get excessive invites and become selective or you end up with 4-5/70+ and are happy as hell you didn't apply to 30-40. Win win in my opinion. Just cancel excess invites very quickly and professionally to allow other students to take the spot. I'm also a DO/23X to give some perspective.
This was more of the strategy i was going for. Cost is not the concern at all, I was searching for strategy as to how many applications would net me at least 11+ interviews. 11+ rank list is what I’m going for so I can feel confident about matching.
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Here’s the deal. With your stats you need to apply smartly to have your best chance of getting 12 interviews. That means at least 30 programs in your geographic region that are not traditionally competitive programs. After this you can add however many reach programs you want depending on how much or how little money you are willing to spend on applications.
As above, you get one shot at this. In December when you have 4 interviews you can’t go back and get a do-over. You’ve spent 300k+ to get to this point, no use in jeopardizing your future to save $200.
I am a DO, applied to ~45 with ~30% return for interviews with higher stats than yours. It turned out well but there were a few months I wished I had sent out 15-20 more applications
I am a DO, applied to ~45 with ~30% return for interviews with higher stats than yours. It turned out well but there were a few months I wished I had sent out 15-20 more applications
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deleted436726
If you can afford it, there's no reason not to apply to all of them.
What? No. That’s absurd. Perhaps if you had terrible score or other red flags and you were just trying to squeeze through filters.
DO here that applied to 60 with a step 1 in the 210s (250s step 2) and solid SLOEs (I got to read the comments). Got >20 invites and matched at a well established/pretty competitive program. Just be smart. Don’t waste apps on places without a single DO unless it’s your dream program or close to family and you just really want to give it a shot.
Geographic filters are more a thing for smaller/community programs in my experience.
You could apply really poorly with 80 programs if you weren’t vetting them well or overshooting your application or you can apply very smart with 50. I’d take the time to really hone in on what you want and what programs will be more willing to look at you rather than shotgunning an application.
Or you know. Just flush thousands of dollars down the toilet and apply to 200+ programs.
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There is no filter for "states the applicant rotated". This is a common misconception. Sure, if a program actually looks at the application and sees you rotated in-state, they may be more apt to consider the candidate, however, rotating in a state isn't going to get your app looked at if they are using geographic filters. The only thing you can filter by are state of the permanent residence and state of the medical school.
Is there anyway to get around the geographic screen? My school and permanent address are all in the South East but all my friends, family and where I want to do residency and practice is in the North West.
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I did more than needed, but I had complete peace of mind on match day. My theory was that I had acquired 200k of debt for my education and it all boiled down to one match day. I applied generously, to me, this was not the time to save a couple thousand dollars as the greater the number of programs I applied, the best shot I had at matching.
My stats were: top 20 MD school, top quartile med school, step 1 245, step 2 267. 2 SLOEs. One from home institute, and the other from University of Cincinnati.
I applied to 60-62 programs I think. Received I believe 24-25 interviews. I did 17 interviews, the ones I didn't do, I physically could not fit them into my schedule. I went to every possible interview that I could go to.
I had absolute peace of mind and didn't even remember to check my "you've matched" email until an attending asked if I had matched 4-5 hours later (I was doing a Sub I during that time).
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How bad would it look to not waive my right to see my 3rd of 3 SLOE?
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From what I've seen, it would probably do more harm than good, but I'm just a student.
Why do you want to waive it? Do you think it will be negative?
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Yea I got negative feedback from a resident
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Sorry man. Do they fill out evaluations for you? Or are you only formally evaluated by attendings?
I wish the SLOEs weren't such a black box. I think they're causing me more anxiety than step 1 and 2 did.
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They fill out evals after every shift, residents or attendings, depends on who ur with.
I'm afraid this resident is gonna kiss of death me
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Waive it. One bad SLOE out of three SLOES is not awful. Refusing to waive the right to see it is a much bigger red flag. Simply put, refusing to waive is one of those taboo things that is Just Not Done.
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You don't need 3 SLOEs. So you aren't obligated to have 3 if you are worried. But on the other hand, also realize that bad feedback from one person is one persons opinion. If you are worried though, meet with the clerkship director or whoever authors the SLOEs towards the end for feedback. Be open about your concerns. If you aren't reassured about your meeting with them, then just don't submit the SLOE they author to any other program. Just because someone uploads you a LOR doesn't mean it has to be submitted to programs.
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I've heard not assigning a SLOE is a "red flag"
I'm a carib student so I really can't afford another red flag
so my concern is that even if I don't assign it im effed either way.
(thanks for the reply)
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People don't know if you don't assign a SLOE. Especially if it's your third rotation. If you didn't assign it to the program that wrote it, they would know. Other programs wouldn't. Now, if it was you first or second rotation and you didn't have a SLOE from one of those, then maybe a program would question why you don't have a SLOE from your first audition rotation. But you only need two SLOEs so it wont look odd not to have a SLOE from your third one.
Ultimately, you don't even need to request one from this rotation if you are concerned.
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Kind of defeats the entire purpose then. If the argument against not seeing SLOEs is to avoid dumping bad SLOEs, then isn't this doing the exact same thing? Sometimes students are just bad. A residency wants to recruit the best student they can. But, if this is an isolated comment by a single resident, then it wouldn't really matter all that much anyway.
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Correct, but I guess my point was that if you already have two SLOEs, and you have one isolated bad experience with one resident that you think may lead to an innacurate portrayal of you as a student, why even ask for a 3rd SLOE when a 3rd SLOE isn't necessary? The only time I tell people to get a third SLOE is if they think one of their first two isn't going to be a good one, so a 3rd SLOE, if good, can elevate their application. Otherwise, its unnecessary.
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As someone who just went through this I'm going to play contrarian and argue that you can't. While the great board scores generally get great SLOEs is probably true overall, that doesn't mean its true for the individual and there is little indication until it is probably too late. While I am n=1, I had scores of 240+/260+, nearly all honors through first 3 years, EM grades of H/HP/HP. And I had 5 interviews in December. I'm guessing I didn't have the best SLOEs but I really never had any indication that it was the case. Ultimately I managed to get to 10 after some very aggressive contacting as well as some help from my home program (and successfully matched) so maybe the optimist will say "it worked" but the process did not go the way the numbers or leadership act like it would. I only applied to about 30 programs based on the data available and direct advice from a PD with whom I rotated with. Ended up adding more throughout the process when I didn't have interviews which is probably extremely low yield. So my n=1 advice is apply to more programs than the numbers tell you to and there is no guarantee on who will offer you interviews. The programs I got interviews from were a total crap shoot. Ex: Got an interview at a very desirable program across the country but didn't hear a peep from many less well known programs much closer to home. Thats the other thing, if Doximity rankings are crap (as everyone says they are) then how are you even supposed to know what the competitive programs are when picking your list? You could be applying to the top 30 programs that year and not know it.
Overall it's my gripe with the EM application process and SLOEs in general. We are blinded to the most important part of our application and what determines our competitiveness. Thats like telling Dermatology applicants they aren't allowed to know their Step 1 score. While I understand why EM leadership wants it this way, I'd argue that its a move that only benefits them and leaves the student in the dark.
Overall it's my gripe with the EM application process and SLOEs in general. We are blinded to the most important part of our application and what determines our competitiveness. Thats like telling Dermatology applicants they aren't allowed to know their Step 1 score. While I understand why EM leadership wants it this way, I'd argue that its a move that only benefits them and leaves the student in the dark.
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Totally agree. Not knowing if SLOEs are good or bad makes the entire application process more difficult for everyone involved. Otherwise competitive applicants are applying to 60+ programs and holding 20+ interviews because they have no idea how competitive their application really is, so they over apply. Programs should at least tell students if their SLOE will be strong, average, or weak. If you give someone a career ruining SLOE, they should have a right to know so that they can alter their application strategy or apply to a different specialty.
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deleted436726
So much this. As someone with no known red flags going into the match last year, the way I found out that I wasn't competitive was by failing to match into EM altogether. As I've written previously, I can only suspect that I had one or more bad SLOEs.
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I do agree that its not possible to totally know how competitive you are because the SLOEs are blinded. However, once interviews start rolling out, that should certainly give you an idea. No one NEEDs to hold onto 20+ interviews for fear they aren't competitive. They wouldn't get 20+interviews early in the application cycle if they weren't competitive. If you are sitting on 10-12 interviews by November, you're probably more than competitive enough to match in EM. If you have to email and scratch and claw for enough interviews later in the season, you have something in your application that is turning programs away.
The problem with using interview invites to gauge how competitive you are is that it takes about until November until most program invites are out. And by that time, its later in the application cycle to pivot towards another specialty.
The problem with using interview invites to gauge how competitive you are is that it takes about until November until most program invites are out. And by that time, its later in the application cycle to pivot towards another specialty.
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Well that's why SLOEs should be open to the applicant.
If we're going to allow this non objective tool to be used to potentially sink someone's career, cause them to go unmatched, which will make their next match attempt even harder, and take away a year of attending income downstream to this, applicants should know where they stand.
There are real implications to the SLOE process you guys dreamed up, and to say that "it's not perfect, but it works the majority of the time" is not acceptable.
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Queue my yearly SLOE rant...
I didn't dream up the sloe process. I applied and had to get SLOEs just like everyone does today. I wish there was more transparency, but as a realist, I also know the second there is complete transparency, the SLOEs will be wildly inaccurate and become worthless. The reason why they are more objective and don't suffer from the same grade inflation that med school / rotation grades do is because they are blinded. It's not perfect, but its still better than the alternative (ie worthless letters and we just all rank by board scores like other specialties).
I understand that frustrates a lot of people. I understand that creates a lot of anxiety. I also don't really lose sleep over it. I dealt with it as a student. In the end if it creates so much anxiety to apply to EM, then apply to something else. You can't demand that you want to do something and make the rules to get yourself hired. That's not how life works. No one is forcing anyone to participate in the EM application process.
Could it be improved? Probably. Will it? Probably not. I doubt the people at CORD have any reason to want to change a process deemed by PDs (the people that go to CORD) find wildly successful.
I'm not trying to belittle anyone that complains about the SLOE process, I understand the anxiety it creates and have dedicated several years of my free time to trying to help guide students through this process because of it. But every time this is brought up, it just turns into a bunch of whining about the system, when the reality is, you aren't in the drivers seat. You are applying for a job and no one cares if you don't like the rules of applying. There are hundreds of people that would take your spot if you chose not to apply. Every single student applying to residency is replaceable. Sometimes in life you just have to realize that the world doesn't revolve around what you want. The rules are made by the people in charge.
Don't blame me for the system that was created before I was a medical student. I lived through it, thought it was reasonable then, and still find it reasonable now. You may disagree, but it is just not going to change anything other than fuel everyone's anxiety about the whole process.
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I agree wholeheartedly. I think the answer on the student side is we just have to apply broadly. That has its own negative implications for the system but is really the only way to make the process work with sloe blinding while not having a ton of people go unmatched every year.
One potential effect I’m interested to see the result of is what will happen as EM continues to grow in competitiveness. The sloe system works great when there are roughly equal number of applicants and spots - even people with low 1/3 will match somewhere. However if EM were to go the way of ortho or derm, where competition is insanely high, there will be an increasing number of low or mid 1/3 students who don’t know they’re not competitive until way too late. Do you see this as a potential issue down the road?
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Honestly I dont. EM isnt FP, sure, but it isn’t THAT competitive when you look at the numbers. Im not sure I honestly see it really changing too much, unless something changes in the healthcare market to make it more popular.
The issue with SLOEs being blinded isnt a new one, and EM hasnt gotten that much more competitive over the last decade. Sure there are more applicants these days, but there’s also way more residencies. The over application / over rotating is relatively a new thing though.
I dont think there is an easy solution. I think the best case scenario would be having students learn their esloe gpa (an average of their sloe rankings) in mid Oct so they know whether they have to pivot or not. I think that would be reasonable. But Im not sure anyone that actually makes these decisions would agree to that. I dont know. I dont sit on the committees at CORD that determines this stuff, so I dont have any inside knowledge on the mindset of the powers that be on this. Just my own speculation.
The issue with SLOEs being blinded isnt a new one, and EM hasnt gotten that much more competitive over the last decade. Sure there are more applicants these days, but there’s also way more residencies. The over application / over rotating is relatively a new thing though.
I dont think there is an easy solution. I think the best case scenario would be having students learn their esloe gpa (an average of their sloe rankings) in mid Oct so they know whether they have to pivot or not. I think that would be reasonable. But Im not sure anyone that actually makes these decisions would agree to that. I dont know. I dont sit on the committees at CORD that determines this stuff, so I dont have any inside knowledge on the mindset of the powers that be on this. Just my own speculation.
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EM is now the third largest specialty in terms of 1st year GME positions (IM--> FM--> EM), I think it's way too large a field to be ever as overall competitive as derm or ortho or anything of that nature.
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I will say in terms of sloes it is difficult because most students are rotating in the first several months of a new year, typically residents are more busy than they’ve ever been and attending‘s are working overtime to try to oversee them. Obviously site dependent but I feel like feedback can vary.
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I doubt it. Once an applicant knows they have poor SLOEs they will likely weed themselves out of the process and maybe choose a different career. From your side it will look like everyone has great SLOEs, but the number of applicants has been reduced by the weaker applicants dropping out. The remaining applicants only have great SLOEs because they are great students, which preserves the accuracy of the SLOE.
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Under that logic then, why aren't the grades from many sites so biased if blinding doesn't effect the grade given? The EM grades often times much higher than what would be predicted by the SLOEs. The main reason that I'd assume is because the students know their grades and see their evaluations, whereas the SLOE is blinded. If there is another explanation, then so be it. But its not uncommon to see some places giving out almost 90% Honors or HP on their rotations.
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@gamerEMdoc question for you-
In addition to SLOEs, are 3rd year clinical grades weighed heavily?
I'm in 3rd year now and scored > avg for EM on step1. But I've been scoring ~ avg on my shelf exams, despite good clinical evals and comments which has resulted in avg clinical grades so far (going to keep grinding to try to improve). I feel that I'm getting better clinically and I get good feedback, but I don't shine on NBME exams and I'm worried this will hurt me (I think sub-i's / SLOEs will be a much better measure of myself as a candidate than NBME exam scores).
thanks for the help
In addition to SLOEs, are 3rd year clinical grades weighed heavily?
I'm in 3rd year now and scored > avg for EM on step1. But I've been scoring ~ avg on my shelf exams, despite good clinical evals and comments which has resulted in avg clinical grades so far (going to keep grinding to try to improve). I feel that I'm getting better clinically and I get good feedback, but I don't shine on NBME exams and I'm worried this will hurt me (I think sub-i's / SLOEs will be a much better measure of myself as a candidate than NBME exam scores).
thanks for the help
