Official WAMC thread for EM applicants

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
As for non-reach programs or those that I may have the best chance of matching into, how does one go about finding this info? Like say I wanted to comprise a list 20 programs with the best odds of taking me, then use said list to apply for always for the best possible set up....

Is this reasonable?
Any resources or threads already on this?

Members don't see this ad.
 
As for non-reach programs or those that I may have the best chance of matching into, how does one go about finding this info? Like say I wanted to comprise a list 20 programs with the best odds of taking me, then use said list to apply for always for the best possible set up....

Is this reasonable?
Any resources or threads already on this?
The Rank Order List this year will be your best bet to see the programs you are competitive for. But even then, this whole process is a crapshoot. I'm convinced it's almost completely random for those of us who aren't rock stars.
 
Hello - I am a M3 at a allopathic med school in the southeast. I did a 2 week EM elective during my Family Medicine rotation, and fell in love with the field. Right now, I am considering IM (eventually critical care), and EM. However, I didn't do all that well on my step 1 - I only achieved a 222. I see on Charting the outcomes that EM average for step 1 is near the mid 230s.

Let's say I score 10 pts higher on Step2CK - and have a 222 Step 1, 232 Step2CK, and get high passes on my 2 EM rotations - do I have good shot of matching? If my chances are low, maybe I will have to arrange my 4th year so that I can apply to a back up specialty.

Thanks Y'all!
 
Members don't see this ad :)
Your Step 1 score will definitely not prevent you from matching in EM. Do well on Step 2 CK, of course, and most importantly, do well on EM rotations and get good SLOEs.
 
Hello - I am a M3 at a allopathic med school in the southeast. I did a 2 week EM elective during my Family Medicine rotation, and fell in love with the field. Right now, I am considering IM (eventually critical care), and EM. However, I didn't do all that well on my step 1 - I only achieved a 222. I see on Charting the outcomes that EM average for step 1 is near the mid 230s.

Let's say I score 10 pts higher on Step2CK - and have a 222 Step 1, 232 Step2CK, and get high passes on my 2 EM rotations - do I have good shot of matching? If my chances are low, maybe I will have to arrange my 4th year so that I can apply to a back up specialty.

Thanks Y'all!

You should look at the data more thoroughly, averages are pretty meaningless by themselves. Step 1 between 221-230 had 309 seniors out of 330 match. Step 1 between 231-240 had 323 seniors out of 341 match. Not gonna bother calculating it, but there is definitely not a significant difference there. Under 220 it drops a little bit, but still the majority match. Look up ALIEM videos on youtube, they have several program director match panels and they discuss a ton of useful information. Basically, most programs really use it as more of a cutoff and don't consider it too important.
 
  • Like
Reactions: 1 user
You should look at the data more thoroughly, averages are pretty meaningless by themselves. Step 1 between 221-230 had 309 seniors out of 330 match. Step 1 between 231-240 had 323 seniors out of 341 match. Not gonna bother calculating it, but there is definitely not a significant difference there. Under 220 it drops a little bit, but still the majority match. Look up ALIEM videos on youtube, they have several program director match panels and they discuss a ton of useful information. Basically, most programs really use it as more of a cutoff and don't consider it too important.

Here's a thing I've always wondered, might as well ask here: Does Charting Outcomes only track people matching to their first-ranked specialty? Or can a single applicant get counted towards two specialties?

Two examples:

1) If imaginary-student Amy ranks EM programs as the first 1-5 programs on her Rank Order List, but then ranks 3 Family programs as backup programs after that, and she matches into Family, does she count toward the unmatched total for EM as well as the matched total for Family?

2) If imaginary-student Bob ranks Derm programs as his first 5 ranks, but applied to EM as a backup with 3 ranks (he's got solid stats but doesn't have the most EM-focused application, and only gets a couple interviews as a result), and doesn't match to either - He would obviously be listed as unmatched for Derm, but does he also contribute to Charting Outcome's tiny pool of 2 people with step scores between 251-260 who didn't match to EM?
 
You should look at the data more thoroughly, averages are pretty meaningless by themselves. Step 1 between 221-230 had 309 seniors out of 330 match. Step 1 between 231-240 had 323 seniors out of 341 match. Not gonna bother calculating it, but there is definitely not a significant difference there. Under 220 it drops a little bit, but still the majority match. Look up ALIEM videos on youtube, they have several program director match panels and they discuss a ton of useful information. Basically, most programs really use it as more of a cutoff and don't consider it too important.

Just for completeness' sake, I want to point out that the Step 1 stats in Charting Outcomes is NOT based on those who applied to EM programs via ERAS, but rather appears to only include applicants who ranked at least one EM program.

So if a person with a 222 applied to EM and didn't get a single EM interview, that person would then not rank any EM programs, and would be "invisible" to Charting Outcomes.

It's theoretically possible, though unlikely, that a significant portion of people are not receiving any EM interviews at all, making Charting Outcomes challenging to draw conclusions from. You could, at best, say that 309 US seniors out of at least 330 within that Step 1 range matched.

For a good example look at Dermatology - It would appear that 50% of the people with Step 1 scores between 201 and 210 matched successfully into Derm, but it's likely that multiple people in that range received no interviews and therefore were not counted (not sure how many people in that range actually applied to Derm, but let's pretend it's non-zero).

Someone correct me if I'm wrong.
 
  • Like
Reactions: 1 user
Sure, you're theoretically right. But you're also wrong. Just take a look at the SDN application and interviews thread. Nobody ends up without interviews - the process of getting SLOEs makes it essentially impossible unless you only do rotations at places that don't always offer interviews to their rotating students (and these programs are rare). You can use the data comfortably.
 
  • Like
Reactions: 1 user
Since there were 4 of these threads, in addition to the inverview, rank order lists, and other threads, I've merged all of the "what are my chances threads".
 
  • Like
Reactions: 4 users
Here's a thing I've always wondered, might as well ask here: Does Charting Outcomes only track people matching to their first-ranked specialty? Or can a single applicant get counted towards two specialties?

Pg 3 states in foot note: "Table 1 provides a summary of the numbers of positions for selected specialties and the numbers of all applicants and U.S. allopathic seniors who preferred each specialty. For example, a total of 1,771 applicants preferred Anesthesiology (or ranked an Anesthesiology position first), among whom 1,076 were U.S. allopathic seniors (1,048 matched and 28 not matched to Anesthesiology). For each of the 1,696 Anesthesiology positions there were 1.04 applicants who preferred the specialty, including 0.63 U.S. allopathic seniors.."
 
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)


Dude I feel for ya but honestly it could be worse.

IMO you've got some room to make things right. Namely, SLOE's, Step2, and your remaining 2 clerkships (and likely in that order of importance). The problem is, its pretty rare to just fumble through school and suddenly make everything up with stellar grades and board scores...its just a lot of base knowledge to have to compensate for. You should really figure out what you need to do in order to perform much better from here forward - you've really got no lives left. That said, if you do somehow pull it off, I'd like to think someone would see potential in you as a resident.
 
Members don't see this ad :)
Hey guys, I just realized that one out of my 3 SLOEs has negative comments. It basically says my performance is average to under average. Now I know I can't change my SLOE comment, but what else can I do to help with my chances? I have 1 more interview coming up and I'm planning on doing well on that one. Other than that, I was just wondering if you guys know someone who matched with a bad SLOE? I have 8 interviews in total for EM. DO student

Sorry to hear that! Just curious though, how do people find out what's written on their SLOEs? I've never gotten any feedback on any of my SLOEs or LORs.
 
Sorry to hear that! Just curious though, how do people find out what's written on their SLOEs? I've never gotten any feedback on any of my SLOEs or LORs.

So much for waiving the right to see the letter....
Waiving your right to see the letter doesn't mean you can't see it, or hear about it's content.

I've had LOR writers email them to me, either before, or after, they were submitted. I've also heard from interviewers that "Dr. X said Y about you in her LOR." Both are totes legit and fulfill both the letter and spirit of "the law".
 
Hey guys, I just realized that one out of my 3 SLOEs has negative comments. It basically says my performance is average to under average. Now I know I can't change my SLOE comment, but what else can I do to help with my chances? I have 1 more interview coming up and I'm planning on doing well on that one. Other than that, I was just wondering if you guys know someone who matched with a bad SLOE? I have 8 interviews in total for EM. DO student

How did they rank you? If you are middle 1/3 - then that is considered "good".
 
How did they rank you? If you are middle 1/3 - then that is considered "good".
The post says he has negative comments, which is completely separate than any of the ranking categories.
 
average to below-average is not a bad comment. Half of all EM applicants are below average by that definition. It does not raise any professionalism or interpersonal issues.
 
Confused 3rd year DO here, 1st time poster. After my EM rotation, I'm convinced that EM is right for me.

Step 1 USMLE: 248.
Step 1 COMLEX: 591.
IM: Honrs
Surgery: Pass
Peds: Honors
EM: Honors

My question is regarding research. I'm over halfway into my 3rd year and I have zero research experience throughout medical school. I'm planning on applying for DO and MD residencies. I'm at a school that put me in a community hospital with no residents and attendings that don't really give a **** so I don't know where to start for research. I'm aware that my USMLE is competitive for EM and I'm confident that I will be getting positive SLOE's but being that it's halfway through 3rd year and I have yet to take Step 2, should I even try for research at this point?
 
Confused 3rd year DO here, 1st time poster. After my EM rotation, I'm convinced that EM is right for me.

Step 1 USMLE: 248.
Step 1 COMLEX: 591.
IM: Honrs
Surgery: Pass
Peds: Honors
EM: Honors

My question is regarding research. I'm over halfway into my 3rd year and I have zero research experience throughout medical school. I'm planning on applying for DO and MD residencies. I'm at a school that put me in a community hospital with no residents and attendings that don't really give a **** so I don't know where to start for research. I'm aware that my USMLE is competitive for EM and I'm confident that I will be getting positive SLOE's but being that it's halfway through 3rd year and I have yet to take Step 2, should I even try for research at this point?

Well what do you want? If you haven't done any research and you aren't interested in it... don't do it. There are plenty of programs that don't care at all if you've done research. If you're interested in a career in academics and want to go to a very academically driven residency, then it's probably more important that you pursue some research - but honestly that's more for your sake than your residency chances.
 
  • Like
Reactions: 1 user
Research matters if applying to research heavy academic programs. If you are going the community academic route, it ranges from being more of an added bonus on the application to making no difference whatsoever. Not discouraging you from research, just saying you should do it because you want to do it, not because you have a mistaken sense of being obligated to do EM research to match in EM.


Sent from my iPhone using SDN mobile
 
Current MS3
School Rank: ~25 MD school
Preclinical grades: average
Step 1: 239
Clinical grades: H or NH (near honors) so far. HP in Surg. Waiting on FM/IM/Neuro. School has F/P/HP/NH/H system.
No AOA. Will be 3rd Quartile by end of 3rd year
Research: 2 pubs (2nd and 3rd) 2 poster presentations, 1 abstract, 1 conference. 1 year of research experience from my masters degree with thesis/dissertation published at schools journal.
Will be doing home for SLOE + chairman letter and 1 or 2 aways for more SLOEs

WAMC for school like Duke, Vandy, Indy, Carolinas, etc? Or some 4 year schools like Cincy or Denver?
 
Last edited:
Current MS3
School Rank: ~25 MD school
Preclinical grades: average
Step 1: 239
Clinical grades: H or NH (near honors) so far. H in Surg. Waiting on FM/IM/Neuro. School has F/P/HP/NH/H system.
No AOA. Will be 2nd Quartile by end of 3rd year
Research: 2 pubs (2nd and 3rd) 2 poster presentations, 1 abstract, 1 conference. 1 year of research experience from my masters degree with thesis/dissertation published at schools journal.
Will be doing home for SLOE + chairman letter and 1 or 2 aways for more SLOEs

WAMC for school like Duke, Vandy, Indy, Carolinas, etc? Or some 4 year schools like Cincy or Denver?
If you get some good SLOEs you should be a candidate for these programs. It can be a crap shoot though. If you're at a West Coast school your chances will probably be better, especially for Denver.
The main thing will be strong SLOEs, though, which makes it tough to predict.
 
Last edited:
WAMC for school like Duke, Vandy, Indy, Carolinas, etc? Or some 4 year schools like Cincy or Denver?
Tough to say. Landing an away is your best chance at guaranteeing an interview at one of these shops. Personal opinion: these programs have pretty different vibes. Think hard about what you want in a program before applying based solely on prestige.
 
Tough to say. Landing an away is your best chance at guaranteeing an interview at one of these shops. Personal opinion: these programs have pretty different vibes. Think hard about what you want in a program before applying based solely on prestige.
well, that would be what the interview is supposed to find out, the vibe that best suits me. Without that, theres no real way to see which fit is better, short of doing aways. And my aways are going to be at 2 of those schools so hopefully ill know ahead of time.
 
well, that would be what the interview is supposed to find out, the vibe that best suits me. Without that, theres no real way to see which fit is better, short of doing aways. And my aways are going to be at 2 of those schools so hopefully ill know ahead of time.
Sorry, I should have been more specific than "vibe". Some of the programs you listed are very different in the way they approach training residents. Try to synthesize the information already available to you (program websites, reviews on SDN, advisor input) to know what sort of training philosophy you're looking for prior to application season - or, even better, prior to selecting your away rotations.
 
Last edited:
Sorry, I should have been more specific than "vibe". Some of the programs you listed are very different in the way they approach training residents. Try to synthesize the information already available to you (program websites, reviews on SDN, advisor input) to know what sort of training philosophy you're looking for prior to application season - or, even better, prior to selecting your away rotations.
Completely agree, important to think about what training environment you want to end up in. Alternatively, if you're not sure where you fit best/ what interests you, you may decide to try to do aways at very different institutions to get a better idea of your options.
 
Sorry, I should have been more specific than "vibe". Some of the programs you listed are very different in the way they approach training residents. Try to synthesize the information already available to you (program websites, reviews on SDN, advisor input) to know what sort of training philosophy you're looking for prior to application season - or, even better, prior to selecting your away rotations.

Completely agree, important to think about what training environment you want to end up in. Alternatively, if you're not sure where you fit best/ what interests you, you may decide to try to do aways at very different institutions to get a better idea of your options.

I will definitely give this more thought. Besides looking at their curriculum, research, and resident responsibilities, what else should I look at when evaluating these programs?
 
Sounds like a pretty good place to start. The one other thing you might want to look at specifically is where graduates have gone, i.e. academic vs. community.
There's also the difference between faculty driven and resident driven programs. There are a lot of programs out there where you start off working with and learning from upper level residents. Other programs have more faculty involvement and input. There is also a difference between programs that have graded responsibility and those that have you seeing everything/anything starting day 1. It seems that most of the programs that are more resident driven tend to be the ones where you hit the ground running, but there are various combinations out there.
It can be tough to identify these things without visiting a program, however some of the residency reviews comment on these issues.
Just my two cents :cigar:
 
Hey guys! Have recently decided on EM and have a few questions. Here are my stats

- School: DO school
- Step 1: 257, Level 1:826
- Pre clinical: top of class
- M3: all 95+ so far
- Research: one paper pending submission, one case report to be submitted in the next few weeks, several poster presentations

How many programs should I apply to as a DO?

I'm mainly interested in staying in Texas...But would be ok in LA,AR,OK. There unfortunately aren't many programs in these areas. Are there any other specific programs in other locations that you guys would recommend?
You'll be fine. Apply wherever you want.
 
How many programs do you recommend?
As many as you want/are interested in. The odds of you matching are very good, especially if you get good letters. Some people do fine applying to 20 programs, others don't match after applying to 100. The trend has been for students to apply broadly due to perceived competitiveness of EM, however whether or not this is warranted depends on the strength of your application. Your stats are good. I would research programs, feel out program differences on aways, and apply to places you'd like to train.
 
Hey guys! Have recently decided on EM and have a few questions. Here are my stats

- School: DO school
- Step 1: 257, Level 1:826
- Pre clinical: top of class
- M3: all 95+ so far
- Research: one paper pending submission, one case report to be submitted in the next few weeks, several poster presentations

How many programs should I apply to as a DO?

I'm mainly interested in staying in Texas...But would be ok in LA,AR,OK. There unfortunately aren't many programs in these areas. Are there any other specific programs in other locations that you guys would recommend?

Other than Emory, Vandy, Carolinas, UNC, and Duke, I would be surprised if you got rejected by any southern programs. NC is southern to me.
 
Other than Emory, Vandy, Carolinas, UNC, and Duke, I would be surprised if you got rejected by any southern programs. NC is southern to me.

Thanks! I finally sat down and made a decent looking list. That NC bias is real haha!
 
Things happen for a reason, though I'm sure its hard to take solace in that for the time being. Do you think you'll pursue the "backdoor to EM" through FM?

Thanks for the kind words. It's going to be difficult, but I think I just may give it a shot. Going to start Step 3 studying very soon.
 
I would apply to more than 40, I applied to every program and was in a similar situation as you and it worked out well for me
 
Hi EM SDNers,

This is my first post, so I am hoping to get some constructive input on my chances.
Medical school: top 50
Graduate school: top tier program
Fellowship in Europe in Ethics

Preclinical grades: All P's
Clinical grades: 4 HPs

Step: 199
Step 2: 246

I understand that my Step I is a glaring deficit, but I have improved dramatically for Step II. I am really grateful for that.
Here's my scenario: I want to go into academic EM, so I am looking into 4-year research programs/5-year residency with research tracks.

Application: 4 different grants, did a project for the CDC, 2 papers in NEJM/Lancet, 2 abstracts, 5 publications/reports, 8 presentations/invited talks, invited as Keynote speaker at national conference, started a national movement around healthcare, currently working with a government on a international relations treaty related to health, etc.

I know that my application will stand-out, but I also know that my Step I might dramatically effect me. How do I approach this? I have mentors at Boston programs that are guiding me, but I am also kind of lost/scared.

Any suggestions? Strategies? Thank you!

Your chances are very, very low at 4 year programs. You had a 62% chance of matching in EM with your Step 1 score (in 2016), but your chance will most likely be decreased in the 2018 application cycle. The problem with your step 1 score is that it doesn't meet any of the cut-offs and 67% of programs have cut-offs.

Also, you stated that you're interested in academic 4 year programs. These programs are typically harder to get into as a whole, since most are either affiliated with prestigious institutions or they're in great locations (or both), so they'll be competitive no matter what.

Even when you get interviews, you're most likely starting towards the bottom of their pre-interview rank list and have to outperform many interviewees to be ranked to match. The vast majority of EM applicants interview "pretty well", so being better than average is not likely.

Therefore, your chances of matching at a 4 year, academic program at this point is very, very low.

Recommendation: Do at least 3-4 away rotations at places in your geographic region, in smaller cities, and have no affiliations with prestigious universities/hospitals. Prepare hard and rock these aways. Then you may have a good shot at landing in one of these spots. After residency, you can do a 1 year fellowship and get into academics.
 
Your chances are very, very low at 4 year programs. You had a 62% chance of matching in EM with your Step 1 score (in 2016), but your chance will most likely be decreased in the 2018 application cycle. The problem with your step 1 score is that it doesn't meet any of the cut-offs and 67% of programs have cut-offs.

Also, you stated that you're interested in academic 4 year programs. These programs are typically harder to get into as a whole, since most are either affiliated with prestigious institutions or they're in great locations (or both), so they'll be competitive no matter what.

Even when you get interviews, you're most likely starting towards the bottom of their pre-interview rank list and have to outperform many interviewees to be ranked to match. The vast majority of EM applicants interview "pretty well", so being better than average is not likely.

Therefore, your chances of matching at a 4 year, academic program at this point is very, very low.

Recommendation: Do at least 3-4 away rotations at places in your geographic region, in smaller cities, and have no affiliations with prestigious universities/hospitals. Prepare hard and rock these aways. Then you may have a good shot at landing in one of these spots. After residency, you can do a 1 year fellowship and get into academics.

Wow. That's so depressing. Even with all my other research, papers, national leadership stuff, you don't think I would have a shot?
 
Wow. That's so depressing. Even with all my other research, papers, national leadership stuff, you don't think I would have a shot?

Scores aren't everything, they just get people over the screening parameters. Your Step 2 shows that you are at lower risk for for board failure than your step 1 might otherwise suggest. You may have to send some emails of interest/reach out to programs to get interviews but honestly, some 4 year programs probably prefer someone with heavy research over great scores. You're an atypical candidate so it's going to be hard to predict how the season will treat you until you're in it. And remember, just because programs interview lots of people with high scores doesn't mean those people end up going there for residency. Great EM involvement and research go a long way toward making your application stand out.
 
Last edited:
Scores aren't everything, they just get people over the screening parameters. Your Step 2 shows that you are at lower risk for for board failure than your step 1 might otherwise suggest. You may have to send some emails of interest/reach out to programs to get interviews but honestly, some 4 year programs probably prefer someone with heavy research over great scores. You're an atypical candidate so it's going to be hard to predict how the season will treat you until you're in it. And remember, just because programs interview lots of people with high scores doesn't mean those people end up going there for residency. Great EM involvement and research go a long way toward making your application stand out.

Also while charting outcomes is helpful as a general rule of thumb, remember there is a danger of post hoc ergo propter hoc when looking at the statistics.

Thank you. That's reassuring. I know I am in a strange boat. It will be interesting to see how it all pans out. Any other tips or suggestions?
 
Wow. That's so depressing. Even with all my other research, papers, national leadership stuff, you don't think I would have a shot?

Research and leadership are typically more important for academic programs, but they're still less important than the SLOE and Step 1/2. You definitely "have a shot" at some academic place, but it's difficult to predict exactly where. If you try to do away rotations at all academic places, non of those places may let your Step 1 score go.

Currently, you are a risk of not matching at ANY place, so that's why I suggested for you to focus more on places that are less competitive. If you apply broadly (in your case to >70-80) places, there may be a few academic places that offer you interviews should you rock your aways. However, even when you get those interviews, you are still starting at a lower spot on the pre-interview list. With that said, if you magically pull off multiple 1st round invites from many academic places, then you know you're in much better shape.

From the 2017 cycle, 2 students at my school with Step 1 of <220 did not match. One of them was a very good applicant otherwise with good SLOEs. The same thing happened in prior years. Based on this, along with the available NRMP data, it's pretty safe to say that your number 1 goal should be to match anywhere first.
 
Top