Hey gameremdoc, can you comment on interviewing students that didn't audition at your institution? I've found that a few interviews really surprised me and are at the top of ,y list been I didn't audition there. How do you keep fresh in a PDs mind?
There are almost 200 ACGME EM programs, and like 60 AOA programs. There are of course some overlap here since some a dual accredidation, but you get the point. Its impossible for students to go to every place they interview at. In the AOA world, there seems to be a belief among students that if you don't rotate somewhere, you won't match there. I think this comes from the fact that many programs are smaller, and tend to rank there lists with sure things. If you only have to match 3 spots, you may only have to rank 20 people. If you are only ranking 20, you probably can get 20 students in to rotate. That becomes a lot harder if you are a program with say 10 residents a year, and have to interview 120 candidates. So on the ACGME side of things, I don't think you see this expectation that you need to have rotated to have any chance. That being said, if you are a really good student, rotating somewhere only helps you. After all, if two candidates are otherwise equal on paper with similar SLOEs, EM grades, MPSEs, boards, etc, of course a program will rank the one they know if they did well on rotation over the unknown. That's common sense. I look at having rotated at a place more as an ultimate tie breaker than something that is going to jettison someone up 30 spots on a rank list.
As for what you can do. You can always go places and shadow for a shift. That will certainly show that you have significant interest in a place. The downside is, when you are shadowing, you do no actual hands on patient care, and that really doesn't help a place evaluate you in anyway. So while its a nice gesture that shows interest, its not really helpful for the program to evaluate you. Almost everyone sends emails or thank you cards after the interview, and this is a nice personal gesture, but almost everyone does it so its hard to gauge from a programs standpoint that this really means much interest. I think reaching out closer to the match with a followup email, stating your interest in a program is meaningful. But don't overdue it. If you tell every program they are #1 on your list, and you don't match there, they obviously know you are a liar. And EM is a small world, you never know if they have friends and former colleagues at other programs that you may make similar statements too. My point is, don't tell everyone on your match list they are #1. Rather, contact your top 3 places maybe, and tell them you have them highly ranked. Pick out what you liked about those places and put that stuff in the email. Make the program realize there is something in their program that is drawing you there, this makes it more genuine. Lastly, I'd let your top choice know they are your top choice. You don't have to do this, but I always like this transparency. Many programs do the same, and call a certain percentage of their list and let students know if they are in the top 10 or so. DONT FREAK OUT if you don't get a call, some programs don't do this, and many programs that are great programs go way deeper into their match lists than the number they contact.
If you do decide to contact programs closer to the match, remember that you can volunteer info about your rank list, and they can volunteer info about theirs. But neither side can ask the other about their intentions. You can email a program and say that you have them #1, but you can't say something like "i'd appreciate it if you told me where I stand". Same goes with the program. A program can contact you and tell you that you are ranked competitvely, but if they ask you where you have them ranked, that's a violation of the rules of the match.
I hope that helps!
