Prelim/TRI to EM?

Started by SW0LDIER
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SW0LDIER

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7+ Year Member
How often does this happen? Anyone know people who have done it? As an MS4, my specialty of interest is currently looking to be more and more difficult to get into due to programs not taking residents (DO Ortho) and I like the idea of EM, but missed the boat on SLOEs and the SVI.

Step 1/2: 240s/260s, good grades, decent research
 
At my program we have two interns (myself included) who did prelim years first. It can be done, and please let me know if there's anything I can answer for you. But I'd also check out gamerEMdoc's "Ask Me Anything" thread because a similar question was asked very recently and his advice was to push hard for an EM away this year, get one great SLOE, and go for it now with a TRI or prelim as a backup plan. (No one cares about the SVI.)
 
SalemK said:
At my program we have two interns (myself included) who did prelim years first. It can be done, and please let me know if there's anything I can answer for you. But I'd also check out gamerEMdoc's "Ask Me Anything" thread because a similar question was asked very recently and his advice was to push hard for an EM away this year, get one great SLOE, and go for it now with a TRI or prelim as a backup plan. (No one cares about the SVI.)
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So the earliest possible EM away I can get is for 10/22-11/16. I feel like that's way too late. Is it? Also, if I had to do prelim, I was told I should do prelim surgery due to funding issues. Would you agree?
 
CajunMedic said:
It's possible, I'm in a TRI right now connected to an EM program. I interviewed with a few on the trail last year that successfully matched EM after a TRI/TY
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Do TRI's give positions to EM aspirants? Arent they usually full with opthal/Rad/Anest aspirants?
 
I matched into EM after a Gen Surg prelim year in the NE. I applied EM the first year around as an MS4 and did not match thus I reapplied again. I had to get a brand new set of letters since that is one of the reasons why I didn't match. My path was not easy and I have seen friends go through it as well. I wouldn't recommend it unless it is absolutely necessary.

During my interview trails, I met people who were in a similar situation as mine or changed too late in the game. I think people who are late switches might have been favored a little bit more in a positive light, pure anecdote though. If you do have to do a prelim year I would recommend getting a SLOE from fourth year for two reasons. One is that your program might not give you EM elective time or even an opportunity to rotate in the ED and two is that a SLOE by definition is written only for 4th year medical students on core EM rotations (not Tox, US, wilderness, or residents). If you secure it even at the end of your 4th year you are still getting a SLOE to apply with in the future.

One thing about getting a SLOE in the next two months, sometimes spots open up very, very last minute that you might be able to swoop into.

As for Surgery vs TY vs Medicine prelim. As a surgery prelim you get 5 years of funding and as a medicine prelim you get 3 years of total funding. I do not know the number of years a TY gets. That means for a medicine prelim your future program will need to make up 1-2 years of unfunded funding. For some programs that doesn't matter, others care a lot. I did not meet a single medicine prelim or TY prelim on either of my two interview paths, I only met surgery prelims.
 
As gamerEMdoc said, why not go for it? I agree with RainbowOtterz that reapplying is rough. Not matching is a tremendous blow, and facing a whole new interview season knowing your chances are even worse because you're a re-applicant does not feel good either. If you can make something happen now, so much the better.

If I were you, I'd start researching programs where you might have a shot with your single SLOE. Hit up friends for contacts at their programs. Email program coordinators. Let them know your situation and ask humbly and politely if they would consider you after you receive your SLOE. Consider trying to get a letter now that, while not a SLOE, could speak to your EM aptitude. Apply strategically, and don't overlook smaller community programs/Level 2 trauma centers/places that are more willing to take someone a little non-traditional. Ask the PD/APD where you are rotating if they would consider writing your letter a little early, possibly the third week, or at the very least remind them gently of your situation so they don't delay after the month is over. When your SLOE is uploaded, contact the programs you've applied to and let them know that it's now available.

You can rank TRIs as a backup plan -- I did not know this, and discovered that nearly all these spots were already gone when I found myself SOAPING. I got mixed advice on whether a surgery or medicine prelim year was better; it seems like there are more people in EM who did surgery prelims, but medicine works, too. I'm out of my depth when it comes to the issue of funding, so I'll defer to the experts on that one.

Good luck! Maybe you will match into your #1 ortho program and none of this will matter, but I think it's pretty smart to do everything you can to secure a future you see yourself enjoying.
 
tarsuc said:
forgive my ignorance, but are all TRI's DO only? and others cant apply at all?
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Yes. It’s kind of the equivalent of ACGME-side transitional year. There are a bunch of these spots every year post-match. Because they are AOA (DO) accredited programs, MD’s cant apply to them.

Disclosure: Yes, I’m an MD grad. I just read a lot. 🙂


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