SLOR + other problems

[cleansocks]

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Hi,

I'm asking this question on behalf of my significant other who is an IMG that will be couples matching with me (USMG going into anesthesia).

This past fall she did 3 rotations in the US. She rotated through an ED affiliated with a major medical school but which does not have a EM residency program. She got 2 regular LOR's from EM attendings there. She barely worked with the clerkship director at that site, who eventually gave her a high pass, and from whom she did not get the best "vibe." We only recently discovered the unique SLOR requirement for EM. I have read that EM program directors look down upon people who do not have this because it demonstrates a "lack of initiative" on the part of the applicant.

Additionally, since she rotated last fall and had no way to store her confidential LOR's until her residency application this upcoming fall, we decided to store her LOR's on interfolio (online confidential LOR storage service). This would not be a problem except that I read ERAS requires original documents for LOR's.

So I am wondering what people think we should do about the lack of SLOR and the fact that we could really only request one from someone who didn't seem to get along with her all that well and who isn't even a real program director.

And I am wondering if anyone else has used interfolio or knows about whether ERAS will accept LOR's from there, even if they are not original documents?



Thanks



Thanks

 

[Seaglass]

If you email the people who wrote the LORs I would be surprised if they would have a problem completing a SLOR for you.

 

[cleansocks]

If you email the people who wrote the LORs I would be surprised if they would have a problem completing a SLOR for you.

Is it acceptable (albeit not ideal) for regular attendings in a community ER with no residency program to fill out an SLOR?

 

[dmitrinyr]

Is it acceptable (albeit not ideal) for regular attendings in a community ER with no residency program to fill out an SLOR?

I think the answer is yes. I am pretty sure that any EM attending can complete an SLOR and so it does not have to be a PD. I think you'll be fine. Good luck.

 

[SoCuteMD]

Is it acceptable (albeit not ideal) for regular attendings in a community ER with no residency program to fill out an SLOR?

The instructions on the SLOR form read:

ONLY Emergency Medicine Faculty are to complete the SLOR. Most programs with student clerkships are encouraged to have the Student Clerkship Director and/or the Program Director do a SLOR. You can get a start now by having the Clerkship Secretary pull the grades from LAST YEAR'S clerkship. This information is needed to complete item #4 of Section A on the first page.​

 

[deleted109597]

The instructions on the SLOR form read:

ONLY Emergency Medicine Faculty are to complete the SLOR. Most programs with student clerkships are encouraged to have the Student Clerkship Director and/or the Program Director do a SLOR. You can get a start now by having the Clerkship Secretary pull the grades from LAST YEAR'S clerkship. This information is needed to complete item #4 of Section A on the first page.​

Yeah, but faculty means people who work in EM. So I wouldn't get one filled out by an FM doctor, even though FM teaches the EM rotation at my medical school (the horror).
That being said, they will read all of them, but if they don't know the person reading it, they don't put as much stock in it as from somebody they know. And if it is at a residency program, they will know that person. It is a small world.

 

[cleansocks]

I think my strategy will be trying to get only 1 person from the hospital at which she rotated to complete an SLOR; I think 2 slor's from the same place would make it extremely obvious that there is at least one person filling out an SLOR that is less than ideal for that responsibility.

Now the decision comes down to who - ask the non-PD clerkship director for one who didn't give her honors and who barely knows her (which would give her a 4th LOR) or ask one of the attendings who thought very highly of her (which would keep her LOR count at 3). I guess we could ask both of them and see what kind of vibe we get from the clerkship director...

 

[BKN]

I think my strategy will be trying to get only 1 person from the hospital at which she rotated to complete an SLOR; I think 2 slor's from the same place would make it extremely obvious that there is at least one person filling out an SLOR that is less than ideal for that responsibility.

Now the decision comes down to who - ask the non-PD clerkship director for one who didn't give her honors and who barely knows her (which would give her a 4th LOR) or ask one of the attendings who thought very highly of her (which would keep her LOR count at 3). I guess we could ask both of them and see what kind of vibe we get from the clerkship director...

I suggest that we expect to see a summary SLOR from the clerkship director or PD. She could ask the clerkship director to review the grade and the comments from faculty to help him to generate the letter.

Also, a 1 month observership might be possible for an IMG at a residency training program. Generally PDs will pay more attention to letters from that kind of site.

 

[cleansocks]

I suggest that we expect to see a summary SLOR from the clerkship director or PD. She could ask the clerkship director to review the grade and the comments from faculty to help him to generate the letter.

Also, a 1 month observership might be possible for an IMG at a residency training program. Generally PDs will pay more attention to letters from that kind of site.

Thank you for your advice on the summary letter with input from the attendings.

A PD puts more weight on a letter evaluating an IMG watching residents for a month rather than one that comments on an IMG actually doing emergency medicine for a month with attendings rather than residents? How strange. Seems bureaucracy is more important than anything else.

 

[tkim]

Thank you for your advice on the summary letter with input from the attendings.

A PD puts more weight on a letter evaluating an IMG watching residents for a month rather than one that comments on an IMG actually doing emergency medicine for a month with attendings rather than residents? How strange. Seems bureaucracy is more important than anything else.

Makes sense to me, as the letter comes from a site where EM residents are trained, rather than from attendings from a non-EM residency site.

Although it's just an observership, it would probably carry more weight if it says "we'd love to have her as a resident in our EM program," rather than "although we don't have an EM residency, if we did we'd take her." How she gets along with the residents can be a positive you cannot get from a LOR with just attendings.

 

[cleansocks]

Makes sense to me, as the letter comes from a site where EM residents are trained, rather than from attendings from a non-EM residency site.

Although it's just an observership, it would probably carry more weight if it says "we'd love to have her as a resident in our EM program," rather than "although we don't have an EM residency, if we did we'd take her." How she gets along with the residents can be a positive you cannot get from a LOR with just attendings.

The PD at an observership site should not be able to comment reliably upon clinical ability or whether or not the applicant can interact well with patients or EM staff (ie nurses, PA's). The only thing it can reliably assess is whether or not the applicant gets along with residents. I cannot understand how one could regard this experience and letters from it more highly than one where the applicant performs and demonstrates their ability as a clinician, which requires both personality AND competency as a doctor. It frankly makes no sense, which is probably why PD-only SLOR's are only required in this one small branch of all residency applications.

 

[tkim]

The PD at an observership site should not be able to comment reliably upon clinical ability or whether or not the applicant can interact well with patients or EM staff (ie nurses, PA's). The only thing it can reliably assess is whether or not the applicant gets along with residents. I cannot understand how one could regard this experience and letters from it more highly than one where the applicant performs and demonstrates their ability as a clinician, which requires both personality AND competency as a doctor. It frankly makes no sense, which is probably why PD-only SLOR's are only required in this one small branch of all residency applications.

Not quite, any EM residency faculty can write a SLOR. And getting along with the other residents is an important factor as you can imagine, so don't discount that.

People are giving you some great advice in trying to increase your SO's chances of getting into an EM residency - including a PD from an EM residency. You can continue to rail on how the advice and the requirements make no sense, or you can take the advice and use it.

*shrug*

 

[EM2BE]

tkim- is that a fb in your avatar?

 

[tkim]

tkim- is that a fb in your avatar?

Rutger Hauer's eye:

 

[cleansocks]

People are giving you some great advice in trying to increase your SO's chances of getting into an EM residency - including a PD from an EM residency. You can continue to rail on how the advice and the requirements make no sense, or you can take the advice and use it.

Thank you for your advice on the summary letter with input from the attendings.

.

 

[tkim]

I wish you the very best of luck! Last year, 20 FMGs matched to EM - out of a total of 1399 - about 1.4% of all who matched. It can be done.

 

[cleansocks]

I wish you the very best of luck! Last year, 20 FMGs matched to EM - out of a total of 1399 - about 1.4% of all who matched. It can be done.

cool statistic - where do u get that info?

 

[RustedFox]

TKim - I think that your statistic is incorrect. Last year, St. George's University (Grenada, West Indies) alone matched 24 graduating seniors into EM PGY-1 programs.

http://www.sgu.edu/ERD/2008/ResidPost.nsf/BYPGY?OpenView&RestrictToCategory=PGY1&Count=-1

If the above link doesn't work, try:
www.sgu.edu/website/SGUWebSite.nsf/alumni/student-profile.html (you can then sort the list by specialty, location, etc.)

 

[tkim]

cool statistic - where do u get that info?

http://www.nrmp.org/data/resultsanddata2008.pdf

 

[tkim]

TKim - I think that your statistic is incorrect. Last year, St. George's University (Grenada, West Indies) alone matched 24 graduating seniors into EM PGY-1 programs.

http://www.sgu.edu/ERD/2008/ResidPost.nsf/BYPGY?OpenView&RestrictToCategory=PGY1&Count=-1

If the above link doesn't work, try:
www.sgu.edu/website/SGUWebSite.nsf/alumni/student-profile.html (you can then sort the list by specialty, location, etc.)

You're talking about USIMG, I'm talking about true FMGs. As I recall, OP's SO is from the Czech Republic.

 

[cleansocks]

You're talking about USIMG, I'm talking about true FMGs. As I recall, OP's SO is from the Czech Republic.

She is a USIMG who goes to school in CZ.

 

[tkim]

She is a USIMG who goes to school in CZ.

Then statistically her chances are even better 55 USIMG/1399 total matched last year.

 

[cleansocks]

Then statistically her chances are even better 55 USIMG/1399 total matched last year.

Based on the link to the Caribbean school's match list, looks like over half went to Detroit! I would rather become a plumber than live in Detroit, so I guess our chances drop because of that.

 

[tkim]

Based on the link to the Caribbean school's match list, looks like over half went to Detroit! I would rather become a plumber than live in Detroit, so I guess our chances drop because of that.

Yeah, I read your other thread about nice geographic places to do a residency and to be honest, it may not go the way you'd like it to with the couples match, choice of specialties and geographic restrictions.

 

[RustedFox]

Thanks for clearing that up for me, Tkim - I've always wondered what the FMG/IMG/USIMG difference was. It seems like it should be the other way 'round, intuitively - doesn't it ?

FMG = Foreign Medical Grad (Grad from a foreign school)
IMG = Immigrating Medical grad (Grad who is not a US Citizen who needs to "immigrate"/have visa clearance/etc?)

Thoughts ?

 

[SoCuteMD]

IMG is International Medical Graduate - someone who graduated from an international school, but isn't necessarily "foreign"

 

[cleansocks]

Yeah, I read your other thread about nice geographic places to do a residency and to be honest, it may not go the way you'd like it to with the couples match, choice of specialties and geographic restrictions.

Well, I'll go on the other side of the fence and say she's awesome enough that despite those handicaps we'll wind up somewhere we want to be in great programs. I'll let ppl know how it turns out ^^.

 

[deleted109597]

Yeah, I read your other thread about nice geographic places to do a residency and to be honest, it may not go the way you'd like it to with the couples match, choice of specialties and geographic restrictions.

Seconded.
Although I would like to say that my second tour of the interview circuit worked out well, and I ended up at a place I would have like to go to the first time anyway. Anybody out there is welcome to come visit.

 

[kalico]

I had a similar problem prior to my away electives. I found that it was hard for the attendings to fill out the parts of the SLOR that involved comparing me to other medical students. If there is a large enough volume of medical students that rotate through that they can form an honest opinion, then you're golden.

 

[cleansocks]

Have been hoping I could post this =).

So for all those people crazy enough to do this type of couples match (AMG w/ IMG), and to stick my eTongue (tm) out at all those people who thought it wouldn't work out for us, I want to let you all know we matched to a beautiful town, and our #1- University of Michigan, which we ranked ahead of such awesome EM places as Mayo, Temple, UAB, Downstate, and Maimonides.