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rg2o3

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Hey everyone,

I've gone through and read some of the other posts that pertain to my question, but I would still like to ask it. I plan on applying for EM, but I am wondering if I need to take step 2. I know it is very good to have a step 2 for EM, but I'm nervous that I won't do great and it will hurt me. Any suggestions?

Step 1 - 221
Level 1 - 617
Preclinical - mix of A's and B's
Clinical so far -A's and B's but more B's

All input is greatly appreciated and I apologize for having another similar post.
 

drducky.

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Definitely take it. Only people that I’ve seen that don’t take step 2 for EM are those with 250+ or top schools.
 

Neopolymath

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EM appears to emphasize step 2 CK so definitely take it. Avoiding step 2 is for top MD applicants to only a few specialties like neurosurgery and ophthalmology.
 
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Dr.Bruh

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Feb 25, 2018
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Take Step 2. even if you score in the same percentile as step 1 your numerical score will be higher. You'd be surprised how many PDs don't realize that or just want a numerical increase rather than %ile increase. I had a 22x/23x and applied EM and got 27 invites (one top 5 program). I've even had a few programs note my "improvement" on step 2 even tho it really isnt lol. But regardless, SLOE matters more than both of your steps for matching EM (I had a top 10% SLOE).
 
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rg2o3

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Take Step 2. even if you score in the same percentile as step 1 your numerical score will be higher. You'd be surprised how many PDs don't realize that or just want a numerical increase rather than %ile increase. I had a 22x/23x and applied EM and got 27 invites (one top 5 program). I've even had a few programs note my "improvement" on step 2 even tho it really isnt lol. But regardless, SLOE matters more than both of your steps for matching EM (I had a top 10% SLOE).

Thanks for the response! I’ll be sure to take it. That’s reassuring. I was disappointed with my step score as it was lower than every practice exam I had taken. So, I’m concerned that will be the same round two, hah. How many programs did you apply to?
 

Dr.Bruh

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Feb 25, 2018
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Thanks for the response! I’ll be sure to take it. That’s reassuring. I was disappointed with my step score as it was lower than every practice exam I had taken. So, I’m concerned that will be the same round two, hah. How many programs did you apply to?
I applied to 75ish (way too many but I got spooked by COVID messing up our app cycle). Realistically 50 is a good number for any EM applicant if you know how to strategically pick programs. Here is a write up I did on my app strategy and what I think worked. Ill just paste it below;

Posting an update on my season bc I think future applicants (particularly those who feel like underdogs) can hopefully learn from it to strategize for next year.

Specialty: EM
Bio: Midwest DO 22x/23x 55x/59x. Bottom half pre-clinical class rank (top 1/3 clinical rank tho).
Letters: 1 eSLOE, 1 Subspecialty SLOE (ultrasound), 2 non residency SLOEs (community EDs my home program lets us rotate at).
Applied: 78 (too many. Was gunna apply 50 but with COVID I got spooked increased)
Invites/Rejections/Waitlist/Cancelled: 27 invites, 11 rejections, 2 waitlists, 38 ghosts
  • 15 Community
  • 12 University/County (mostly mid-tier, 1 Top 5 program)
  • 4 of these were former DO programs
  • 2 From the programs I rotated at.
  • 8 Invites from programs I networked with(Attending socials, Contacting residents, EMRA Residency fair etc).
Letters of Interest:
  • Sent 10 (Sent to any program that if I was offered an invite I would rank in top 1-5)
  • 3 invites post LOI (not sure if I got the invites bc of the LOI bc the invites like a month+ after lol)
  • 2 Waitlists post LOI, ghosted by the rest.
Invite Timeline:
  • I got the majority (17) in Oct/November, another 6 in December and 4 in January.
Cancelled: 11. ranks = 16 (13 uni/county, 3 community). I Feel bad bc I planned to rank 12-15 but I got 2-3 invites in Jan that were in my top 5 and already went on my other interviews. I would have cancelled a few more if I got those ones earlier.
Interview distribution:
  • 14 Midwest/North (included Chicago/Michigan/Minnesota in this)
  • 4 Northeast (NY/NJ)
  • 8 South/Southeast
  • 1 West coast/PNW (only applied to 2-3 programs here)
Application Strategy:
  • So going in a was just praying to get at least 10-12 invites and wasn't feeling confident as I felt very average/below average stat-wise. So I applied to 10-15ish programs I considered safeties. Obvi there is no formal definition of a "safety" program, but I considered any brand new program former DO program in my geographic region a safety . I tried to make close to 1/2 of them in my region (Midwest/South/North), and did not apply to very many coast programs (mainly bc I didn't want to go there). I also didn't apply to any program that didn't have at least on DO in each class (or if they had a class without a DO they at least had one in all others). I also identified programs i had a "good shot" at based on geography, number of DOs, etc. Here's my interview yield based on those classifications I made based on my app:
- Safety programs (9): 6/9
- Good shot programs (14): 7/14
- Top choices (10): 4/10
- All others (45): 10/45
  • - As you can see its kind of a crapshoot but I definitely think being able to accurately understand your competitiveness and identify programs that fit with that is crucial to getting a comfortable enough amount of invites.
  • Overall very happy with rank list: Would be over the moon to match at any of my top 5 and my top 10 are all programs a year ago I thought were pipe dreams for me personally.
What I think worked/helped me:
1.) SLOEs
  • This was by far the biggest and most obvious factor. My letters were mentioned in every single interview I had. Was told by one that by SLOE and Subspecialty SLOEs were both Honors.
  • Idk what was all in my SLOEs but I think being likeable and someone who everyone at the programs thinks is nice/fun and would want to work with is much more important that knowledge base. I dont' think I crushed my auditions in terms of nailing every pimp question, but based on my interviews the letters seem to focus on my personality, being well likely by faculty and staff, and looking eager to be there and that I enjoyed all my shifts.
2.) Perceived commitment to the specialty and ED experience
  • This also came up on most of my interviews. I worked in the ED for 3 years in undergrad (phlebotomist and a scribe).
  • Was heavily involved with EM leadership (EMRA, ACEP etc), Attending a national EM conference, published articles for EM magazines/websites.
  • I was lucky enough that despite COVID I was able to go into the application cycle having 5EM rotations (3 non-residency electives I did 3rd year, my audition, and US rotation).
3.) Networking
  • My school did not have a home EM program/department so I used EMRA to assign me an EM resident mentor as an M1 (who was a grad from my school/DO) and I used him periodically throughout med school for advise etc.
  • Once auditions were cancelled I realized that I was not going to be able to rotate at my top places and as an average DO I knew I had to get noticed somehow. So I was pretty active on social media, zoom stuff, contacted DO residents at programs I was interested in (literally just asking them If based on my app if I would even have a shot). This seemed to pay off pretty big for me.
4.) Other things that came in clutch
  • My hobbies and interest section
    • DO NOT SKIMP ON THIS. This was talked about in every interview. I do have other hobbies (guitar, music on spotify, did improv comedy etc).
    • I literally listed all of my fav Netflix/Hulu shows and it was a talking point a lot. I'd be quoting Arrested Development, The Office, or talking Star Trek with random interviewers.
  • Working in the service industry
    • I was a bartender/server for 4 years (and I maintain that the skills from this job translated better to me working in the ED than any other job I had).
    • I was told by multiple interviews that they either try to find applicants who have worked in the service/food industry. 2 programs told me its an extra point they have on their app scoring system.
    • I knew a few friends who left out their service jobs on their apps. If you're applying EM DO NOT DO THIS. Its valued.
TLDR:
- Building an accurate understanding of your true competitiveness (which I think many people miscalculate) and identify programs who typically interview/rank applicants of similar competitiveness is key in my opinion. SLOEs, networking, and being well rounded very important.
 
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As others have said, you should absolutely take Step 2.....and ideally take it early enough that your scores will be back BEFORE ERAS OPENS. Not having scores before ERAS opens can limit the amount of IIs you get. Also do everything you can to get at least a 240-250 on step 2.....programs like to see your performance improved on it.
Have you given any thought to where you want to audition yet?
 
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rg2o3

2+ Year Member
Sep 25, 2017
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I applied to 75ish (way too many but I got spooked by COVID messing up our app cycle). Realistically 50 is a good number for any EM applicant if you know how to strategically pick programs. Here is a write up I did on my app strategy and what I think worked. Ill just paste it below;

Posting an update on my season bc I think future applicants (particularly those who feel like underdogs) can hopefully learn from it to strategize for next year.

Specialty: EM
Bio: Midwest DO 22x/23x 55x/59x. Bottom half pre-clinical class rank (top 1/3 clinical rank tho).
Letters: 1 eSLOE, 1 Subspecialty SLOE (ultrasound), 2 non residency SLOEs (community EDs my home program lets us rotate at).
Applied: 78 (too many. Was gunna apply 50 but with COVID I got spooked increased)
Invites/Rejections/Waitlist/Cancelled: 27 invites, 11 rejections, 2 waitlists, 38 ghosts
  • 15 Community
  • 12 University/County (mostly mid-tier, 1 Top 5 program)
  • 4 of these were former DO programs
  • 2 From the programs I rotated at.
  • 8 Invites from programs I networked with(Attending socials, Contacting residents, EMRA Residency fair etc).
Letters of Interest:
  • Sent 10 (Sent to any program that if I was offered an invite I would rank in top 1-5)
  • 3 invites post LOI (not sure if I got the invites bc of the LOI bc the invites like a month+ after lol)
  • 2 Waitlists post LOI, ghosted by the rest.
Invite Timeline:
  • I got the majority (17) in Oct/November, another 6 in December and 4 in January.
Cancelled: 11. ranks = 16 (13 uni/county, 3 community). I Feel bad bc I planned to rank 12-15 but I got 2-3 invites in Jan that were in my top 5 and already went on my other interviews. I would have cancelled a few more if I got those ones earlier.
Interview distribution:
  • 14 Midwest/North (included Chicago/Michigan/Minnesota in this)
  • 4 Northeast (NY/NJ)
  • 8 South/Southeast
  • 1 West coast/PNW (only applied to 2-3 programs here)
Application Strategy:
  • So going in a was just praying to get at least 10-12 invites and wasn't feeling confident as I felt very average/below average stat-wise. So I applied to 10-15ish programs I considered safeties. Obvi there is no formal definition of a "safety" program, but I considered any brand new program former DO program in my geographic region a safety . I tried to make close to 1/2 of them in my region (Midwest/South/North), and did not apply to very many coast programs (mainly bc I didn't want to go there). I also didn't apply to any program that didn't have at least on DO in each class (or if they had a class without a DO they at least had one in all others). I also identified programs i had a "good shot" at based on geography, number of DOs, etc. Here's my interview yield based on those classifications I made based on my app:
- Safety programs (9): 6/9
- Good shot programs (14): 7/14
- Top choices (10): 4/10
- All others (45): 10/45
  • - As you can see its kind of a crapshoot but I definitely think being able to accurately understand your competitiveness and identify programs that fit with that is crucial to getting a comfortable enough amount of invites.
  • Overall very happy with rank list: Would be over the moon to match at any of my top 5 and my top 10 are all programs a year ago I thought were pipe dreams for me personally.
What I think worked/helped me:
1.) SLOEs
  • This was by far the biggest and most obvious factor. My letters were mentioned in every single interview I had. Was told by one that by SLOE and Subspecialty SLOEs were both Honors.
  • Idk what was all in my SLOEs but I think being likeable and someone who everyone at the programs thinks is nice/fun and would want to work with is much more important that knowledge base. I dont' think I crushed my auditions in terms of nailing every pimp question, but based on my interviews the letters seem to focus on my personality, being well likely by faculty and staff, and looking eager to be there and that I enjoyed all my shifts.
2.) Perceived commitment to the specialty and ED experience
  • This also came up on most of my interviews. I worked in the ED for 3 years in undergrad (phlebotomist and a scribe).
  • Was heavily involved with EM leadership (EMRA, ACEP etc), Attending a national EM conference, published articles for EM magazines/websites.
  • I was lucky enough that despite COVID I was able to go into the application cycle having 5EM rotations (3 non-residency electives I did 3rd year, my audition, and US rotation).
3.) Networking
  • My school did not have a home EM program/department so I used EMRA to assign me an EM resident mentor as an M1 (who was a grad from my school/DO) and I used him periodically throughout med school for advise etc.
  • Once auditions were cancelled I realized that I was not going to be able to rotate at my top places and as an average DO I knew I had to get noticed somehow. So I was pretty active on social media, zoom stuff, contacted DO residents at programs I was interested in (literally just asking them If based on my app if I would even have a shot). This seemed to pay off pretty big for me.
4.) Other things that came in clutch
  • My hobbies and interest section
    • DO NOT SKIMP ON THIS. This was talked about in every interview. I do have other hobbies (guitar, music on spotify, did improv comedy etc).
    • I literally listed all of my fav Netflix/Hulu shows and it was a talking point a lot. I'd be quoting Arrested Development, The Office, or talking Star Trek with random interviewers.
  • Working in the service industry
    • I was a bartender/server for 4 years (and I maintain that the skills from this job translated better to me working in the ED than any other job I had).
    • I was told by multiple interviews that they either try to find applicants who have worked in the service/food industry. 2 programs told me its an extra point they have on their app scoring system.
    • I knew a few friends who left out their service jobs on their apps. If you're applying EM DO NOT DO THIS. Its valued.
TLDR:
- Building an accurate understanding of your true competitiveness (which I think many people miscalculate) and identify programs who typically interview/rank applicants of similar competitiveness is key in my opinion. SLOEs, networking, and being well rounded very important.

Thank you so much! This is extremely helpful. I’m glad things went and are going so well for you!
 

rg2o3

2+ Year Member
Sep 25, 2017
598
514
Status (Visible)
  1. Medical Student
As others have said, you should absolutely take Step 2.....and ideally take it early enough that your scores will be back BEFORE ERAS OPENS. Not having scores before ERAS opens can limit the amount of IIs you get. Also do everything you can to get at least a 240-250 on step 2.....programs like to see your performance improved on it.
Have you given any thought to where you want to audition yet?

I plan on taking it in June. Just waiting for this semesters check to clear and I’ll be signing up. Yes! I have two locations I’d like to rotate at. One is local (NE) and one is Midwest.
 
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I plan on taking it in June. Just waiting for this semesters check to clear and I’ll be signing up. Yes! I have two locations I’d like to rotate at. One is local (NE) and one is Midwest.
Hopefully there won't be an Prometric closures from COVID so you should be good to go. If there's anything you can do now to get to know the med student coordinator at your desired audition sites, do it. Them knowing you can increase your chances of snagging an audition there. You can even go outside VSAS in some circumstances: UPMC Hamot and Connemaugh will work outside of VSAS.....I got a couple of there places to offer me auditions outside of VSAS last year as well.....but had to cancel them when CORD released their recommendations for students to only do one audition.
 
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rg2o3

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Hopefully there won't be an Prometric closures from COVID so you should be good to go. If there's anything you can do now to get to know the med student coordinator at your desired audition sites, do it. Them knowing you can increase your chances of snagging an audition there. You can even go outside VSAS in some circumstances: UPMC Hamot and Connemaugh will work outside of VSAS.....I got a couple of there places to offer me auditions outside of VSAS last year as well.....but had to cancel them when CORD released their recommendations for students to only do one audition.

Thanks! Yes I was just looking on VSAS and noticed the site I’d like to rotate at doesn’t have anything past next June. I’m assuming I’m too early? I also noticed UPMC doesn’t show up since I’m a DO, so I did email them.
 
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I started sending info out in early March to places asking to take me outside of VSAS as I didn't have Step 1 scores back yet. If you want to bypass VSAS you could do the same....just be aware that they may not get back to you until after match day (March 19th) for obvious reasons. As for why UPMC doesn't show up.....IDK....I never used VSAS. But it might be worth reaching out to Hamot and Pinnacle.....I've heard both have accepted students for auditions outside VSAS in the past.
 
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rg2o3

2+ Year Member
Sep 25, 2017
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I started sending info out in early March to places asking to take me outside of VSAS as I didn't have Step 1 scores back yet. If you want to bypass VSAS you could do the same....just be aware that they may not get back to you until after match day (March 19th) for obvious reasons. As for why UPMC doesn't show up.....IDK....I never used VSAS. But it might be worth reaching out to Hamot and Pinnacle.....I've heard both have accepted students for auditions outside VSAS in the past.

Awesome. Thank you so much! And goodluck with the match!
 
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