Too many 4th year ER rotations? Need your advice!

[UHSDOMBA]

---

Members do not see this ad.

Hey fellow colleagues,
I am applying for ER residencies this summer. I really really want to do residency in California so I am "showcasing" myself at many ER sites. Thanks to the EMRA-Match website and doing some research on my own, I picked sites that are more "D.O. friendly". Now my question for you all is: am I doing too many ER rotations for 4th year?

Here's the schedule:

ER at UCSF-Fresno, MLK-Drew, USC, Kern Medical Center, Florida Hospital East Orlando (4th year req.), St Barnabas (3rd year elective) - 6 total!!?

EM-Ultrasound at UC Irvine

Pacific Hospital - Radiology

Florida Hospital East Orlando - Cardiology (4th year req.)

Rural Medicine - 4th year requirement

Please give me some feedback. Thanks! 👍

-C-

 

[EMRaiden]

In a word-- yes.

I would reccommend no more that 2 rotations in EM. You can throw in a PEM or U/S if you like.

If you fill your schedule with EM (which I presume you want to do for the rest of your life) you miss out on the opportunuity to enjoy the GREATEST YEAR in MEDICINE. Do a little of everything-- anes, ortho, MICU. Go somewhere- go to the high altitude clinic in Tibet, ski clinic at Tahoe, make something up and present it as a great learning opportunity and your school will likely let you go.

 

[UHSDOMBA]

Just want to bump this up to get more feedback. Please help me out if you can. Thanks! 😱

 

[DocWagner]

When in the hell are you doing these rotations? If you rotate too late in the year, it may be a moot point...furthermore, if you are rotating somewhere (say in Dec), and they decide not to even interview you...that would suck.

I say, 3 rotations max. Give yourself some vacation and planned times for interviews.

 

[basementbeastie]

emraiden nailed it on the head....no further advice....

 

[UHSDOMBA]

Hey dudes,
Thanks for the awesome feedback. The reason I am doing the 4 ER rotations in California is because those are the only 4 that accept COMLEX. I will complete all those rotations by the end of December. I just want to "showcase" myself by working hard and displaying a genuine interest in the field of emed. The other 2 ER rotations are at DO hospitals: a third year elective and a fourth year core. I am planning on applying to only allopathic programs (location reason). So should I still do three max? I am desperate for advice. 😕

-C-

 

[DocWagner]

Now I see your logic...St. Barnabas is warmup to Cali...but the other EM required should be fulfilled by one of the other EM rotations (I went to UHS and that is what I did, in fact my cards was also at an Allopathic university).

Get rid of the DO required EM, substitute one of the Cali rotations and then give yourself some vation (like rads or Anesthesiology or just plain interview time).

 

[DrQuinn]

I agree with all the other posters here... you are doing a bit too much. Like DW said... 3 rotations max. You are doing more EM rotations your M4 year than I did my intern year!! Honestly you will probably be burnt out of doing EM...

Yes I said it. You'll get burnt out. You'll be burnt out because you will be in teh "student" role and honestly I got pretty tired of being the "med student in the ER" at my third rotation. Very limited in what you can do, you can't really order anything, and you can only push yourself so much (i.e. not like you are going to stand at the head of the trauma bed and do the airway... if you're lucky you can do the rectal/foley). So I think 3 max... You will match EM somewhere, at SOME program. Just don't limit yourself to the # of programs you're applying to.

Q, DO

 

[roja]

concurrance.




(and filler)

 

[UHSDOMBA]

Thanks for the support dudes. I will go ahead and drop that MLK-Drew University ER and do an anesthesia instead. You guys are grrreeeat! Any other electives one can suggest? Hyperbaric medicine? Emergency Crisis Intervention (psych)? Peds ER?

-C-

 

[DocWagner]

MICU is great...but likely has call, and that sucks right before you are graduating.
I did orthopedic surgery for fun...
I also did pulmonology to learn vent management...but you can get that in the ICU.

 

[DrQuinn]

For my electives I did two weeks of anesthesia/radiology, one month of FP (with an attending who let me off after like 3 hours of work... plus I had lots of drug rep interaction, which is always peachy with me), and one month of Psychiatry (besides my two EM electives). I definately took it eaaaaasyyyyy my 4th year, which was great... one of the least-productive years in my life (except for age 11 when I was still prepubescent).

Q, DO

 

[UHSDOMBA]

Hey dudes,
Thanks again for the help. I just started my first day of ER as my third year elective. It's awesome! Love the chaos. 😍 Anyway, I went ahead and dropped MLK-Drew and added an anesthesia. I also added a two week optho. Wish me luck this summer!

Peace out! 😀

 

[grouptherapy]

hmm. i disagree with the others. if you're smoking hot sh1t, then take a 4th year vacation. if you perceive that your app is weak in any way, i would try to maximize my chances of matching by choosing to do as many EM rotations (different places) i can get my hands on through February. you'll get a courtesy interview wherever you rotate and they'll rank you higher since you're a known quantity. it's true what they say about EM being a small world. bust your ass/shine and ask the PD to make the call for you to another program. all the cali PDs know each other. same goes for New York. hell, they all know each other since they all go to the national ACEP or SAEM conferences. even if they don't call for you, their written rec is gold.

as for the fourth year being a year for learning opportunities in other fields, i point to the old saying, "use it or lose it." i learned plenty from the non EM rotations at the time, but i can't say i remember most of what i learned.

 

[Apollyon]

you'll get a courtesy interview wherever you rotate

Not true. Newark - Beth Israel not only didn't grant me an interview, but the student coordinator didn't fill out my eval for 4 months, and, when he finally did, it was the most dismal/average it could be without being actively bad.

That's all right, though - it wasn't a good fit - at all.

 

[jazz]

you'll get a courtesy interview wherever you rotate and they'll rank you higher since you're a known quantity

plus, you don't just want a courtesy interview -- you want a real interview.

my point is that just do 2, at most 3 rotations. you don't want to burn out and look bad. if you do badly at an away rotation, you'll likely actually decrease your changes of matching. so even if they give you a courtesy interview, it may not mean much. doing 6 er rotations (before you apply/interview) is way too much. i love er but with the hours or residency, i can't do much more than 2-3 er blocks in a row. that's why our schedule is interspersed with other rotations...

 

[grouptherapy]

Not true. Newark - Beth Israel not only didn't grant me an interview, but the student coordinator didn't fill out my eval for 4 months, and, when he finally did, it was the most dismal/average it could be without being actively bad.

sorry about that bro. that was just wrong. you ended up at a great program anyway.

a couple of days before the rotation started, i would hook up with the student coordinator and ask if i could work the days the PD was working that month. at end of the first day with the PD, i would state my interest in the program and ask them what my chances were of getting an interview. this usually led to them saying they would take a look at my app. then i would go to the PD secretary a couple of days afterwards and ask her to ask the PD again. this would result in a yea. i never encountered a nay, but i guess if that happened, i would try again during week 3 and 4 and enlist the help of some attendings to ask for me. the point i'm trying to make is that you have to be one tenacious sob. you paid for the rotation, you should feel entitled to an interview. an interview, even if it is a bullsh1t one to get you off their back, means a foot in the door for you. even if they didn't rank you, maybe you've got a shot at them during scramble if it comes to that. they will have had you on file. advantage goes to you

 

[grouptherapy]

plus, you don't just want a courtesy interview -- you want a real interview.

my point is that just do 2, at most 3 rotations. you don't want to burn out and look bad. if you do badly at an away rotation, you'll likely actually decrease your changes of matching. so even if they give you a courtesy interview, it may not mean much. doing 6 er rotations (before you apply/interview) is way too much. i love er but with the hours or residency, i can't do much more than 2-3 er blocks in a row. that's why our schedule is interspersed with other rotations...

ah, but a courtesy interview doesn't mean that you're not getting a real interview! and even if the PD approaches the interview as merely a courtesy, it doesn't mean you can't change his or her mind during one.

statistically, the more programs you rank, the better your chances of matching. i think apollyon's newark beth israel example is an oddity; if you rotate through a program, they'll most likely extend an interview to you.

the more interviews you have under your belt, the more confident you feel during one and the better it will be.

when a PD asks you what programs you've interviewed at, rattle the many interviews you've had-he/she doesn't know which ones are courtesy and which ones are not (in fact he'll wonder why you're so wanted and will want you even more).

i did three rotations and wanted to do more. i did not feel burned out. those 12 hour shifts were rough, but one of my rotations had 8 hour shifts which was cake, so it varies with each person and each program.

 

[frog4brooke]

I found that at a lot of my interviews programs wanted someone who was well rounded with varied experiences to draw upon.

There are a lot of rotations that will give you some good experiences and good stuff to talk about on interviews that are not necessarily in the ED. There are also a fair number of rotations you could do that would give you a little exposure to the ED attendings, too.

I did 2 ED months, a Peds EM months, Ortho, Anes, trauma, plastics and some school requirements. Have you looked into Peds EM, Tox, EMS, U/S, Trauma, hyperbarics or EM research at any of the schools you want to apply to?

Good luck-
F4B