Emergency Medicine: The Application Process

Outline Emergency Medicine Scores and statistics How to match? 3rd and 4th year schedule Away Rotations Standardized Letters of Evaluation (SLOEs) Research Personal statement Process overview Interviews Tips and tricks Resources Questions

Emergency Medicine Why EM? You will hear this question 1000 times Have answers for it

Averages Overview From Charting Outcomes in the Match 2014

Resident Selection From “Selection Criteria for Emergency Medicine Residency Applicants” (JT Crane & CM Ferraro, 1999) 118 program directors surveyed (79.7% responded) Rated 20 factors from 5 = most important to 1 = least important

Number of Programs Ranked Take home message: aim for 11 - 12 interviews to feel comfortable. Rank all programs unless you absolutely hated one or you went on >12 interviews. A job is better than no job! Note: these numbers are for ranked interviews, not number of interviews attended or programs ranked

Developing Trends Rank more programs in your specialty US graduate AOA membership Higher Step 1 and Step 2 scores

2016 Match Data 174 programs offering 1,895 positions Of all U.S. seniors who applied to emergency medicine, 87.8% matched, and only 1 EM position remained unfilled. 53% of matched U.S. Seniors got their first choice 14.9% needing to go past the fourth spot on their rank list

Want more numbers? Google “Charting outcomes for the match 2014” The NRMP website historical match data for several years prior and some preliminary data for 2016

Scheduling Ideal schedule: Can still take Peds EM, Tox, Ultrasound etc 3rd year – EM 4th year EM sub I in B block Aways in C/D block for SLOEs and to “get your face out there” Only allowed to take 3 EM rotations Can still take Peds EM, Tox, Ultrasound etc

Example Schedule Tips and tricks Sub-I here? That’s up to you If an away does no overlap with UB’s schedule, use a vacation month and spend the time off studying for USMLE Step 2

It is not the end of the world if you don’t get the perfect schedule You should aim to have everything in by Oct. 1st (ERAS opens mid-September) Many programs not offering interviews until mid- October to allow more time to complete aways and get SLOEs

Away Rotations “You don’t have to do them”  becoming the new norm to do them VSAS  Apply now! Don’t apply to too many (retractions look bad) Scheduling is a pain (may need to take months off/combine with USMLE studying, research, etc) Apply to schools you think you want to go to Apply to regions you want to go to also (SLOEs are regional) If you do multiple aways, do each in different environments (community vs. university hospital) Get a SLOE from each away (not doing so is a red flag) It is a month long audition elective, so give it your all, attend everything offered, and be on your best behavior You are not guaranteed an interview, but some programs will interview you before you leave (bring some nice clothes in case) Expensive, but worth it

Standardized Letter of Evaluation (SLOE) Not necessarily recommendations. Evaluates performance in the ED and ranks you compared to others Need a minimum of 3 letters for ERAS (2 SLOEs best) 3rd letter can be tradition LoR, but carries much less weight than a SLOE (better to have 3 SLOEs) Many rotations will automatically write one if you ask early on in the rotation Many are “group” SLOEs based of ED evaluations from residents/attendings For non-EM letters, just ask  “Do you feel comfortable writing me a LoR” You will need to formally request on ERAS and give the confirmation to your letter writer, so that they can upload it Some may want resume and/or your personal statement, so have a solid draft before your EM electives Google SLOR online to see what that is all about

Research Statistics say: “1 – 2” research experiences Likely more important for more academic programs Personal experience: my research was infrequently brought up during interviews Plenty of opportunities here Check the Buffalo EM site and email whoever’s project you find interesting or talk to Dr. Clemency

Personal Statement Not of high importance for EM More likely to hurt you than elevate your app  don’t try to be overly creative Does offer an opportunity for you to stand out if done well Writing tip: try to grab the reader’s attention early on (don’t be cliché though) Must address: “Why do you fit into EM (i.e. personality)?” and what attributes you would bring to a program Don’t just write an essay on why you like EM Other topics: subspecialty interests, hobbies/background, things you are looking for in a program, career goals (don’t be so specific as to turn off programs) Have a few readers (too many cooks in the kitchen can get messy) Dr. Wiech and Dr. Pugh are really good Grammar is paramount! Quadruple check before submitting

Process Overview Submit applications in mid-September. Get CV & personal statement proofread and entered before that SLOEs slowly come in (by mid October) Stay on top of your letter writers (politely!) Avoid being obnoxious (they are busy people) Dean’s letter uploaded October 1st Aim to submit no later than October 1st (sometimes before your last letter is uploaded) Interviews come in before Dean’s letter Many EM programs are not offering interviews until mid-October (some offer as early mid-September)

Interviews They conversational for the most part However, canned/scenario questions are not infrequent Common topics: hobbies, CV activities, current events, patient stories (both good and frustrating), strength/weakness, why this program/area, etc Be able to answer why EM! You will be asked ad naseaum Remember that it is a job/coworker interview (dress to impress) Do you have any other questions? (always have several ready because some interviewers start with this) Go to all pre-interview dinners (remember to behave!)

Personal tips Keep a residency journal with your gestalt, attitudes, interesting tid bits (don’t drown in the details). Have a running rank list going Email program coordinator before program director if you have a simple question about the program Email/write a program you really want to go to Only say “I am ranking your program number 1” to ONE program (dishonesty travels). For the other top 2 or 3 use “I am ranking your program very highly” Thank you notes (the norm)  try to reference some specifics of your interview conversation

Common Regrets Not calling programs / expressing interest Not asking for an advisor Find someone you clicked with and not asking for a LoR Not researching programs enough Not being aware of certain programs

Resources -SAEM: http://www.saem.org/membership/medical-students -EMRA: https://www.emra.org/students/ -The EM Match: A Top 10 List For Success https://www.emra.org/publications/em-resident/2009/the-emergency-medicine-match--a-top-10-list-for-success/ -Advice for Emergency Med Applicants: http://med.wmich.edu/education/internshipresidency/emergency-medicine/advice-emergency-medicine-applicants -What To Look for in an EM Residency: http://denverem.org/index.php?option=com_content&view=article&id=14&Itemid=36 -Specific Residency Websites -GHHS residency guide

Thanks for listening and good luck! Questions? Thanks for listening and good luck!