B-1 Applying for an Emergency Medicine Residency American College of Emergency Physicians

B-2 Goals How to prepare before you apply Choosing a program The application process The interview

B-3 Background Program Formats –1-3: 86 programs –1-4: 14 programs –2-4: 22 programs

B-4 Homework Browse the web Know whos who in EM Know the major clinical issues facing EM National EM organization membership –Including your local EM interest group

B-5 Homework Choose your mentor well Carefully plan your final medical school years Read the Macy report on EM Purchase : Getting Into a Residency: A Guide for Medical Students Talk to graduates/seniors from your school

B-6 Browse the Web Most EM program information is on line Most residencies have home pages Can contact programs via Can participate in EM discussion groups Many lectures are now electronic

B-7 Whos Who in EM Tintinalli and Rosen chapter authors Editorial boards of EM journals Keynote speakers National leaders Recurrent conference lecturers

B-8 Major Issues Facing EM Editorial subjects Macy report Clinical issues Educational issues Legislative/regulatory issues

B-9 Emergency Medicine Organizations American College of Emergency Physicians Society for Academic Emergency Medicine American Academy of Emergency Medicine Emergency Medicine Residents Association

B-10 Ken Isersons: Getting into a residency Application process CVs Personal statements Letters of recommendation Interviewing tips

B-11 Extra Credit Participate in research –Know the details EMS ride along Leadership role in EM interest group

B-12 The Match 2000 NRMP data 971 PGY-I EM positions 794 (81.7%) filled by US graduates 966 (99.4%) filled in match 122 allopathic programs; 25 AOA programs

B-13 Choosing a Program: The Big Picture RRC role –Consistent educational elements –Ensures adequate exposure to various clinical scenarios Your role –Maximize learning –(Have fun)

B-14 Maximize Learning Location –Hobbies –Spouse/SO Educational/Teaching philosophy –County, community, private –Reading vs patient-based

B-15 Maximize Learning Special interests –Fellowship opportunities –EMS/Flight experience –HBO –International –Ultrasound –Will the program meet your needs?

B-16 The Big Picture Program accreditation Length of re-certification –on probation Financial stability

B-17 The Application:Begin with the End in Mind Deans letter Board scores Academic record Personal statement Letters of recommendation Outside interests/activities

B-18 Selection Criteria EM rotation grades 4.79 Interview 4.62 Clinical grades 4.35 Recommendations 4.11 Grades (overall) 3.95 Elective at the institution 3.76 Board scores (overall) 3.35 USMLE (II) 3.34 Interest expressed 3.30

B-19 Selection Criteria USMLE (I) 3.28 Awards/achievements 3.16 Honor society selection (osteopathic) 3.01 Medical school 3.00 Extracurricular activities 2.99 Basic science grades 2.88 Publications 2.87 Personal statement 2.75

B-20 Deans Letter Medical Students –November 1 st –Review for accuracy/content –Meet with writer about special attributes Program Directors –Class rank –Last paragraph –Rotation summary

B-21 Board Scores Medical Students –Do your best –Study hard –Rest before exam –Only one part of picture Program Directors –Filter based on score –Only one part of picture after the filter

B-22 Academic Record Medical Students –Do your best –Study hard –Be prepared to explain low grades Program Directors –Look for trends –Look for flags –Confusing scoring system

B-23 Personal Statement Medical Students –Chance to express yourself –Why you would fit into the specialty –Have others review/critique –One page only –Monitor spelling/grammar Program Directors –Review hundreds –Unique character/quality

B-24 Letters of Recommendation Medical Students –Need at least 3 –At least 2 should be in your specialty –Consider assistant / associate / program director –Personal statement CV / USMLE / transcript –SLOR format / EM score –More valuable if from EM training programs –Approach letter writer early while you are still fresh in their mind

B-25 Letters of Recommendation Program Directors –Do I know the person who wrote the letter? –How does this letter compare to others?

B-26 Standard Letter of Recommendation Title and position of author Context that you know the applicant EM grade Commitment to EM Work ethic Treatment plan Personality Global assessment Match range Comments

B-27 Outside Interests/Activities Medical Students –Have fun –Become involved –Interest groups –Research Program Directors –Quality of involvement –Leadership potential

B-28 Before You Interview Read: Koscove EM. An applicants evaluation of an Emergency Medicine Internship and Residency. Ann Emerg Med 19:774, 1990 Read: Getting into A Residency: A Guide for Medical Students by Kenneth Iserson Read: EMRA. EM in Focus: A Guide for Medical Students

B-29 The Interview When –November – January –Winter weather travel –Revisit program –Rank list preparation The Night Before –Prepare/review questions –Gather data: visit site

B-30 The Interview That day: –Be on time –Dont over/under dress –Dont dominate the interview –Be yourself –Ask questions –Take notes –How did it feel Program director Faculty Residents Support staff

B-31 The Interview Its a small world – make friends Never ever bad-mouth another program Dont blow off an interview Follow-up letter or phone-call

B-32 First and Second Year Students Observe in ED Summer research projects with EM staff EM interest group affiliation Be open to any medical specialty

B-33 Third Year Students See patients in ED on various rotations Obtain EM physician as mentor Start selecting fourth year rotations

B-34 Fourth Year Students Mandatory/Elective EM rotation –Shine Consider extramural rotations –Community experience –Opportunity at a residency program SAEM list of extramural EM rotations Letters of recommendation

B-35 Finally… Relax Have fun Choose your mentor well Talk to your peers Talk to your advisor

B-36 Web Sites

B-37 References to Read AAMC. Medicare Payments for Graduate Medical Education: What Every Medical Student, Resident, and Advisor Needs to Know. Ivy Baer, JD MPH. Grum CM, Wooliscroft JO. Choosing a Specialty: A Guide for Students. JAMA 1993;269:1183,1186 Iserson K. Getting Into a Residency: A Guide for Medical Students Camden S.C.: Camden House Publishers 1996 Klass D,Clauser B. Evaluating Clinical Skills: Getting It Right Slowly (editorial). Arch Pediatr Adolesc Med 1994;148: Miller RS et al. Employment-Seeking Experiences Resident Physicians Completing Training in JAMA :777 Krane JT, Ferraro CM. Selection Criteria for Emergency Medicine Residency Applicants. Acad Emerg Med 2000, 7:54-60

B-38 References to Read Rosenblum ND, Wetzel M, Platt O, Daniels S, Crawford J, Rosenthal R. Predicting Medical Student Success in a Clinical Clerkship by Rating Students' Nonverbal Behavior. Arch Pediatr Adolesc Med 1994;148: Tracy E. How Graduate Medical Education Funding Affects Residency Program Changes. JAMA 1996;276:1536 Wagoner NE, Suriano JR, Stoner JA. Factors Used by Program Directors to Select Residents. J Med Educ 1986;61:10-21 Wagoner and Suriano. Program Directors Responses To a Survey on Variables Used to Select Residents In A Time of Change. Acad Med :51-58