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Applying for an Emergency Medicine Residency
American College of
Emergency Physicians
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Goals
• How to prepare before you apply
• Choosing a program
• The application process
• The interview
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Background
• Program Formats– 1-3: 86 programs– 1-4: 14 programs– 2-4: 22 programs
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Homework
• Browse the web
• Know who’s who in EM
• Know the major clinical issues facing EM
• National EM organization membership– Including your local EM interest group
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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
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Browse the Web
• Most EM program information is on line
• Most residencies have home pages
• Can contact programs via e-mail
• Can participate in EM discussion groups
• Many lectures are now electronic
• www.saem.org/rescat/contents
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Who’s Who in EM
• Tintinalli and Rosen chapter authors
• Editorial boards of EM journals
• Keynote speakers
• National leaders
• Recurrent conference lecturers
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Major Issues Facing EM
• Editorial subjects
• Macy report
• Clinical issues
• Educational issues
• Legislative/regulatory issues
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Emergency Medicine Organizations
• American College of Emergency Physicians
• Society for Academic Emergency Medicine
• American Academy of Emergency Medicine
• Emergency Medicine Residents’ Association
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Ken Iserson’s: Getting into a residency
• Application process
• CVs
• Personal statements
• Letters of recommendation
• Interviewing tips
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Extra Credit
• Participate in research– Know the details
• EMS ride along
• Leadership role in EM interest group
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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
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Choosing a Program: The Big Picture
• RRC role– Consistent educational elements– Ensures adequate exposure to various clinical
scenarios
• Your role – Maximize learning– (Have fun)
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Maximize Learning
• Location– Hobbies– Spouse/SO
• Educational/Teaching philosophy– County, community, private– Reading vs patient-based
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Maximize Learning
• Special interests– Fellowship opportunities– EMS/Flight experience– HBO– International– Ultrasound– Will the program meet your needs?
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The Big Picture
• Program accreditation
• Length of re-certification– on probation
• Financial stability
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The Application:“Begin with the End in Mind”
• Dean’s letter
• Board scores
• Academic record
• Personal statement
• Letters of recommendation
• Outside interests/activities
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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
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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
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Dean’s Letter
• Medical Students– November 1st
– Review for accuracy/content– Meet with writer about special attributes
• Program Directors– Class rank– Last paragraph– Rotation summary
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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
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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
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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
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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
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Letters of Recommendation
• Program Directors– Do I know the person who wrote the letter?
– How does this letter compare to others?
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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
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Outside Interests/Activities
• Medical Students– Have fun– Become involved– Interest groups– Research
• Program Directors– Quality of involvement– Leadership potential
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Before You Interview
• Read: Koscove EM. An applicant’s 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
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The Interview
• When– November – January
– Winter weather travel
– Revisit program
– Rank list preparation
• The Night Before– Prepare/review questions
– Gather data: visit site
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The Interview
• That day:– Be on time
– Don’t over/under dress
– Don’t dominate the interview
– Be yourself
– Ask questions
– Take notes
– How did it “feel”
Program director
Faculty
Residents
Support staff
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The Interview
• It’s a small world – make friends
• Never ever bad-mouth another program
• Don’t blow off an interview
• Follow-up letter or phone-call
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First and Second Year Students
• Observe in ED
• Summer research projects with EM staff
• EM interest group affiliation
• Be open to any medical specialty
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Third Year Students
• See patients in ED on various rotations
• Obtain EM physician as mentor
• Start selecting fourth year rotations
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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
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Finally…
Relax
Have fun
Choose your mentor well
Talk to your peers
Talk to your advisor
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Web Sites
• www.acgme.org
• www.ama-assn.org
• www.aamc.org
• www.acep.org
• www.saem.org
• www.aaem.org
• www.emra.org
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References to Read
• AAMC. Medicare Payments for Graduate Medical Education: What Every Medical Student, Resident, and Advisor Needs to Know. Ivy Baer, JD MPH. [email protected]
• 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;148:133-134
• Miller RS et al. Employment-Seeking Experiences Resident Physicians Completing Training in 1996. JAMA 1998 280:777
• Krane JT, Ferraro CM. Selection Criteria for Emergency Medicine Residency Applicants. Acad Emerg Med 2000, 7:54-60
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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;148:213-219
• 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 1999 74:51-58
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