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 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

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 Iserson’s: 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)

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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

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

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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

B-28

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

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

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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

B-35

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

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. Ibaer@aamc.org

• 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

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;148:213-219

• 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