[2015-2016] EM Rank Order List Thread

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Found out only a few weeks ago that I got trashed in a letter from an away rotation (very unexpectedly, based on feedback, and unfairly, IMO), quivered in my boots until last Monday, was very relieved to match, and on Match Day found out that I fell pretty far down my list and feel really lucky to have matched. I matched to a fantastic program in a not-so-favorite location, but I am so grateful and very excited to start. With EM getting as competitive as it is, any little thing on your app that could be viewed negatively can hurt you really badly. It was absolutely terrifying to think how much that SLOE hurt me. Two strong SLOEs and a great app + 1 questionable SLOE is truly dangerous. I very much regret ever doing that rotation; I got all my interview invites before that letter was sent and feel like most of my interviews went quite well. Future EM applicants: Be very, very careful where you rotate. Sadly, I now completely agree with past advice I have seen on SDN about doing "safe" aways.

Anyhow, I am very happy and excited that I am going to be an EM doc! Very grateful.

It's funny how everyone thinks a bad letter, or even marginal, letter is never their fault. Now, you may be the exception, but you should probably seek feedback and see what you did poorly - it will make you a better doctor.

Every med stud with a bad SLOE thinks it's not their fault, or its a sample size that's too small, etc. When we review applicants each year, our program is usually unanimous in how we feel about almost everyone - some of us just don't have the balls to tell people they suck.

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It's funny how everyone thinks a bad letter, or even marginal, letter is never their fault. Now, you may be the exception, but you should probably seek feedback and see what you did poorly - it will make you a better doctor.

Every med stud with a bad SLOE thinks it's not their fault, or its a sample size that's too small, etc. When we review applicants each year, our program is usually unanimous in how we feel about almost everyone - some of us just don't have the balls to tell people they suck.

:eek:
I do wish feedback was given in a more timely and honest fashion
 
I have to say, even if a student does deserve a less-than-stellar SLOE, the letter writer should have the balls to give him/her honest feedback on their performance. A couple of friends of mine going into EM had poor SLOE comments that they were not made aware of during their rotations. I can't think of a worse way to find out you didn't get a strong SLOE than by hearing about it from one of your interviewers or by not getting enough invitations.
 
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It's funny how everyone thinks a bad letter, or even marginal, letter is never their fault. Now, you may be the exception, but you should probably seek feedback and see what you did poorly - it will make you a better doctor.

Every med stud with a bad SLOE thinks it's not their fault, or its a sample size that's too small, etc. When we review applicants each year, our program is usually unanimous in how we feel about almost everyone - some of us just don't have the balls to tell people they suck.

If I deserved it, I sure didn't see it coming. I sought feedback during and after every shift, asked during subsequent shifts how I was progressing on whatever I was trying to improve, and sought a final feedback session at the end from the CD. It feels like a stab in the back. I could have easily withheld this letter if I had a clue (rotation was a late one), but all signs pointed towards, "You're doing great! High five!" After this experience, I am not so quick to dismiss others who have had a similar experience. It's like an unexpected punch to the gut, and it is infuriating. It feels like I was lied to; if there is a problem, let somebody know if they are asking how to improve. (It was a poor student rotation experience, too, in case anyone is wondering. Kind of a disorganized mess compared to the others. Nobody could give me a clear picture of how I was going to be graded. Plus, it seemed like there were far too many away rotators for them to handle.)

Anyhow, I regret this rotation very much, but again, I am very excited and grateful to have matched despite this unexpected red flag.
 
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I can't think of a worse way to find out you didn't get a strong SLOE than by hearing about it from one of your interviewers or by not getting enough invitations.
I plus/minus agree with this. The entire point of the confidentiality requirement for the SLOE is so that people can't submit only their good letters and withhold their bad ones, thus giving programs an artificially inflated sense of the applicant.

I do, however, agree that the letter writer should be giving honest feedback during the rotation which, if the applicant sucks, should be "you suck" not "oh yeah, you're doing great, I'd love to write your letter."
 
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Found out only a few weeks ago that I got trashed in a letter from an away rotation (very unexpectedly, based on feedback, and unfairly, IMO), quivered in my boots until last Monday, was very relieved to match, and on Match Day found out that I fell pretty far down my list and feel really lucky to have matched. I matched to a fantastic program in a not-so-favorite location, but I am so grateful and very excited to start. With EM getting as competitive as it is, any little thing on your app that could be viewed negatively can hurt you really badly. It was absolutely terrifying to think how much that SLOE hurt me. Two strong SLOEs and a great app + 1 questionable SLOE is truly dangerous. I very much regret ever doing that rotation; I got all my interview invites before that letter was sent and feel like most of my interviews went quite well. Future EM applicants: Be very, very careful where you rotate. Sadly, I now completely agree with past advice I have seen on SDN about doing "safe" aways.

Anyhow, I am very happy and excited that I am going to be an EM doc! Very grateful.

I had the same thing happen to me, and it pissed me off to no end. I honored my first two auditions, then I guess I rubbed someone the wrong way at my third. I was trashed on my SLOE, and had no idea that anything was wrong until one of the interviewers that I knew read it out loud to me. The entire time I was on that rotation, I asked for feedback and was told that I was doing a great job, keep doing what you're doing, etc. No inclination that I should change the way I was doing things or acting. I asked the senior resident that I worked with the most to sit down with me for some feedback halfway through the rotation and they were always "too busy".

When I heard what that SLOE said, I felt betrayed and lied to. It's completely two-faced to make a student think they're doing a great job with zero criticism and then to slam them on their SLOE. It definitely cut down the number of interviews I had. I had half the number of interviews that my classmates had, despite having far better board scores, prior work experience as a paramedic, lots of EM-oriented extracurriculars, etc. They all had 20-25 interview invitations and I struggled to get to 14 after sending interest e-mails, and a lot of those invitations were late in the season. Now all I can do is advise my underclassmen to avoid rotating at that program. And, after all of that, they sent me an early interview invitation! I declined it and was super fortunate to match at my number 1 program (one of the ones that I rotated at and got honors).
 
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If I deserved it, I sure didn't see it coming. I sought feedback during and after every shift, asked during subsequent shifts how I was progressing on whatever I was trying to improve, and sought a final feedback session at the end from the CD. It feels like a stab in the back. I could have easily withheld this letter if I had a clue (rotation was a late one), but all signs pointed towards, "You're doing great! High five!" After this experience, I am not so quick to dismiss others who have had a similar experience. It's like an unexpected punch to the gut, and it is infuriating. It feels like I was lied to; if there is a problem, let somebody know if they are asking how to improve. (It was a poor student rotation experience, too, in case anyone is wondering. Kind of a disorganized mess compared to the others. Nobody could give me a clear picture of how I was going to be graded. Plus, it seemed like there were far too many away rotators for them to handle.)

Anyhow, I regret this rotation very much, but again, I am very excited and grateful to have matched despite this unexpected red flag.

How'd you find out about the bad SLOE? At least you kinda got a reason why things played out for you the way they did.
Similar thing happened to me (or at least I assume it did). I was a pretty strong applicant statistically, told good things about myself on rotations. Ended up not getting as many interview invites as I had expected, and I fell way down on my match list. In the end, it all worked out really well, matched at a great program, but just in a location I wasn't as thrilled about. Turns out I like the place more than I ever thought. Anyway, I can't help but wonder to this day what my LORs said...
 
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Same situation, but the letter came early in the season and impacted my # of invites and I never made it to the magic #. First chalked it up to being neurotic but after a few weeks I had my advisor review my application since it was very strong for EM and found the bomb. Did what I could in terms of feedback during the rotation at the end of the shift and the assigned grade they gave at the end of the rotation (w/comments) didn't indicate anything out of the ordinary.

The entire season was anxiety-provoking, lost a lot of weight, and had lots of doubts but I made my peace eventually. My expectations going into this were low, but I ended up at a good university program and I am grateful that I even matched. Getting blindsided by something like this later on in the season, when all signs point towards a strong match is arguably worse.
 
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Same situation, but the letter came early in the season and impacted my # of invites and I never made it to the magic #. First chalked it up to being neurotic but after a few weeks I had my advisor review my application since it was very strong for EM and found the bomb. Did what I could in terms of feedback during the rotation at the end of the shift and the assigned grade they gave at the end of the rotation (w/comments) didn't indicate anything out of the ordinary.

The entire season was anxiety-provoking, lost a lot of weight, and had lots of doubts but I made my peace eventually. My expectations going into this were low, but I ended up at a good university program and I am grateful that I even matched. Getting blindsided by something like this later on in the season, when all signs point towards a strong match is arguably worse.

I found out in February. I was absolutely gutted.
 
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I found out in February. I was absolutely gutted.

mC7cTyN3.jpeg
 
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Found out only a few weeks ago that I got trashed in a letter from an away rotation (very unexpectedly, based on feedback, and unfairly, IMO), quivered in my boots until last Monday, was very relieved to match, and on Match Day found out that I fell pretty far down my list and feel really lucky to have matched. I matched to a fantastic program in a not-so-favorite location, but I am so grateful and very excited to start. With EM getting as competitive as it is, any little thing on your app that could be viewed negatively can hurt you really badly. It was absolutely terrifying to think how much that SLOE hurt me. Two strong SLOEs and a great app + 1 questionable SLOE is truly dangerous. I very much regret ever doing that rotation; I got all my interview invites before that letter was sent and feel like most of my interviews went quite well. Future EM applicants: Be very, very careful where you rotate. Sadly, I now completely agree with past advice I have seen on SDN about doing "safe" aways.

Anyhow, I am very happy and excited that I am going to be an EM doc! Very grateful.

Scary stuff.

I think this happens far more often than some people like to admit. While I didn't have any issues with my SLOEs per se, I did have the same thing happen on a couple 3rd year evals that made it into my dean's letter (no negative feedback whatsoever then received negative comments). Not a fun experience to say the least. Luckily the vast majority of my evals were great so it wasn't a big issue. That being said, who knows how many more interviews I might have received...

While I understand the need to keep SLOEs confidential, that doesn't mean you shouldn't get honest and timely feedback on your performance during the rotation. If you suck, they should tell you that you suck so you can learn from your mistakes and improve your performance. On the flip side if you're doing great, they should also tell you that you're doing great so you can keep up the good work. Sometimes, unfortunately, its just out of your control since there are bad residents out there who just don't care if they end up screwing people over because they don't want to take the extra 5min to give honest feedback and help people to become better doctors.
 
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How'd you find out about the bad SLOE? At least you kinda got a reason why things played out for you the way they did.
Similar thing happened to me (or at least I assume it did). I was a pretty strong applicant statistically, told good things about myself on rotations. Ended up not getting as many interview invites as I had expected, and I fell way down on my match list. In the end, it all worked out really well, matched at a great program, but just in a location I wasn't as thrilled about. Turns out I like the place more than I ever thought. Anyway, I can't help but wonder to this day what my LORs said...

Not sure how your interviews went but quite a few interviewers on the trail would literally pull out my SLOEs in front of me and read them out loud.

A couple faculty even showed them to me after asking me about them.
 
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Not sure how your interviews went but quite a few interviewers on the trail would literally pull out my SLOEs in front of me and read them out loud.

A couple faculty even showed them to me after asking me about them.

Hah I had one interview where they read my letters to me. Luckily all the comments were good. I guess it really varies by rotation site, I felt like the two auditions I did where I got SLOE's were very upfront with my regarding feedback, we even did mid rotation evals where they sat down and went through all of your shift evals and read off the scores and comments. I did do two other auditions where I got basically no feedback at all, one didn't even have shift evals. These were later in the fall so I did not ask for SLOE's.
 
I definitely had no idea it was this common. I had a similar found out in February situation that the numbers part was "far below average" (written was meh?). I was told it was ignored because it was so anomalous but a place called the SLOE-writer to find out but never heard back. I was fortunate to have 2 other strong SLOEs, and Deans letter. Felt very lucky to have a good outcome match day.

So upcoming M4s be very careful with and on your aways! I wish you luck.
 
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I definitely had no idea it was this common. I had a similar found out in February situation that the numbers part was "far below average" (written was meh?). I was told it was ignored because it was so anomalous but a place called the SLOE-writer to find out but never heard back. I was fortunate to have 2 other strong SLOEs, and Deans letter. Felt very lucky to have a good outcome match day.

So upcoming M4s be very careful with and on your aways! I wish you luck.


Stalking this thread for awhile M3 applying EM next year.

I thought I saw a thread somewhere that was based on EM aways that tend to give bad SLOEs, I can't find it now and didn't want to start a thread unless I'm hallucinating. Is there such a thread?
 
Stalking this thread for awhile M3 applying EM next year.

I thought I saw a thread somewhere that was based on EM aways that tend to give bad SLOEs, I can't find it now and didn't want to start a thread unless I'm hallucinating. Is there such a thread?
There's a post with that info, but take it with a grain of sal.
 
Congratulations to everyone that matched. I matched at my #3.

I hope everyone who went to the SOAP got something good. One of my friends got Psych in the scramble and is happy/at peace.

This SLOE monkey business is really pissing me off. There is no reason to headfake someone into believing it will be a good/great SLOE and then trashing them privately. How does that in any way help them as a future physician? Makes my blood boil. I'm sure this was already addressed, but any way to anonymously post about which programs did something like this? They should be publicly shamed if they're screwing with someone's career/life.
 
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Just to give hope to future applicants reading this thread, I received 17 interviews and matched into my top 3 with less than stellar board scores...~220 for Step 1/2. I remember reading previous iterations of this thread and considering a specialty change after receiving my Step 2 score but I worked my tail off in aways, got great letters, and kept a good attitude. Congrats to everyone who matched this year.
 
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My experience was that nobody really cares about my good board scores. It got mentioned a couple times at interviews but in the same way that they mentioned "so you play hockey". It seemed like it really wasn't the biggest thing. It seemed more like you just had to meet some minimum score and that everything after that didn't really matter much.
 
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Congratulations to everyone that matched. I matched at my #3.

I hope everyone who went to the SOAP got something good. One of my friends got Psych in the scramble and is happy/at peace.

This SLOE monkey business is really pissing me off. There is no reason to headfake someone into believing it will be a good/great SLOE and then trashing them privately. How does that in any way help them as a future physician? Makes my blood boil. I'm sure this was already addressed, but any way to anonymously post about which programs did something like this? They should be publicly shamed if they're screwing with someone's career/life.

You could always post a confidential review (including feedback and SLOE quality) in the away rotation thread.
 
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True story. Our match ceremony is set up so that each student is randomly called up the stage to get their envelope. One by one students place 1-2 dollars inside a money basket/pot as they pick up their envelopes, so that the very last person (who had to wait an hour for 200 others to get theirs envelopes first) gets to keep that cash price.

Well...

EcoabTW.jpg
Used the money to buy all my classmates drinks last night.

I randomly stumbled upon your twitter and I feel like I unlocked a huge mystery scooby-doo style
 
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I randomly stumbled upon your twitter and I feel like I unlocked a huge mystery scooby-doo style
If there are no Scooby snacks involved, then not even remotely interested!! Btw I think I just woke up from a 7 day drinking binge...felt like I was at a day spa for an entire week, zoolander style ;)!! The only other time I felt this dirty was that weekend in Thailand, which I'm still trying to erase from my memory!!
 
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Hey guys. I'll come in on this with my perspective. So I'd always been EM, prepped for it since undergrad. Got to know asst. clerkship director at where I was going to do 3rd year EM. Did 1st and 2nd year shifts in that same ED building relationships. Thought I was doing great. Got outstanding 3rd year SLOE from said asst. director, then decided to do sub-I there. Was told that my Step 1 was pretty low and that they wouldn't normally let me in to do rotation, but since I had done well with others there, ok. Do rotation, work my darndest, but just not feeling it. Ask for feedback half way through and find out that "one or two" folks have said that I could improve on stuff...was news to me, normal "hey good job on this, make sure to read up on ___ for next time" after every shift. Nothing serious was said to me. So, ok. I work hard at everything I was told to do. Meet with clerkship director. Asked what I should do, got advice etc. They commented on how my entheusiasm was second to none, always helping etc. Seemed to like my improvement. Felt that I did alright and needed to include the SLOE since my only other SLOE was 3rd year clerkship and my other sub-I was going to be in October. Did really well in October, with positive SLOE and got 8 interviews. Manageable after low step scores. Go to interview at place with bad feedback and residency director tells me that I most likely will not have success because of that SLOE and need to "remove it from my application". OK....so why did the person offer to write me a letter if it was going to hammer me, and now the same institution is telling me to remove it (when we both know that I can't)? I mean, I agree with @TimesNewRoman that I am not blameless and have things to work on, but it would have been nice to know that this letter was going to be so brutal and I would have taken my changes with only 2. Match day came and went with no EM success. Feels bad man. As such, I was fortunate to find an FM spot that I think will still allow me to complete work goals in the future. It still stings having what I've worked so hard for be dashed in an instant, but it is what it is. Greater tragedies have happened, and I still get to be a practicing physician.
 
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You could always post a confidential review (including feedback and SLOE quality) in the away rotation thread.



Found out only a few weeks ago that I got trashed in a letter from an away rotation...


I had the same thing happen to me, and it pissed me off to no end. I honored my first two auditions, then I guess I rubbed someone the wrong way at my third. I was trashed on my SLOE...


How'd you find out about the bad SLOE? At least you kinda got a reason why things played out for you the way they did...


Same situation, but the letter came early in the season and impacted my # of invites and I never made it to the magic #...


I definitely had no idea it was this common. I had a similar found out in February situation that the numbers part was "far below average" (written was meh?)...


Had the same thing happen to me. I don't think this is an uncommon tale unfortunately. Overall I got great letters, had a strong app, etc etc. Did a rotation where I actually probably got my BEST feedback - "You're well above most of your peers", "You're doing an amazing job, I don't really think there's anything for you to work on", and "Just keep doing what you're doing" were the comments I received when soliciting feedback and when I met with an attending at the end. Absolutely zero negative comments. Then during application season I watched as my classmates got 10, 15, 20, then 25 interviews while I got 3, then 4, then 5. One interviewer was kind enough to go over my SLOE from this place, and it turns out I got trashed...

Here's the above referenced thread: http://www-forums.studentdoctor.net...u-have-a-*great*-student-EM-rotation?.114708/

I'm so sorry to hear about what happened to all of you. Not only is it rude and unprofessional, but it's a terrible blow to a person's ego. Definitely please leave feedback for those of us that will be going through this next year! (The thread has a link to submit reviews anonymously.)

Very happy that it sounds like everyone came out ok!
 
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Just to give hope to future applicants reading this thread, I received 17 interviews and matched into my top 3 with less than stellar board scores...~220 for Step 1/2. I remember reading previous iterations of this thread and considering a specialty change after receiving my Step 2 score but I worked my tail off in aways, got great letters, and kept a good attitude. Congrats to everyone who matched this year.

Just so others have multiple experiences to draw from: I got 219/240, all passes with one preclinical honors (don't know what I got on my EM rotations). One home EM, one home US, one home EMS, one away. Got 9 interviews (several of those after emailing PDs expressing interest). Applied to 50 EM programs total.

Edit: matched at my #6 spot thank god. I was super nervous I would have to resort to my FM backup. To all you guys who didn't match or had to use your backup... I feel for you guys. I'm really sorry and I wish you the best of luck in the future.
 
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Just to chime along with the previous post to contribute to sharing experiences. I got 225 on step 1. Took step 2 CK on 12/31 (in retrospect I should have taken it way earlier. I'm sure it hurt me a lot in getting interviews) and got 241. Not so great class rank (urgh).
Only did two sub-I (adult and peds) at home institution with high pass. No away. Only one SLOE with 2 other EM letters and one non-EM letter. Submitted on ERAS on Sept. 30th (should have done it earlier, like 9/15).
Applied to ~60 programs (in hindsight I should have picked the programs more carefully as I was applying to places that I had no business applying to, because I can't go there anyway due to location constraint. Then it would have come out to perhaps 30 programs). Got 8 interviews total. Two of which are brand new programs. One of which I got because someone in my program made a call for me. One of which I got because of sending an email expressing interest (I sent emails to several programs). One of which I got right after I submitted my Step 2 CK score. My last two interviews were on Feb 1st and 6th. No back up (gutsy, I know). I felt that all my interviews went well (except for one that didn't quite click). I have no idea what my SLOE said, but given that it was coming from home school, I think it probably wasn't bad. None of the interviews mentioned my SLOE or LORs.
The emotion roller-coaster that I experienced during interview season was rough. I waited and waited for more interviews but only got trickles. When I got to 4-5 interviews, friends with similar stats already got like 12-14 interviews. I thought perhaps the stats, no away, late step 2 ck, and two spelling mistakes (stupid, I know) on my CV were the cause. So please, don't make the mistakes I did.
Anyhow, in the end I matched to my first choice, which was also the program that sent me the first interview invite (Thanks goodness!). I'm over the moon to have matched there. I feel very lucky and grateful for everything.
Best of luck to everyone moving forward!
 
Congrats everyone! For future applicants, sending interest emails works! I matched to a place where I sent an interest email and was wait listed. Couldn't be happier!
 
I matched at a place that put me on hold pending a letter, I emailed the PD when it was uploaded and was like "please love me"


Sent from my iPhone using SDN mobile app
 
I matched my #1, too. I was waitlisted in October, politely begged for an interview a month later, and interviewed the last week of January. Never say never.
 
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I just wanted to mention that I also matched to a program that did not offer me an interview until I contacted them. It was late in the season and they told me they were full so I accepted a spot on the wait list. Well what do ya know a spot opened and I matched! I was quite surprised but super excited. It is kind of a reach program for me so I'm still a little woozy from it.

Bottom line for MS3s looking at this thread. Do not hesitate to write programs and tell them you are interested in them if you aren't hearing from them.

Best of luck to everyone. Cheers!
 
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in terms of SLOE requests, I would advise future applicants to explicitly ask: "might you be willing to write me a strong, positive SLOE that would support my application for EM residency?" I realize that some faculty will lie through their teeth to your face, but I think this way of asking may help you decide whether to risk including their letter or not--you have more to lose than gain. If they give you any hesitation or dont respond directly/explicitly, or you just get a bad feeling, do not submit the SLOE to programs.

i wish i had scheduled a third and maybe even a fourth EM sub-i to allow more flexibility in the above.

It may also be wise to avoid SLOEs from places that did not give you Honors (if you are an honors student in general). fyi...it is possible to request a SlOE but not submit it to programs until your grade comes out.

also, at end of shift on your sub-i, dont just give them the grade form and walk away--give them a strong handshake and a toothy smile, tell them you enjoyed working with them, try to find out if you are working other shifts together and what they want done differently on that shift, ask to go over what to improve on, and give a critical assessment of what you think you personally want to improve on from the shift (and ask them next steps to get there).

also it helps at beginning of shift to tell attg that you want to work on x or y and how helpful it would be if they would check in with you about that during the shift...its may seem like a silly and insincere game, but you'll learn more and may get better evals (which = better SLOE) this way. its easier psychologically for them to write "below average" if you are more or less anonymous to them; shift grading is almost entirely subjective. also, on the eval form, it can help for you to write the procedures you did, or other shift highlights, so they have something to include in the comments of the shift eval (especially if they do it later), which may literally end up word for word on your SLOE.

ask the clerkship director after the first week of the rotation to review your evals and performance with you, and what specifically to improve (in a formal meeting, in their office--not during a shift). they could potentially lie, but if you ask for objective data like shift eval comments and average shift eval grade so far, its harder to. if you email them midway through rotation and meet the third week, it could be harder to change your performance quickly enough to reverse a poor SLOE.

PS...obviously try to be somewhat subtle with the above, being annoying i guess could be worse than anonymous lol
 
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What I think a lot of people don't realize is that there is a concerted effort at residencies across the country to really stick to the distribution on the SLOEs: 10% Honors. Not everyone can honor.
 
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If they give you any hesitation or dont respond directly/explicitly, or you just get a bad feeling, do not submit the SLOE to programs.

It may also be wise to avoid SLOEs from places that did not give you Honors (if you are an honors student in general). fyi...it is possible to request a SlOE but not submit it to programs until your grade comes out.
Fair warning: not submitting a SLOE from a rotation you did is suspect. You will be asked about it unless you lie when they ask you where you did your aways.

I had one SLOE that was late coming in and until it came in every interviewer asked about it; they all followed up after the interview to be sure I submitted it.
 
I am in complete understanding of what the term honors (top 10% means) and that not everyone will honor. I respect greatly that they are honest with that. However, i find it deplorable without words when faculty agreee to write you a SLOE and then put negative remarks in it that will blindside you. The only thing that is worse (and i know several faculty and institutions that have become known for this) is when you ask for feedback, they say keep up the hard work, and then the letter has comments that youve never ever heard of or could've changed months ago.

They ask students to be completely honest, forthcoming, etc yet pull this crap wayyyy to often.
 
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I am in complete understanding of what the term honors (top 10% means) and that not everyone will honor. I respect greatly that they are honest with that. However, i find it deplorable without words when faculty agreee to write you a SLOE and then put negative remarks in it that will blindside you. The only thing that is worse (and i know several faculty and institutions that have become known for this) is when you ask for feedback, they say keep up the hard work, and then the letter has comments that youve never ever heard of or could've changed months ago.

They ask students to be completely honest, forthcoming, etc yet pull this crap wayyyy to often.

The only thing that can done about this is letting people know. Posts on the 'great away rotation thread' are helpful to those that are applying in the coming years.
 
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+1 if this happened to you please please post anonymously in the away rotation thread, even if you have to omit details to remain anonymous. To many people have had 8+ years of hard work set to fire by this unprofessional behavior.
 
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One possible strategy if you do your aways early in the season and have the SLOES uploaded prior to Oct is to submit only to your home program and have someone review it for red flags. Not sure how "allowed" this is, but you don't have to ask for specifics. You can always elect to not assign certain letters to programs although this doesn't escape explaining why you didn't have a letter from a rotation and if you were counting on that SLOE to reach 3, then you'd have to scramble to find another one. More for peace of mind, but that's super valuable during this process. If you look at the interview invite thread, nothing really happened until early Oct, so you wouldn't miss the boat by doing this.
 
I read through a lot of SLOEs every year and write a good number as well.
There are occasional really bad letters that don't fit in with the rest of the application, but most of the time if the application has one really bad SLOE there are other issues somewhere either on clinical rotations or on other EM away rotations. The extra data may not be as obvious, but if someone gets torn up on a SLOE for being overly confident or unreceptive to feedback, chances are they haven't made it to 4th year without someone else picking up on that tendency. As a student I got criticized for joking around too much on a rotation...turns out I was joking around too much on a rotation. Was frustrating at the time, and the criticism came from a questionable source, but the underlying message wasn't totally off base.
 
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What I think a lot of people don't realize is that there is a concerted effort at residencies across the country to really stick to the distribution on the SLOEs: 10% Honors. Not everyone can honor.

That isn't quite true. There are definitely programs out there where large percentages of students honor, however, there is a specific question on the SLOE which breaks down each grade (H, HP, P, F) and asks what percentage of each grade is assigned.
 
That isn't quite true. There are definitely programs out there where large percentages of students honor, however, there is a specific question on the SLOE which breaks down each grade (H, HP, P, F) and asks what percentage of each grade is assigned.
I know of at least one program that likely lies about their grade distribution and essentially gives everyone honors or high pass.
 
Random fun (or maybe not) experiences on the interview trail:
Best interview day lunch: UT Southwestern in Dallas
Best overall interview experience: Denver Health
Best resident interviewer: Mayo Clinic
Coolest PD: Dr. Suau at LSU in New Orleans
Best tour: UCSF in Fresno
Worst tour: All tours that included visits to the ICU. They all look the same
– Best interview day applicant group was at Emory
Nicest-looking ED: The new University Hospital at LSU New Orleans
Oldest-looking ED: Cook County Hospital
Least diverse program: Vanderbilt
– Went overtime on almost all of my interviews (not intentionally)
– Longest individual interview was ~45 minutes (15 minutes overtime)
– Shortest was ~8 minutes (3 minutes overtime)
– A good number of interviewers do actually read your personal statement
– Most interview questions were very predictable. Just Google that Northwestern U document
– Three interviews were in a different language. This is for the people out there exaggerating their foreign language proficiency. You will get caught.
– Some programs offered paid-for (i.e., cost of airplane tickets, hotel stay, booze) 2nd look visits to a very small number of candidates. I went on three of these.
– The best pre-interview socials were the ones hosted at a resident's house rather than a loud/packed restaurant/bar.
– Cringed at the number of non-Texas applicants who only applied to UT Austin out of all Texas EM programs.
– Airbnb + Uber are the best.

That is all.

I like this, so I'm adding to it.

-Most fun group of residents: Nevada, hands down. They really seemed like a big group of friends and genuinely wanted to get to know us. They even e-mailed us after the interview day was over inviting us out for happy hour, too bad I had to catch a flight.
-Most fun interview day: Christus Spohn. One of the faculty came by in a Hawaiian shirt and scrub pants, and they drove us to the beach during our tour. We took off our shoes and walked in the surf. Everyone was super nice and the coordinator was so sweet. They put you up in a hotel the night before, and the social was fun (beer and pizza, totally my speed).
-Best interview experience: UT San Antonio. The faculty are super fun, and the APD let me pick the Pandora station that played during my interview. It's a good sign when the faculty are heckling each other and dropping "that's what she said" during the program presentation.
-Worst interview experience: Western Michigan. The interview went on forever (7AM-5PM). The PD's interview questions made me feel like I was at a psychiatrist's office. The residents were polite but didn't seem thrilled (I think our tour guide seriously needed an SSRI). At least they put you up in a nice hotel the night before and they provide drinks.
-Most diverse program: Baylor. I felt out-of-place for not being a minority applicant.
-Best eye candy: Jackson/Miami campus. Good grief I almost tripped and fell on the tour.
-Cringiest applicant moment: I'm at the Baylor social talking to some of the residents, beers in hand, talking about the city and if they're happy at the program. Some guy sits down next to us (no beer in hand) and introduces himself to the residents. The first thing out of his mouth is "So do you use the HEART score?" All of the fun was sucked out of the room.
-Weirdest interview apparel: bow ties. Seriously. Unless you're going into pediatrics and you're from the southeast and interviewing in the southeast...just don't do it. However, special props to the lady applicant wearing snakeskin shoes, you rocked the hell out of them.

Big +1 for Uber and AirBNB. I was able to rent an entire house for $45 a night on one of my interviews, in a major city.
 
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The point of the SLOE is to paint a true picture of an applicant. If there is a deficiency it is fair to point that out. If everyone had "positive" letters something needs to change otherwise the letter is a useless tool for evaluating applicants. This being said, asking for a "good" letter is absolutely ridiculous.

I will agree that IF someone is receiving a less than ideal letter, they should be worked with on the rotation to improve and notified of their shortcomings.

Flame if you might, but the letters should remain confidential to avoid any hurt feelings and complaining.
 
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If everyone has a positive letter, the SLOE becomes nothing less than a participation trophy.
 
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If everyone has a positive letter, the SLOE becomes nothing less than a participation trophy.

I don't think anyone is disagreeing with that. What people are getting upset about is that there are some low-life SLOE writers out there who will trash students who otherwise receive great verbal/written feedback on their performance during shifts. It's the disconnect between what is said to a student during the rotation vs. what shows up on the SLOE that we are talking about here.
 
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I don't think anyone is disagreeing with that. What people are getting upset about is that there are some low-life SLOE writers out there who will trash students who otherwise receive great verbal/written feedback on their performance during shifts. It's the disconnect between what is said to a student during the rotation vs. what shows up on the SLOE that we are talking about here.

 
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I love coming back here every few days and seeing a different display pic in the mobile app


Sent from my iPhone using SDN mobile app
 
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PS, anyone here from any of the Detroit hospitals? I'm just wondering where most residents live, and j can't find my folder from interview day


Sent from my iPhone using SDN mobile app
 
Cared about diverse experiences, volume/acuity, peds, ultrasound, weather/family, and my SO. Top 4 impossible to choose between.
1. UNC
2. Carolinas
3. Orlando Health
4. Ohio State
5. USF
6. Shands (UF Gainesville)
7. EVMS
8. Palmetto
9. Cincinatti
10. UPMC
Others ranked, alphabetically: Akron, Metro, MUSC, Summa, UVA, UWisco, Wake Forest
Didn't get interviews: Duke, ECU, Vandy, Jacksonville
Cancelled/withdrew: Emory, Texas programs, WVU

Good allopathic school, Step1 in 240s, Step2 in 250s, was told SLOEs were good.
 
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