Official WAMC thread for EM applicants

[gamerEMdoc]

@gamerEMdoc question for you-

In addition to SLOEs, are 3rd year clinical grades weighed heavily?

I'm in 3rd year now and scored > avg for EM on step1. But I've been scoring ~ avg on my shelf exams, despite good clinical evals and comments which has resulted in avg clinical grades so far (going to keep grinding to try to improve). I feel that I'm getting better clinically and I get good feedback, but I don't shine on NBME exams and I'm worried this will hurt me (I think sub-i's / SLOEs will be a much better measure of myself as a candidate than NBME exam scores).

thanks for the help

Weighted a little less than boards, important but not THAT important. SLOEs trump everything else.

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[gamerEMdoc]

hello @gamerEMdoc,

Under the same principle that strong school evaluations doesn't always yield top SLOEs, can a good, but not perfect school eval still lead to a top 1/3 SLOE?

My school's eval is particularly brutal with 7/10 questions having to do with pure knowledge of the student, but just phrased in various different ways.

IN GENERAL, the SLOEs are more often more critical than the school evaluations. Their blinded nature usually leads to evaluators feeling more free to speak their honest opinion about a candidate. I've seen many times students getting HP or Honors at a rotation, but there SLOE is lower than predicted. While its possible I'd imagine to get say a top 1/3 SLOE with just a middle of the road school evaluation, I'd say that isn't common.

 

[casadepapel]

Hey all. Long-time lurker, newly joined secondary to all the anxiety and uncertainty, and was hoping you kind folks would be able to help me.

4th year US MD student in the south
Step 1: 227
Step 2 CK: 257
Step 2 CS: pending
4th quartile
2 solid non-SLOE LORs, 1 SLOE from home likely top-middle 1/3, but I feel like my second SLOE where I am currently rotating will be middle-bottom 1/3 (trying to improve).

I was hoping to get an indication of my competitiveness, some good programs to apply (I had looked and while it’s easier to identify target, I can’t ascertain any “safe” programs and I was advised to apply to many), and lastly how much a not stellar SLOE could impact my chances as it is truly causing me a great deal of anxiety.

Location preference for the south and southeast but would literally go anywhere.

Thank you all for the help.

 

[Apollyon]

You'll match. Period. No joke.

Just don't F up, and be (reasonably) normal; i.e., smile, and keep your mouth shut. Seriously.

 

[Apollyon]

And I'm not being flippant. As a first time applicant, US senior, MD, just don't apply to one program only (a/k/a "suicide matching"), or have any bogus reason to limit your list to 5 programs or whatever. Apply widely, and you'll match.

 

[casadepapel]

And I'm not being flippant. As a first time applicant, US senior, MD, just don't apply to one program only (a/k/a "suicide matching"), or have any bogus reason to limit your list to 5 programs or whatever. Apply widely, and you'll match.

Thank you so much for that. I will definitely case the nest wide to maximize opportunity. I guess the main point of my anxiety after Step 2 resulted has been the impact of a potential bottom 1/3 SLOE. I had heard that it can very negatively impact an application and was wondering if that impact is something that should make me expand my planned number of programs to apply (60ish).

 

[Apollyon]

That's a bit beyond my pay grade. As to 60 apps, or more or less, I'll defer to my esteemed bud, @gamerEMdoc .

 

[gamerEMdoc]

Depends without actually knowing if its a low 1/3 or not. But casting a wide net with a direction towards less competitive places and all the places in your geographic region should help. 50 programs doing this should be enough, but could be too many if the sloes arent as bad as you think.

 

[casadepapel]

Thank you @gamerEMdoc for your advice/input It is much appreciated. I was genuinely having some difficulty identifying less competitive places as everything seems to me to be just about a "target" or reasonably competitive program. As such, I was wondering if you knew of any programs or could recommend any that may serve as a starting point of being less competitive. Thank you again!

 

[gamerEMdoc]

BIG Generalization here but less competitive programs tend to be identified by:

1. Geography. If its a vacation destination, it'll be more competitive. Programs in major cities tend to be more competitive than rural programs.
2. Programs that just started out are less competitive
3. Former DO programs and programs with a higher percentage of DO residents are often in more rural places, and are often less competitive
4. Community EM programs (as opposed to programs attached to the name of a major University) are often times less competive

None of those are hard and fast rules, this is just a generalization obviously. First and foremost, I'd say geography probably plays the biggest factor in the competitiveness of most programs, mainly because geography is typically one of the most important, if not THE most important, factor in students making their rank list.

 

[Shmoclo]

i wasnt able to get my second sloe during my second 4th year elective and will have to wait until my 3rd elective is complete which is end of september. If i get my 2nd sloe in say october 1st how much of a problem would this be? thanks.

 

[gamerEMdoc]

Shouldn't be a problem. Programs understand not everyone has two SLOEs by Sept 15, and the majority of programs don't send out invites until October anyways.

Just curious, why couldn't you get a SLOE from your 2nd rotation?

 

[Listen2Savage]

Hey @gamerEMdoc

Should I apply on the 15th with no letters

or

Wait until the letters are uploaded then apply, should be before october 1st

Just now finding out for some reason ECFMG (IMG stuff) takes 1-2 weeks to "clear" uploaded letters, until theyre available on ERAS.

 

[gamerEMdoc]

Either way, shouldn't make a difference on way or the other.

 

[Listen2Savage]

Either way, shouldn't make a difference on way or the other.

are you saying it doesn't matter because either way if my app isn't complete on sept 15 I'm screwed?

or

Sept 15 is an arbitrary date since MSPEs dont come out until October anyway?

 

[gamerEMdoc]

Im saying that your app will get marked as incomplete on Sept 15 with no letters. So either way, no one is extending an interview until there are LORs anyways. And most interviews dont come out until after Oct 1st anyways.

 

[Mat the coolcat]

I know board scores are of lower importance than SLOE's anyway, but my USMLE Step 2 score is way better than my COMLEX level 2 score (which still wasn't bad...) Step 1/Level 1 were similar in competitiveness.

For non-osteopathic programs, would it be wise to not assign my COMLEX scores? Or will that just turn up eyebrows more...?

 

[gamerEMdoc]

I know board scores are of lower importance than SLOE's anyway, but my USMLE Step 2 score is way better than my COMLEX level 2 score (which still wasn't bad...) Step 1/Level 1 were similar in competitiveness.

For non-osteopathic programs, would it be wise to not assign my COMLEX scores? Or will that just turn up eyebrows more...?

Release both. Its going to immediately make someone question why you didn't release your comlex score and make you appear dishonest.

 

[hopefulERdoc251]

Not sure if this is the right place but just wondering since step2 score came out...wamc?

Step1: 231
Step2: 250
Currently taking a year off to get an MPH
Leadership in EMIG and research
Home SLOE is honors (per the PD who i've worked with a lot during third year - had 4 wk EM rotation 3rd yr)
Caveat: S/o will likely be doing EM and we'll be couples matching - she's very competitive based on evals/step1 score so far

 

[gamerEMdoc]

Other than the wrinkle the couples match throws in on paper so far you are a very competitive candidate. The caveat there is, ultimately the overall competitiveness of the application is mostly a function of a candidates SLOEs, or in the case of someone in the couples match, it’s a function of both of their SLOEs. So judging how competitive someone (or a couple) is before their fourth year can be innacurate.

You’ve done all the right things thus far to make you a competitive candidate.

 

[TheNiceOne]

Reading this thread for the last few pages, I understand that SLOEs make or break your application but I still wanted to get everyone's opinion on my board scores and competitiveness

DO student
COMLEX Level 1: <500,
COMLEX Level 2: <500 (lower score than Level 1)
USMLE Step 1: Low 210s
USMLE Step 2: Mid 210s (higher score than step 1)

Doing 3 EM rotations, with 2 SLOEs uploaded by october 1st. The 3rd SLOE will be uploaded late Oct/Early Nov. Based on the feedback I've been getting, I should at least get middle 1/3 SLOEs, with one possibly a top 1/3.

I know my scores are very poor, but Im trying to take solace in the fact that I didn't fail any of the boards. Im shooting for newer/former AOA/ less competitive EM programs. Am I at risk for not matching? Should I focus extensively on a backup specialty? Thanks in advance!

 

[gamerEMdoc]

If you have one top 1/3 you'll almost certainly match EM. Because it only takes one program to rank you highly. Match rate for a COMLEx of 450-500 in the acgme match is somewhere around 70% I think, but I dont have the data in front of me at the moment. The 70% that match have good sloes, the ones that dont match do not have good sloes. So ultimately, its the sloes that either make up for the scores or are the final nail in the coffin.

Send me a PM once apps are out, you likely will have applied to my program by what you described above and I can give you a little better more direct advice once I see your application.

 

[CellPowerhouse]

Hello! Looking for input on # of places to apply to, thanks in advance!

Step 1: 210s
Step 2: 250s

Third quintile

Honors in IM, Psych, FM
HP in OB/Gyn, Peds, Surgery

EM rotations: Honors (home, M3 year) and Honors (away). I’m thinking *at least* mid 1/3 SLOE for each based on the narrative part in my evals, which they said would be pretty similar to what they put in the SLOE. Possibly top 1/3 for one of them given the comments, but I really have no idea.

Other things:
research (10+ pubs, posters, abstracts overall), some unique humanities-type activities, clinic manager for student-run free clinic

Thinking of academic medicine, possibly a PEM fellowship, so most of the 60ish programs on my list are university programs. Given my Step 1 score I feel like I’ll be screened out of some/most of these. Applying mostly Northeast and CA.

 

[oobie]

Hi folks! Just wanted to get your opinion. (MD student)
Step 1: low 200s
Step 2: low 240s (39 point improvement)

Sloes: one that I originally thought was middle third, but could be bottom third?, one that's definitely middle or top 1/3 (obviously hoping top 1/3). The first one is a more prestigious place while the second is a newer program, so would the first sloe be weighted more than the second?

3rd year grades: mostly hp or pass

Applying to a mix of community and academic places, and was thinking 50 would be a sweet spot number but didn't know if that was too few places. Mainly to northeast, some parts of the south and Midwest. Thoughts?

 

[deleted436726]

Hi folks! Just wanted to get your opinion. (MD student)
Step 1: low 200s
Step 2: low 240s (39 point improvement)

Sloes: one that I originally thought was middle third, but could be bottom third?, one that's definitely middle or top 1/3 (obviously hoping top 1/3). The first one is a more prestigious place while the second is a newer program, so would the first sloe be weighted more than the second?

3rd year grades: mostly hp or pass

Applying to a mix of community and academic places, and was thinking 50 would be a sweet spot number but didn't know if that was too few places. Mainly to northeast, some parts of the south and Midwest. Thoughts?

Don't want to discourage you or anything, but I failed to match last year as a USMD with slightly better stats (Step 1 in the high 220s, H/HP/P clinical grades, 2 SLOEs that were probably bottom 1/3 and middle 1/3) applying initially to 80 programs. If anything I think the low Step 1 will hold you back the most and if you really do have a bottom 1/3 SLOE on top of that, your fate is sealed.

 

[boomshaketheroom]

Hi folks! Just wanted to get your opinion. (MD student)
Step 1: low 200s
Step 2: low 240s (39 point improvement)

Sloes: one that I originally thought was middle third, but could be bottom third?, one that's definitely middle or top 1/3 (obviously hoping top 1/3). The first one is a more prestigious place while the second is a newer program, so would the first sloe be weighted more than the second?

3rd year grades: mostly hp or pass

Applying to a mix of community and academic places, and was thinking 50 would be a sweet spot number but didn't know if that was too few places. Mainly to northeast, some parts of the south and Midwest. Thoughts?

Don't want to discourage you or anything, but I failed to match last year as a USMD with slightly better stats (Step 1 in the high 220s, H/HP/P clinical grades, 2 SLOEs that were probably bottom 1/3 and middle 1/3) applying initially to 80 programs. If anything I think the low Step 1 will hold you back the most and if you really do have a bottom 1/3 SLOE on top of that, your fate is sealed.

I think it may depend more on the SLOEs than the step score. Low step 1 might hurt getting interviews, but once you do the big jump for step 2 should assuage any worries about academics.

Some people may give more weight to a better known residency but a lot of that depends on who they know. Do the people interviewing you know people at the newer program? If so they are more likely to give it more weight. Does the more academic place have a reputation for lower grades on SLOEs? Who knows but if so they may know that.

I had a slightly better step 1 and a slightly worse step 2 and had a wide range of SLOEs and did okay (actually had to cancel some interviews to get down to 13/14) so Id say dont give up hope yet.

 

[gamerEMdoc]

Hi folks! Just wanted to get your opinion. (MD student)
Step 1: low 200s
Step 2: low 240s (39 point improvement)

Sloes: one that I originally thought was middle third, but could be bottom third?, one that's definitely middle or top 1/3 (obviously hoping top 1/3). The first one is a more prestigious place while the second is a newer program, so would the first sloe be weighted more than the second?

3rd year grades: mostly hp or pass

Applying to a mix of community and academic places, and was thinking 50 would be a sweet spot number but didn't know if that was too few places. Mainly to northeast, some parts of the south and Midwest. Thoughts?

Don't want to discourage you or anything, but I failed to match last year as a USMD with slightly better stats (Step 1 in the high 220s, H/HP/P clinical grades, 2 SLOEs that were probably bottom 1/3 and middle 1/3) applying initially to 80 programs. If anything I think the low Step 1 will hold you back the most and if you really do have a bottom 1/3 SLOE on top of that, your fate is sealed.

I think it may depend more on the SLOEs than the step score. Low step 1 might hurt getting interviews, but once you do the big jump for step 2 should assuage any worries about academics.

Some people may give more weight to a better known residency but a lot of that depends on who they know. Do the people interviewing you know people at the newer program? If so they are more likely to give it more weight. Does the more academic place have a reputation for lower grades on SLOEs? Who knows but if so they may know that.

I had a slightly better step 1 and a slightly worse step 2 and had a wide range of SLOEs and did okay (actually had to cancel some interviews to get down to 13/14) so Id say dont give up hope yet.

Yeah its all dependent on if the SLOE is a bottom 1/3 or not. If not, and there is a middle 1/3 and top 1/3 SLOE, I don't think the Step 1 score will prevent you from matching. I do think that if you have a bottom 1/3 SLOE, that will put you at risk.

 

[The Knife & Gun Club]

Whelp here goes nothing -

USMD, top 40 NIH funded school

Step 1&2 both 240s

2nd quartile preclinical and 3rd quartile clinical grades (were pass fail)

SLOES: 1 likely top 1/3 (pass fail but got strong comments), 1 either top or middle 1/3 (got honors but no idea how I did against the cohort), 1 likely lower 1/3 (went to a super competitive power house and got rocked).

+10 pubs but not in EM

Spattering of activities, minor role in EMSIG, a few decent committees.

And I’m couples matching, fiancé in a surgical sub, applying to around 85 programs.

Wondering if anyone has thoughts on HOW bad it is to get a lower 1/3 from a prestigious place? as always thanks for the help SDN!

 

[Sterling_Archer]

Hi all,

I'd love to hear a some opinions on which EM residencies I would be competitive at.

US MD

Step 1 & 2: 250+

SLOEs:
Home probably top third (honors, excellent feedback)
Away probably middle third (HP but solid comments on MSPE, purely guessing at which third).
I'm doing a third away but the SLOE wouldn't be in until mid-interview season.

Some research/presentations, nothing exceptional

Some volunteering and leadership experiences but nothing exceptional.

Would like to stay on the easy coast.

How many competitive vs. average vs. safety programs should I apply to?

Thank you!

 

[Mat the coolcat]

Whelp here goes nothing -

USMD, top 40 NIH funded school

Step 1&2 both 240s

2nd quartile preclinical and 3rd quartile clinical grades (were pass fail)

SLOES: 1 likely top 1/3 (pass fail but got strong comments), 1 either top or middle 1/3 (got honors but no idea how I did against the cohort), 1 likely lower 1/3 (went to a super competitive power house and got rocked).

+10 pubs but not in EM

Spattering of activities, minor role in EMSIG, a few decent committees.

And I’m couples matching, fiancé in a surgical sub, applying to around 85 programs.

Wondering if anyone has thoughts on HOW bad it is to get a lower 1/3 from a prestigious place? as always thanks for the help SDN!

*Disclaimer: I'm a DO re-applicant who was moderately competitive (you seem very competitive), so take what I say with a grain of salt.

Last year I had a similar story; bottom 1/3 at a big name west-coast program, and it cost me the match, in light of the rest of my application that was solid. I think if anything doing bad at a big name place bodes worse for people in general...

Is there a reason you have to use that SLOE? I wouldn't use it if I were you, but I'd defer to @gamerEMdoc of course.

 

[gamerEMdoc]

My general belief is that a low 1/3 SLOE submitted probably looks worse than not submitting a SLOE. Sure, programs expect you to submit SLOEs, but most won't figure it out that you got a SLOE from some place and didn't submit it. So if you are certain you got a low 1/3 SLOE from some place, then I'd consider not submitting it. Especially if you had 2 other SLOEs you strongly suspected were mid 1/3 or above.

 

[maseezy]

non US IMG
240 Step 1
246 Step 2 (2nd attempt)
CS pass 1st attempt

Have 2 SLOEs, both probably average.
I addressed the CK fail on my PS. Do I have a slim/decent chance?

 

[gamerEMdoc]

non US IMG
240 Step 1
246 Step 2 (2nd attempt)
CS pass 1st attempt

Have 2 SLOEs, both probably average.
I addressed the CK fail on my PS. Do I have a slim/decent chance?

Non-US IMGs have an abysmal match rate to begin with. When you add in a single negative factor, I'd say the chances of matching is near 0%. I'm typically an optimist, but there are only a handful of non US IMGs that match in EM every year. So a failed board and average at best SLOEs is going to make it really a long shot.

 

[Mat the coolcat]

SVI question: If you get an extension for the SVI and complete it in the allotted extension time, does it still cause one's application to be "incomplete" as the score isn't released until October?

 

[gamerEMdoc]

SVI question: If you get an extension for the SVI and complete it in the allotted extension time, does it still cause one's application to be "incomplete" as the score isn't released until October?

Can't say I understand the question. What defines an "incomplete" application. I don't think there is anything on ERAS end that marks an application complete or incomplete. I know programs can have individual requirements, and if not met they can check off a box marking the application incomplete to flag to go back, but that's an individual program thing. I'm not aware of anything on ERAS end that marks ones application "incomplete".

 

[Mat the coolcat]

Can't say I understand the question. What defines an "incomplete" application. I don't think there is anything on ERAS end that marks an application complete or incomplete. I know programs can have individual requirements, and if not met they can check off a box marking the application incomplete to flag to go back, but that's an individual program thing. I'm not aware of anything on ERAS end that marks ones application "incomplete".

Whoops, that makes more sense. Someone was pulling my leg...

Thanks @gamerEMdoc !

 

[bombay2pac]

Is there anyway we can see how many interview invites a residency program gives and how many they accept?

 

[boolin_1]

*Disclaimer: I'm a DO re-applicant who was moderately competitive (you seem very competitive), so take what I say with a grain of salt.

Last year I had a similar story; bottom 1/3 at a big name west-coast program, and it cost me the match, in light of the rest of my application that was solid. I think if anything doing bad at a big name place bodes worse for people in general...

Is there a reason you have to use that SLOE? I wouldn't use it if I were you, but I'd defer to @gamerEMdoc of course.

this scares the **** outta me

 

[gamerEMdoc]

Is there anyway we can see how many interview invites a residency program gives and how many they accept?

Go to their website. Generally it says how many spots they have. In terms of invites given out, that's not published anywhere, and may very a little bit every year, but in general, programs interview about 10 candidates for each spot they have. So if they are have 10 spots in the match, they will interview about 100 or so.

The national average is about 6.5/spot in terms of how far programs go down their list to match all their spots. So if a program has 10 spots, they will on average go down to about 65/100 that they interviewed.

 

[boolin_1]

Just want to say. I'm about to be in this page heavy. Current 3rd year on the cusp of making my decision between EM and IM. Because my school is dumb and makes our ER rotation in 4th year, I have been taking extra days in the ER on my weekends off. 1st day was horrible but since then, I've been doing well and having a blast.

this decision will be tough for me

 

[dotheDO92]

Is there anyway we can see how many interview invites a residency program gives and how many they accept?

FREIDA Residency Program Database | Medical Fellowship Database | AMA

Looking for the right medical residency? Get started by searching 11,000 medical residency and fellowship programs on the AMA's FREIDA database.

freida.ama-assn.org

There is some data for # of interviews for some programs on their profiles, under Program & Faculty>applying information.

 

[bic_atlantis]

currently a TY resident, DO, level 1:568, level 2:620, no sloes, was wondering if it would realistic to have any chance at matching anywhere this cycle? Just recently fell in love with EM after actually working in an ER as a resident in a level 1 trauma center. please advise. thanks

 

[deleted436726]

currently a TY resident, DO, level 1:568, level 2:620, no sloes, was wondering if it would realistic to have any chance at matching anywhere this cycle? Just recently fell in love with EM after actually working in an ER as a resident in a level 1 trauma center. please advise. thanks

Did you apply EM this year? If not and you've only just started to consider it it's most likely too late this year as app/interview season is already in full swing

 

[bic_atlantis]

Did you apply EM this year? If not and you've only just started to consider it it's most likely too late this year as app/interview season is already in full swing

Currently haven’t applied but my app is ready to go at moments notice. It’s too bad, had I worked in the ED earlier I could’ve been much better prepared.

 

[Neighborr]

US MD here, applying mainly to the more "competitive" programs. Anyone have an idea of how having absolutely *zero* research experiences affects my chances? I know research is very ... unimportant for EM, but still everyone I talk to has at least something for research experience. Otherwise, I think I have a strong app

 

[gamerEMdoc]

You'll be fine. A US MD grad with even average boards and a mid 1/3 SLOE will be more than competitive enough to match in EM. Plenty match with well below average scores. Just need a mid 1/3 SLOE or better, that's usually the ticket.

 

[Labrat07]

Hello. I'm a M4 really interesting in EM. But I have couple red flags on my application. I just wonder if I should aim another specialty instead of wasting my time applying

Red flags:

Low board scores
Step 1 207 (77% matching on matching outcome data)
Step 2 ck 226 (79% matching on matching outcome data)
Step 2 CS pass

One pre-clinical fail on a random class.


Non-redflag
Honor on my sub-i
Will have two SLOEs. One from sub-i, I assume will be good since honor. Other will be from a faculty (asked for a GOOD eval). Rest LOR
Pass everything else except the pre-clinical.
Hx of volunteer, Non-traditional (hx of working over >12 years)

I knew it will be an uphill battle from the start. So I did ask for LORs for IM just in case. Now I'm really questioning my path. Please help me and be honest as you can. Thank you so much

Please be honest as you can.

 

[gamerEMdoc]

Hello. I'm a M4 really interesting in EM. But I have couple red flags on my application. I just wonder if I should aim another specialty instead of wasting my time applying

Red flags:

Low board scores
Step 1 207 (77% matching on matching outcome data)
Step 2 ck 226 (79% matching on matching outcome data)
Step 2 CS pass

One pre-clinical fail on a random class.


Non-redflag
Honor on my sub-i
Will have two SLOEs. One from sub-i, I assume will be good since honor. Other will be from a faculty (asked for a GOOD eval). Rest LOR
Pass everything else except the pre-clinical.
Hx of volunteer, Non-traditional (hx of working over >12 years)

I knew it will be an uphill battle from the start. So I did ask for LORs for IM just in case. Now I'm really questioning my path. Please help me and be honest as you can. Thank you so much

Please be honest as you can.

Yeah low board scores are not a red flag. Red flags: arrested in med school, honor code violation from school for stalking another student or cheating, board failures

If you have a good SLOE (or sloes) you will match. Will you match at a top tier place with board cutoffs that you are below? No. But you will almost certainly without a doubt match in EM if your SLOE(s) is/are good.

 

[Labrat07]

Yeah low board scores are not a red flag. Red flags: arrested in med school, honor code violation from school for stalking another student or cheating, board failures

If you have a good SLOE (or sloes) you will match. Will you match at a top tier place with board cutoffs that you are below? No. But you will almost certainly without a doubt match in EM if your SLOE(s) is/are good.

Oh I thought everything not average = red flag. Lol I was wrong. Thank you so much for the votes of confidence. I will continue toward my goal. Truly appreciated

 

[gamerEMdoc]

Oh I thought everything not average = red flag. Lol I was wrong. Thank you so much for the votes of confidence. I will continue toward my goal. Truly appreciated

I consider red flags as things you potentially are going to avoid interviewing, or avoid ranking someone for. The rest are just part of the positives and negatives of any application.