Steven H. Bowman, M.D., F.A.C.E.P.Program Director

Cook County Emergency Medicine Program

True Confessions of an Emergency Medicine Program Director

Monday, July 28, 14

Who’s going into EM?

completed their personal statement?

completed their ERAS application?

has interview invitations?

has already had an interview?

is finished interviewing?

finalized their match list?

matched?

A little survey…

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Provide you with accurate information to increase your likelihood a successful match in

Emergency Medicine.

Goal:

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Have you already taken care of the basics?

Know why you want to do EM.

You’ve completed some basic background research on the specialty.

You have a mentor or an advisor.

At least one EM rotation is scheduled.

You’ve done reasonably well in medical school.

Assumptions

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ABEM The American Board of Emergency Medicine

ACGME Accreditation Council of Graduate Medical Education

NRMP National Residency Matching Program

ERAS Electronic Residency Application Service

Others ACEP, EMRA, SAEM, AAEM, CORD

Key Acronyms

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1978 ABEM founded

1979 EM becomes 23rd medical specialty

1988 ABEM becomes an independent board recognized by the American Board of Medical Specialties (ABMS)

Essential History…

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Three EM Training Formats

ABEM: 36 months to be eligible for certification

170 EM Programs*:

~135 PGY 1 – 3

~35 PGY 1 – 4

0 PGY 2 – 4

Why? What’s the difference?

TWO

http://acgme.org/acgmeweb/Portals/0/PFAssets/PublicationsBooks/2012-2013_ACGME_DATABOOK_DOCUMENT_Final.pdf

http://www.acgme.org/ads/Public/Reports/ReportRun?ReportId=8&CurrentYear=2015&SpecialtyId=10&AcademicYearId=2013March 2014Monday, July 28, 14

Combined Training

Emergency Medicine - Internal Medicine

Emergency Medicine - Pediatrics

Emergency Medicine - Family Medicine

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EM FellowshipsToxicology

EMS

Undersea and Hyperbaric

Pediatric EM

Sports Medicine

Hospice and Palliative Care

Critical Care

Ultrasound

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Trends in EM

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Current Trends in EM

• 32,000 practicing EM Physicians in the U.S.

• 5000 hospitals in the U.S.

• 114,000,000 ED visits annually

• Projected shortage of EM Physicians until 2030!

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EM-1 Positions

0

360

720

1080

1440

1800

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

#Positions

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0

500

1000

1500

2000

2500

3000

2001 2003 2005 2007 2009 2011 2013

US Grads IMG’s

EM Applicants

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2014 Results170 EM programs

1,786 PGY-1positions

2,322 total applicants

1,772 filled

14 vacancies (99.2%)

1,388 US seniors

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2011: 5 vacancies of 1,607

2012: 0 vacancies of 1,668

2013: 3 vacancies of 1,744

2014: 14 vacancies of 1,786

EM Fill Rate

This trend will likely continue.

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Good NewsOnly 6.5% of 2013 U.S. seniors applying only to EM went unmatched.

Match ratio for EM:

= 1.3 applicants/position2,322 total applicants

1,786 PGY-1positions

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How many programs do I need to apply to?

How many programs do I need to rank?

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Strategy

Given the competitiveness of EM,

does applying to more,

interviewing at more, and

ranking more programs

improve your chances of matching?

Not as much as you would think.

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Applications per Candidate

0

5

10

15

20

25

30

35

40

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

U.S. Grads INTL Grads

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Bottom LineYou want to apply to enough programs so that at the end of it all you have 12 programs on your rank list.

Everyone doesn’t need to apply to 40 programs.

Your advisor should guide you.

2014 outcome data is still pending*.

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EM is competitive, but it could be worse.

There are a lot of programs and a thoughtful application strategy will yield the results you want.

What’s a thoughtful application strategy?

Remember This

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4th Year Timeline

July 1 – ERAS Opens

Sept 15 – Applications Released

Oct 1 – MSPE Release

Feb 26 – Rank List Deadline

Mar 20 – Match Day

Away Rotations

Interviews

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500-1200 applicants

100-200 interviews

6-18 residents

The goal is to identify candidates with the greatest potential for success…

What most reliably predicts future success?

Typical EM Program’s Recruitment Mission

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• What’s the goal of the application?

• To get you an interview.

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Spell-check it!

Have your advisor read it.

Adhere to deadlines.

Be prepared to discuss details

Don’t exaggerate. . .

Electronic Residency Application Service (ERAS)

The EM Application

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Personal statement

Curriculum vitae

USMLE scores

Dean’s Letter (MSPE)

Transcripts

Letters of Recommendation

Research/publications

Components of the EM Application

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The application: What’s most important?*

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Put yourself in our place…

Be original.

Be honest and proud (not cocky).

Talk about you.

Don’t mention any TV shows.

Don’t use any permutation of “ER doctor” or “emergency room doctor”. It’s “emergency medicine physician”.

Personal Statement Pearls

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The sad reality…programs do filter by USMLE.

High USMLE ≠good doctor.

Predictive of future testing

EM PD’s generally consider them one piece of the puzzle.

USMLE 1, USMLE 2, or both?

USMLE Scores

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Summarizes four years of medical school

Very detailed

Standardized but schools (and Deans) differ slightly

Students review for accuracy

You get ranked!

Keep it closed.

Dean’s Letter (MSPE)

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There is no substitute for excellence…

Transcripts

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You’ll need 3 or 4

At least one from core M-3 clerkship

Others from EM or representative specialty

EM faculty at residency programs are best

Standardized Letter of Evaluation (SLOE) for EM rotations.

Waive your right to review it.

No friends, family, or residents

Letters of Recommendation

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You have twenty interviews!

What’s the goal of the interview?

To get you a high rank.

So now what?

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Program’s philosophy and reputation

Accreditation Status

Strengths: Clinical, academic, teaching

Specialized training, fellowships, research

Patient population

Chair, PD, faculty (stability & expertise)

Residents

Hit the web sites

Before You Visit

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Research before you arrive.

Dress and groom professionally.

Be courteous to faculty, residents, and administrative staff…

Attend “resident only” events.

Sleep the night before, and pay attention.

Nothing you say is “Off the record…”

The Excellent Interview

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Enthusiasm for EM

Knowledgeable

Interesting

Uniqueness/Genuineness

Personality

What will get you higher on the rank list?

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Unprofessionalism in any way

Offensiveness

Deception

Communication issues

Flirting, profanity, disinterest…

What will get you off the rank list?

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The Match

• You only want to try to match once.

• This means it is very difficult to scramble into EM if you don’t match.

• The success rate of second attempt applicants is near 50%.

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If you have unanswered questions, call or visit the program again.

Rank programs in your order of preference.

Don’t trust anyone who guarantees you a spot.

Don’t rank programs that you don’t like.

Don’t ask residency directors where you will be ranked…

Don’t Try to “Outsmart” the Match

Monday, July 28, 14

Steven H. Bowman, M.D., F.A.C.E.P.Program DirectorDepartment of Emergency MedicineJohn H. Stroger, Jr. Hospital of Cook County1900 West Polk Street, Admin 10th floorChicago, IL 60612312.864.0064

Questions?

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www.saem.org

www.aaem.org “The Rules of the Road”

www.emra.org

www.acep.org

www.nrmp.org

EM journals:

Academic Emergency Medicine

Annals of Emergency Medicine

Journal of Emergency Medicine

Resources Every Applicant Should Know

Monday, July 28, 14