true confessions of an emergency medicine program director · 2018. 3. 7. · steven h. bowman,...
TRANSCRIPT
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
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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
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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
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