Applying for an Emergency Medicine Residency

1. Applying for an Emergency Medicine Residency American College of Emergency Physicians

2. Goals • How to prepare before you apply • Choosing a program • The application process • The interview

3. Emergency Medicine Residencies • Emergency Medicine Residencies • 1983 - 66 • 1990 - 84 • 2000 - 122 allopathic; 25 osteopathic • 2005 - 134 allopathic; 36 osteopathic • Resident Positions in NRMP • 1990 - 440 • 2000 - 971 • 2005 - 1332

4. Homework • Browse the web • Know who’s who in EM • Know the major issues facing EM • National EM organization membership • Join your local EM interest group • Choose your mentor well • Carefully plan your final medical school years • Read: Iserson’s Getting Into a Residency: A Guide for Medical Students • Talk to graduates/seniors from your school

5. 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

6. Who’s Who in EM • Tintinalli and Rosen chapter authors • Editorial boards of EM journals • Keynote speakers • National leaders • Recurrent conference lecturers • Chairs/Program Directors in emergency medicine

7. Read About Major Issues Facing EM • Editorial subjects • Clinical issues • Educational issues • Legislative/regulatory issues

8. Rally at the US Capitol • September 27, 2005 • 4000+ Participants Including 1000+ Residents • More than 30 programs sent 300 residents to Washington specifically for the Rally • Largest event of its kind in the history of emergency medicine • Urged Congress to Pass “The Access to Emergency Medical Services Act of 2005”

9. Choosing a Program: The Big Picture • ACGME/RRC role • Consistent educational elements • Ensures adequate & varied experience • Your role • Find program that fits • Maximize experience • Best program for you • Stability • Accreditation, re-accreditation, length of accreditation

10. The Big Picture-cont • Location • Family, significant other, etc. • Specific part of country • Urban, suburban, rural • Educational/Teaching philosophy • University, county, community, combination • Approach to teaching & resident responsibility

11. Maximize Experience • Special interests • Fellowship opportunities • EMS/Flight/Disaster • Pediatrics • International • Ultrasound • Will the program meet your needs?

12. The Application:“Begin with the End in Mind” • Dean’s letter • Board scores • Academic record • Personal statement • Letters of recommendation • Outside interests/activities

14. EM rotation grades Interview Clinical grades Recommendations Grades (overall) Elective at the institution Board scores (overall) USMLE (II) Interest expressed USMLE (I) Awards/achievements Honor society selection Medical school Extracurricular activities Basic science grades Publications Personal statement Selection Criteria

15. 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

16. 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

17. 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

18. 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

19. Letters of Recommendation • Need at least 3 • At least 2 should be in your specialty • More valuable if from EM training programs • Solicit letters early while they remember you • Supply personal statement / CV / transcript

20. Letters of Recommendation • Who should you ask? • How well do they know you? • How well are they known? • Program director / chairman / research director • National lecturer • Politically involved • How well did you do in their eyes?

22. Title and position of author Context that you know the applicant EM rotation grade Commitment to EM Work ethic Treatment plan Personality Global assessment Match range Comments Standard Letter of Recommendation

23. Outside Interests/Activities • Medical Students • Have fun • Become involved • Interest groups • Research • Program Directors • Quality of involvement • Leadership potential

24. Read Before You Interview • Koscove EM. An applicant’s evaluation of an Emergency Medicine Internship and Residency. Ann Emerg Med 19:774, 1990 • Iserson’s Getting Into A Residency: A Guide for Medical Students by Kenneth Iserson • EMRA. EM in Focus: A Guide for Medical Students • Your CV!

25. The Interview • When • November – January • Winter weather travel • Rank list preparation • The Night Before • Prepare/review questions • Gather data: visit site, area, review webpage

26. That day: Eat breakfast Be on time Don’t over/under dress Don’t dominate the interview Be yourself Ask questions Take notes/pictures Be nice to everyone! Program director Faculty Residents Support staff How did it feel…? Did I fit in? The Interview

27. Professionalism • It’s a small world – make friends • Never ever bad-mouth another program • Don’t blow off an interview • Follow-up letter, phone-call, or e-mail.

28. MS-I and MS -II • Clinical observation in ED • Summer/ongoing research projects with EM staff • EM interest group affiliation • National medical societies • Keep an open mind about specialty selection!

29. MS-III • ED rotation(s) • ED interactions on off-service rotations • Develop relationship with EM physician as mentor • Start selecting fourth year rotations

30. MS-IV • Mandatory/Elective EM rotation • Develop clinical expertise, experience • Develop information management skills • Consider extramural rotations • Additional clinical experience • Exposure to residency programs, other clinical settings • Plan for letters of recommendation

31. SUMMARY Relax Enjoy emergency medicine! Choose your mentor Communicate with peers Communicate with advisor and mentor