So it's time to find the right Emergency Medicine rotations to set you up for success in the match

The skinny on where, when and how to get your sub-internships, rotations, and letters...


Throughout this post you find links to useful pages within this blog and outside resources to help you better understand  the process of applying to EM

Where?

• Home - if your school has an EM residency, you should start with a home rotation
• This gets you a letter called a Standardized Letter of Evaluation (SLOE)
• You will be in familiar surroundings and a system you know, so you can focus on learning EM as you are starting out 
• Away - even if you have multiple options at your school you should do an away
• This gets you a second SLOE
• This throws you into the deep end - you won't be familiar with your surroundings, you will have to learn a new system, and you will do it all while progressing forward from your first rotation

*For students who don't have a residency at their school two Aways should be scheduled

When?

• As soon as you can get them, between May and October is ideal
• Schools and rotations have different requirements, so start looking now
• Earlier is better so your SLOEs are written and in your application, ready to be reviewed for interview offers
• Many programs will review your application and consider you for interviews with one SLOE. EMRA match lists how many SLOE are required at each program for an application to be reviewed
• Dates for electives may not match with your schools blocks
• Review the dates carefully 

How?

• Visiting Student Application Service(VSAS) allows you to apply to most rotations 
• SAEM.org has a student directory that can help with planning
• EMRA Match Student Directory provide interactive maps of the United States that links to information on EM rotations in the country, including those that do not participate in the VSAS

Ways to succeed:

• Many rotations ask for a letter of recommendation
• Decide who will do this for you, and ask them ahead of time. This will allow your application to go smoothly
• Generally the rotation wants someone to vouch for you as a student in good standing, interested in applying to EM
• Start early 
• Try to envision where you want to be for residency and rotate some place similar in location, structure, or culture
• A bird in the hand is worth two in the bush
• Take what is offered to ensure you have the two early rotations you need, rather than waiting for the perfect one
• Variety is the spice of life
• This is a great time to try out someplace new
• If you already have a 3 year program rotation, see what a 4 year program is like
• If you rotate in community for one try a county or hybrid program for the other
• EMRA Match Residency Directory has information on the programs associated with rotations and lists many of these characteristics

Lucienne Lutfy-Clayton is an Associate Residency Director, former Medical Student Clerkship Director, a past Chair of the CORD-EM Student Advising Task Force, current co-Chair of the CORD-EM Application Process Improvement Task Force and lead author on the SATF Applying Guide and Frequently Asked Questions. 

Match Day 2018 - Contingency Planning for the Unmatched

Match Day 2018 is friday, March 16.  That day is anxiety provoking for every student in the match as they find out where they are going to continue their training.  Even more stressful is monday the 12th, sometimes called "No-Match Day".  At 12 pm all programs and applicants find out if they matched or if they are going to have to scramble for a position in the SOAP.  Most applicants will get good new on monday and their worries will quickly shift from "if I match" to "where will I match?".  

This post is for applicants who get bad news on monday.  We will outline the big decision points and connect you with additional resources.

The first thing you need to do if you are notified that you did not match is to take a little time to grieve.  Even if you knew you were at risk to not match and this news is disappointing, but not a surprise, take a little time to wrap your head around it.  

Then you need to make a plan, or put into action the plan you already made.  

The big decision:  Do you still want to match into EM?

Using the SOAP process to get into EM, or finding a spot post-match, are not viable routes to get an EM training spot.  A very few lucky folks may make this happen but there are not enough spots for this to be something you plan for.  

The most commonly recommended path to pursue in setting up a re-application to EM next year is to get clinical training in a one year internship (surgical, medical, transitional, etc.).  Other options include matching to a categorical program (full course of training, like categorical IM or FP), extending medical school graduation to improve your application, or pursuing additional experience like a research project or masters degree after graduating on time.  Which option(s) is best for you depends on a variety of factors including why you did not match, how likely are you to be successful in reapplying, and which are available.  

Resources to help you make an informed decision:

• This previous EM Advisor post takes you through deciding what route to pursue in much more detail.
• This post: The Re-Applicant Playbook, takes you through self-assessing your situation and making plans to reapply.  It served as the foundation for an Advising Guideline written by the Council of Emergency Medicine Residency Directors (CORD-EM) Student Advising Task Force:  The Emergency Medicine Re-Applicant Applying Guide.  This guide adds national consensus and evidence based recommendations for those facing a second time through the application cycle.  All of the guides written by the Task Force live on their web-page.  
• There is a paucity of expert advice available for students who do not match, and even less literature.  However, a recent article published in Academic Medicine provided some insights for students who did not match.  The implications for the applicant to EM were discussed in this post on the CORD EM Blog.  

If you know of additional quality resources for the unmatched applicant to EM please share them in comments below and we will incorporate them into future resources.  

Adam Kellogg is an Associate Residency Director, former Medical Student Clerkship Director, a past Chair of the CORD-EM Student Advising Task Force, and an author on far too many of the resources for re-applicants.  Seriously, if you have some other good resources, share them!