Updated August 2016
"Red Flag" is a term common in medicine, like the "Red Flags" for spinal cord compression in back pain. It indicates warning signs for more serious disease and it has been adopted by application reviewers to refer to signs in an application that raise concerns about the qualities of an applicant.
Knowing if you are an applicant that will raise "Red Flags" in the mind of a Program Director is really important for planning your application strategy. You will need to do everything you can to make these "flags" as small as possible.
What are common "Red Flags"?
Failing a step of the Boards. A great fear for program director's is that their graduates will not pass the boards when they finish. Not passing the USMLE or COMLEX is a strong predictor of struggling to pass later exams. Most advisors will recommend addressing any mitigating circumstances that led to failing the boards in your Personal Statement. Even low scores, borderline for passing, can scare off some programs.
Repeating a preclinical course or year. Another sign of academic struggle. Also needs to be addressed.
Repeating a clerkship. Failing a clinical experience will almost always be interpreted as a result of professionalism deficiencies. These are deal breakers to most Program Directors and need to be explained.
Academic misconduct. Get caught cheating and you are in a lot of trouble. For your school to still graduate you, you must have convinced them that it was a misunderstanding or that you have been rehabilitated. In a competitive specialty like EM, there is little reason for a Program Director to bother taking the chance.
Unexplained gaps in your career. Big unaccounted for chunks of time are concerning. There can be really good reasons that these happen. But if left unexplained, application reviewers may just assume you were in prison or rehab.
What do I do if I have a "Red Flags"?
There are two approachesthat most applicants use:
- Hope they go unnoticed or that some reviewers of your application will not be dissuaded. This is often wishful thinking, depending on how visible the "Red Flag" is in your application.
- Get in front of them - Use your Personal Statement to explain mitigating circumstances and how you emerged from this better prepared for a career in EM. This is almost always a better way to go. Things happen, life is complicated, and reviewers can understand this. If you give them the chance.