Consensus Statement on 2021-22 EM Match - Implications for Applicants

 The COVID-19 pandemic is anticipated to impact the 2021-22 Residency Application cycle, though in different ways than this past year.  The Coalition for Physician Accountability (CoPA) released guidelines for Away rotations in general and all of the Emergency Medicine stakeholder organizations put together a detailed Consensus Statement that you can read here.  

Despite this attempt to provide clarity, there are still a lot of questions as to what this really means for students, especially those without a traditional "home" rotation available.  

Below is some Q&A on common questions that have come up in response to these guidelines.

When can students complete "away" rotations?  These are not supposed to be available before August 1, 2021.  However, this restriction does not apply to students without a "home" rotation.  Those students can take the first available opportunity at an institution that is open to "away" rotators.  

How many rotations can students complete?  The recommendation is one or two rotations at Residency Programs (usually called something like "Sub-Internship" or "Advanced Elective").  If two rotations, then either one "home" and one "away" or two "away" rotations.  Other EM rotations do not count towards this total, including sub-specialty rotations (like Ultrasound or Pedi-EM) that take place at a Residency Program.  

What if I have two separate "home" sites available to me?  While this is not available for many students, you can do both, but you should then NOT do an away rotation.  If you are looking to be considered outside of the region where your medical school is you are likely to be better off doing only one of the "home" sites and doing an "away" rotation somewhere else you are interested in going to.  

How many SLOE's should I have this year?  The recommendation is two SLOE's from Residency Program Leadership (Residency SLOE).  The other letters in your application can be from the other types of SLOE's, but two Residency SLOE's should always take precedence in planning your application.  However, having just one of these letters is NOT going to be disqualifying.  Having three or four Residency SLOE's is strongly discouraged and will likely result in some application reviewers down-rating your application.  

Do I need to do an "away"?  Only having one Residency SLOE will not hurt your application.  However, there is added value in having two separate residencies evaluate your performance and candidacy for EM.  If one letter is not particularly strong the other letter can compensate for that, especially if growth is shown from one rotation to the next.  This is why EM has always preferred that students do two rotations.  The lack of a second SLOE may have hurt some applicants in the 2021 Match who would not have faced similar challenges getting interviews in a previous year when a second letter would have been available to provide reassurance.  

There is still a lot we don't know about what the 2021-22 Application cycle will look like, including whether interviews will be in-person, virtual, or a hybrid of the two.  

If you have other questions, or want some additional clarification, please submit those in the comments section below.

COVID-19 and the 2021 EM Match: Everything on this site is wrong!

We have endeavored to keep the advice on this site based on the best evidence and consensus recommendations, AND thoroughly up to date with changes in the EM Match.  That has all gone out the window with the COVID-19 Pandemic (plus Step 1 going to Pass/Fail and the SVI getting cancelled).  As anyone reading this probably knows, most medical schools are banning travel by students and limiting the clinical contact they are allowed to have at home.  Most hospitals are also not accepting visiting students.  And we don't know when this will end or what "normal" will look like when things get back to "normal".

The Advising Students Committee (ASC-EM) of the Council of Residency Directors in EM (CORD-EM) authored this Consensus Statement to start to address the impact COVID-19 is going to have students in the 2021 EM Match.  We urge you to read this through as it will hopefully offer some reassurance that the students are not being forgotten, and give you an idea of what is planned to support you. 

As for the problem of everything on this site being wrong, that is going to take a while.  When one of our authors gets COVID and is sent home to self-quarantine all the updates will happen quickly. Until then, like the folks delivering all my Amazon packages, cleaning the empty shelves at the grocery store, and working around the clock making more PPE (thank you!), we are a little short on time.

We will get the Applying Pages updated for this scary new world. In the meantime, stay safe and start studying for Step 2.

Adam Kellogg is an Associate Residency Director, past Chair of the ASC-EM, a contributor to the Consensus Statement, and a master of social distancing.  

Non-VSAS Rotation Option

This time of year many applicants are frustrated by their lack of progress getting EM Away elective rotations scheduled.  Looking at non-VSAS sites can work really well.  And this service we just heard about might help too.

Robyn Hoelle, the program director from North Florida Regional Medical Center in Gainesville sent this out:
I wanted to make sure that all of you out there who are mentoring students looking for EM rotations knew that many of us have withdrawn from VSAS. We are a part of Clinical Nexus which manages our rotations. There are 60 Hospitals on this system and the students only have to put in one application to be able to apply for rotations in all of the participating hospitals. It is free for the students. 

We don't know much about this resource, but it could be really helpful to those looking for rotations in the Southeast. Please share your experiences using Clinical Nexus in the comments.  

More VSAS Advice

We recently tackled the torturous VSAS system for setting up your crucial away rotations in this post: "Rules of the Road for Away Rotation Applications".

The fantastic team at Academic Life in Emergency Medicine (ALiEM) had the same idea.  Dr. Mike Gisondi assembled a panel for the latest video in their EM Match Advice series to address the same issue: VSAS 101 - Securing an Away Rotation.

This is a great resource.  Have a look and then check out the rest of this invaluable series.

Enjoy!

Adam Kellogg is an Associate Residency Director and former Clerkship Director, and he wishes he had thought of using Google Hangouts for panel interviews. Brilliant!

Rules of the Road for Away Rotation Applications

Now that you have decided on EM (or are at least treating it as your front-runner), you will need to complete a Home and an Away rotation this summer and early fall. These rotations are where you will get the SLOEs that will be the most important part of your EM application. Take a look at this approach to your myriad of choices, and below is a discussion of the most common questions...

Vacillating on the VSAS

There are no perfect number of clerkship applications. First, self evaluate your competitiveness and the competitiveness of where you are applying to. Your local advisors should be able to help you get a sense of your competitiveness at this point.  Keep in mind that this is going to change as you complete rotations. For most students 4 applications will suffice. If you are a weaker applicant or looking at a more competitive market - consider 6. 

The Bird in the Hand

Many students get an invitation to one clerkship, but want to wait for their dream spot. In this application your goal is to ensure you have an away rotation during the spring and summer. You have a rotation, take it and smile. If you can manage a third rotation, keep your other applications in. If you cannot do a third rotation and still have applications outstanding call and let them know you appreciate their time but have accepted another opportunity. This is better than waiting and declining the spot. This proactive stance will win you points with the clerkship director and the coordinator (they may remember if you string them along). 

Check the Boxes

Read the paperwork from the program carefully, and complete it in a timely manner. There is no second chance for a first impression. You don't want to arrive and not be able to rotate because of paperwork. Health requirements vary at different institutions. Check with the undergraduate medical education office or health services at the hospital you are going to. They should be able to list what you need in detail. This is the time to jump through the hoop and just get it done.

Burn Baby Burn (or Don't!)

Declining an offered spot will be a small annoyance to the clerkship. If you need to, ensure you do it quickly and politely. Waiting weeks to decline hurts your impression with the program. They assume you are stringing them along and not genuinely interested in the program. Never accept a rotation and then back out of it if you want to get an interview there. Getting your perfect rotation is not worth the damage to your credibility elsewhere. If you discover a particular program is not a good fit and expect not to apply to them, go ahead and cancel. Just know that this program interprets withdrawing as disinterest and inconsiderate - not a good impression. The clerkship director and residency coordinator will recognize your name and will be reluctant to interview you.

Lucienne Lutfy-Clayton is an Associate Program Director and former Clerkship Director, she hates when students cancel on her clerkship making her scramble at the last minute.