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Medical Student Advisor Program Frequently Asked Questions About Emergency Medicine As a Career 1.  How competitive is Emergency Medicine? Moderately competitive. In the 2000 NRMP match there were 971 PGY-1 positions in EM offered.  Of the 818 students who chose EM as their only specialty, 794 matched (97%)  with a "position per US student" rate of 0.9.  2.  Do I need research experience? Research experience helps, but it is not necessary.  It will strengthen an applicant's position. The research involved does not necessarily have to be in emergency medicine. Mostly, it denotes a student who goes above and beyond the expected. There may be volunteer work or other ways to show this. 3. What is the difference between 3 and 4-year programs? First, you can find a very good article on our web site. It is a Pro and Con for 3 versus 4-year programs by Dr. Peter Rosen and Dr. Glenn Hamilton. Some 4-year EM residency programs build in the internship and some let you get it wherever you want. Many places have an affiliation with an institution to be able to assist you in looking at a local program. Four-year programs offer more elective time than 3-year programs, thus allowing the resident to build in some extra education time for areas of interest or special needs. Some believe that four year programs prepare residents better for academics. However, a 3-year residency with a fellowship is another effective option. Depending on your personal goals you may want to consider this option very strongly.  For example, research fellowships are highly recommended for those physicians who want to develop a career based on research. In general, medical students should match to a program based on its overall educational program and not on one specific point.  4.  What can I do in my first year of medical school to help? The first year get involved in any EM interest groups available at your school or in your area.  Check to see if there any EM elective courses offered. These will expose you to some of the EM faculty and residents. Most EM courses have some clinical observation time built into the course. Start thinking about developing a relationship with an EM mentor.  Students are a good source of which EM faculty are interested in students or which ones have research opportunities available. It is never too early to start research. Even if you decide not to go into EM, research of any kind helps. Join SAEM and EMRA/ACEP, this will help you learn more about the specialty, identify opportunities to become involved and keep you abreast of the latest issues.  With your memberships, you will also receive the two major journals in EM, Academic Emergency Medicine and Annals of Emergency Medicine.  Read them.  If you enjoy the literature, there is a good chance you will enjoy the practice. 5.  What can I do in my second year of medical school to help? Get more heavily involved in the EM club.  Become an officer of the club.  The second year medical students run many EM clubs/interest groups. First year students are still getting to know the lay of the land, third year students are too busy. Sometimes, fourth year students assume the leadership role. SAEM also has a wonderful student program at the annual meeting, and its regional meetings which are held in the spring.  It may seem premature to go in your second year, however, your third year is usually too busy to get away and the spring of your fourth year is too late for the match. 6. What can I do in my third year of medical school to help? Get good clinical grades, especially in Medicine and Surgery. Concentrate on the clinical work.  Try to stay involved with the EM club when able.  Some clubs have workshops. Helping out with these helps you to teach your new skills. Meet with an advisor or your mentor at the end of third year to help get your fourth year schedule set up. They can assist you in the timing of your electives, where to do your EM electives, and what other electives to do that will assist you in EM. 7. What can I do in my final year of medical school to help? Become re-involved with the EM club; complete any ongoing research projects that might be dangling.  Do well in your EM rotations.  Try to set up your EM rotation shift schedules so that you get to know at least one faculty member. Try to meet with this faculty member early just to "talk" about EM as a career. Make sure they know that you are interested in EM without being obnoxious. If there is an opportunity for you to do a short presentation at student rounds etc., volunteer for this. 8.  Is it more important to have good letters of recommendation or a letter from a faculty in EM? One or more strong letters from academic EM faculty is essential. If you have a mentor in another specialty that is your champion and can write you an excellent letter of recommendation then include this one as well. Most residency directors will look for a letter from the EM course director so get to know that person well and set up a meeting with them so they can help you define your goals and objectives.  The EM course director will frequently be able to set up additional opportunities for you during your EM month so if you have a specific interest, inquire about it. 9. How do I decide where to do my EM student rotation(s)? Most students do one rotation at their home institution, provided they have a residency program.  Some students choose to rotate at another program that they believe they may rank highly.  It is best to do your EM rotations at sites with residency programs to give you a chance to check out the program and to get a letter from someone who is known to other residency directors. You may also want to find a program that has a strong reputation in a particular field of EM that you may be interested in such as EMS or Toxicology.  In consultation with your advisor pick a program that will give you the best exposure to EM and allow you to showcase your skills while finding out if this is a good fit for you as a residency program. 10.  How many EM rotations should I do? Most students do 1 or 2.  Doing more than 2 won't necessarily hurt you, however, most medical schools will only give credit for 2 elective rotations in one sub-specialty. You want to present yourself as a well-rounded applicant and spending your entire senior year in one specialty does not send this message.  It is best to limit yourself to one or two well timed EM rotations and really shine while you're there.  Use the rest of your electives to explore other areas of medicine that you will not have exposure to once you have matched in EM. 11.  How do I decide how many EM programs to apply to? Meet with your EM advisor, go over your Part I board scores, your transcripts and your CV. Ask them to give you honest feedback on how competitive you look to them.  Use this feedback to decide how many programs to apply to. Remember, the first 20 programs you apply to are covered under one basic fee, after that, you pay per program.  If you apply to 20 programs and get 7-8 interviews you have a very good chance of matching.  If you get more than this you probably need to prioritize how many places you can manage to interview. If you get less than 7-8 interviews then you probably need to send out another 10-20 applications.  12.  Is there any source to find out what are the rankings of the various EM residency programs? There is no source.  "Beauty is in the eye of the beholder".  It depends on what you want from residency. Most residency programs now have web sites so you can use these to get information about the individual programs.  SAEM has an on-line residency catalog.  The best source is other students and your EM advisor to rank programs.  Ask around, you will hear the top echelon programs mentioned frequently.  How competitive you are should factor into which programs you apply to. Always remember to shoot high.  You never know unless you try. Even the best applicant should have a few fail-safe programs that they evaluate.  13.  How do I decide to rank EM programs when the time comes? Ranking programs is one of the most stressful parts of the application process.  Many advisors have said that you need to make your list according to how you feel you fit at an individual program. When you go for an interview, really try to imagine yourself spending the next three or four years with the people you are meeting. Be sure that your ideas about residency fit with those of the program and that the curriculum offered covers the areas that you believe are important in an EM residency.   Do the rank list early so that you have time to live with it and make any changes before the deadline.  And finally, if you are thinking of moving your family or significant others, be sure that they are comfortable with your list.  An unhappy home-life makes for a miserable residency.   14.  Where can I get more information? The SAEM Undergraduate Committee has compiled a group of articles designed to be of interest to medical students considering a career in Emergency Medicine.  These articles are available on the SAEM medical student web page. Click here if you would like to sign up now to receive an advisor. 15.  What if I am an International Medical Student? The Virtual Advisor Program, while designed to assist students with questions about the specialty of Emergency Medicine and about career planning, has received a number of requests regarding topics specific to international students such as visa status, residency status, and graduate medical education funding for international applications. The information is unfortunately outside the scope of the Virtual Advisor program at this time. Therefore, we regretfully cannot pair international students with personal advisors. We are sorry for this inconvenience. The virtual advisor page contains links to many important resources, such as the FAQ section, the on-line Residency Catalog, the Undergraduate Rotation List and other sites. Students might also try the registrar's office at the home institution or the Graduate Medical Education office at the institution to which they are applying.

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