Getting Ready for the ERAS Application and Residency Interview Season

1. Getting Ready for the ERAS Application and Residency Interview Season From a Coordinators View

2. Your M3 Surgery Rotation • Create your M3 schedule to perform rotation specialties you are torn between early. • Or • Create your M3 schedule to perform the rotations you know you are not interested in early to get them out of the way and gain experience to excel in your chosen specialty. • Contact Bev Vaughn at 9-4718 to perform the 2-week emergency medicine elective during your surgery rotation well in advance.

3. Your M4 Year • Perform rotations in departments you hope to receive LORs from first. • Perform rotations where you hope to receive LORs or hope to match • Plan your November, December, & January rotations carefully • Performing rotations February, March, & April-2 schools of thought

4. Requesting LORs • 3-5 letters from people who know you well & a variety of settings • MUST have a LOR from EM Chairman • MUST have LOR from EM Program Director • Ask your mentor/advisor • Ask MD from a rotation with a Honors performance • Ask from MD who wanted to recruit you for his/her specialty-they love you! • Ask early-Beginning in June/July/August/September(ERAS opens 9/05) • Recent=Never Submit a LOR older than 365 days • Family members/friends/clergy don’t count-Only MDs who can speak of your skills and commitment to EM

5. What to Provide to Writers • Personal statement • CV • Transcript • USMLE 1 and 2 if you have it • WAIVER FORM (filled out and signed) • STAMPED ENVELOPE addressed to Sue Pope • Instructions (with DEADLINE) • If asking an EM MD to write a letter, Get CORD SLOR form on www.cordem.org

6. 2004-2005 APPLICATION SEASON • Emergency Medicine Residency Recommendation Form • Emergency Medicine Faculty ONLY – Read Instructions first @ www.cordem.org • Applicant's Name:      ERAS ID No. • Reference Provided By:  • Present Position:      Email:      • Institution:      Telephone Number:       • A. Background Information • 1. How long have you known the applicant?      • 2. Nature of contact with applicant: (Check all that apply) • Know indirectly through others/evaluations • Extended, direct observation in the ED • Clinical contact outside the ED • Advisor • Occasional contact (< 10 hours) in the ED • Other       • 3. If this candidate rotated in your ED, what grade was given? • Honors High Pass Pass Low Pass Fail • Optional: One Key Comment from ED Faculty Eval:       • 4. Is this the student’s first, second, or third EM rotation?____________ • 5. Indicate what % of students rotating in your Emergency Department received the following grades last academic year: • Honors      % Total # students last year:      • High Pass      % • Pass      % • Low Pass      % • Fail      % • 100% Total • B. Qualifications for EM. Compare the applicant to other EM applicants/peers. • 1. Commitment to Emergency Medicine. Has carefully thought out this career choice. • Outstanding (top 10%) Excellent (top 1/3 ) Very Good (middle 1/3) Good (lower 1/3) • 2. Work ethic, willingness to assume responsibility. • Outstanding (top 10%) Excellent (top 1/3) Very Good (middle 1/3) Good (lower 1/3)

7. 3. Ability to develop and justify an appropriate differential and a cohesive treatment plan. • Outstanding (top 10%) Excellent (top 1/3) Very Good (middle 1/3) Good (lower 1/3) • 4a. Personality; ability to interact with others. • Superior Good Quiet Poor • 4b. Personality; ability to communicate a caring nature to patients • Superior Excellent Adequate Poor • 5a. How much guidance do you predict this applicant will need during residency? • Almost None Minimal Moderate • 5b. Given the necessary guidance, what is your prediction of success for the applicant? • Outstanding Excellent Good • C. Global Assessment • 1. Compared to other EM residency candidates you have recommended as such last academic year, this candidate is ranked as: • Ranking# Recommended as such last academic year • Outstanding (top 10%)       • Excellent (top 1/3)       • Very Good (middle 1/3)       • Good (lower 1/3)       • Total # of letters you wrote last year:       • 2. How highly would you estimate the candidate will reside on your match list? • Very competitive Competitive Possible match Unlikely match • D.Written Comments • Signature: Dated:: • STUDENT HAS WAIVED RIGHT TO SEE THIS LETTER

8. How to Ask, and Keep Asking • Ask in person • Only ask people who you feel can provide a “strong letter” • Be prepared for the answer • Follow up w/ a Thank You note • Check with Sue Pope to confirm receipt • If not received by promised time, send a follow up Thank You note • If deadline rapidly approaching, POLITELY call to notify writer that LOR has not been received and that Sue is prompting you to contact writer • Follow up w/ Thank You note once letter received

9. Looking for LORs • Drs. Muelleman, Wadman, & Hoffman will meet with you and provide a letter of recommendation based on your EM experience in our department.

10. Board Scores • What do your scores mean to us? • USMLE Step 1 average for this institution is about 210ish from last year • 182 is passing • Most programs prefer to see scores 200 and above for Steps 1 & 2 • Most programs demand improvement from step 1 to step 2 • What if your Step 1 is below 200? • When should I take Step 2?

11. The Goal of the Personal Statement • To explain why you are pursuing EM • Explain WHY you are suited for EM • Why YOU should be considered for their EM residency program

12. Pitfalls to Personal Statements • Generic; Could anyone’s name be substituted for yours with equal truth • Omitting why you are going into your chosen specialty • Making statements without examples that back your statements • Making statements that focus on all of your greatness-sounding cocky

13. Personal Statements • Should not be more than 1 page, single spaced, Times New Roman 12 font, & 700-750 words. • Do not include BOLD, underlined, italics, “Quotes” and other annoying punctuation!, ? ~ @ # % & if the sentence doesn’t require it. These do not translate into the ERAS system.

15. Numbering/Assigning Paragraphs Avoid Numbering your paragraphs with 1, 2, 3… One, Two, Three…bulleting or titling them:

17. What should I write about? • Focus on your chosen Specialty • Focus on your strengths/personal achievements. • Address areas of concern that appear on your application or that will appear in your deans letter • Focus on the program • Optional mention of personal interests

18. Focusing on the EM Specialty • Talk about when you became interested in EM and what you did to learn more about it • I want to know why you chose EM • Include statements that support how you reached the decision to enter EM • I want to know why you chose EM • Use anecdotes to bring out your reasons for choosing EM • I want to know why you chose EM

19. Focusing on the EM Specialty • Obvious Statements in every Personal Statement… • In the ED, you treat all types from Headaches & Colds to MI’s & PE’s • During a shift I treated a lac on a 5 year old, 60 yr old smoker w/chest pain, 28 yr old meth user with psychotic episodes. (we already know this) • In EM, the physician is the first contact with patients who may not receive regular care • EM MDs have to multitask • EM MDs have to be prepared for anything that walks through the door • I like the lifestyle, it is a set schedule so I can spend time with my family. • “I knew I wanted to do EM, but I kept an open mind” or “I had no idea which specialty I wanted to apply for during my M3 year”

20. Focus on your Strengths/Personal Achievements • You have gained valuable experience in your M3 & M4 year-so has everyone else-why are you special? • Provide information or stories that detail your strengths or achievements

21. Focus on your Strengths/Personal Achievements • When telling a personal story-do not become emotionally involved. • Be careful how state your attributes-it may come across cocky • Provide information that backs up your claim • How your quick reflexes, honed through years of playing piano, prepared you for the technical dexterity you’ll need in EM • You do not need to list an experience to match each skill, but enough balance to demonstrate your strengths and make your essay come alive without sounding cocky • Beware of “Red-Cape” personal statements

22. Focus on the Program • What do hope to find in a program? • What attracts you to this particular program?

23. Optional Mention • Why tell about your outside interests? • To humanize the statement • To add content-beef up the length • To have something to talk about during the interview

24. Example: Emergency Medicine Enjoyable Diversity of patients Diversity of complaints Fast Pace Performing procedures Solving Mysteries Where Do I Start? Brainstorm as many aspects of what you find enjoyable, interesting, valuable, worthwhile, challenging, or important-Get specificPush further; ask ‘why?’ five times

25. Where to look • Talk to parents/family, important community members (doctors, teachers, ministers, etc.) • Look at your Coursework • Look at your Extracurricular • Look at your community service • The last three will usually tell you how you developed or solidified your intent; you should ask why you chose each in the first place

26. Form • If you don’t want to create an average personal statement-be careful • Attempting to create the “Eye Catcher” could backfire on you • Make every sentence perform a function or work toward the goal of the personal statement • Take time in between revisions • Ask several HONEST people for HONEST input (“does this sound like me”) • Ask parents, sibs, long time friends. After the revisions, ask mentor/advisor, Sue Pope, EM PD, EM Asst PD, EM Coordinator. • Don’t ask people that will tell you it is good because they don’t want to hurt your feelings-It will hurt your application • It has to come from down deep; lots of soul searching, self-reflection, and introspection (if it’s too painful, you’re not doing it right) • Minimize adverbs; “very” and “really” almost never should be used

27. Interview Season Dates • Mid August-Applicant Registration Begins • September 1, 2005 Institutions begin downloading applications • December 1, 2005-deadline for using ERAS • Most programs also use 12/1 as a cutoff for accepting apps • Last week of February 2006 Rank list due for Applicants and programs • 3rd week of March is Match week • Monday-Did I match • Tuesday-Scramble • Wednesday-Day to rest • Thursday-Announcement of Program Match

28. Accepting/Declining Interviews • Respond within 3-4 days of invitation to either accept or decline • Be sure if you need to cancel your interview later that you provide enough time for other candidates to take your place and so the coordinator has time to adjust the interview schedule • Never No Call/No Show-we will call your medical school Dean

29. Contact with Coordinator • Do not contact any programs with the inquiry of the status of your app • OK to question if you are a late applicant (past deadline) • Be nice to the Coordinator-(s)he will be sure to let the PD know if you are a jerk

30. When to Worry • If you find yourself worrying about the number of invites they have received. Ask if these things have happened yet: • Deans letter release on Nov 1, programs often will not make any considerations until then • Has the program deadline passed? Dec 1 is the deadline for most programs and they don’t offer interviews until they have received all applications for the season • Start worrying if… • If you have little or no interview dates by early December (check that your application is complete) • Make an appointment with Dr. Wadman about your situation. He should be able to shed light.

31. Some Questions They will Ask you • How do you make an important decision regarding a patient in your care & describe the circumstance surrounding a recent decision & how you went about making the right choice. • Describe an incident in which you observed a patient care situation where an error was made or where you did not agree with the medical decision-making of your senior resident or attending. • What actions might you take if you suspected a physician (resident or staff) colleague’s performance of being impaired by substance abuse? • Teach me something about one of your interest outside of medicine. • What type of criticisms upset you? • Describe to me, something funny that has happened to you recently. • What is your biggest pet peeve? • What are your weaknesses? (Remember these should not be positive weaknesses (I stay until the job is finished) • What would you do if you did not obtain a residency position next year? • Are there any types of patients you don’t like to take care of? • How (by which methods) do you like to learn? • What do you see as the negative and positive features of this specialty? • What problems do you believe this specialty faces? • What do you think about medical advice being available on the web? • What 3 MATERIAL objects are most important to you? • How will you deal with know-it-all patients? • So, you're on the Admissions Committee for the medical school. How do you choose from among the applicants?

32. Some Questions you could ask the faculty • What do you feel is your strongest attribute of your program • Is this program involved in research & publication? • Is the staff involved in Flight/Ground EMS • What teaching opportunities will be afforded to me during my residency, if yes-is there formal training on HO’s teaching MS? • How many hrs of formal education take place each week? • What percentage of weekly didactics is performed by Residents-by faculty? • Where do most of your matched residents come from? • Are your graduates typically successful with boards on the first attempt? • How many of your graduating residents match fellowships? • Which subspecialty? –Where? • Where do your residents typically practice medicine upon graduation? • Do the graduating residents typically have jobs in place by the time they graduate? • Is there an orientation month for incoming residents? • How does the residents autonomy change as (s)he progresses in training? • Does the ED have its own phleb, x-ray tech, RRT, pharm tech? • How does the trauma team activation work? How involved is the EM resident?

33. Questions you should NOT ask Faculty • 1. What qualities are you looking for in a resident applicant? • 2. How do you handle complaints from residents and fellows? • 3. Asking for a sample copy of the contract (it should have been offered) • 4. Do you offer residency contracts outside of ERAS/NRMP • 5. Does this program allow Moonlighting? • 6. What are the program’s weaknesses? • 7. Is there resident turn over? • 8. On your last site visit, what citations did you get and how are you correcting them? • 9. How solid is the financial status of this program? • 10. How committed is this institution to resident education? • 11. Is there a union?

34. Questions for the Residents • Vacation policy-don’t just ask about how much time you get but be specific- • Positive aspects • Negative aspects • Relationships with other specialties/depts...... in the institution • What is done to help prepare for in-training exam each year. • Are conferences typically taught by faculty or residents? • Does the call schedule allow attendance to the conference without being on call the night before? • Does this institution pay for • Parking, meals, laundering of coat/scrubs, DEA, ACLS, ATLS, PALS, BLS, national conferences, required books? • Cost of Living • What has changed since you came to the program? • Overall does the faculty seem to enjoy teaching? • Would you consider this program if you were applying again? • Is the nursing staff supportive of the residency program? • Do the faculty members seem to get along with each other or is their obvious tension? • What types of activities are there to do around here? • What is a typical EM monthly schedule, Cards monthly, Radiology, Anes, EMS, etc.

35. Questions you won’t ask because you did your homework and already know the answers • PGY 1-3 rotation structure • Weekly Didactic schedule • How many hospitals is this program partnered with • Do you have minimum USMLE scores • Is this program affiliated with a Medical School? • Is moonlighting allowed • Vacation & Sick time information should be offered to you-if it is not-go find it on their GME web-site • Does the program typically accept IMG’s or people from its own medical school or one nearby? (found on their web-site) • Starting Salary (again-should be on the GME web-site)

36. When you still don’t know, ask the coordinator • EVERYTHING! • She/He knows everything-if they don’t they will find out.

37. Sending Thank You Notes • Optional • Shows Interest in program • Include all Person’s you met with • Some include a photo with note • OK to email a thank you • Some will send a follow up note of interest after they have completed interviews-especially if you have a strong desire to match that program-it tells us you are interested

38. Relying on Web-sites • You can Google anything, but be selective-consider the source • Site that are good are typically associated with • AAMC • ABEM-American Board of Emergency Medicine abem.org • ACEP-American College of Emergency Medicine acep.org • ACGME-Accreditation Council for Graduate Medical Education acgme.org • FREIDA-Fellowship and Residency Electronic Interactive Database ama-assn.org • CORD-Council on Residency Directors for EM cordem.org • EMRA-Emergency Medicine Resident Association emra.org • SAEM-Society for Academic Emergency Medicine saem.org • Scutwork.com-speaks for itself • These are all reliable sites for Emergency Medicine • You can typically rely on sites that are found on University sites. • Believe nothing of what you hear and half of what you see