Getting Ready for the ERAS Application and Residency Interview Season

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Getting Ready for the ERAS Application and
Residency Interview Season

• From a Coordinators View

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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.

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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

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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)
• RecentNever Submit a LOR older than 365 days
• Family members/friends/clergy dont count-Only
  MDs who can speak of your skills and commitment
  to EM

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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

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• 2004-2005 APPLICATION SEASON
• Emergency Medicine Residency Recommendation Form
• Emergency Medicine Faculty ONLY Read
  Instructions first _at_ 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 (
• Other      

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• 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

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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

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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.

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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?

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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

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Pitfalls to Personal Statements

• Generic Could anyones 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

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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!, ? _at_
  if the sentence doesnt require it. These do
  not translate into the ERAS system.

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(No Transcript)
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Numbering/Assigning Paragraphs

• Avoid Numbering your paragraphs with 1, 2, 3
  One, Two, Threebulleting or titling them

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(No Transcript)
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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

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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

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Focusing on the EM Specialty

• Obvious Statements in every Personal Statement
• In the ED, you treat all types from Headaches
  Colds to MIs PEs
• 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

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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

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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 youll 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

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Focus on the Program

• What do hope to find in a program?
• What attracts you to this particular program?

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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

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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

• Example Emergency Medicine
• Enjoyable
• Diversity of patients
• Diversity of complaints
• Fast Pace
• Performing procedures
• Solving Mysteries

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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

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Form

• If you dont 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.
• Dont ask people that will tell you it is good
  because they dont 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
  its too painful, youre not doing it right)
• Minimize adverbs very and really almost
  never should be used

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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

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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

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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

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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 dont 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.

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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) colleagues
  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 dont like to
  take care of?

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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 HOs 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?

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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 programs 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?

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Questions for the Residents

• Vacation policy-dont 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.

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Questions you wont 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 IMGs 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)

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When you still dont know, ask the coordinator

• EVERYTHING!
• She/He knows everything-if they dont they will
  find out.

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Sending Thank You Notes

• Optional
• Shows Interest in program
• Include all Persons 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

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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