The following questions were answered by various members of the Wake Forest University Emergency Medicine Faculty and solely represent their individual opinions.
So how important are board scores, what if I got a 200?
The higher the better, however we like to see scores at or above the national mean. Would rather see you do better on Step 2 than Step 1 since it is more clinically oriented.
Not a problem unless you have marginal clinical scores. Clinical scores and grades mean more.
Do I need to be doing research, and what kind is most beneficial?
Only if you are: 1) interested in academics or 2) have a marginal application that needs a boost.
Would much rather match a very good student with no research experience than a below average student with a lot of research experience.
If you choose to do it, EM research carries more weight.
If you are a marginal student, your time may be better spent improving your performance clinically. Often letters of recommendation from research mentors carry less weight than those from clinical encounters.
What are my options for fellowships after residency?
Pediatric Emergency Medicine
Emergency Medical Systems
Only the first four give your board certification.
What does the average EM resident’s first and second year grades look like? How about the 3rd and 4th year?
Most students we interview are at or above the mean for their class, particularly in the 3rd/4th years.
What is the basic format of each year of residency?
Residents tend to spend more time in the ED as they advance through residency with more and more progressive clinical responsibility. Internship year generally contains several off-service rotations. The second and third years usually contain more ED experience with specific defined roles for each year and different goals and objectives for each year. See the SAEM Website for each residency’s specific format
What kind of personality fits best with EM?
Decision Maker, Risk Taker, Visual Learner, Aggressive, Hard worker, Assertive, Multi-tasker, Team player, Leader, Outstanding interpersonal skills.
Someone who doesn’t get rattled when things start falling apart but steps to the forefront and leads effectively
Essentially the “Work hard, play hard” type of person.
Under what circumstances should I do an externship, or not?
If you have one particular program that you have your heart on matching at, then rotate there particularly if you are not a strong candidate on paper. Be aware that it may backfire if you don’t impress them.
Do a rotation at a hospital with an EM residency in order to get letters of recommendation from academic EM faculty if you are at a medical school without an EM residency.
Most people interested in EM would benefit from doing an externship under the right circumstances. Both should be at a facility with a residency. Both should be different (one academic and one community or one academic and one county based, etc). This allows you to get letters of recommendation from two separate centers and allows you to see two different styles of training programs.
Do not do an externship at a hospital to which you were not considering an application.
What is the best way to know if I am suited for EM?
Can you get along with people and can you multi-task? If you say “no” to either one of these then EM is not right for you.
Do a rotation in EM early in your fourth year and at another ED as a visiting student. See what the evaluations say.
Talk to EM faculty about career choices and life after residency. Ask what the cons of the specialty are and see if you can live with them.
Think seriously about working nights, weekends, and holidays the rest of your life. This does not bother most who go into EM. If it bothers you, reconsider.
What should I do during my limited time off during medical school to make me a more competitive applicant?
The best thing you can do to make yourself competitive is to make good grades in school and receive outstanding clinical evaluations from the clinical faculty.
Getting involved with EMIG and getting to know your home school EM faculty certainly can help you gain valuable insight into the whole residency applicant process.
How can medical students get more exposure to EM during their 3rd and 4th years?
Through clinical rotations, EMIG meetings, EM research, attend EM conferences, etc.
Attend national meetings like SAEM, AAEM, and ACEP.
Volunteer shifts / Shadow shifts in the ED
What are the differences between the standard ED programs and combined programs, such as Peds-ED, and how are these programs beneficial to the practicing physician?
Combined residencies exist in EM/IM and EM/Peds. You can get board certified in each specialty in five years instead of six if you did them separately. In order to get board certified in Peds EM you must do either an EM residency followed by a two year Peds EM fellowship or a Peds residency followed by a three year Peds EM fellowship.
They are beneficial to those physicians who want to practice another specialty other than EM or who want to develop a particular academic niche in a certain clinical area.
Practicing emergency physicians (either academics or community) need only a three year accredited EM residency which leads to board certification through the American Board of Emergency Medicine (ABEM).
Who should or should not consider a combined program?
Combined programs are not that popular because most people want to practice one or the other specialty not both. The best advice would be to contact someone who has done similar training or a program director from a combined residency program for their opinion.
These programs are usually for people interested in teaching /academics.
Who can I talk to in order to receive the most candid details about the life of an EM resident or doctor in my institution?
Talk to a current senior EM resident to find out the life of an EM resident at your institution.
To find out about life after residency, talk to the EM faculty. I think the best person would be someone who has practiced in a community hospital as well as an academic center. Both careers are different in many ways and you may get an obscured view if you talk to someone who has only experienced one side or the other.