Christina Powell, DO
Past Director of Student Affairs, ACOEP-RSO
University of Maryland Medical Center, Class of 2022

As we transition to yet another cycle of daunting applications, painfully edited personal statements, and hours waiting anxiously by the phone for interview offers to enter the email inbox, I thought it may be helpful to review the process for our budding fourth year medical students interested in applying to the competitive specialty of emergency medicine. I have interviewed Dr. Kaitlin Bowers, Chief Resident of Doctors Hospital Emergency Medicine residency program in Columbus, Ohio and Dr. Andy Little, producer of the infamous EM Over Easy podcast and core faculty at Doctors Hospital, on the interview process from last year’s application season. Both physicians conducted interviews and were actively involved in the application process for their program. However, this time I’ll be the one doing the interviewing…

Christina: Many students find the application and interview process daunting and overwhelming. Previous statistics show that applicants who rank 9 programs have a ~90% chance of matching in EM, and those with 12+ rankings have a 95-99% chance of matching.1 Do you find these statistics to be true in your daily experience? How many programs do you advise your mentees to apply to, in order to capture the 12 interviews necessary to meet these statistics?

Dr. Kaitlin Bowers (K): This is a hard question to answer because there are a lot of variables that go into it. I agree you ultimately want around 10-12 interviews to feel confident that you will match. How many programs you should apply to get there depends on how good of an applicant you are and the type of programs you are applying to. 25-30 programs you think you have a solid chance at getting an interview from is probably a good starting point. If you are applying to any “reach” programs I wouldn’t count those in your numbers since getting an interview there would be an added bonus. Just keep in mind that if you end up getting 12+ interviews be sure to decline any you are no longer interested in early so that other candidates can take your interview spot. 

C: Does the “early bird get the worm”? How important is early application submissions for interview invitations?

K: The earlier a completed application is submitted, the sooner it will be reviewed. It is always advantageous to be on the earlier end of this process as there will be more interview spots and dates available. I would recommend writing your personal statement in January of your third year, it can be a long review process and seems to be a common hold up for not submitting the day ERAS opens. If your personal statement is done early there is a lot less for you to do in June when you are likely studying for boards and preparing for auditions. Also, remember that most programs will review your application and some will even offer interviews prior to getting all of your SLOEs. 

Dr. Andy Little (A): The adage holds true here. But remember that it is okay to submit an incomplete application. Many programs put applicants into piles. An interview now, a review once complete, and then interview applicants they like as soon as they get everything in. Many programs will also offer you an interview even if your application isn’t complete, as they know it may take time for your SLOE’s to get done and uploaded.

C: What are some of the more important aspects of an individual’s application that you look for when determining who will be interviewed, and who will not?

K: Every program has their minimums that they filter applications by. Unfortunately, with the number of applicants that apply to our specialty this is really unavoidable. Outside of that, we look a lot at applicants’ experiences in Emergency Medicine. Has the applicant conducted any relevant EM activities (research, work experience, EMIG involvement, national conferences, shadowing, etc…)? If your application has red flags be sure to explain them in ERAS or your personal statement. Lastly, a lot of medical schools encourage students to apply to a “back-up” primary care specialty. If you are going to do this, do not apply to two programs in the same hospital/health system, programs can see this and it makes us question if you are really interested in Emergency Medicine. 

A: This is very program-specific, but the simple answer is YES. ERAS allows programs to filter your application via hundreds of different data points. Most will start with a minimum Comlex/USMLE score and go from there. The next factors again are very specific to the program, but usually include: SLOE comments, personal statements, and experience (whether it be research or real life).

C: Are there any hard STOPS on an application or red flags that students should avoid?

A: Failing exams, failing rotations. With how competitive EM has become, failing is no longer tolerated. That’s not saying that you can’t rebound, but say you fail a STEP, it better be seen as a “blip” followed by high (upper percentile) scores on any other test you take and then you’ll have to pray a program is willing to take a chance on you.

K: I know it isn’t necessarily “on your application” but remember EM is a small world. Don’t talk bad about other programs/faculty/residents as you never know who may be listening. Come prepared, show up early to shifts and stay late, be prepared for didactics and take advantage of any extra opportunities on audition rotations. Also, work hard on off-service rotations, just because you aren’t interested in that speciality doesn’t mean you can’t learn something, and this comes up in dean’s letters. All of these things can negatively influence an application. 

C: Where do you get your interview questions from? What motivations reside behind some of the questions asked?

K: Outside of the standard interview type questions most students expect to be asked, a majority of us come up with our own questions. Our program tends to ask a lot of questions about hobbies and wellness to get to know the candidates better. Remember getting an interview is the hardest step, once you make it to the interview it is just a matter of if you would be a good fit for the program. Relax and be yourself! 

A: There are good resources from CORD and SAEM on possible interview questions as well as hands-off questions we encourage folks to look at. Otherwise we let faculty/residents ask what they want. 

C: What is one of the more humorous interview answers that you’ve received? Did it help this candidate to use humor, or did it harm their application?

K: This is a tough question. The best thing you can do in an interview is BE YOURSELF! If humor is genuinely a part of who you are then it will come across in your interview. It’s human nature for people to try to use humor when they are nervous and interviewers can sense that. The downfall is if you are just trying to be funny and crack jokes non-stop instead of taking the interview questions seriously. There are certain scenarios like that where it can hurt you. 

A: I had a student answer “where would you go right now if you could snap your fingers and go anywhere?” with an immediate “to Sprinkles, my cat, I miss my cat Sprinkles so much.” Most other students mention going somewhere tropical (it was December in the Midwest) or historical. I wasn’t ready for a cat answer. It made for a great post interview story, don’t think it helped or hurt the person. 

C: Personal statements: friend or foe? Are they important any longer? What advice do you have for individuals getting ready to prepare them this application cycle?

A: I think people spend a lot of time trying to “wow” programs with their personal statement. I’m of the mind frame that we should remember that the favorite type of ice cream is vanilla. So spend time making your personal statement about you, tell me something I can’t find in the rest of your application. 

C: How does a traditional interview day look like at your program?

K: A traditional interview day starts by going to dinner the night before with some of our residents. This is a great opportunity to really feel out the program, get some of your questions answered in an informal setting and likely gain insight into what you can expect on interview day. On interview day our applicants attend a portion of our didactics and a program overview lecture by either our PD or APD. After didactics there is a lunch with the residents and faculty that will be interviewing that day. The afternoon consists of multiple interviews with faculty and residents as well as a tour of our campus. We do have a slightly abbreviated format we use for end of rotation interviews. 

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In 2018, the American College of Osteopathic Emergency Physicians Resident Student Organization (RSO) piloted on-site residency interviews. These interviews were offered as an alternate to the traditional interview days located at the host residency program. “On-site” interviews were held at ACOEP’s Fall Scientific Assembly in Chicago. Residency programs were given a list of fourth year medical students who were registered to attend the conference. The programs could elect to offer those students a conference “on-site” interview during a specific block of time. Doctors Hospital participated in the “on-site” interview process. The following questions reflect the “on-site” interview process. 

C: Did you feel like this form of “on-site” conference interview hindered the applicant in anyway? Does it benefit the applicant in anyway?

K: Interviewing at ACOEP doesn’t hinder the applicant in anyway. However, it is a very abbreviated interview day. Applicants only meet 2-3 representatives from our program and miss out having dinner with residents as well as observing our didactics. Also, if you have never been to Doctors Hospital or the city of Columbus you miss out on seeing where you may be spending your next four years. There are definitely financial benefits of not having to travel to the interview day. However, it seems most of conference interviewees end up coming for a second look day which would cancel out the initial financial benefit. If you would otherwise not be able to interview or if you have visited a program before and had interactions with their faculty/residents at conferences then this may be a great opportunity for you. If not, you probably need to make the trip to gain insight into the program you will need when making your match list. 

C: Would you consider participating in on-site residency interviews again? Why or why not?

K: We are considering participating again but won’t make a final decision until our interview committee meets for the upcoming applicant cycle. As we’ve mentioned, this type of interview day tends to appeal more to applicants who have rotated at a program and don’t want the added expense of flying back to interview. Now that we offer end-of-rotation interviews during the last week of rotations, most of those applicants will have already interviewed. This leaves a smaller pool of applicants to interview on-site at conference, many of whom want to visit our program and opted to interview in Columbus. 

Some important dates to bookmark:

June 6, 2019 ERAS 2020 season opens

Sept 5, 2019 Applicants start applying to ACGME programs

Sept 15, 2019 ACGME residency programs start receiving applications

Oct 1, 2019 Medical Student Performance Evaluations (MSPEs aka Dean’s Letters) are released to ACGME residency programs

References:

  1. 1. National Resident Matching Program, Charting Outcomes in the Match for U.S. Osteopathic Medical Students and Graduates, 2016. National Resident Matching Program, Washington, DC. 2016.