Dominic Williams, OMS-IV

In my term as the ACOEP-RSO Student President, I had the privilege of meeting many osteopathic students from across the country: students with a passion for emergency medicine, students taking the initiative to attend events relevant to their future, students wanting to do everything they could to be a part of the future of the profession, and students who often felt like they were not receiving the advice and recommendations they needed from their respective institutions. The role of the ACOEP has always been to help nurture future generations of physicians, and with the unification of residencies under the ACGME, the RSO is continuing to help students be as successful as possible in a competitive environment.

My personal experience on the interview trail has been particularly interesting. I’m sure many of my fourth year compatriots have similar tales of interview rejections and acceptances, with no discernible pattern to either. I made it my business to attend the residency expositions at both ACEP and ACOEP to search for more information. I’d like to take this opportunity to share my findings with you. These are my personal anecdotes, so take from them what you will.

Many of the traditional ACGME programs will not even look at your application without a complete set of USMLE scores. This cannot be stated firmly enough. Based on my informal survey at ACEP, many programs use these numbers as an initial screening tool. If you are a first or second year reading this article, take this point to heart. With more and more candidates applying  to programs, the screening process will continue to get more stringent, and ranking students by numbers is a convenient way to screen applications. Below are my recommendations for helping students make this decision.

  1. Consider your budget. Spending an extra $1500 on exams that aren’t required for your diploma is certainly irritating. But, is it less frustrating than being limited in your residency opportunities.
  2. Do your research. Find out which programs use the USMLE as a screening tool. Some of these programs have this information readily available on their websites, while others require you to email the program for specific information. If you plan to rank any of these programs, then the utility of the USMLE exams becomes even greater.
  3. Rotate at the programs you are interested in. VSAS is opening soon for current 3rd years. Students that rotate at programs will often be given a more thorough examination of their application and will commonly (but not always) be invited to interview.
  4. Do not lose hope. Reach out to the programs that you feel may have overlooked you. If you are a student that neglected to take the USMLE Step 1, address that in an email to the program and see if they are willing to consider your application despite its absence. Regardless of having completed Step 1, taking the USMLE Step 2 will also help to show you are competitive in direct comparison to your allopathic counterparts.

That being said, there are many programs that still recognize the value of osteopathic students and will welcome you based on the merits of your application, COMLEX scores, academic prowess, and community involvement in medical school. I cannot say how long this will last. Of particular interest, I was surprised to learn of traditionally AOA programs that will be expecting all applicants to have USMLE scores moving forward. As an exam available to all applicants, it is seen by these programs as the best way to compare candidates from different programs.

I am proud to be an osteopathic medical student. I firmly believe that we have a lot to offer the emergency medicine community. I would hate to think that something as simple as proving ourselves on one more examination would be the difference between a student successfully  gaining an interview spot or not, but this currently seems to be the situation. Emergency medicine is evolving, becoming increasingly popular. For a seat at the table, we must rise to the occasion.  I would urge the students reading this to strongly consider taking the USMLE. I wish you all the best in your endeavors.  If you feel there is any way the RSO can help you further, please do not hesitate to reach out to us!