Tips for a Successful Match into EM

From first year to graduation, every step of medical school is an opportunity to prepare for your future career. Within the last decade, Emergency Medicine became one of the most competitive specialties in the nation. However, recent trends in Match statistics show that Emergency Medicine has seen a decline in applicants over the last 2-3 cycles. Regardless of the recent Match statistics, it is important to remember that you cannot predict the competitiveness of your Match year in Emergency Medicine, and it is still imperative to be the most competitive applicant that you can be.

While this is not a comprehensive list of what it takes to Match, it does highlight important things to focus on and aims to answer frequently asked questions.

  1. Pass Step I/Level I and score competitively on Step II/Level II
  • Your goal should be > national average, but understand that board exams are not a measure of your worth or potential to be a great physician, so treat yourself with kindness and grace throughout the process
  • Step1/Level 1 Goal: PASS
  • Step 2/Level 2 Goal: At or above national average for matched EM applicants
    • ~245 for USMLE Step 2
    • ~585 for COMLEX Level 2
  • Avoid Failures! Reschedule if you need to, but don’t take the exam if you’re sick, a family emergency occurred, or some other event that would risk not passing your exam.
    • However, many programs still interview applicants with failed board scores, so do not give up! Contact your advisor or us here at ACOEP for more information, and do your research on which programs interview applicants in your situation
  • Plan to take both the COMLEX and USMLE, especially Step 2/Level 2
    • Use your practice score data (NBMEs, ideally) to advise your decision
    • Particularly for Step 1, if you do not think you have a reasonable chance at passing, do not sit for the exam since it is now Pass/Fail
    • Remember that failing to pass Step 1 hurts your application MORE THAN deciding not to take the exam in the first place
  • “As a DO student, why should I take the USMLE?” Most EM programs want to see that you can pass at least one of the USMLE exams (Step 1 or Step 2); additionally, some programs require Step 1 for away rotation applications during your 3rd and 4th-years.
    • As of 2022, if you are only going to take one USMLE exam, choose to take Step 2, since it is still scored and allows a direct comparison of your score to MD applicants
  1. Personal Statement
  • Residency programs do not want to read the same stories over and over. Everyone wants to “help people”. Talk about something original, make the piece creative, and don’t tell a program what emergency medicine is. They live there. They know.
  • Spell check and grammar check – Multiple times!
  • Here are some questions to think about while writing your personal statement:
    • What brought you to this profession?
    • Outside of what’s on your application what have you done to prepare to enter this profession?
    • What will you bring to this profession and/or your residency?
  • National Organizations: Be a member, follow them on social media, and participate in their events. Use those experiences in your statement.
    • EMRA: Emergency Medicine Resident Organization (an affiliate of the American College of Osteopathic Emergency Medicine) – https://www.emra.org/
    • AAEM: American Academy of Emergency Medicine – AAEM
    • SAEM: Society for Academic Emergency Medicine- SAEM
  1. Rotations:
  • Schedule 2-3 EM rotations before interview season
    • Two should be at academic institutions that you can obtain a SLOE from
    • Most programs use VSAS for applications. A few programs have individual applications, these are more cumbersome, but the non-VSAS schools tend to have less applicants. Newer programs may also get less applicants, and can be a great opportunity.
  • Other 4th year rotations should be outside of Emergency Medicine – learn skills you will need: Ophthalmology, Radiology/Ultrasound, Toxicology, Anesthesia, ICU, Dermatology, etc.
  1. SLOE:
  • #1 most important part of your residency application is arguably your SLOE (Standard Letter of Evaluation).
  • Plan to have rotations done early in 4th year so that you can submit SLOEs early in the application cycle.
  1. The Application
  • DATES:
    • July 1: ERAS Electronic Residency Application Service Opens
    • Sept 15: Applicants can apply to ACGME programs
    • Oct 1: Dean’s letter sent to residency programs
  • Program Preference Signaling
  1. Stay up to date on the basics of EM and FOAMed:
  • Podcasts:
    • EM:RAP – free with EMRA membership and has its own app.
    • EM: Basic – basics in EM care. Great resource to prepare for rotations/auditions in the ED.
    • EM: Crit – Critical Care and Airway medicine.
    • EM Overeasy – a fun podcast on the outlying aspects of life as an EM doctor/resident/student.
  • Blogs:
  1. Interviews and Auditions:
  • Be humble (especially if you have previous experience in the ED). Never try to outshine a resident or attending. RULE: Do not make the resident look bad
  • Be interested and engaged, but not annoying.
  • 15 mins early is on time, on time is late, and being late is unacceptable.
  • Be genuine, kind, and look for any opportunity to be an asset to the team (refill a patient’s water, do chest compressions, help nurses, etc).
  • Don’t forget about the follow up. If you see something interesting or new, read up on it and talk to your attending about it the next day. Follow up on interesting cases you saw from the day before and see how they are doing whether in person or through the EHR.
  • Have fun! You are now living out the dream that you had as a pre-med just a few years ago!

For a more detailed outline that takes a year by year approach to preparing for a successful match, click here. Read our Fast Track article on how to prepare for a successful match, here.