Emergency Medicine Residency Match: BEAT more than 2600 Applications
Learning about the specialty
Since emergency medicine is a specialty many students don’t have direct exposure to until the fourth year of medical school, it is important to learn about this specialty early in your medical education if you think it might interest you. This means trying to plan some shadowing with an emergency physician or in the emergency department at your medical school during your first and/or second years. Many students, however, frequent the ED during other core rotations such as internal medicine and surgery when they can learn about the specialty. Some medical schools also offer a two week block of emergency medicine during the third year. The Society of Academic Emergency Medicine (www.saem.org) is a great resource for students who want to learn more about the field. However, nothing can replace actual exposure to the field and meeting a variety of emergency physicians who work in different settings to know if the specialty is a good fit for your interests and strengths.
What criteria are most important to match in emergency medicine?
Understanding what criteria are most important to emergency medicine program directors and admissions committees will allow you to position yourself as well as possible to match in the specialty. It is important to know how competitive you are for emergency medicine by reviewing data published by the National Residency Matching Program (NRMP). This data includes the 2018 Program Director’s Survey and Charting Outcomes in the Match for all three applicant types (allopathic students, osteopathic student and international students). Summarizing this data, together with our own knowledge of what makes a successful applicant, we will outline what is most important to match!
Emergency Medicine Residency Match
In 2018, there were a total of 2,278 EM positions. US seniors filled 70% of those positions. Emergency Medicine (EM) is a residency that has two entry points. Some programs start in the PGY1 year while others start in the PGY2 year.
Three year programs:
Three year programs always start in the PGY1 year and are commonly referred to as one, two, three programs.
Four year programs:
There are two types of four year programs. The first types start in the PGY2 year and are referred to as two, three, four programs. Residents in two, three, four programs complete an internship year (typically in internal medicine, surgery, transitional, or pediatrics) before starting emergency medicine residency. Finally, some four year emergency medicine programs are one, two, three, four programs that start in the PGY1 year.
Most attendings and advisors with whom you speak with will have a personal preference about which “type” of program is best. Keep in mind that all three types of programs will prepare you well to practice the specialty. Emergency medicine specialty board pass rates are the same for graduates for all three types of programs. If you might want a career in academic emergency medicine, four year programs may offer you a slight advantage over three year programs. Ultimately, it is a personal decision when choosing what type and length of program is best for you.
Emergency Medicine Away/Audition Electives
Most emergency medicine program directors recommend away electives as a way to gain exposure to another institution, prove yourself on another “turf” and to have letters of reference from somewhere other than your home institution. Where to complete away electives will be largely determined by your competitiveness and geographic preferences. Ideally, away electives should be completed by October of the application year. In 2018, 78% of program directors considered an audition elective in his or her department influential in ranking an applicant.
Emergency Medicine Letters of Reference
Something else to keep in mind is that emergency medicine residencies use the Standardized Letter of Evaluation (SLOE). Every emergency medicine faculty member letter writer completes a SLOE in place of a “traditional letter.” In the evaluation process, your SLOEs carry the most weight.
Allopathic US Senior Medical Students:
Cumulatively, 2,693 applicants applied for 2,278 EM (PGY1 and PGY2) residency positions in 2018. Of those 2,693 applicants, 1,748 were US senior medical students. 151 US senior EM applicants did not match in to EM residencies last year (four percent). Therefore, 91.4% of allopathic US senior EM applicants matched.
This is the data for those US senior medical students who matched successfully:
- Mean number of contiguous ranks: 12.8 (444 applicants ranked 16 more more programs)
- Mean number of distinct specialties ranked: 1.1
- Mean USMLE Step 1 score: 233
- Mean USMLE Step 2 score: 247
- Mean number of research experiences: 2.5
- Mean number of abstracts, presentations, and publications: 3.7
- Mean number of work experiences: 3.5
- Mean number of volunteer experiences: 7.3
- Percentage who are AOA members: 12.4
- Percentage who graduated from one of the 40 U.S. medical schools with the highest NIH funding: 27.6
- Percentage who have Ph.D. degree: 1.2
- Percentage who have another graduate degree: 16.9
Osteopathic Medical Students
Cumulatively, 2,693 applicants applied for 2,278 EM (PGY1 and PGY2) residency positions in 2018. There were 558 osteopathic applicants. Of those, 457 matched. Therefore, 81.9% of osteopathic medical student EM applicants matched in EM.
The data for those osteopathic students who matched successfully:
- Mean number of contiguous ranks: 9.1
- Mean number of distinct specialties ranked: 1.2
- Mean COMLEX-USA Level 1 score: 569
- Mean COMLEX-USA Level 2-CE score: 621
- Mean USMLE Step 1 score: 229
- Mean USMLE Step 2 CK score: 241
- Mean number of research experiences: 1.5
- Mean number of abstracts, presentations, and publications: 1.8
- Mean number of work experiences: 3.3
- Mean number of volunteer experiences: 6.0
- Percentage who have a Ph.D. degree: 0.3
- Percentage who have another graduate degree: 17.4
Because emergency medicine allopathic residencies are very competitive for osteopathic students, it is recommended that students have a minimum of two audition electives (at least one at an allopathic residency program) and a minimum of two SLOEs from academic emergency medicine faculty. It is also advisable that osteopathic applicants take the USMLE. Many programs will not consider COMLEX scores in place of the USMLE.
Keep in mind that osteopathic medical students can also apply to AOA-approved emergency medicine residency programs. In 2018, there were 172 positions for emergency medicine in the AOA match.
United States International Medical Student/Graduate (IMG) Data
Cumulatively, 2,693 applicants applied for 2,278 EM (PGY1 and PGY2) residency positions in 2018. There were 166 US IMGs who applied for emergency. A total of 77 matched. Therefore, 46.4 percent of US IMGs emergency medicine applicants matched in emergency medicine.
Below is the data for those US IMG applicants who matched successfully:
- Mean number of contiguous ranks: 7.3
- Mean number of distinct specialties ranked: 1.5
- Mean USMLE Step 1 score: 222
- Mean USMLE Step 2 score: 232
- Mean number of research experiences: 1.7
- Mean number of abstracts, presentations, and publications: 2.5
- Mean number of work experiences: 4.0
- Mean number of volunteer experiences: 5.0
- Percentage who have a Ph.D. degree: 0.7
- Percentage who have another graduate degree: 20.9
Because emergency medicine residencies are very competitive for US international students, it is recommended that students have a minimum of two audition electives (at least one at an allopathic residency program) and a minimum of two SLOEs from academic emergency medicine faculty.
Non-US International Medical Student/Graduate Data:
Cumulatively, 2,693 applicants applied for 2,278 EM (PGY1 and PGY2) residency positions in 2018. A total of 68 non-US IMGs applied and 28 matched. Therefore, a total of 41.2% of non-US IMGs emergency medicine applicants matched in emergency medicine.
Below is the data for those non-US IMG applicants who matched successfully:
- Mean number of contiguous ranks: 6.4
- Mean number of distinct specialties ranked: 1.3
- Mean USMLE Step 1 score: 234
- Mean USMLE Step 2 score: 240
- Mean number of research experiences: 2.3
- Mean number of abstracts, presentations, and publications: 5.9
- Mean number of work experiences: 5.4
- Mean number of volunteer experiences: 3.6
- Percentage who have a Ph.D. degree: 3.3
- Percentage who have another graduate degree: 28.2
Because emergency medicine residencies are very competitive for non-US international students, it is recommended that students have a minimum of two audition electives (at least one at an allopathic residency program) and a minimum of two SLOEs from academic emergency medicine faculty.
Looking for the raw residency match data? Be sure you click below:
Standardized Video Interview (SVI) Mock Interviews
With the 2019 application season, 80% of emergency medicine residency programs will require applicants to take a Standardized Video Interview (SVI). This is a “one way” online interview where applicants are required to answer a series of questions and tape themselves using a webcam. More and more medical schools, and now residency programs, are attempting to measure applicants’ interpersonal qualities and communication skills to screen applicants.
What does the SVI consist of?
- Six questions.
- Applicants have 30 seconds to review each question.
- Applicants have three minutes to respond to each question.
- You cannot pause once you start reading the question.
- You can pause between questions.
What does the SVI assess?
The SVI assesses and applicant’s interpersonal and communication skills as well as professionalism defined as follows:
Interpersonal and Communication Skills: Being able to demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals.
- Oral Communication
- Emotional Intelligence
- Teamwork and Leadership
Knowledge of Professional Behaviors (Professionalism): Being able to demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.
- Empathy and Altruism
- Cultural Competence
Emergency Medicine Standardized Video Interview Questions
What types of questions will you be asked?
There are two types of questions you will be asked during the SVI.
- Behavioral questions.
- You will be asked about past experiences that demonstrate your interpersonal and communication skills as well as your understanding of professionalism.
- Situation or scenario-based question.
- You will be given a hypothetical scenario and asked how you would respond or behave given your role in the scenario.
Sample SVI Behavioral Questions:
- Describe a conflict you were involved in at the hospital, clinic, or during medical school. How did you resolve the conflict? What happened next with the person or people involved?
- Tell me about a time when you disagreed with the actions or decisions of a fellow medical student, nurse, staff member, resident or attending. How did you approach the situation? What was the outcome?
- Tell me about a time you had to give bad news. How did you deliver this news? What was the outcome?
Sample Scenario-Based Questions:
- Your patient refuses to follow your advice to stay in the hospital for her serious asthma attack. She insists on going home despite the fact you think she needs inpatient treatment. Describe the situation. What do you do?
- Your nurse tells you your patient is not arousable. You quickly realize you ordered a dose of Ativan that is 10 times more than what you should have ordered. What action do you take?
- A patient you are caring for starts screaming that he doesn’t want you, a medical student, taking care of him. He wants a “real doctor.” What is the situation? What do you do?
How are you rated?
Each scenario will have an assigned “competency” the rater will assess. The rater will evaluate your response on a scale from one to five based on your ability to apply that competency to the situation. Raters will have access to only one of your interview responses. Having multiple raters decreases the possibility of any bias. All raters are trained by the Association of American Medical Colleges (AAMC) about how to evaluate responses.
How should you prepare?
As long as you are an ethical and honest person, little preparation is necessary. However, the AAMC is recommending one to four hours of preparation for the SVI since students who prepare perform better on the test. MedEdits offers mock interviews which will adequately prepare you to do well on the SVI.
Also make sure you have a quiet place to take your exam where you will be free of interruption. Dress professionally as you would for a real interview.
Emergency Medicine Residency Interview
Based on the 2018 Program Director’s Survey published by the NRMP, the following factors were most important in deciding who to invite for an emergency medicine residency interview:
1) Any failed attempt in USMLE/COMLEX
There is no question that a USMLE/COMLEX failure is a deal breaker for many programs. However, in our experience, this is “easier” to overcome if you are a US allopathic student. The 2018 Program Director’s Survey indicated that 61% of programs rarely consider an applicant with a Step 1 failure and 37% never consider an applicant with a Step 1 failure.
2) USMLE Step 1/COMLEX Level 1 score
It is a fact of life that your performance on Step 1 or COMLEX 1 will impact the likelihood that your application is “screened in” and that you are invited for an interview. Many programs automatically screen out applications if the Step/COMLEX 1 score falls below a certain threshold. The 2018 Program Director’s Survey indicated that 62% of programs have a “target score” they like to see applicants earn. That cut off for most programs is between 210-220. By the same token, some programs automatically grant interviews for students with scores above a certain threshold. That threshold varies but is usually between 205 and 215 depending on the program. The average Step 1 score above which students are automatically interviewed was 235, but, keep in mind that not all programs offer automatic interviews. If you don’t do as well on Step 1 as you would have liked, take Step 2 CK early and do as well as you can! The mean Step 2 CK score for US seniors who matched was 247.
3) Evidence of Professionalism and Ethics
You might ask how your professionalism and ethics might be assessed based on your written application. Program directors glean information about your personal characteristics and traits from your emergency medicine personal statement, ERAS written application, and letters of reference. This is why it is important to compose your personal statement and ERAS work, research, and volunteer experience entries thoughtfully. It is empowering to know that the outcome of your application season is, in part, within your control at this stage of the process.
4) Perceived commitment to specialty, personal prior knowledge of the applicant, grades in clerkship in desired specialty, audition elective/rotation within your department, letters of recommendation in the specialty.
Emergency medicine program directors want to understand your commitment to the specialty and that you have adequately demonstrated that interest by doing as much as possible to learn about the practice of emergency medicine and gain exposure. You can express this commitment though your personal statement and ERAS experience entries. Of course, if you are known and well liked by a program to which you are applying, this is a real plus which is why away electives can be beneficial in the residency admissions process. Letters of recommendation from emergency physicians who know you well is also of the utmost importance and was considered one of the most important factors in deciding whom to interview.
When should you apply?
Sixty percent of programs extend interviews in October.Therefore, it is important to send your ERAS application in early!
Now, assuming you are selected for an interview, what factors influence how (and if) you are ranked?
Here’s the list:
- Interactions with faculty during interview and visit
- Interpersonal skills
- Interactions with housestaff during interview and visit
- Feedback from current residents
As you can see, after the interview, it is your “interview performance,” interpersonal qualities, and how you are perceived by anyone and everyone you meet that will influence how you are ranked (and even if you are ranked) the most. This is why, no matter how strong an applicant you are, it is important to be comfortable with the interview process. It is also valuable to know yourself; are you an introvert or more of an extrovert? What types of social situations make you comfortable or uncomfortable? During residency interviews you will be meeting many new people and having numerous conversations with strangers. Be prepared! While your USMLE/COMLEX scores, grades, letters of reference and written application will still be considered after you interview, it is how you do on your interview day itself that will most greatly influence your rank position at any program where you interview.
What if you don’t match or you feel you need personalized help?
Applicants often feel lost, confused and overwhelmed by the residency application process. This is where MedEdits can help. We have helped hundreds of applicants match successfully. Whether you need a fourth year planing strategy, help with your personal statement, interview help, or any other guidance related to the residency match, we will make sure you are positioned as well as possible to match well!
Looking for an emergency medicine residency program?
Check out our state by state list below.
|Midwestern University Osteopathic Postdoctoral Training Institute Program|
|Creighton University School of Medicine/Maricopa Medical Center (Phoenix) Program|
|University of Arizona College of Medicine at South Campus Program|
|University of Arizona College of Medicine-Tucson Program|
Denver Health Medical Center Program
|Aventura Hospital and Medical Center Program|
|Florida Atlantic University Charles E. Schmidt College of Medicine Program|
|HCA West Florida GME Consortium/Brandon Regional Hospital Program|
|HCA West Florida GME Consortium/Oak Hill Hospital Program|
|University of Central Florida/HCA GME Consortium (Gainesville) Program|
|University of Florida Program|
|University of Florida College of Medicine Jacksonville Program|
|Jackson Memorial Hospital/Jackson Health System Program|
|Kendall Regional Medical Center Program|
|Mount Sinai Medical Center of Florida, Inc Program|
|University of Central Florida/HCA GME Consortium (Ocala) Program|
|Florida Hospital Medical Center Program|
|Orlando Health Program|
|University of Central Florida/HCA GME Consortium (Greater Orlando) Program|
|Palm Beach Consortium for Graduate Medical Education Program|
|Florida State University College of Medicine Program|
|University of South Florida Morsani Program|
|University of North Carolina Hospitals Program|
|Carolinas Medical Center Program|
|Duke University Hospital Program|
|Campbell University/Cape Fear Valley Medical Center Program|
|Vidant Medical Center/East Carolina University Program|
|Campbell University/Southeastern Regional Medical Center Program|
|Wake Forest University School of Medicine Program|
|Cooper Medical School of Rowan University/Cooper University Hospital Program|
|Hackensack University Medical Center Program|
|Atlantic Health (Morristown) Program|
|Rutgers Robert Wood Johnson Medical School Program|
|Newark Beth Israel Medical Center Program|
|Rutgers New Jersey Medical School Program|
|St Joseph’s Regional Medical Center Program|
|Rowan SOM/Jefferson Health/Our Lady of Lourdes Health System Program|
|Inspira Medical Center Woodbury Program|
|Oklahoma State University Center for Health Sciences (Lawton) Program|
|Integris Health Program|
|Oklahoma State University Center for Health Sciences (Tulsa) Program Osteopathic Recognized!|
|University of Oklahoma School of Community Medicine (Tulsa) Program|