How to Join

That is a great question! Choosing a specialty can be difficult and is often a very individualized process. Early exploration of interests during preclinical years, exposure to different specialties during your clinical rotation year, and aways and other rotations can all help provide some insight. Thinking about what one’s future might look like in a specialty after residency is also important. Common things to think about above and beyond one’s academic interests include but are certainly not limited to patient population, work-life balance, salary/benefits, and specialty culture.

EM is a fantastic specialty! People are often drawn to the opportunity to work with undifferentiated and often high-acuity patients in a team-based environment. You never know what cases might come through the door on any given day! Shiftwork is also a common draw for folks looking for flexibility in their schedules.

Please refer to these additional resources:

• EMRA – Choosing Emergency Medicine
• Medical Student Forum – Is Emergency Medicine the Right Choice for Me?

While some of this may differ slightly from program to program (your best bet is to look at the program’s website), on average, the application consists of the following:

• Completed ERAS application
• 2-3 SLOEs
• Medical school transcript
• USMLE scores (STEP 1 & STEP 2 CK)
• Personal statement

SLOE (Standardized Letter Of Evaluation) is an evaluative tool used to assess an applicant’s candidacy in comparison to their peers. In emergency medicine, they are used in lieu of traditional letters of recommendation. Here is a sample SLOE. 

While these are most often acquired during emergency medicine sub-internships, they can also come from other sub-internships (ex. ultrasound electives, critical care, IM etc.). EM Sub-I SLOEs tend to carry more weight as they are considered a “group” SLOE given they are compiled from multiple sources of feedback and are written by clerkship and/or program directors.

SLOE writers will often require a personal statement (draft) and a CV (draft).

Please learn more with this EMRA – EM Rotations & SLOEs in 2021-2022 Video.

Most of the application components specific to EM come together during the fourth year after one has decided on EM as a specialty.

Spring:

• STEP exam completion
• Away rotation applications
• Home EM rotations (sometimes)

Summer:

• Completing away and home rotations (typically)
• Assembling ERAS application
• Writing personal statement

Fall:

• Final touches on applications and submission (early fall/late summer)
• Completing away rotations (sometimes)
• Preparation for interviews
• Interviews (typically October through January)

Winter:

• Programs submit their rank-lists
• Applicants submit their rank-lists (February)
• MATCH (mid-March)

Away rotations are EM sub-internships at programs other than your home institution. These are typically one-month rotations completed at programs of interest. They can be fantastic opportunities to explore new geography, healthcare systems, patient populations, and learning environments.

Learn more about applying for away rotations.

Usually, these rotations occur during one’s fourth year sometime between April-October, though mostly during the summer to allow for SLOEs acquired as part of the rotation to be part of one’s application in time. Typically, home rotations (EM sub-internship at home institution) are completed prior to attending aways.

Applications to most aways are managed through the VSLO (Visiting Student Learning Opportunities) program run by the AAMC. Applications to different programs open at different times (usually March-April). Some programs, however, do not participate in the VSLO program so checking individual program websites is the best source of up-to-date information.

Importantly, many applications require lots of paperwork which can include N95 fit testing, vaccine titers, letters of recommendation, and drug testing, so getting your materials together early before the application opens can be very beneficial!

The type of setting one trains in during residency is an important consideration during the application process. In emergency medicine, people tend to talk about this terminology while assessing a program’s character, patient population, resources, and environment. It is important to remember that these terms are by no means clear-cut or all encompassing, and often programs offer the opportunity to train in more than one setting:

• Academic: Generally larger university hospitals with emphasis on research and with extensive resources (ex. extensive consult services) with varying patient populations. Emphasis on teaching with multiple learners (students and residents) in the ED.
• County: Typically high patient volumes with more underserved populations and varying degrees of resident responsibility.
• Community: The term is very broad, but typically describes more suburban settings or a mix of academic and county characteristics. Sometimes without the full breadth of specialties available on hand compared to a full academic hospital. The majority of attending physicians in the US work in the community setting.

Please refer to this additional resource on six elements to consider when making your rank list.