I did not know what specialty I wanted to go into entering or finishing
third year. When the time came to make a decision, I reflected back
over the year and realized that the clinical information I had wanted
to learn the most from each rotation were the "acute presentations." I
also spent some time thinking about why I had decided on becoming
a doctor, and remembered it was because I hate the feeling of not
knowing what to do when someone says "help, I need a doctor" (that
had happened to me before medical school). Emergency medicine specifically
trains you (knowledge and skills) to be able to resond to an overdose,
gun shot, mi, acute sob, broken leg, etc. I definitely had the impression
that after even 5 years of practicing in a particular field (e.g.
Cardiology, ob/gyn, ct surgery), a lot of medicine is forgotten.
How did you prepare yourself for application to
your chosen specialty?
Since I made my decision to do emergency medicine rather late in
the game, I did not do any research in the field. I would think it
would be worthwhile if someone knows from the beginning. I did a
two-week rotation and a four-week sub-internship. One way I did prepare
is to learn about the issues surrounding emergency medicine - both
in terms of research being done in the field and health policy (emergency
medicine is in a key position to speak up on health policy issues
- another reason I chose the field.
Who wrote your letters of recommendation for your
application?
It is starndard at our school to have the program directors write
one letter of rec. I also had one emergency medicine attending write
a letter. My other letters came from research and other clerkship.
I think it is true that you should have someone who knows you well
write over a big name - but if you can get both, great!
Which programs did you apply to and why?
I applied to a wide range of programs (old school and new school)
because I was couples matching. From having talked to applicants
on the interview trail, most people applied to a large number, but
were more selective about where they decided to accept interviews
(perhaps average of 12 interview). Be very careful of the phenomenon
of interview-burn out. You will cancel your last interviews so make
sure you don't put a program you may be interested in late in your
interview schedule.
What kinds of questions did programs tend to ask
you?
Most of my interviews were discussions about my research (which
was a Significant part of my medical school experience) and health
policy (because I have an mph in health policy & administration).
No trick questions. Of course, the questions 1) why em? And 2) why
here? Will always be asked. After that, it is free flow about your
application.
What would you have done differently in applying?
I did my sub-I at an academic center. It would have been nice to
spend some time in a "county program." there seems to be a divide
in terms of county programs vs other programs - and it is important
to know which you prefer.
What was the most difficult part of the application
process?
I don't think there was any aspect of it that was harder than applying
to any other field. In fact, I think it is easier (i.e. Lower stress)
than interviewing in other fields because most of the attending/interviewers
are relatively young, hip, relaxed, and warm! Another great component
of the field.
What should I look for on my interview and tour
day?
By far, "gestalt fit" with the place is the most important aspect
of the interview day that you should try to assess. Other than that,
set Priorities for yourself and just look into those (vs generic
questions). Emergency medicine curriculum's vary greatly with respect
to amount of time in the ed versus off-services. If you have a preference
for what you will be exposed to, look into it. But it is all personal
perference. And of course, it is important to find out if residents
are happy.
What questions should I ask of residents, faculty,
and program directors?
I overheard one of the applicants ask a resident, "if you couldn't
chose your own program, what other program would you chose?" I thought
this was a great question because it often leads to an honest pro/con
of their own program versus another program. Don't focus on short-comings
of the program with a program director... It really does make for
a more down interview.
How did you form your rank list?
I ruled out the ones I definitely did not want to be at for one
reason or another. And of the ones I liked, I ranked based on "life
factors" (e.g. Where my fiance would match, closeness to family and
friends, potential to stay long-term). I think once you get a handful
of places, they will likely be similar in strength and reputation,
forming a rank list after that should be about what fits your life
circumstances.
What other advice can you give seniors applying in your specialty?
Don't base your interest in emergency medicine on the experience you
had in your medical school rotation. There are many flavors of ed's
out there. If you think you like the knowledge, the pace, the patient
population, the policy issues, whatever, make sure to try to prove
to yourself that emergency medicine is not for you by visiting other
ed's (vs basing it on your experience at your own institution).
