Hi all, I have a quick question about EM programs. I have a strong desire to match in the southwest region for EM. I just got my step 1 back, 235 satisfied with my score overall, but middle of the pack for EM. From my little understanding, most of the residencies in the SW are competitive. I know I'm probably above most cutoffs, but can a 235 really get me looked at by top programs like Denver, Utah, UCSD? My ideal programs location wise would actually be Maricopa or U of Arizona. I have no idea what type of scores for both step1 and step2 these programs go for. Could anyone give me some more insight into the competitiveness and requirements of these programs?
Competitiveness for top EM programs?
- Thread starter jaw93
- Start date
- Joined
- Dec 9, 2014
- Messages
- 1,572
- Reaction score
- 2,241
Head to the EM forum for a better response but from my understanding, your step score would be completely fine. The major method of currency in EM more so relies on SLOEs when you do your rotation + aways during 4th year followed by clerkship grades
- Joined
- Jan 5, 2007
- Messages
- 3,171
- Reaction score
- 12,367
Look at the resident alumni pages on the residencies you are interested in. If all you see is inbreeding and ivy leaguing and you don’t fit the bill, don’t count on it. West coast is tough. Speaking from personal experience.
- Joined
- May 8, 2012
- Messages
- 647
- Reaction score
- 435
Your step score should not keep you out of EM in general. However, if you are a New Yorker and looking to interview in the southwest, for programs to take interest you need one (or more) of several of the below:
- a killer application: most importantly excellent SLOEs, high step 1&2, mostly H's on your transcript, some demonstrated EM interest, interesting extracurricular involvement/leadership, EM research
- a connection to the region via family or having grown up in the region
- an away rotation in the desired region
- a special interest in the particular program
- an EM doc in your home program who knows people in these areas and can personally advocate for you
- luck
Look at the EM forums and past match/interview threads -- the regional bias can be a powerful influence in your ability to obtain interviews.
- Joined
- Sep 17, 2014
- Messages
- 773
- Reaction score
- 1,456
A 235 regardless of SLOEs is not going to get him into a highly competitive program unless he has some major leadership positions in EMRA under his belt or he is from the area and has a good relationship with a specific program's leadership. Competitive EM programs (USC, UCLA, Denver, UCSF, etc.) take similar applicants to those that match into plastics or derm. Most will be AOA, step 1 of 250+, excellent SLOEs, etc. I would say Maricopa is less competitive to the ones listed; however, it is still fairly competitive.
- Joined
- Dec 16, 2011
- Messages
- 1,101
- Reaction score
- 2,210
This isn't true in the least. I don't have derm-level stats and I interviewed at 2 of the 4 places you listed. I know people with step scores in the 230s who matched at ¾ places you listed.
Your SLOEs and CV are king. Step scores are important but the idea that you need at 250+ to match even a top EM program is ridiculous and flat out untrue.
- Joined
- Sep 17, 2014
- Messages
- 773
- Reaction score
- 1,456
Did you match at one of those two places? Lets not give people this false hope that all you have to do is get good SLOEs and suddenly you'll be able to match into the most competitive programs in the country with average scores. Is it possible? Sure. Is it likely? Not at all. I'm also curious how you know the scores of people that matched at 3/4 of the places I listed. Most people I know don't really go around telling the world their step scores. That is also ignoring the fact that if they indeed had step scores in the 230s, they clearly had to have something else that set them apart on paper. Every other applicant has great SLOEs, I would know, as I was part of my residency's committee on selecting applicants to interview and to rank. We didn't even interview anyone under a 225 on step 1 and we are hardly as competitive as the programs I listed. The average step score for those that matched with us was 241 (and again, we are not that competitive). The two lowest scores that matched with us were one person that scribed in our ER prior to medical school, and another whose mother works at one of our community ERs.
A program like USC and Denver literally has the entire country applying to them. That is 1500+ applicants for a total of 17-18 spots. Based on charting outcome data from 2016, there are over 200 applicants that had step 1 scores >250 (that is just US MD applicants, it does not include DO). An additional 240 had scores between 241-250. I would imagine more than half of those individuals with scores >250 applied to USC. Of those 100 or so that applied to USC, over half of them will have good SLOEs (based on my experience reviewing applicants, especially those with good scores). That is over 50 applicants that will have both excellent step scores and good SLOEs. Programs, like you, rank applicants based on how much they would like them to match there. On their rank list of 200 applicants, they will likely only fall to 40th-50th spot before they fill. Where do you think they are going to rank the guy with 255 step score and good SLOEs compared to the guy with the 235 and good SLOE? Step scores are the most objective way of sorting through countless hordes of similar applicants with great SLOEs. Unless you have major research under your belt, have connections, or have a major leadership role in an organization like EMRA, you ain't getting into Denver or USC. Every person on their rank list has either amazing step scores, or amazing SLOEs, or for most, both.
- Joined
- Dec 16, 2011
- Messages
- 1,101
- Reaction score
- 2,210
You missed the part where I said SLOEs and CV are king.
I think you misunderstood my post. I know individual scores for individual people in three of the four programs you'd mentioned and that's largely because people talk. What your programmes ranking criteria is, is your business however unless you're in an extremely desirable area I don't quite see how any EM program can get away with not interviewing anyone under 225 when the EM mean is 233. You're talking about restricting yourself to less than 1 SD from the mean, which for a noncompetitive programme makes absolutely zero mathematical sense.
Even with the score creep in EM as of late, the average Step 1 score of a USMD in EM is still 233 - nowhere remotely near Derm and Plastics level. Only ⅓ of EM applicants (based on your own numbers) realistically have any shot of matching Derm so please refrain from the hyperbole. EM for the most part still is a specialty that is largely driven by SLOEs and accomplishments on your CV.
You're also making a massive assumption in stating that everyone is applying to programs of similar caliber to USC & Denver. Not everyone wants to work in Denver. Not everyone wants to live in a high COL city like LA. Not everyone wants to deal with the idiosyncrasies of working at a County hospital (especially one with a jail - very off putting for many). And, probably most importantly, not everyone wants to do a muthafxcking 4 year residency. For every highly motivated guy/gal with a 250 on the boards who lives for the intensity of USC or Denver there are just as many who have derm attitudes to match that derm step score and just wanna train someplace that will afford them a good QOL while training them well.
- Joined
- Sep 17, 2014
- Messages
- 773
- Reaction score
- 1,456
You realize that there are programs that average below and above the mean, correct? Here is a pretty simple breakdown of how we managed to use step score cutoffs using some pretty basic math. Because we get a 1000 applicants a year who apply to our program which is about 1/3rd of all applicants for EM which is pretty standard for most established EM programs our size. There are ~900 U.S. MDs who will have step scores >225. If even 1/6th of U.S. MD applicants with scores >225 applied to our program, that would be 150 applicants which happens to be the total number of individuals that we interview every year. Now when you include DOs and IMGs thats nearly double the number of applicants that fit the criteria. We end up ranking about 120 of them, knowing that on average we will only go about 60-70 ranks deep, which again, is standard for a program our size (15 residents). So it should be obvious how it is pretty simple to quickly get the necessary number of residents without having to take individuals with lower Step scores.
Where is this "hyperbole" you speak of and why are you citing EM average step scores when we are talking about EM's most competitive programs which are obviously going to have much higher average step scores? Nowhere did I say that all EM applicants were as competitive as Derm and plastics. Please read carefully before replying.
I'm not making assumptions, USC and Denver both literally have half the applicants in the country applying to them. Per the PD listserv last year, they both had 1500 applicants during the 2017-18 interview season. That is about half of all EM applicants.
At this point I have no idea what you are trying to argue. Will some people with lower scores get into highly competitive programs? Sure, but they are the exception, and you should not expect that you are the exception unless you have something other than some good SLOEs that makes you as competitive as the top applicants in the country in terms of scores.
Not to poke the bear, but do you have any intimate knowledge of the who gets admitted to these places exactly?
It does not make clear sense why a 255-260 scorer would be the typical matriculant into *any* EM program. Even if "half of all applicants" apply to Denver, that does not change the level of applicants in EM.
