Why emergency medicine?

As with any specialty, choosing emergency medicine is an assessment of the clinical and academic experiences available, the lifestyle it affords, and the day-to-day work you will be doing. That being said, the decision should be primarily visceral. Most students find themselves excited, interested, and “at home,” in certain environments – the operating room, on rounds, in the emergency department, etc. – and not others. That feeling is the best guide to what will allow you to excel and make you most happy during your career.

Some commonly cited advantages to emergency medicine above and beyond how fun the ED itself can be:

  • The type of medicine you will practice
    o    Patients present only with symptoms; you get to make the diagnosis
    o    “Hands on” medicine with extensive procedures
    o    Emergency physicians see patients of all ages with all kinds of complaints
    o    You will perform “high profile” medicine, taking care of acutely ill patients
  • Diversity of potential experiences outside the department
    o    Wilderness medicine
    o    Social emergency medicine
    o    Sports medicine
    o    Research
    o    EMS
    o    Toxicology
    o    Public Health / Policy
    o    International health
  • Giving back to the community
    o    The ED is the safety net for all patients when they have nowhere else to go
    o    The ED is a great place to educate patients on basic preventative medicine
  • Lifestyle
    o    Most emergency physicians work 8-15 eight to twelve hour shifts per month
    o    This allows for exploration of outside interests, time spent with family, etc.

How do I decide where to apply?

You will get a great training at any accredited program. The EMRA Match map is a wonderful resource.

The most important issues are:

  • Location
    o    It is much easier to get a job where you do your residency
    o    Residency is difficult - having family/friend support nearby is key
    o    It’s nice to love where you are during the time when you’re not working
  • County vs. Community vs. Academic
    o    Most programs have all three elements, weighted differently
    o    If you have a strong preference for one, choose accordingly
  • The sense you get when you interview
    o    Are the residents happy?
    o    Does it just feel right when you are there?

How many programs to apply to?

It is better to apply broadly (generally minimum 25 programs; usually preferably 30+, will vary depending upon your academic profile). Emergency medicine is competitive, west coast programs in particular. Certain factors that will make your match more challenging (couples match, low USMLE scores, etc.) will require a longer list. Talk with your EM career advisor to get an idea of where to start. In general it is advisable to apply broadly and then become more selective if/when you get a large number of interview offers; obviously, the longer the list the less likely you are to go unmatched.

How many interviews?

Obviously, the more programs where you interview, the better your chances. 10 interviews is our generally recommended goal. This goal may be adjusted depending upon the strength of your application, if you are couples matching, etc.

How to rank programs?

Rank programs in the order of YOUR preference ONLY. Do not rank based on where you think you can get in. The match favors the applicants – you will get the highest rank you prefer.

Only rank programs you would be willing to attend. Don’t rank a program if you’d prefer to take another year or do a transitional year. Consider ranking other specialties as well, especially if you think you are less competitive and want to avoid scrambling at all cost.

Should I have a parallel application plan?

This depends on the strength of your application and external limitations to how broadly you can apply. This should be discussed early with a faculty advisor and readdressed as interviews come in. 

Additional Information