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Just submitted EM residency application.

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  • Avatar sobutter 
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    Hello everyone, I’m an MS4 at a US MD school and I just submitted my eras application to 70+ EM programs. My board scores are at the national average for EM and I suspect I’ll be an average applicant with average to above average SLOEs.

    Are there any good advice articles for choosing an EM residency for money minded people? Like 3 versus 4 year program, etc.? Thanks.

    #246405 Reply
    CordMcNally CordMcNally 
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    4 year EM residencies are a scam. They’re good for the hospital but not for the resident. Many of them will try to sell the whole “make your own path” or “mini-fellowships” to make that 4th year seem more palatable. I don’t think I applied to any 4 year programs and I wouldn’t really encourage anyone to unless you were absolutely bound to a specific geographic area.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #246440 Reply
    Lordosis Lordosis 
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    I just submitted my eras application to 70+ EM programs.

    Click to expand…

    Egads! Is it common to apply to so many?

    “Never let your sense of morals prevent you from doing what is right.”

    #246442 Reply
    Avatar nephron 
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    a money minded person would not consider a 4 yr residency program when you could finish in 3.  Thats a year of attending salary off your career lifespan if you think about it.

    Avatar Panscan 
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    As well as another year of supporting the academic medicine machine which is a joke to begin with

    #246447 Reply
    Avatar Anne 
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    Location is probably the biggest factor that will impact your finances during residency. But I wouldn’t give financial factors much clout when choosing your rank list. Choose the best residency for you (which is not always the highest rated/most prestigious residency). The better trained you are the better off you will be moving forward with your professional, personal, and financial life.

    #246448 Reply
    CordMcNally CordMcNally 
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    Splash Refinancing Bonus
    I just submitted my eras application to 70+ EM programs. 

    Click to expand…

    Egads! Is it common to apply to so many?

    Click to expand…

    EM has gotten considerably more competitive over the last decade but if you have average scores and average to above average SLOEs then 30-40 applications are probably about right.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #246449 Reply
    Liked by Lordosis
    Avatar Brains428 
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    Get a good rewards card and pay it off accordingly. If you can swing multi-destination flights that usually will be a cheaper route in the long run. Go to pre-interview dinners if they have them.

    If you’re applying to something competitive then the things you should be hoping for at the end of interview season is that you’re a little tired, a little poorer, and a little fatter (everyone says yes to dessert).

    Be nice to the program coordinator. Ask him/her what the appropriate post interview correspondence is.

    Everyone you meet is apart of the interview process.

    Good luck

    #246451 Reply
    Lordosis Lordosis 
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    EM has gotten considerably more competitive over the last decade but if you have average scores and average to above average SLOEs then 30-40 applications are probably about right.

    Click to expand…

    Wow I didn’t know EM was so competitive.

     

    Be nice to the program coordinator. Ask him/her what the appropriate post interview correspondence is. Everyone you meet is apart of the interview process.

    Click to expand…

    ^^ This.  It does not take much to sink an otherwise good interview.  Be nice and friendly to everyone even other applicants!

     

    The difference in pay is not likely going to matter much.  Which state and how expensive of an area likely will matter more.   Benefits matter.  Good health insurance, can you get a 401k match, HSA eligible, do they cover meals, etc.

    Most of these things are so minor because they will be grossly overshadowed by your post residency career.

    “Never let your sense of morals prevent you from doing what is right.”

    #246458 Reply
    MPMD MPMD 
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    4 year EM residencies are a scam. They’re good for the hospital but not for the resident. Many of them will try to sell the whole “make your own path” or “mini-fellowships” to make that 4th year seem more palatable. I don’t think I applied to any 4 year programs and I wouldn’t really encourage anyone to unless you were absolutely bound to a specific geographic area.

    Click to expand…

    That is way to harsh to be good advice.

    I am a part of residency leadership at a 4 year program. We are not scamming anyone that I know of.

    3 years is fine, there are a massive number of 3 year programs out there some are amazing some are much less so. I have never told any of my students not to apply to 3 year programs I just try to help them be selective.

    The worst thing you can do financially as an EM doc is be badly trained and then miserable in your first job and every job after that. If you start residency looking to be done as quickly and easily as possible you are in danger of that.

    All of that being said, I will admit that I am less bullish on 4 year programs than I was 5-6 years ago. This is b/c 4 year programs have basically stopped hiring their own grads without a fellowship. That hiring practice really does damage the sales pitch of 4 year shops and frankly I can see why. If >4 years of post-grad training are de facto required for a great academic gig at this point then I have a hard time telling a student not to go to a great 3 year shop and then do a fellowship.

    #246465 Reply
    SerrateAndDominate SerrateAndDominate 
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    I’m not EM, but I echo the statement that everything is an interview. You want to judge a program based on training, connections, and how much you’ll enjoy being around everyone/everything.

    Also agree that fit should outweigh prestige (assuming training and job connections are fairly equal)

    Best of luck. It’s an exciting time

    Earn everything.

    #246474 Reply
    Avatar snowcanyon 
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    “Scam” seems harsh; it’s just there’s no real reason to do a four year program when you can finish in three. I’d be curious how MPMD’s program justifies and markets its fourth year beyond geography/sunshine tax. You are far better off career-wise doing a fellowship than a fourth year. The four year programs seem to mostly be located in popular areas like NY and California where it’s the programs’ market. In NYC intern year seems often to be mostly scut with little learning, so maybe they need three years after you complete your one year of nursing and tech duties.

    Definitely go for fit and geography. If you want to be in a competitive area geographically, train there or see where docs there trained.

    As to finances, don’t run up credit card debt, all else being equal some programs do have a 401k match and other bennies such as HSA, free meals, and good insurance do matter. But finances shouldn’t be how or why you pick a program.

    Good luck!

     

     

    #246480 Reply
    CordMcNally CordMcNally 
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    That is way to harsh to be good advice. I am a part of residency leadership at a 4 year program. We are not scamming anyone that I know of. 3 years is fine, there are a massive number of 3 year programs out there some are amazing some are much less so. I have never told any of my students not to apply to 3 year programs I just try to help them be selective. The worst thing you can do financially as an EM doc is be badly trained and then miserable in your first job and every job after that. If you start residency looking to be done as quickly and easily as possible you are in danger of that. All of that being said, I will admit that I am less bullish on 4 year programs than I was 5-6 years ago. This is b/c 4 year programs have basically stopped hiring their own grads without a fellowship. That hiring practice really does damage the sales pitch of 4 year shops and frankly I can see why. If >4 years of post-grad training are de facto required for a great academic gig at this point then I have a hard time telling a student not to go to a great 3 year shop and then do a fellowship.

    Click to expand…

    Scam was probably too aggressive of a description but I think the rest stands on its own. I think if leadership from 4 year programs truly thought there were dangerous 3 year programs out there then they’d be taking it up with the ACGME. If you’re going to be a poorly trained EM physician after 3 years, you’re probably going to be a poorly trained EM physician after 4 years. There’s probably just as many weak 4 year programs as there are 3 year programs, percentage wise. I just don’t see a benefit to a 4th year of residency when you’re going to learn so much more once you’re out and making decisions on your own. That’s also why I’m a big fan of moonlighting in residency.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #246484 Reply
    MPMD MPMD 
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    Joined: 05/01/2017

    “Scam” seems harsh; it’s just there’s no real reason to do a four year program when you can finish in three. I’d be curious how MPMD’s program justifies and markets its fourth year beyond geography/sunshine tax.

    Click to expand…

    Since you asked: we have a very long track record of actually launching grads into leadership positions within 1-3 years out of residency. We have the receipts but you’d have to take my word for it since we’re on a forum. We have created dozens of APDs, clerkship directors, medical directors, regional directors for CMGs etc in extremely diverse geographical settings. Our grads are kind of a unique product. I don’t expect anyone on here to take my word for it but I know it to be a fact. They easily break into markets others can’t (Denver, SD, etc) and they are insanely prepared for their first jobs. Was talking to a friend of mine who is a regional director for a big CMG and he was noting how one of our recent grads (2 months out) is basically already one of their best docs at his site. We do some pretty unique things in the program that we feel have actual results. It is commonplace for one of our grads to be a top producer RVU wise even in a group of much more experienced docs within a few months of graduation.

     

     

    Click to expand…

    Scam was probably too aggressive of a description but I think the rest stands on its own. I think if leadership from 4 year programs truly thought there were dangerous 3 year programs out there then they’d be taking it up with the ACGME. If you’re going to be a poorly trained EM physician after 3 years, you’re probably going to be a poorly trained EM physician after 4 years. There’s probably just as many weak 4 year programs as there are 3 year programs, percentage wise. I just don’t see a benefit to a 4th year of residency when you’re going to learn so much more once you’re out and making decisions on your own. That’s also why I’m a big fan of moonlighting in residency.

    Click to expand…

    Eh, it’s not really our job to police the world of 3 year programs. There aren’t as many weak 4 year programs b/c there aren’t as many and they cluster at bigger places with more resources.

    Again I mean this whole convo is a proxy-war for where anyone went to residency. I realize this can be very triggering based on people’s actual training. I have nothing against any program that actually gets the job done. As I said above I think the current best bet for the academically-minded student is to go to a top tier 3 year program and then do a fellowship.

    #246495 Reply
    Liked by Tim
    Avatar Brains428 
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    I know it’s a finance forum, but other than equitable compensation for the region, I would look mostly at the program, and not necessarily the 401k. The things that’ll put your farther back are losing money on buying a house/too fancy living situation and credit card debt. I’m not even sure all places have a match or vest by the time you’re done.

    Good training, good fit. I know if a program advertises itself as “hard working” it may sound bad (at least in the radiology world, it can be a detractor), then some people may stay away. I can much more easily remember the hard cases/weird cases/and cases that I missed than page 375 of a text book or hour 7 of a lecture. The best way to be prepared for something in the real world is to have seen it before.

    #246503 Reply

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