How to Match into an Emergency Medicine Residency Program

Residency application season is here and today we are looking at what you need to successfully match into an Emergency Medicine Residency Program. The NRMP conducted a survey to determine what factors Program Directors consider when deciding which candidates to interview and rank for their residency program. The results were compiled into a “at a glance” tool, which is extremely helpful in gauging where your application packet stands compared to the applicant pool, and whether adding additional components, like a letter of recommendation (LOR) in the specialty, could give you a leg up as programs review your application.

The interactive tableau tool can be found here, and we recommend taking a look at the specialty you’ll be applying to before submitting your ERAS packet: https://public.tableau.com/profile/national.resident.matching.program#!/vizhome/PDSurvey_0/Desktoptablet

For emergency medicine residency, major components of the survey you should pay attention to include: (from top to bottom of the page):

• Selection Criteria for an Interview – LOR in the specialty is a MAJOR factor, while having an appropriate Step 1 score and clerkship grades are also highly recommended.

• Step 1 and Step 2 Scores:

• Step 1 – Score

• • • 243+ looks like a very solid score in emergency medicine, with the median being 240.
    • Range programs do NOT typically offer interviews: 210-215 seems to be the minimum threshold we would recommend for having a good chance at enough interviews. If you’re below 210-215 range, we suggest having a back-up specialty you could consider.
    • Range programs DO typically offer interviews: 243+ seems to be the range at which you can feel comfortable in being offered interviews by a decent number of programs. If you’re in the 250+ range, you can likely be selective about where you apply.

• Step 2CK – Score

• • • 210-220 seems to be the minimum threshold at which programs will grant interviews
    • Scores below 210 generally will place you in a unfavorable position to receive an interview 

• Step 2CK – Timing of Taking the Exam

• 21% of programs required at least passing CK, although we do expect this number to grow. You can wait to take Step 2CK until after you have submitted ERAS.

• Failing Step 1 could be a show stopper: 
  • Failing Step 1 is a BIG deal in ANY specialty, and this remains relevant in emergency medicine. 34% of EM programs will NOT consider you if you’ve failed Step 1. So, if you’ve failed an exam, you can still apply, but you should apply to a larger number of programs than you would otherwise.

• Types of Applicants Considered:

  • International Grads (U.S. and non-U.S.) are likely to have moderate difficulty matching into emergency medicine: 22% of programs report never interviewing US IMGs, and 56% of programs report never interviewing non-US IMGs. This is a pretty hefty proportion. Only 12% of programs report often interviewing US IMGs, and <1% of programs reported often interviewing non-US IMGs. If you’re an international grad, we recommend doing your homework to determine which programs may be more likely to consider IMGs, and definitely recommend a back-up specialty to apply into.
  • Osteopathic graduates should be able to match into emergency medicine: 60% of programs will often interview DO applicants, and 62% of programs often rank them. Only 5% of programs will never interview a DO applicant. If you went to an osteopathic school you might want to take a look into the MD/DO composition of programs you’re applying to, but this should not be a prohibitive barrier for you.

• Interviewing to Ranking: If you receive an interview for an EM program you have about a 2/3 chance of being ranked. We recommend making a rankings list of at least 8-10 programs, so once you receive 10 interview invitations, you can feel okay with starting to prioritize and cancel as more come in given you are likely to get ranked.
• Expect to receive interview invitations in October: A full 47% of interview invitations are sent out in October. While you may receive invites in September and November (or beyond!), this is the densest month for offers. 
• Expect to interview in November/December: 64% of total interviews are conducted during these two months Only 13% of interviews will occur before November, which gives you ample time to prepare. For further discussion on how to prep for your interview, see our blog post on How to Crush your Residency Interview. 

After you’ve browsed your specialty, take a look at a few other specialties and note what’s NOT important for emergency medicine residency:

• Away rotations are not particularly important in emergency medicine
• The MSPE/Dean’s letter isn’t particularly important for emergency medicine
• Grades in your required clerkships are not as important in emergency medicine as in other specialties

Summary for Emergency Medicine Residency Applications:

• A solid emergency medicine application would include a 243+ on Step 1, a strong LOR from 1-3 emergency medicine physicians, and a good clerkship grade in an EM rotation (although not as necessarily in your core rotations)

• Emergency medicine is slightly more difficult to apply into as an international grad, but this does not need to be a prohibitive barrier! We only recommend that you do your research to identify programs with active IMG residents and establish proper connections.

• If you’ve failed an exam, you can still apply in emergency medicine, but you should apply broadly and apply for a back-up specialty.
• Expect Interviews in November-December. Reach out to programs you have high interest in if you haven’t heard from them by late October or early November. Once you have about 10 interview invitations, you can consider being a bit more selective about which ones you actually take (but not before).

Good Luck! ☺ 

Wondering about your chances of matching into other specialties for residency? Check out our analysis of the NRMP directors survey “at a glance” tool for areas including anesthesia, dermatology, family medicine, transitional year, psychiatry, neurology, and more under the Residency Applications category of our blog! If you need further or specialized assistance understanding which residency specialties you are best suited to apply to, you can contact us or visit our residency advising page to learn more about how Elite Medical Prep residency advising services.