You are not required to submit a SLOE from every EM rotation you do. Seeking out clerkships that do not have testing requirements as a criterion for grading may also be beneficial for these students. Programs are more likely to consider students with weaker test scores if they have established a consistent pattern of strong clinical performance. Has carefully thought out career choice.” Be sure to convey to your SLOE writers how you have thought out your choice and how committed you are to EM even though you may have chosen the specialty later than others.Īt-Risk Candidates: Having strong clinical skills but difficulty translating this knowledge in testing situations is a familiar struggle. In 2018, the first of this series of questions on the SLOE is: “Commitment to EM. 5 Prioritize getting a SLOE as early as possible after you choose EM. If you have a later letter, make sure to notify the residency programs when it is uploaded. Latecomers: Very few programs will extend an interview invitation with no SLOEs (only 8 on EMRA Match in 2018), but 80% report extending offers with 1 SLOE. IMG Students: For an IMG applicant with similar competitiveness to the average allopathic applicant, 63% of residency program leadership respondents to a recent survey recommend 2 SLOEs whereas 19% recommend 3 or more. Osteopathic Students: For an osteopathic applicant with similar competitiveness to the average allopathic applicant, 79% of residency leadership respondents to a recent survey recommended 2 SLOEs and 11% recommended submitting 3 or more. There is rarely a need for a third SLOE and rotation, unless your advisor feels it’s needed to strengthen your application. In this case, a SLOE from your home institution, as long as it has an accredited EM residency program, may be more important. If you can only complete 1 EM rotation but are otherwise qualified, it may hamper but not bar you from matching. ![]() Of note, this data is not meant to apply to EM subspecialty SLOEs like ultrasound or pediatric emergency medicine.īased on this, we recommend 2 SLOEs from separate institutions to maximize your competitiveness. It is exceedingly rare for a program to require more than 2 SLOEs. Nonetheless, it shows the importance of having 2 SLOEs to make a competitive application. 2-4 This variance may be due to differences in respondents and wording. In addition, the studies show 20–45% of programs require 2 SLOEs to grant an interview. In regard to number of rotations needed to interview, 2 studies found 80–90% of programs require at least 1 EM rotation or SLOE to grant an interview. 3 This suggests that students, barring significant conflict, should still secure their home EM rotation first. 1,2 On the other hand, in a 2016 survey, 27% of PDs reported that it was “critical” for students to complete a home rotation, even if they had no interest in attending residency there. Two 2018 surveys showed that performance on an away rotation is one of the most influential factors used by program directors in interview selection decisions. Program directors place high value on away rotation evaluations. If you’re unable to complete 2 rotations by this time, the 2 SLOEs should be submitted by the time you interview or as soon as possible thereafter to assist in rank list formation. For students without a home EM rotation, this will be 2 away rotations at different institutions. Students should have at least 1, but ideally 2, SLOE(s) submitted in time for ERAS Application opening in mid-September to be granted interview offers. Typically, this will be 1 home rotation and 1 away rotation. To be a competitive EM applicant, aim to complete 2 EM rotations and obtain 2 SLOEs. More information about the structure and content of the SLOE can be found in Chapter 6: Crush Your EM Clerkships, Secure Your SLOEs. As SLOEs can only be obtained through an emergency medicine rotation, it is no surprise that “Audition elective/rotation within your department” and “Away rotation in your specialty at another institution” were among the other most important factors. In the 2018 NRMP Program Director Survey, “Letters of Recommendation in the Specialty” - known in EM as the SLOE (Standardized Letter of Evaluation) - was one of the most commonly cited factors (97% of respondents) in selecting which applicants to interview and had the highest importance rating (4.8 out of 5). For the residency program, the away rotation offers an independent assessment of a student’s ability to learn and grow from the feedback they receive, or demonstrate consistency across institutions and different clinical settings. For the medical student, it is an opportunity to explore different geography and learning environments that may vary by region or hospital. The away rotation plays a critical role in the EM residency match.
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