Emergency Medicine Residency: Where Every Second Counts

List of Best Emergency Medicine Residencies in US

Here are some of the best emergency medicine residency programs in the US:

• Duke University
• Harvard University
• Johns Hopkins University
• Baylor College of Medicine
• Emory University
• Denver Health Medical Center
• University of Cincinnati
• Carolinas Medical Center
• Indiana University School of Medicine
• The University of Colorado
• University of California - San Francisco
• The University of Southern California LAC+USC Medical Center
• The University of Washington

List of US Emergency Medicine Residencies with Most First-year Positions

The following emergency medicine residency programs offer the biggest number of spots for first-year medical graduates in the US, according to the American Medical Association (AMA).

• University of Texas Southwestern Medical Center Program – 26 positions
•  Icahn School of Medicine at Mount Sinai Program – 25 positions
•  Zucker School of Medicine at Hofstra/Northwell Program – 23 positions
•  Emory University School of Medicine Program – 22 positions
•  Montefiore Medical Center/Albert Einstein College of Medicine (Jacobi/Montefiore) Program – 21 positions
•  SUNY Downstate Health Sciences University Program – 21 positions
•  Indiana University School of Medicine Program – 21 positions
•  University of Texas Health Science Center at Houston Program – 21 positions
•  University of Southern California/LAC+USC Medical Center Program – 20 positions
•  Icahn School of Medicine at Mount Sinai (Morningside/West) Program – 20 positions
•  University of California Davis Health Program – 20 positions
•  Yale-New Haven Medical Center Program – 19 positions
•  Wright State University Program – 18 positions
•  Orlando Health Program – 18 positions
•  University of Connecticut Program – 18 positions

List of Emergency Medicine Residencies in Canada

Here is a list of the medical schools in Canada that have an emergency medicine residency program:

• Dalhousie University
• Université Laval
• Université de Montréal
• McGill University
• University of Ottawa
• Queen’s University
• University of Toronto
• McMaster University
• Western University
• University of Manitoba
• University of Saskatchewan
• University of Alberta
• University of Calgary
• University of British Columbia

What is Emergency Medicine Residency?

Emergency medicine residency, by definition, is one of the most diverse and fast-paced specialties out there. As a bonus, it is also one of the easiest doctors to become overall. As an emergency medicine resident, you’ll spend most of your time in hospital emergency rooms, caring for critically ill and injured patients. You’ll learn to quickly assess, diagnose and treat a huge variety of patients suffering from a wide range of conditions. Emergency medicine residents spend most of their time in the ER, ICU, OR and wards caring for patients in need of critical care or patients with chronic illness.

Emergency medicine is one of the top choice of specialty for many medical school graduates, and it also makes it one of the most competitive specialties to match into. Historically, every position offered in emergency medicine residency in the US has been filled. The fast pace and excitement of emergency medicine draws many to the specialty.

Emergency medicine residency can also offer unique and varied medical training experiences. Every hospital and ER is different. For example, whether you choose an urban or rural residency and the business of the hospital ER will affect the patients you see, the cases you encounter and the overall environment you’ll be working in.

Where you complete your training can also affect your working hours and experiences. The curriculum and hours can differ a lot between programs. One downside of emergency medicine is the long and odd working hours on your feet, always in motion, but this aspect is appealing to some med grads! Still, the lifestyle can be stressful, but you will have greater control of your schedule than other residencies.

Some more pros of emergency medicine residency include a fairly good job security and remuneration. In North America, there is a growing shortage of emergency medicine physicians, so it is an area of medicine that is growing in demand, making it appealing to grads. The diversity of cases and patients and the “never a dull moment” aspect of emergency medicine is also a huge plus for some medical school graduates who want to jump right in.

Here are the easiest and hardest residencies to match to!

Emergency Medicine Residency: Structure

Wondering how long residency is? Emergency medicine residency is one of the shorter ones, typically between 3-4 years in both the US and Canada. A fifth year may be included for subspecialty training.

Emergency medicine rotations in the US are accredited and overseen by the Accreditation Council for Graduate Medical Education (ACGME). The council also sets out the guidelines for residency training in emergency medicine. In Canada, the Royal College of Physicians and Surgeons oversees emergency medicine residencies.

In general, emergency medicine residencies are configured in 36-month and 48-month formats (3-4 years) and are required to include a minimum of 35 months or 3 years of clinical education for residents. This includes a minimum of 4 months of critical care rotations and 5 months of pediatric emergency medicine rotations.

Many emergency medicine residencies also include dedicated time for residents to conduct research, too. That being said, each residency program may vary widely in the rotations and electives it offers to residents. The most common rotations for emergency medicine residency are critical care, pediatric, trauma, ultrasound, toxicology and emergency medical services.

In Canada, the requirements and structure of emergency medicine residency are much the same. The post-graduate year 1 (PGY-1 is typically dedicated to basic clinical training in emergency medicine, transitioning to training in the emergency aspects of different rotations, including anesthesia, critical care, internal medicine, general surgery, pediatrics and more. You will often have an entire year dedicated to electives and research time.

Here’s what an average emergency medicine residency might look like:

Emergency Medicine Residency: Fellowships and Subspecialties

Emergency medicine isn’t just about working in a busy ER. If you’re interested in pursuing a medical fellowship after your emergency medicine residency, there are a number of areas you can subspecialize in, including some truly unique career paths!

• Addiction Medicine
• Administration/ED Operations/Patient Safety & Quality Improvement Fellowships
• Aerospace Medicine
• Cardiovascular Emergencies
• Anesthesia Critical Care Medicine
• Internal Medicine Critical Care Medicine
• Neurological Critical Care
• Surgical Critical Care
• Disaster Medicine
• Emergency Medical Services (EMS)
• Forensic Emergency Medicine Niche
• Geriatric Emergency Medicine (GEM)
• Health Policy
• Informatics
• Injury Control
• International Emergency Medicine
• Medical Education
• Neurovascular and Stroke
• Observation Medicine
• Occupational and Environmental Health
• Pain Management
• Palliative Care
• Pediatric Emergency Medicine
• Population Health and Social Emergency Medicine
• Research Fellowship
• Resuscitation
• Simulation Fellowship
• Primary Care Sports Medicine (PCSM)
• Tactical Medicine
• Telemedicine
• Toxicology
• Emergency Ultrasound
• Undersea and Hyperbaric Medicine
• Wilderness Medicine
• Women's Health

Emergency Medicine Residency Match Rates

Emergency medicine is considered one of the most competitive residencies out there, consistently receiving a high volume of applicants from MDs, DOs and IMGs. The specialty is a popular choice, and although it has many open positions available, you can expect an equally large number of applicants vying for those positions.

All in all, emergency medicine does have a higher-than-average match rate for DO seniors and graduates. In the most recent match, emergency medicine was one of the top 3 specialties for both DOs and US IMGs. DOs had a match rate of 91.3% for emergency medicine, with a fill rate of 24.3%. MDs had a match rate in emergency medicine of 95.3% and a fill rate of 42.3%.

US international medical graduates (IMGs) also had a fairly high match rate in emergency medicine, with 289 graduates matching into the specialty. Overall though, emergency medicine has some of the lowest match rates for IMGs overall, making it one of the least IMG friendly residency programs.

MD Match Rate for Emergency Medicine

DO Match Rate for Emergency Medicine

Subspecialties in emergency medicine were quite a bit more competitive, although far fewer positions were offered. For instance, only one position was offered in Emergency Medicine-Anesthesiology, and it went unfilled in the latest match.

Matching to Emergency Medicine Residency Programs

Applying for emergency medicine residency programs involves registering through the Main Residency Match in both the US and Canada. For US applicants, this means registering for the National Residency Matching Program (NRMP) Main Match and creating an ERAS application online. For Canadians, you will register and submit your application through the Canadian Resident Matching Service (CaRMS) R-1 Match.

Both applications are quite similar, though you should become familiar with the application you’re planning to use (or both, if you’re applying to residencies in both countries!). You should know how to prep for your residency application and start researching programs so you can create a residency rank order list. If you’re unsure how many residency programs to apply to, for emergency medicine it is better to apply to a larger number of programs and cast your net wide. There is a great deal of competition, even with a greater number of programs and positions, so you’ll increase your chances of matching by not limiting yourself to a handful of potential programs.

Note that if you’re applying to emergency medicine residency programs, your approach to letters of recommendation will be a little different, depending on if you apply through CaRMS or ERAS. Your ERAS letter of recommendation for emergency medicine with be fairly straightforward, but your CaRMS application will ask for a CaRMS emergency medicine structured reference letter, which has a different format. Most emergency medicine programs will ask for 3 letters of reference, so be sure to check the requirements and instructions carefully for both!

Aside from recommendations, your ERAS or CaRMS application may also include a residency personal statement, a residency CV and residency letter of intent.

Here are some tips for a great emergency medicine personal statement!

How to Match Emergency Medicine Residency Programs

Matching to emergency medicine residency programs can be a challenge. Perhaps the biggest obstacle is making your residency application stand out from a crowd of applicants. In general, it helps to know what residency program directors look for, what they value and how to present yourself as an ideal applicant.

Working in an emergency medicine setting requires excellent communication, teamwork and interpersonal skills. You also need to be extremely competent in a clinical setting and show great patient assessment skills. Emergency medicine requires flexibility, adaptability and quick thinking.

When it comes to applications, here’s what program directors look at first:

1. USMLE Step 1 and USMLE Step CK scores/COMLEX Level 1 and COMLEX Level 2 scores
2. MSPE and clinical clerkship grades
3. Letters of recommendation
4. Emergency medicine personal statement

Here are some quick tips on how to ace your application to emergency medicine residency programs!

#1 Ace standardized tests

Emergency medicine receives a higher than usual number of applicants, and just like medical schools, standardized test scores are the go-to used to “weed out” weaker applicants early on. To avoid getting axed in the first round of elimination, aim to achieve as high a score as possible on your USMLE or COMLEX exams, particularly your clinical skills assessment. Strong clinical skills are a must for emergency medicine, and strong test scores will assure residency programs that you are well prepared to work hard.

#2 Clinical competence

Your Medical Student Performance Evaluation (MSPE) and scores received in your clinical rotations during med school will reflect on your overall clinical ability. High scores across the board will demonstrate that you possess the qualities of a good emergency room team member, and that you have the clinical skills to succeed in a program.

#3 Stellar application

Your personal statement and letters of recommendation will offer another qualitative look at your abilities that test scores don’t capture. And, this is where you can really personalize your application and make it stand out. A great narrative in your personal statement and glowing recommendations (at least one from an emergency physician!) will give your application a nice boost.

When it comes to the interview, although it’s not THE most important selection criteria, it’s still important to ace it. Practice with some emergency medicine residency interview questions and start working on your answers to some of the toughest residency interview questions.

#4 Get an advisor

If your medical school has an emergency medicine residency affiliated with it, take the opportunity to start networking and find an emergency medicine advisor! Talk with them about opportunities for further learning, research and advice on how you can make yourself a more attractive candidate. If there are no options among your medical school faculty for emergency medicine mentors, you’ll need to widen your networking efforts.

#5 Apply strategically

Don’t make the mistake of selecting your top 5 or 10 programs, applying to those and leaving it at that. Emergency medicine is deceptively competitive. Aim for a list of 20-30+ programs, and if you go unmatched during residency, explore your options if your heart is set on emergency medicine. Research your programs carefully and curate a rank order list of programs that are good fit for you. Keep in mind that you will likely not match to a program right near you, so don’t be afraid to apply to many different locations, so long as the program’s curriculum and structure is a good fit for you.

FAQs

To your success,

Your friends at BeMo

BeMo Academic Consulting

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