Getting into a residency: How-to/Tips & Tricks

[enginerdPA]

First of all, if this is in the wrong spot feel free to move it or I can delete it. I figured it would get more attention from those that are appropriately qualified here. 

Either way, I am a PA-S who wants to do a residency in critical care or EM after graduation. I just finished up my first semester and know I have a lot ahead of me in terms of rotations etc and may end up interested in another area after the experience. However, my work experience as an EMT and ER Tech and background as an engineer has lead me to an interest in these specific areas. So, as I’m going through school I’m keeping getting into a critical care or EM residency as my goal and am looking for any tips or tricks in getting into a residency. 

What did you do before graduating that you credit for helping to get you into a residency/fellowship? 

What sort of things do you wish you had done that would have helped you get into residency/fellowship?

Any other tips for a student who wants to do postgraduate training?

Thanks for the replies. Hopefully this can help others interested too. 

[LT_Oneal_PAC]

26 minutes ago, enginerdPA said:

First of all, if this is in the wrong spot feel free to move it or I can delete it. I figured it would get more attention from those that are appropriately qualified here. 

Either way, I am a PA-S who wants to do a residency in critical care or EM after graduation. I just finished up my first semester and know I have a lot ahead of me in terms of rotations etc and may end up interested in another area after the experience. However, my work experience as an EMT and ER Tech and background as an engineer has lead me to an interest in these specific areas. So, as I’m going through school I’m keeping getting into a critical care or EM residency as my goal and am looking for any tips or tricks in getting into a residency. 

What did you do before graduating that you credit for helping to get you into a residency/fellowship? 

What sort of things do you wish you had done that would have helped you get into residency/fellowship?

Any other tips for a student who wants to do postgraduate training?

Thanks for the replies. Hopefully this can help others interested too. 

Getting good grades. Honestly I avoid any other responsibilities, like class president or whatever, that detracted from studying or me time. I’m not saying sacrifice your life and study all the time, I’m saying if you aren’t studying, it should be doing something you enjoy and not work. No one will care about your elected positions in school. I joined SEMPA to show commitment, though the helpfulness of this is debatable, but low risk/high reward. You can do EM electives, which is good, but also make sure you do things you enjoy and make you better at the things you only do infrequently in the ED. Part of being a resident is being well rounded and speaking the language of your colleagues.

I wouldn’t have done anything differently, personally, but something I didn’t realize the extent of is they like interesting people at my residency. Play violin, live in another country for a year, or whatever. International rotations seem to be popular with our admissions.

Good, not generic, letters of recommendations. I really had some wonderful letters written for me, and honestly credit them with making my acceptance a slam dunk.

 

[JMann]

15 hours ago, LT_Oneal_PAC said:

Good, not generic, letters of recommendations. I really had some wonderful letters written for me, and honestly credit them with making my acceptance a slam dunk.

This is huge!! Have great references. Really strong experience can overcome "okay" letters, but that's the minority. You need good recs! 

If you don't have big EMS or ED experience prior to school, then take extra ED rotations to show your commitment. These residency spots are limited and programs aren't going to award them to someone that's not committed to EM. 

Be willing to relocate for residency. Apply broadly, say 5-10 programs, but do your homework and know why you are applying to each one. 

Also, search this forum as this question has been addressed here several times and you may find other advice that way. 

[SERENITY NOW]

 

I wrote a few posts regarding this topic on my residency blog which I will copy paste here.  Hope this helps!

 

FOR STUDENTS:  INCREASING YOUR CHANCES OF GETTING INTO AN EM RESIDENCY...

At the end of the day, the best way to increase your chances of getting into a residency is to have a killer application.  Obviously, more important than just superficially "buffing" your application, you want to really know what you're getting into and learn as much of the EM foundation as possible.  Still, you want to make sure you have a great application that reflects your hard work so that you can actually get into a program.  The following are the main application components and what you can do to strengthen them:

 

1. Past experience.  If you're a pre-PA, it would be great if you could get experience as an EMT/paramedic/ER nurse/ER tech before school.  This looks great on your application and will seriously help your transition to an EM provider.  If you aren't able to do this, you will still have a chance so don't worry.  Shadowing experience is a good start to getting a sense for the way things are done in EM.  

 

2. GPA - study hard!  Higher GPAs are favored in admission committees, so don't shrug this off as unimportant in PA school if you really want to be competitive for a residency.  I don't think that your PANCE score matters at all.  

 

3.  Letters of recommendation - The best way to get the best LOR is to really shine on your EM rotation, which requires you to really know your EM stuff...  During didactic year, focus on EM topics, really prepare for and do well in your procedure labs, and consider starting to listen to EM podcasts on free time/commutes.  Start with the podcast 'EM Basic'.  Also, develop a relationship with your PA program director, and make sure they can see your passion for EM.  Many residencies require one LOR to be from your program director, and it will look a lot better if it isn't a generic cookie cutter LOR!  During clinical year, work really hard on your EM rotation, come in early and stay late, show initiative and be active about learning from your preceptor.  Definitely dive into the EM podcast scene; its a lot more fun way to learn IMO - listen to as much of EMBasic as possible, then check out FOAMcast too.  Get as many EM-related electives as possible (trauma, ortho, peds EM, ICU).  If you stick with all of these things, you'll be an EM stud on your rotation and will get a shining LOR. Please see the copy/paste below from a prior post I made about more tips for making the most of your rotations.

 

4.  "Buffing the resume" - show a specific interest in EM and do activities that reflect that.  Does your PA program have a unique track dedicated to acute care?  Perhaps a student "EM interest group"?  Opportunities to learn about bedside ultrasound, advanced procedures, ACLS/ATLS/PALS?  Opportunities to go to EM conferences around the area?  Consider joining SEMPA as well.  

 

5. Personal essay and Interview skills - be prepared, practice, and articulate yourself well.  See my earlier post about interview questions to reflect on. 

 

[CSCH]

I'll jump on the bandwagon and repeat what's been said above:

I think the strongest part of my application were my letters of recommendation from clinical preceptors who thought I stood out. I recently asked one of my program directors why they picked me (I was competing with people with much more critical care experience), and they said my interview was a big part, too. No one seemed to care much about my grades (other than that they were decent), they just wanted to know what kind of human I was and how I thought. They're looking for people who can excel in the high-stress residency environment, who have the right combination of assertiveness and people skills to get the most out of it while competing with other learners, and who seem well-suited for actual practice in critical care.

[ryebread203]

On 1/8/2019 at 12:16 PM, SERENITY NOW said:

Definitely dive into the EM podcast scene; its a lot more fun way to learn IMO - listen to as much of EMBasic as possible, then check out FOAMcast too.

After EMBasic, but before FOAMCast, consider CrackCast, which goes through Rosen's Emergency Medicine chapter by chapter. Pound for pound, it has provided me with the best EM instruction.

[scarfire]

Have very specific answers to why you want to do a residency in your given area, and also be ready to answer the question of "What would you do if you don't get accepted into a residency this year?" I applied to critical care residencies and got interviews, however wasn't able to stick the landing at either...the feedback I got was that I didn't show enough passion for the field. I felt like I wasn't able to adequately convey my interest in critical care because I didn't have experience in the field and didn't have ICU rotations.

[ISeeYou]

For somebody who has been out of PA school, do you think that obtaining a job in an ED or UC would significantly help your chances of getting into an ED residency?  I was an EMT prior to PA school and now have two years work experience in a trauma/surgical ICU.  Would it be worth trying to add these jobs even if you were to only work for a few months to a year prior to applying?

(I understand many people use an ED residency to get an ED job, but I would be hoping to use it to be able to practice in a solo provider or advanced role in the ED)

Thank you for your time

Edited November 20, 2019 by ISeeYou

[LT_Oneal_PAC]

7 hours ago, ISeeYou said:

For somebody who has been out of PA school, do you think that obtaining a job in an ED or UC would significantly help your chances of getting into an ED residency?  I was an EMT prior to PA school and now have two years work experience in a trauma/surgical ICU.  Would it be worth trying to add these jobs even if you were to only work for a few months to a year prior to applying?

(I understand many people use an ED residency to get an ED job, but I would be hoping to use it to be able to practice in a solo provider or advanced role in the ED)

Thank you for your time

It could help. Certainly wouldn’t hurt. Though I think at my residency it wouldn’t be a deal breaker between 2 qualified residents. 

[Randito]

On 11/20/2019 at 8:22 AM, ISeeYou said:

For somebody who has been out of PA school, do you think that obtaining a job in an ED or UC would significantly help your chances of getting into an ED residency?  I was an EMT prior to PA school and now have two years work experience in a trauma/surgical ICU.  Would it be worth trying to add these jobs even if you were to only work for a few months to a year prior to applying?

(I understand many people use an ED residency to get an ED job, but I would be hoping to use it to be able to practice in a solo provider or advanced role in the ED)

Thank you for your time

Stay at your current position as you apply to residencies. Your trauma/critical care background will really make you standout as an applicant compared to all the new grads. You could probably walk in day one and teach the staff PAs and senior residents a thing or 5. 

Maybe add on a per diem UC job if you have time just to refamiliarize with all the low acuity fast track complaints, but even that is probably not necessary.   

[kettle]

I recently interviewed and accepted a position in an EM residency. I think it varies on location regarding applicant pool numbers. I was able to speak after acceptance with one of the faculty members and was told my letters of recommendation made me stand out as well as past experience. Teachable individuals that work well with others I feel like is one of the most desirable traight employers seek. Was in EMS for ten years as a paramedic. My GPA through 5 semesters was a 4.0. 

Edited November 26, 2019 by kettle

[ISeeYou]

Thank you all for your responses!

[Rudeboyirie]

Hello, 

I am currently in the process of getting application materials ready to ship off hopefully in the next couple of months when things calm down and life returns to normal. 

For those who posted “do extra EM rotations,” does that imply that you listed all of your rotations on your CV? I have two scheduled, but have only completed one so far. Should I list all of my scheduled rotations on my CV, or just the ones I’ve completed? Of course, things may change in the future which may change any rotations I currently have scheduled. Has anyone else run into a similar situation? 

Thanks! 

[JD2012]

15 hours ago, Rudeboyirie said:

Hello, 

I am currently in the process of getting application materials ready to ship off hopefully in the next couple of months when things calm down and life returns to normal. 

For those who posted “do extra EM rotations,” does that imply that you listed all of your rotations on your CV? I have two scheduled, but have only completed one so far. Should I list all of my scheduled rotations on my CV, or just the ones I’ve completed? Of course, things may change in the future which may change any rotations I currently have scheduled. Has anyone else run into a similar situation? 

Thanks! 

I put all of my rotations on there including ones not completed yet with their dates. The ones I've completed I described some pertinent details including procedures, etc.

[Rudeboyirie]

Oh okay, thanks! I guess it’s out of my hands if any rotations down the road get changed so I’ll just add what I know at this time. Of course, with the current COVID-19 situation, many programs are switching to virtual electives to get them through. Has anybody dealt with virtual rotations on a CV before?