Is EM really that hard to match into?

[Guest clinicalchief]

Is matching into EM like getting into a top 5 med school? How competitive is it? Is there anything you can do in undergrad / undergrad med that would give you an advantage?

 

Thanks in advance.

[Guest Carolyn]

I'm assuming you are talking about the FRCP 5- year specialty. There is also the CCFP-EM route which you apply to from Family medicine; I don't know as much about the competitiveness of that, but I think it is still relatively competitive.

 

This year 29 people ranked EM as their first choice discipline and there were 21 positions. Last year it was 30 with only 17 positions. So it is somewhat competitive. The majority of the programmes are really quite good with some having specific areas of specialty (i.e. Ottawa incorporates an MSc in Epi (you can probabaly do this at any school if you wanted to though), Alberta has a large international focus I think, etc. etc.)... That said, most of the schools provide some leaway for you to develop your own area of interest.

 

I am planning to apply this fall for EM - I have been told a variety of things with regards to applying. You really need to show interest in the field... Through electives at your top choices, research, conferences etc. it is also important to apply across the country. It is kind of the same for any specialty you are interested in... But leadership, good clinical experiences, strong references etc. are very important. I asked at the CAEP conference about the necessity of doing electives at other schools and the programme directors said you definitely didn't need to but many still do. I have done a lot of ER elective time (both internationally, in a smaller Ontario community and at my home school (both pre-clerkship and in clerkship) So I have decided to do just one visiting ER elective at the place I think might be my top choice and then spend the rest of my elective time (which is post-carms anyways) rounding out my education!

 

Hope that helps. I definitely don't know the secret; but I've been trying to keep my ear to the ground in order to play my cards right. So if you have any specific questions, let me know.

 

Carolyn

[Guest Ian Wong]

Getting into Emerg in Canada, like Carolyn mentioned, can be done through a 5 year residency in Emergency Medicine, or as a 1 year fellowship after completing a 2 year Family Medicine residency. This one year fellowship is arranged through the Canadian College of Family Practitioners; therefore you will hear it referred to as the CCFP fellowship, which turns you into a licensed Emerg doc after only 3 years of residency in total.

 

The drawback to the CCFP is that some larger hospitals do not recognise it; ie: to work at Vancouver General Hospital, you need to have completed the full 5 year program. However, at many smaller hospitals, and certainly in smaller communities, many of the Emerg docs there did the 3 year CCFP option. Given that there's a massive shortage of doctors in Canada, particularly in rural areas, the CCFP license is going to be in demand, and you will be able to get a job most places with the CCFP alone (so there's not a huge limitation if you don't do the 5 year residency).

 

Emerg is quite a competitive specialty, but there's not really much you can do at the premed stage to boost your chances, unless you happen to have previous experiences that would lend yourself to this career. One of the guys in this year's graduating class was a former paramedic, who I believe continued to do work in that area throughout med school (he was involved in teaching a lot of the mandatory first aid licensing stuff that all med students have to learn), and I believe he's on a path to do the CCFP Emerg eventually.

 

Most of the groundwork for getting into a residency starts in med school, so there's no sense in stressing about it beforehand. There'll be plenty of time to stress about it once you're in!

 

Ian

UBC, Med 3

[Guest clinicalchief]

Thanks for the thoughtful replies!

[Guest UWOMED2005]

Hey Ian - have you heard anything about Family Physicians without the fellowship getting positions in Emergency Rooms? I'd heard a rumour that some of the hospitals in Ontario were starting to hire Family Physicians to do essentially triage and treat some of the minor presenting cases (ie colds, flus, the odd stitches) allowing the Emerg specialists more time to deal with serious things.

[Guest Carolyn]

You don't even require the EM year from family medicine to work in an emerg - many of our rural emergs are staffed just by doctors.

 

Most larger communities are now hiring only those with the 3rd year or the 5 year specialty. Many ERs will only have one doc on at a time anyways, but in some of the larger centres here in Hamilton there will be 2 or 3 and often they will split it up with one taking more of the Quick Care types and the other dealing with the actual emergencies -- but then I haven't seen it split up by bckgd, just deciding between the docs on... but then the doctor on quick care always seems to help out if things get hectic on the emerg side and vice versa.

 

I don't think there are any hard and fast rules out there.