In part one of this series, we explored the evolving role of community-based physicians as mentors in emergency medicine, along with an overview of recent changes in the EM residency match process. In this second part, we’ll dive deeper into specific aspects of mentoring, focusing on writing impactful letters of recommendation, providing targeted guidance for special populations (such as osteopathic students, military candidates, and couples in the match), and sharing key resources to support both you and your mentee. With these tools, you can help your students navigate their unique paths to a successful EM career.
Letters of Recommendation
Regarding letters of recommendation, the most powerful letter a student can obtain is the Standardized Letter of Evaluation (SLOE). These are a central and key component to the student’s ERAS application. There are several different versions of the SLOE form, including one designed to be completed by an EM physician/department not associated with a residency program, sub-specialty rotations (e.g. a Pediatric EM rotation), and even a version to be completed by a non-emergency medicine physician. The strongest SLOE comes from a rotation experience completed in a department associated with an EM-residency program and written by a committee of individuals from that department.
Although students can complete an EM rotation anytime in their 3rd or 4th year, it is standard practice for a SLOE to be based on a 4th-year, sub-intern, one-month rotation. Comparing apples to apples, this helps calibrate expectations and therefore performance standards for the student being evaluated. Many students will complete an EM rotation in their 3rd-year, but they should also do rotations in their 4th-year. Comments from their 3rd-year rotation can be included in their SLOE to show growth and progress over time.
Students will need at least one SLOE posted to their ERAS application by the time it is released to programs at the end of September. Without this, programs will not review their application. That being said, it is VERY common for students to add their subsequent rotation SLOEs to their ERAS application even as late as October and November. Every student should have at least 2 SLOEs; a 3rd SLOE may come from a sub-specialty rotation with rare situations where a 3rd sub-intern rotation experience SLOE may be needed for students with red flags on their application.
Special Populations
- Osteopathic Students: Most osteopathic schools are in community/rural areas so it is very common for community physicians to have DO students rotating with them. Many of you probably trained in the time of two separate matches (AOA and ACGME). This is no longer the case after the merger that occurred from 2015-2020. Medical students now all participate in the ACGME match regardless of whether they attended an allopathic or osteopathic medical school. DO students have the option after residency of taking either AOBEM or ABEM boards. It is also important to note that COMLEX is becoming more widely accepted throughout the emergency medicine residency community. In recent years, osteopathic applicants have been matching at larger university programs more frequently than in the past.
- Military Match: Military students apply to both military and civilian programs. In the military match, students will rank their desired specialty, a backup specialty, and civilian deferment (aka participating in the ACGME match). Each branch has different odds of obtaining civilian deferment, which is where a military-specific advisor comes in. The military match occurs in December so students who get deferment still have time to interview and participate in the ACGME match. All military students must have a solid backup plan for the civilian match.
- Couples Match: Applicants who enter the couples match need a specialized plan based on their specific application variables. This will depend on what specialty their “couple” is applying to. General advice would include applying to more programs, being clever about geography, and finding an advisor who has experience with the couples match.
- International Medical Graduates: IMG applicants have had more success matching into emergency medicine in recent years. However, given the variability of each individual’s circumstances and application, including details of how and when institutions can host different types of visas, we will not go into further detail in this article.
Resources
As a mentor, there’s no need to reinvent the wheel—numerous resources are readily available through national EM organizations to support you and your mentees. Familiarizing yourself with these tools enhances your ability to guide students through the match process and career planning, while also providing excellent aids for on-shift teaching. The list below includes some of our favorite free, open-access resources, which serve as a great foundation for enriching your mentorship and supporting your mentee’s development in emergency medicine.
Council of Residency Directors in EM (CORD)
- EMRA/CORD Student Advising Guide: An Evidence-Based Approach to Matching into Emergency Medicine
- Medical Student and Advisor Resource Guides provide resources for planning 4th year and how to approach the match process geared towards specific students. Available guides include; military, couples match, IMG, osteopathic, reapplicants, at risk applicants, latecomers, and underrepresented minorities.
- Medical Student Planners provide a structured approach to planning and optimizing performance in medical school, starting from the first year. These tailored planners cater to each special populations including reapplicants, branches of the military, couples matching, international medical graduates (IMGs), and osteopathic students.
Emergency Medicine Residents Association (EMRA)
- Medical Student Advising Resource List
- Student Resident Mentorship Program
- Skill Demonstration Videos collection provides an extensive list of links to high-quality videos that demonstrate proper techniques for a wide range of emergency medicine procedures. This resource is invaluable for students to use during their rotations.
- Patient Presentations
American Academy of Emergency Medicine (AAEM)
- Road to Match Mentorship Program for 3rd year students
- CDEM Curriculum is an excellent, free resource designed to help medical students master core emergency medicine topics. Organized by chief complaint, it offers tailored curricula for third-year students, fourth-year students, and pediatric emergency medicine. This curriculum serves as a valuable supplement for students during their rotations, enhancing their understanding of foundational EM concepts.
In addition to these online resources, one of your greatest assets as a mentor is your network. Introducing your mentee to colleagues, former classmates, or other professionals with similar interests, geographic ties, or connections to specific residency programs can be invaluable. These introductions give students unique insights and special opportunities that help them build a well-rounded support system. Additionally, connecting students with local events, research opportunities, or residency fairs adds depth to their experience and prepares them for the journey ahead. By combining accessible resources, personal connections, and community events, you can empower your mentee with a strong foundation for a successful career in emergency medicine.
Mentoring in emergency medicine, especially in a community setting, is an invaluable opportunity to shape future EM physicians. By mastering the essentials of writing impactful letters of recommendation, understanding the unique needs of special student populations, and using accessible resources, you can provide your mentees with well-rounded, informed support. The insights and guidance you offer help students navigate a stressful match process and make informed career decisions. With your mentorship, they’ll not only gain the skills and confidence needed for a successful match but also a clearer vision of what it means to thrive in emergency medicine. Thank you for your dedication to shaping the future of our specialty!
