Frequently Asked Questions

FAQs for medical students applying to EM FRCP (5yr program)

The answers below are compiled from a selection of responses by residents currently enrolled in FRCP-EM programs within Canada.

These FAQs are aimed to address issues for those interested in FRCP-EM. A separate document has been compiled by the resident committee of CAEP to address choosing between CCFP-EM & FRCP-EM.

Electives

1. Should I complete all my electives in emergency medicine?

• No, they definitely don’t need to be all in emergency medicine
• most programs like to see a variety of elective experience
• however, there’s a balance in which you need to demonstrate a proven interest and commitment to EM

2. If I don’t complete all EM electives, what other electives would be good alternatives?

• it can be difficult to schedule all EM electives but the diverse nature of emergency medicine allows for applicable electives in many other specialties
•  these include: orthopedics, general surgery, ICU, anesthesia, radiology, family medicine, psychiatric emergency

3. How should I choose where to complete my electives?

• variety of approaches
• ideally, you should try to complete electives in places where you’re strongly considering for residency
• speak with residents about their experiences & check out the CaRMS website for information on specific programs (consider size, strengths/weaknesses, emphasis on research, fellowship opportunities)
• pick a variety of locations to enable a more diverse experience
• broad geographical electives enable a more convincing argument that you would be willing to go somewhere new (e.g. if you want to go to UBC, electives at U of C & U of A at least show your interest in being out West).
• if you’re very keen on doing EM, then depending on elective availability, you may need to go to locations that aren’t as high on your lis

4. Should I be in an academic centre to complete EM electives? Or is rural a feasible option?

• obviously you should be completing some electives at an academic centre to gain some recognition by residency programs as well as getting firsthand experience of how each program works
• rural may be something to consider in the month or two leading up, after initial CaRMS applications have been submitted especially if you are considering returning to a community/rural location afterwards
• a rural elective has the advantage of making you a more well-rounded candidate and may provide an interesting area for discussion during your interview
• rural electives may be a disadvantage if you only have a few EM electives (not as much bang for your buck!!!)

5. What can I do if I’m unable to get an elective in a location that is high on my list for the match? 

• this can be a distinct reality as EM electives fill up quickly!
• apply early to prevent this from happening – some places have dates however, and won’t accept applications until then
• ask if there’s a waiting list
• be careful about bending the rules and trying to set up electives without proper authorization – this can end up significantly impacting your chances – NOT recommended!!!
• even after all your efforts and you still can’t get one, then consider meeting with the program director (or at least set up a telephone meeting), make it clear to them that you tried to do an elective but were unable to and you are very interested in their program
• try to learn as much as you can about the program by contacting a resident so you will be well prepared for the CaRMS interview

6. Do you have any tips for me while I’m on elective as to maximize my experience?

• arrange a meeting with the program director(s) – go armed with questions for them
• meet the residents – residents have more to do with the selection then you may think
• attend rounds &/or journal club
• even if you’re doing another elective than EM while at a location, try to meet the residents and attend rounds
• let the staff know at the beginning of your shift, that you’re an elective student interested in their program
• ask (early) to be paired with the program director for a couple of shifts
• read around cases
• be on time!!
• remember, its not just about you making an impression, you need to figure out if this program is for you
• ALWAYS work hard!!! It will go noticed by residents and staff and this goes a long way during selection time

Reference Letters

1. How do I go about getting reference letters since it’s difficult to work with the same physician multiple times?

• EM docs know this, and are used to giving letters of reference even after only a few shifts
• you can never have too many letters – during CaRMS, you pick which letters you wish to use, so you may not end up using them all
• ask during your 3rd year too when doing core EM rotation at your own school
• look at the schedule – if you’re with a doc for 3-4 shifts, then approach them after the first shift and enquire if they would write you a letter
• ask a resident on who to approach for a letter – you may also be able to better arrange some shifts based on this info

2. Should I get a reference letter from a non-EM physician? How many letters should I have from EM physicians?

• non-EM letters can be just as valuable BUT make sure whoever is writing it knows you’re applying to EM and that you’ll be using it for your EM application
• if you’re going to use it for EM applications, then have your referee comment on your abilities and how it would make you a great EM physician – provides a different perspective
• possibilities include anesthesia, ICU, etc.
• check out the CaRMS website to find out requirements for numbers of EM physician letters required (most require a minimum of 2)

3. Should I try to get a well-known researcher/clinician to give me a letter?

• best letters are from well-known EM physicians BUT…only as long as they know you well; its obvious when it’s a generic letter (those don’t go along way)
• a well-written letter by a lesser known MD is better than a poor/average letter by a well known MD
• MAKE SURE YOU ASK FOR A “STRONG” LETTER – most people will tell you if they can’t do that; this also allows them a way of opting out if they don’t feel comfortable which is also in your best interest

4. Does it matter whether the physician writing my letter is CCFP-EM trained or FRCP trained?

• consensus amongst residents is that it shouldn’t matter – especially if the CCFP-EM is involved in academia or research at their institution  
• it does still help to have at least one letter from an FRCP because the EM community is small and close-knit

5. How and when do I approach a physician about getting a reference letter?

• bring it up after your first shift with the physician; especially if it went very well
• make sure you ask if they’re willing to write a STRONG letter of reference (and say “strong”)
• make copies of your shift evaluation cards after the shift – give it to the doctor who’s writing your letter – it will allow them to make a better judgement and write a more meaningful letter 
• the best letters are from those who can comment on a wide range of your abilities (clinical, research, personal attributes, etc)
• you may also be able to ask someone you worked with in the past; providing a picture may help!
• ALWAYS give them your CV and send a thank you letter afterwards
• GIVE THEM LOTS OF TIME, recontact them 3-4wks before the deadline

Extra-curricular activities

1. Do I need to do research to be qualified candidate? And does it need to be in emergency medicine?

• research in EM is great! But it doesn’t have to be in EM; generic topics like medical education or patient safety can be great alternatives
• some residents responded they didn’t do any research at all! And they still got in!
• especially for programs with less research emphasis, it’s less important

2. What other things can I do to strengthen my application?

• attend CAEP conference
• join associations like CAEP, SAEM, your EMIG
• anything that is unique!
• get involved in things that interest you – just because you want to do EM doesn’t mean you can’t like other things! Well-rounded is always good!
• while on other rural electives (e.g. family medicine), try and sneak in a couple of EM shifts!

CCFP-EM questions

For a more comprehensive list of questions & answers, please see the residents’ section of CAEP.