EM Match Advice Series: The Non-LCME Applicant


Yesterday the Electronic Residency Application Service (ERAS) opened its digital doors to medical students applying to ACGME residency programs. So we thought it was a perfect time to host another EM Match Advice Series installment. This time, we focus on the challenges that the non-LCME applicant encounters throughout the ACGME application process. These applicants include:

  1. Students from osteopathic medical schools
  2. Students from non-U.S. medical schools
  3. Applicants who have been in the military service and are returning for residency training
  4. Residents who want to transfer in from another specialty training program.

The Panelists: The Non-LCME Applicant

  • Michael Gisondi, MD (Northwestern PD, host)
  • Merle Carter, MD (Albert Einstein prior PD and soon-to-be Designated Institutional Official)
  • Doug Finefrock, DO (Hackensack PD and Vice Chair)
  • Damon Kuehl, MD (Virginia Tech Carilion PD)
  • Michelle Lin, MD (University of California San Francisco, ALiEM host)


  • 00:00 Introductions
  • 02:18  Defining the “Non-LCME Applicant”
  • 05:50  Dr. Carter provides advice for DO medical students
  • 27:30  Dr. Finefrock provides advice for international medical graduates
  • 43:30  Dr. Kuehl discusses military servicemen and servicewomen interested EM residency training
  • 53:00  Dr. Kuehl discusses non-EM residents interested in transferring into an EM residency training program
  • 59:51  The panelists try to stump Dr. Gisondi with cool information that he doesn’t already know about their programs.



Smith-Coggins R, Marco CA, Baren JM, et al. American Board of Emergency Medicine report on residency training information (2014-2015). Ann Emerg Med. 2015; 65(5): 584-94. PMID: 25910762


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Michael Gisondi, MD

Michael Gisondi, MD

Associate Professor and Vice Chair of Education
Department of Emergency Medicine
Stanford University
Editor, ALiEM EM Match Advice series
Michelle Lin, MD
ALiEM Editor-in-Chief
Academy Endowed Chair of EM Education
Professor of Clinical Emergency Medicine
University of California, San Francisco
Michelle Lin, MD
Michelle Lin, MD

Latest posts by Michelle Lin, MD (see all)

  • Great question. Any additional piece of supporting evidence is helpful in your application showing that you are:

    1. A hard working individual
    2. Committed to the field of EM (research or any longitudinal project in EM)
    3. Show leadership potential (MBA degree)

    No individual extra endeavor (MBA, research) puts you automatically into a different tier for consideration unfortunately. It more generally pushes you slightly more towards the competitive end of the applicant spectrum.

    The tricky issue is that most programs as for at least 2 EM letters with each using the SLOE. Since I’ve been away from the EM application world for a few years now, I’ll defer that question to Mike or someone else on the panel.

  • gmcguitar4

    This is a great resource, thank you. I am an osteopathic student and had a question regarding SLOE’s and the timing of submitting applications for the allopathic match. I have EM elective rotations in July, September, and November. I want to obtain SLOE’s from the July and September rotations but I am worried my application will be submitted too late because I probably wouldn’t obtain the September one until mid/late october. What is your advice regarding the ideal number of SLOE’s and the timing with submitting them? Is a late complete application better than an early, not 100% complete (meaning just 1 SLOE) application? If I submit my application early, can I update my application or let program directors know that I will be obtaining a second SLOE that I can send?

    • Michael Gisondi

      Hi GMC,

      Great question — and one that doesn’t have a single correct answer, unfortunately. In general, you should submit all parts of your application as early as possible. Don’t wait until it’s ‘complete.’ Many programs can make an interview decision based on SLOEs from a single rotation, in combination with the remainder of your application. Some will wait. Three LORs is all you need to have a ‘complete’ application, despite the option of a fourth letter. Try and get two sloes from your earliest rotation and one other non-EM letter; this allows for a complete app and the open slot to upload the Sept letter when it’s available. The Nov rotation is too late and a letter won’t be useful for an interview decision, but some schools will want it for ranking purposes — something to ask of the PDs in your interviews. Hope that helps and good luck!

      • gmcguitar4

        Dr. Gisondi,
        That helps tremendously, thank you.

  • gmcguitar4

    Another question. I am currently scheduled to take the USMLE in the end of July but will have to move it again to the beginning of August or a week earlier. My Step 1 is >90th percentile and the rest of my app is solid with no red flags. So basically, how important is the timing of taking Step 2 for receiving an interview? Does taking it a little later affect chances of receiving interviews? How do you value Step 1 vs. Step 2 score? Thank you again for this great resource!

    • Personally I see the step 1 score as something to get you an interview (or not get you an interview) while both scores are important equally when programs decide on where to rank you at the end of interview season. So I think your later step 2 exam is ok.

      • gmcguitar4

        Thank you for the response.