TY - JOUR
T1 - Factors influencing emergency medicine residency choice
T2 - Diversity, community, and recruitment red flags
AU - Weygandt, Paul L.
AU - Smylie, Laura
AU - Ordonez, Edgardo
AU - Jordan, Jaime
AU - Chung, Arlene S.
N1 - Funding Information:
The authors acknowledge the Medical Education Research Certificate Program for guiding the authors through early study concept and design. The authors to acknowledge Dr. Sean Tackett, MD, MPH, for contributing to the quantitative data analysis and revisions of the manuscript. The authors also acknowledge Dr. Lauren Licatino, MD, for providing timely feedback on the final manuscript. The authors acknowledge the 2019–2020 first-year residents from Johns Hopkins University School of Medicine, Wayne State University School of Medicine, Baylor College of Medicine, and Maimonides Medical Center for participating in the pilot and providing feedback for survey improvement. Finally, the authors acknowledge the emergency medicine applicants from the 2019–2020 application season for providing their insights and without whom this manuscript would not have been possible.
Publisher Copyright:
© 2021 The Authors. AEM Education and Training published by Wiley Periodicals LLC on behalf of Society for Academic Emergency Medicine
PY - 2021/10
Y1 - 2021/10
N2 - Background: Emergency medicine (EM) applicants consider many factors when selecting residency programs. Prior studies have demonstrated that applicants consider geography as well as modifiable/nonmodifiable program factors. Less attention, however, has been paid to underrepresented groups. Additionally, the prevalence and characteristics of “red flags,” or factors that may lead an applicant to lower a program's rank or not rank it at all, remain unknown in EM. Our objective was to describe the factors that influence current EM-bound medical students’ residency selection focusing on underrepresented applicants and red flags encountered during the recruitment process. Methods: We conducted a mixed-methods survey study of EM-bound graduates from U.S. medical schools in the 2020 application cycle. Quantitative analysis included descriptive statistics, measures of central tendency, 95% confidence intervals (CIs), nonparametric tests for ordinal data, and logistic regression. For the qualitative portion of the study, two independent reviewers performed a thematic analysis of the red flag free-text responses. Discrepancies were addressed via consensus with third-party oversight. Results: Our survey response rate was 49%, and most applicants considered both geographic and program factors. Underrepresented applicants prioritized program diversity, program commitment to the underserved, neighborhood/community, and patient population. Of all respondents, 71% reported red flags. Women had a significantly higher odds of encountering red flags (odds ratio = 1.64, 95% CI = 1.25 to 2.18). Red flags included seven key themes: violations of regulatory standards, program characteristics, interview day experience, program culture, interpersonal interactions, lack of fit, and quality of life; subthemes included lack of diversity and racism. Conclusions: Modifiable/nonmodifiable program factors and geography continue to influence EM-bound applicants’ residency choices. Underrepresented applicants place a higher value on diversity, community, and patients served. Residency programs should consider modifiable factors and self-assess for red flags to successfully recruit the next generation of EM physicians.
AB - Background: Emergency medicine (EM) applicants consider many factors when selecting residency programs. Prior studies have demonstrated that applicants consider geography as well as modifiable/nonmodifiable program factors. Less attention, however, has been paid to underrepresented groups. Additionally, the prevalence and characteristics of “red flags,” or factors that may lead an applicant to lower a program's rank or not rank it at all, remain unknown in EM. Our objective was to describe the factors that influence current EM-bound medical students’ residency selection focusing on underrepresented applicants and red flags encountered during the recruitment process. Methods: We conducted a mixed-methods survey study of EM-bound graduates from U.S. medical schools in the 2020 application cycle. Quantitative analysis included descriptive statistics, measures of central tendency, 95% confidence intervals (CIs), nonparametric tests for ordinal data, and logistic regression. For the qualitative portion of the study, two independent reviewers performed a thematic analysis of the red flag free-text responses. Discrepancies were addressed via consensus with third-party oversight. Results: Our survey response rate was 49%, and most applicants considered both geographic and program factors. Underrepresented applicants prioritized program diversity, program commitment to the underserved, neighborhood/community, and patient population. Of all respondents, 71% reported red flags. Women had a significantly higher odds of encountering red flags (odds ratio = 1.64, 95% CI = 1.25 to 2.18). Red flags included seven key themes: violations of regulatory standards, program characteristics, interview day experience, program culture, interpersonal interactions, lack of fit, and quality of life; subthemes included lack of diversity and racism. Conclusions: Modifiable/nonmodifiable program factors and geography continue to influence EM-bound applicants’ residency choices. Underrepresented applicants place a higher value on diversity, community, and patients served. Residency programs should consider modifiable factors and self-assess for red flags to successfully recruit the next generation of EM physicians.
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U2 - 10.1002/aet2.10638
DO - 10.1002/aet2.10638
M3 - Article
C2 - 34485803
AN - SCOPUS:85122075067
SN - 2472-5390
VL - 5
JO - AEM Education and Training
JF - AEM Education and Training
IS - 4
M1 - e10638
ER -