Department of Emergency Medicine, Georgetown University Hospital/Washington Hospital Center, Washington, DC, USA.
Acad Emerg Med. 2012 Apr;19(4):455-60. doi: 10.1111/j.1553-2712.2012.01323.x.
An understanding of student decision-making when selecting an emergency medicine (EM) training program is essential for program directors as they enter interview season. To build upon preexisting knowledge, a survey was created to identify and prioritize the factors influencing candidate decision-making of U.S. medical graduates.
This was a cross-sectional, multi-institutional study that anonymously surveyed U.S. allopathic applicants to EM training programs. It took place in the 3-week period between the 2011 National Residency Matching Program (NRMP) rank list submission deadline and the announcement of match results.
Of 1,525 invitations to participate, 870 candidates (57%) completed the survey. Overall, 96% of respondents stated that both geographic location and individual program characteristics were important to decision-making, with approximately equal numbers favoring location when compared to those who favored program characteristics. The most important factors in this regard were preference for a particular geographic location (74.9%, 95% confidence interval [CI] = 72% to 78%) and to be close to spouse, significant other, or family (59.7%, 95% CI = 56% to 63%). Factors pertaining to geographic location tend to be out of the control of the program leadership. The most important program factors include the interview experience (48.9%, 95% CI = 46% to 52%), personal experience with the residents (48.5%, 95% CI = 45% to 52%), and academic reputation (44.9%, 95% CI = 42% to 48%). Unlike location, individual program factors are often either directly or somewhat under the control of the program leadership. Several other factors were ranked as the most important factor a disproportionate number of times, including a rotation in that emergency department (ED), orientation (academic vs. community), and duration of training (3-year vs. 4-year programs). For a subset of applicants, these factors had particular importance in overall decision-making.
The vast majority of applicants to EM residency programs employed a balance of geographic location factors with individual program factors in selecting a residency program. Specific program characteristics represent the greatest opportunity to maximize the success of the immediate interview experience/season, while others provide potential for strategic planning over time. A working knowledge of these results empowers program directors to make informed decisions while providing an appreciation for the limitations in attracting applicants.
了解医学生在选择急诊医学（EM）培训项目时的决策，对于项目主任来说至关重要，因为他们即将进入面试季。为了在已有知识的基础上进一步了解，我们进行了一项调查，以确定并优先考虑影响美国医学毕业生候选人决策的因素。
这是一项横断面、多机构研究，匿名调查了参加急诊医学培训项目的美国医学毕业生申请者。该研究在 2011 年全国住院医师匹配项目（NRMP）排名提交截止日期和公布匹配结果之间的 3 周内进行。
在 1525 份邀请参加调查的邀请中，有 870 名候选人（57%）完成了调查。总体而言，96%的受访者表示地理位置和个人项目特点对决策很重要，在比较喜欢地理位置和喜欢项目特点的人数上大致相等。在这方面最重要的因素是对特定地理位置的偏好（74.9%，95%置信区间[CI] = 72%至 78%），以及靠近配偶、重要他人或家人（59.7%，95%CI = 56%至 63%）。与地理位置相关的因素往往超出项目领导层的控制范围。最重要的项目因素包括面试体验（48.9%，95%CI = 46%至 52%）、与住院医师的个人经历（48.5%，95%CI = 45%至 52%）和学术声誉（44.9%，95%CI = 42%至 48%）。与地理位置不同，个别项目因素往往直接或在一定程度上受项目领导层的控制。其他一些因素也被列为最重要的因素，出现的次数不成比例，包括在该急诊科轮转、定向（学术与社区）以及培训时长（3 年制与 4 年制项目）。对于一部分申请者来说，这些因素在总体决策中具有特别重要的意义。
绝大多数急诊医学住院医师项目的申请者在选择住院医师项目时，综合考虑了地理位置因素和个人项目因素。具体的项目特点是最大限度地提高当前面试体验/季节成功的最大机会，而其他因素则为长期战略规划提供了潜力。了解这些结果可以使项目主任在做出决策时更加明智，并认识到吸引申请者的局限性。
