University of Michigan, Department of Emergency Medicine, Ann Arbor, Michigan.
University of Massachusetts Medical School - Baystate Health, Department of Emergency Medicine, Springfield, Massachusetts.
West J Emerg Med. 2020 Dec 10;22(1):77-85. doi: 10.5811/westjem.2020.10.48210.
The average number of applications per allopathic applicant to emergency medicine (EM) residency programs in the United States (US) has increased significantly since 2014. This increase in applications has caused a significant burden on both programs and applicants. Our goal in this study was to investigate the drivers of this application increase so as to inform strategies to mitigate the surge.
An expert panel designed an anonymous, web-based survey, which was distributed to US allopathic senior applicants in the 2017-2018 EM match cycle via the Council of Residency Directors in Emergency Medicine and the Emergency Medicine Residents Association listservs for completion between the rank list certification deadline and release of match results. The survey collected descriptive statistics and factors affecting application decisions.
A total of 532 of 1748 (30.4%) US allopathic seniors responded to the survey. Of these respondents, 47.3% felt they had applied to too many programs, 11.8% felt they had applied to too few, and 57.7% felt that their perception of their own competitiveness increased their number of applications. Application behavior of peers going into EM was identified as the largest external factor driving an increase in applications (61.1%), followed by US Medical Licensing Exam scores (46.9%) - the latter was most pronounced in applicants who self-perceived as "less competitive." The most significant limiter of application numbers was the cost of using the Electronic Residency Application Service (34.3%).
A substantial group of EM applicants identified that they were over-applying to residencies. The largest driver of this process was individual applicant response to the behavior of their peers who were also going into EM. Understanding these motivations may help inform solutions to overapplication.
自 2014 年以来，美国（US）申请急诊医学（EM）住院医师项目的全科学员的平均申请数量显著增加。这种申请数量的增加给项目和申请人都带来了巨大的负担。我们在这项研究中的目标是调查申请增加的驱动因素，以便为缓解这一增长提供策略。
一个专家小组设计了一个匿名的网络调查，通过急诊医学住院医师主任理事会和急诊医学住院医师协会的电子邮件列表，在 2017-2018 年 EM 匹配周期内向美国全科学员高年级申请者分发，要求他们在排名表认证截止日期和匹配结果发布之间完成调查。该调查收集了描述性统计数据和影响申请决策的因素。
共有 1748 名美国全科学员中的 532 名（30.4%）对调查做出了回应。在这些回答者中，47.3%的人认为他们申请的项目太多，11.8%的人认为他们申请的项目太少，57.7%的人认为他们对自己竞争力的看法增加了他们的申请数量。进入急诊医学领域的同行的申请行为被认为是导致申请数量增加的最大外部因素（61.1%），其次是美国医师执照考试成绩（46.9%）——在那些自我认为“竞争力较低”的申请者中，这一因素最为明显。限制申请数量的最重要因素是使用电子住院医师申请服务的成本（34.3%）。
相当一部分急诊医学申请人表示，他们对住院医师过度申请。这一过程的最大驱动力是个体申请者对也选择进入急诊医学领域的同行行为的反应。了解这些动机可能有助于为过度申请提供解决方案。
