Dacre Michael, Hopson Laura R, Branzetti Jeremy, Regan Linda, Sebok-Syer Stefanie S, Gisondi Michael A
Stanford School of Medicine Stanford California USA.
University of Michigan Medical School Ann Arbor Michigan USA.
AEM Educ Train. 2021 Jul 1;5(3):e10616. doi: 10.1002/aet2.10616. eCollection 2021 Jul.
The number of residency applications submitted by medical students rises annually, resulting in increased work and costs for residency programs and applicants, particularly in emergency medicine. We propose a solution to this problem: an optional, two-stage Match with a "summer match" stage, in which applicants can submit a limited number of applications early. This would be conducted similarly to the early decision process for college admissions. The study objectives were to explore stakeholder opinions on the feasibility of a summer match and to identify the ideal logistic parameters to operationalize this proposal.
We used exploratory qualitative methodology following a constructivist paradigm to develop an understanding of the potential impact of a summer match. We interviewed 34 key stakeholders in the U.S. residency application process identified through purposive sampling including educational administrators (program directors, designated institutional officials, medical school deans) and trainees (students, residents). We coded and thematically analyzed interview data in two stages using an inductive approach.
We identified six themes from the participant interviews that broadly reflected issues of the residency application process, value, and equity. These themes included disrupting the status quo, logistic concerns, match strategy, differential benefits, unintended consequences, and return on investment. Most study participants supported the summer match concept, with medical students and residents most in favor. We developed a theoretical summer match protocol based on these findings.
A summer match may reduce the burdens of increasing residency applications and associated costs. Pilot testing is necessary to confirm this hypothesis and determine the impact of the proposed summer match protocol. Unintended consequences must be considered carefully during implementation.
医学生提交的住院医师培训申请数量逐年增加,给住院医师培训项目和申请者带来了更多的工作和成本,尤其是在急诊医学领域。我们提出了一个解决这一问题的方案:一个可选的两阶段匹配,其中包括一个“夏季匹配”阶段,申请者可以提前提交有限数量的申请。这一过程将类似于大学招生的提前决定程序。本研究的目的是探讨利益相关者对夏季匹配可行性的看法,并确定实施该方案的理想后勤参数。
我们采用探索性定性方法,遵循建构主义范式,以了解夏季匹配的潜在影响。我们通过目的抽样对美国住院医师培训申请过程中的34名关键利益相关者进行了访谈,包括教育管理人员(项目主任、指定机构官员、医学院院长)和学员(学生、住院医师)。我们分两个阶段使用归纳法对访谈数据进行编码和主题分析。
我们从参与者访谈中确定了六个主题,这些主题广泛反映了住院医师培训申请过程、价值和公平性等问题。这些主题包括打破现状、后勤问题、匹配策略、差异收益、意外后果和投资回报。大多数研究参与者支持夏季匹配的概念,医学生和住院医师最为支持。基于这些发现,我们制定了一个理论上的夏季匹配方案。
夏季匹配可能会减轻住院医师培训申请增加带来的负担和相关成本。需要进行试点测试以证实这一假设,并确定拟议的夏季匹配方案的影响。在实施过程中必须仔细考虑意外后果。