Lewis Mary, Williams Kathleen, Timpe Joshua, Corbo Samuel, Wilbanks Morgan, Hayes Alisa K
Emergency Medicine, Medical College of Wisconsin, Milwaukee, USA.
Cureus. 2023 May 5;15(5):e38601. doi: 10.7759/cureus.38601. eCollection 2023 May.
Introduction The emergency medicine (EM) match has undergone significant shifts in 2022 and 2023. While variation in specialty fill rates is expected over time, EM programs noted a significant increase in open positions starting in 2022. Utilizing National Resident Matching Program (NRMP) data over a 10-year period, we identified significant deviations in the emergency medicine match. Methods Shewhart control charts were used to plot the match results over time. A 10-year sample was used to establish the baseline value. From this value, the upper and lower control limits were established. Residency program expansion, decreasing applicant numbers, and changing applicant types were evaluated to detect any non-random changes to the process. Results While the number of EM PGY-1 positions added over time was within the expected range, both the number of unmatched positions and the change in the number of total US MD applicants were outside of this range and are considered to be "out of control." Conclusion It is not yet clear which contributing causes may underlie this sudden change. Several potential etiologies exist, including mismatches in supply and demand for positions, changes in perceptions of the specialty, the effects of COVID-19, and changing workforce needs. Historically similar experiences affecting other specialties, including anesthesia and radiation oncology, are analyzed. Potential solutions for returning to the necessary and usual success of the emergency medicine specialty match are explored.
引言 急诊医学（EM）住院医师匹配在2022年和2023年发生了重大变化。虽然随着时间的推移，专科填补率会有所变化，但急诊医学项目指出，自2022年起空缺职位显著增加。利用国家住院医师匹配计划（NRMP）十年期间的数据，我们发现急诊医学匹配存在显著偏差。方法 使用休哈特控制图绘制随时间变化的匹配结果。以十年的样本数据确定基线值。据此确定控制上限和下限。评估住院医师项目扩张、申请人数量减少以及申请人类型变化，以检测该过程中是否存在任何非随机变化。结果 虽然随着时间的推移增加的急诊医学PGY-1职位数量在预期范围内，但未匹配职位数量和美国医学博士申请人总数的变化均超出该范围，被视为“失控”。结论 尚不清楚导致这一突然变化的潜在原因。存在多种潜在病因，包括职位供需不匹配、对该专科认知的变化、COVID-19的影响以及劳动力需求的变化。分析了历史上影响其他专科（包括麻醉和放射肿瘤学）的类似情况。探讨了使急诊医学专科匹配回归到必要且通常成功状态的潜在解决方案。
