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Foreword

Students are applying to twice as many residency programs as they were a decade ago. But what does the data show to be effective for matching in emergency medicine?  We’ve broken it down for you.

Every year on the third Friday of March, medical students across the country open their “Match Day” envelopes and (hopefully) breathe a sigh of relief to discover they will be training at one of their top-choice programs. It’s the culmination of years of hard work, and it comes at the end of an exceptionally stressful process.

This book will help alleviate some of that stress. We want to help you apply smarter, not harder.

As promised in the subtitle, we have focused on the evidence. What does the data show to be effective for matching in emergency medicine? We’ve broken it down for you. An incredible team of authors and editors have worked hard to bring you a highly referenced, evidence-based road map to joining this incredible specialty of ours.

The data is reassuring. Across all specialties, half of all U.S. seniors will end up at their top-ranked program, and threequarters of seniors will end up at one of their top 3 choices. Yet students are applying to twice as many residency programs as they were a decade ago: 53.8 in 2018, compared to only 25.7 in 2008. Consequently, program directors — now inundated with more applications than ever before — are forced to resort to filtering applications, and tools like the AAMC Standardized Video Interview are being considered to help assess applicants.

Why are students over-applying? The most common response I hear is “because emergency medicine is becoming more competitive.” But does the evidence support this assertion? Approximately 90% of all EM-bound U.S. seniors continue to match in EM each yerar, and over the past decade, the 4 NRMP “Charting Outcomes in the Match” reports that have been released show that mean Step 1 scores and number of volunteer and work experiences for EM applicants remain average. In fact, EM consistently falls below average in terms of the percentage of Alpha Omega Alpha members matched and the average number of research experiences and abstracts/posters presented.

While the NRMP’s “Charting Outcomes” helps students predict their likelihood of matching based upon the number of programs on their rank list, it doesn’t help students understand the number of applications they need to secure enough interviews to build a rank list that will guarantee a match. This is where the AAMC’s Point of Diminishing Returns figures come into play. For example, students with low Step 1 scores (< 215) applying to EM will experience diminishing returns after 32 programs, while students with Step 1 scores at or above the national average (> 234) will experience diminishing returns after only 18 programs. The evidence shows that scattershooting for a residency spot will not be as effective as fine-tuning your application strategy. That’s where this book shines. Using evidence — not anecdotes from years past — we help you position yourself for success.

This book also includes targeted tips for:

  • Osteopathic students
  • IMG students
  • Military match
  • Couples
  • Dual training
  • Latecomers
  • At-risk students

We know the match process (and everything leading up to it) can be daunting. We know you’re getting advice from all corners. But we also know you are going to be OK. Using the evidence we’ve distilled in this book, turn your attention to applying smarter, not harder.

Good luck! We look forward to welcoming you as colleagues in emergency medicine!

Zach Jarou, MD
Editor-in-Chief