Abstract
BackgroundThe objective of this study was to determine the advising and emergency medicine (EM) residency selection practices for special population applicant groups for whom traditional advice may not apply.MethodsA survey was distributed on the Council of Residency Directors in EM and Clerkship Directors in EM Academy listservs. Multiple choice, Likert-type scale, and fill-in-the-blank questions addressed the average EM applicant and special population groups (osteopathic; international medical graduate (IMG); couples; at-risk; re-applicant; dual-accreditation applicant; and military). Percentages and 95% confidence intervals [CI] were calculated.ResultsOne hundred four surveys were completed. Of respondents involved in the interview process, 2 or more standardized letters of evaluation (SLOEs) were recommended for osteopathic (90.1% [95% CI 84–96]), IMG (82.5% [73–92]), dual-accreditation (46% [19–73]), and average applicants (48.5% [39–58]). Recommendations for numbers of residency applications to submit were 21–30 (50.5% [40.7–60.3]) for the average applicant, 31–40 (41.6% [31.3–51.8]) for osteopathic, and > 50 (50.9% [37.5–64.4]) for IMG. For below-average Step 1 performance, 56.0% [46.3–65.7] were more likely to interview with an average Step 2 score. 88.1% [81.8–94.4] will consider matching an EM-EM couple. The majority were more likely to interview a military applicant with similar competitiveness to a traditional applicant. Respondents felt the best option for re-applicants was to pursue the Supplemental Offer and Acceptance Program (SOAP) for a preliminary residency position.ConclusionAdvising and residency selection practices for special population applicants differ from those of traditional EM applicants. These data serve as an important foundation for advising these distinct applicant groups in ways that were previously only speculative. While respondents agree on many advising recommendations, outliers exist.
Highlights
The objective of this study was to determine the advising and emergency medicine (EM) residency selection practices for special population applicant groups for whom traditional advice may not apply
Advisors need to be familiar with the importance of the residency application components, including but not limited to: the U.S Medical Licensing Exam (USMLE) Steps 1 & 2 Clinical Knowledge (CK) and Step 2 Clinical Skills (CS), which are required by U.S allopathic and international medical graduates (IMGs) for licensure to practice medicine in the U.S and optional for U.S osteopathic applicants; the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Levels 1, 2-Cognitive Evaluation (CE) and 2Performance Evaluation (PE), which are required for U.S osteopathic licensure; and the standardized letter of evaluation (SLOE), the gold standard letter of evaluation that EM applicants traditionally obtain from each of their EM audition rotations at an academic institution associated with a U.S EM residency program
A recent study showed that osteopathic applicants find their mentorship and advising regarding SLOEs to be lacking, highlighting the need for quality advising for this growing applicant population to Accreditation Council for Graduate Medical Education (ACGME)-accredited residencies [8]
Summary
The objective of this study was to determine the advising and emergency medicine (EM) residency selection practices for special population applicant groups for whom traditional advice may not apply. Advisors need to be familiar with the importance of the residency application components, including but not limited to: the U.S Medical Licensing Exam (USMLE) Steps 1 & 2 Clinical Knowledge (CK) and Step 2 Clinical Skills (CS), which are required by U.S allopathic and international medical graduates (IMGs) for licensure to practice medicine in the U.S and optional for U.S osteopathic applicants; the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Levels 1, 2-Cognitive Evaluation (CE) and 2Performance Evaluation (PE), which are required for U.S osteopathic licensure; and the standardized letter of evaluation (SLOE), the gold standard letter of evaluation that EM applicants traditionally obtain from each of their EM audition rotations at an academic institution associated with a U.S EM residency program. A recent study showed that osteopathic applicants find their mentorship and advising regarding SLOEs to be lacking, highlighting the need for quality advising for this growing applicant population to Accreditation Council for Graduate Medical Education (ACGME)-accredited residencies [8]
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