Geographic mobility in the emergency medicine residency match and the influence of gender.

Abstract

Women are underrepresented in emergency medicine (EM) leadership. Some evidence suggests that geographic mobility improves career advancement. We compared movement between medical school and residency by gender. Our hypothesis was that women move a shorter distance than men. We collected National Residency Matching Program (NRMP) lists of ranked applicants from eight EM residency programs from the 2020 Main Residency Match. We added the gender expressed in interviews and left the Association of American Medical Colleges (AAMC) number as the unique identifier. Applicant data for matched osteopathic and allopathic seniors in the continental United States was included. We obtained street addresses for medical schools from an AAMC database and residency program addresses from the ACGME website. We performed geospatial analysis using ArcGIS Pro and compared results by gender. NRMP approved the data use and our institutional review board granted exempt status. A total of 881 of 944 unique applicants met inclusion criteria and included 48.5% (830/1,713) of matched allopaths and 37% of all matched seniors; 48% (420) were female. There was no significant difference between genders for distance moved (p=0.31). Women moved a mean (±SD) 619 (±698) miles (median=341 miles, range=0-2,679 miles); and men, a mean (±SD) 641 (±717) miles (median=315 miles, range=0-2,671 miles). Further analysis of applicants traveling less than 50 miles (49 women, 51 men) and by census division showed no significant frequency differences. Women and men travel similar distances for EM residency with the majority staying within geographic proximity to their medical school. This suggests that professional mobility at this stage is not a constraint. Our study findings are limited because we do not know which personal and professional factors inform relocation decisions. Gender is not associated with a difference in distance moved by students for residency. This finding may have implications for resident selection and career development.