Emergency Medicine Residency Applicants Research Articles

114 Emergency Medicine Residency Applicant Interview Scoring: Can a Global Visual Analog Scale Produce Reliable Results?

114 Emergency Medicine Residency Applicant Interview Scoring: Can a Global Visual Analog Scale Produce Reliable Results?

421 Comparison of the Multiple-Mini Interview With Traditional Interviewing Techniques For Emergency Medicine Residency Applicants: A Single-Institution Experience

421 Comparison of the Multiple-Mini Interview With Traditional Interviewing Techniques For Emergency Medicine Residency Applicants: A Single-Institution Experience

Emergency Medicine Residency Applicant Views on the Interview Day Process

Emergency medicine (EM) residency programs spend significant time and money offering an interview day experience for their applicants. The day may include a range of activities, although which are most important from the applicants' point of view are not known. An anonymous web-based survey was sent to all applicants to an EM residency program from the 2006/07 cycle. The study assessed factors about the interview day that were most helpful to applicants in assessing goodness of fit and preparing their rank list of programs. When considering whether a program was a good fit for them, the respondents chose (from most to least important) how happy the residents seem, faculty-resident relationships, how well the residents work together, resident and faculty values match my own, the residents spend time together outside of the residency, and the residents share my outside interests. Applicants most value assessing program "personality," informal off-campus gatherings with residents, and interviewing with the program director as ways to decide where a program will reside on their rank list. Touring off-campus emergency departments and off-service facilities received the lowest rating averages. Residency programs have the opportunity to control two of the three most important ways in which applicants use the interview day to assess programs by offering off-campus gatherings with residents and ensuring that every candidate interviews with the program director. Residency programs may use this knowledge to optimize interview day resources.

Emergency Medicine Residency Applicant Perceptions of Unethical Recruiting Practices and Illegal Questioning in the Match

The authors hypothesized that unethical recruiting practices and illegal questioning occur during emergency medicine (EM) resident recruitment. The objectives were to estimate the prevalence of specific unethical recruiting practices and illegal questioning by EM programs based on the perceptions of residency applicants and to measure the effect of these perceptions on applicant appraisal of programs. This was a cross-sectional survey of all applicants who matched to U.S. EM programs in 2005 and 2006. The survey questionnaire was developed by the study authors and was validated by pretesting on a small group representative of the study population. The survey addressed specific questions regarding program recruiting behaviors and interview questioning. The hyperlink to the secure anonymous online survey questionnaire was distributed to all EM program directors, asking them in turn to forward the hyperlink to their newly matched incoming residency class. All data were calculated with Score method with continuity correction and reported in proportions with 95% confidence intervals (CIs). The authors received 671 survey responses. Among respondents, 56 (8.3%, 95% CI = 6.4% to 10.7%) stated that they were specifically asked to disclose at least one program's position on their rank list by a program representative, and 44 (6.6%, 95% CI = 4.9% to 8.9%) reported that they matched at a program residing lower on their rank list than at least one other program that had informed the applicant they were ranked to match. Furthermore, 201 respondents (30.0%, 95% CI = 26.5% to 33.7%) believed that they were asked at least one illegal question during their interviews, the most common of which was inquiry into their marital status (189 respondents: 28.2%, 95% CI = 24.8% to 31.9%). Respondents were 11 times more likely to move a program to a lower position of preference on their rank order list (12.2%, 95% CI = 9.8% to 15.0%) rather than a higher position (1.1%, 95% CI = 0.5% to 2.3%) as a result of perceiving unethical recruiting behaviors or illegal questioning. These results demonstrate that among survey respondents, some perceived unethical recruiting behaviors and illegal questioning in the 2005 and 2006 Match. Perceptions of such behaviors appeared to have a negative impact on applicant appraisal of EM residency programs.

The impact of a rural emergency department rotation on applicant ranking of a US emergency medicine residency program

Few US emergency medicine (EM) residency programs have been located in rural states due to program requirements for emergency department (ED) patient volume. Recent revision to the program requirements now permits 'educationally justifiable exceptions' to the patient population requirement, 'such as clinical sites in a rural setting', and some EM residency programs now plan to offer rural ED clinical experiences as a required curricular component. The impact of a required rural EM rotation on the ranking decisions of applicants is important to residency programs seeking to attract the most desirable applicants. To assess the impact of a required rural ED rotation on applicant ranking of an EM residency program in the US National Resident Matching Program (NMRP). All applicants to the study's EM residency program completing the interview portion of the application process received a mailed and emailed survey following the release of the 2004 NMRP results. The survey included questions addressing the rural/non-rural classification of the location of the applicants' childhood home, medical school, and anticipated future practice. Of 46 eligible subjects, 32 (69.6%) completed the survey. Of subjects with a rural childhood, 73.3% reported a positive impact on rank order (95% CI 50.9-95.7%) and 26.7% reported no impact (CI 4.3-49.1%); 81.3% of subjects with non-rural backgrounds reported no impact (CI 62.2-100%), 12.5% higher rank (CI 0-28.7%), and 6.3% lower (CI 0-18.2%). If planning a future practice in a rural community, 83.3% reported positive impact (CI 62.2-100%) and 16.7% no impact (CI 0-37.8%); 78.9% of subjects anticipating future practice in non-rural communities reported no impact (CI 60.6-97.3%), 15.8% higher rank (CI 0-32.2%), and 5.3% lower (CI 0-15.4). Of the subjects attending medical school in rural states, 52.2% reported a positive impact (CI 31.8-72.6%) and 47.8% no impact (CI 27.4-68.2%), while 75% of graduates of medical schools in non-rural states reported no impact (CI 32.6-100%) and 25% (CI 0-67.4%) a negative impact. The presence of a rural ED rotation did not adversely impact EM residency applicants' ranking of the program.

367: Emergency Medicine Residency Applicants’ Perceptions About Being Contacted After Interview Day

367: Emergency Medicine Residency Applicants’ Perceptions About Being Contacted After Interview Day

Successful Reduction of Inaccuracies on Emergency Medicine Residency Applications: We Can Affect Behavior!

Successful Reduction of Inaccuracies on Emergency Medicine Residency Applications: We Can Affect Behavior!

Identifying inaccuracies on emergency medicine residency applications

BackgroundPrevious trials have showed a 10–30% rate of inaccuracies on applications to individual residency programs. No studies have attempted to corroborate this on a national level. Attempts by residency programs to diminish the frequency of inaccuracies on applications have not been reported. We seek to clarify the national incidence of inaccuracies on applications to emergency medicine residency programs.MethodsThis is a multi-center, single-blinded, randomized, cohort study of all applicants from LCME accredited schools to involved EM residency programs. Applications were randomly selected to investigate claims of AOA election, advanced degrees and publications. Errors were reported to applicants' deans and the NRMP.ResultsNine residencies reviewed 493 applications (28.6% of all applicants who applied to any EM program). 56 applications (11.4%, 95%CI 8.6–14.2%) contained at least one error. Excluding "benign" errors, 9.8% (95% CI 7.2–12.4%), contained at least one error. 41% (95% CI 35.0–47.0%) of all publications contained an error. All AOA membership claims were verified, but 13.7% (95%CI 4.4–23.1%) of claimed advanced degrees were inaccurate. Inter-rater reliability of evaluations was good. Investigators were reluctant to notify applicants' dean's offices and the NRMP.ConclusionThis is the largest study to date of accuracy on application for residency and the first such multi-centered trial. High rates of incorrect data were found on applications. This data will serve as a baseline for future years of the project, with emphasis on reporting inaccuracies and warning applicants of the project's goals.

Enforcing Accuracy on Emergency Medicine Residency Applications

Enforcing Accuracy on Emergency Medicine Residency Applications

The influence of an emergency medicine ultrasonography program on the ranking of senior medical students who choose emergency medicine residencies: A prospective survey

Study objectives: We assess the importance of an active ultrasonography program on residency program selection among senior medical students applying to enter an emergency medicine residency. Methods: This institutional review board–approved, prospective survey was sent by electronic mail to 250 senior medical students who had submitted their e-mail address to our emergency medicine residency program (subsequent to match list submission). The survey consisted of 12 questions pertaining to how the inclusion of an active ultrasonography program influenced their residency match list choices. Results: A total of 62 (25%) senior medical students responded. (A small number of surveys were returned unanswered because of e-mail address changes.) Ninety-four percent of the senior medical students stated that an active ultrasonography program was a priority to them. The majority (80%) stated that an active ultrasonography program was either somewhat important (53%) or extremely important (27%) in their ranking of an emergency medicine residency program. Sixty-two percent stated that if the emergency medicine residency program did not have an ultrasonography machine in the emergency department, they would change their program choice, and 66% said that they would not rank the program "highly." Seventy-four percent stated that an ultrasonography rotation would be a priority in their training, and 55% stated that it was an influencing factor in their decision to rank emergency medicine residency programs. Additionally, 53% stated that a 1-month rotation was desirable. Ninety percent stated that ultrasonography was either very important (56%) or extremely important (34%) to the emergency practice, although faculty without credentials or who had not published did not affect ranking of emergency medicine residency programs, 97% and 100%, respectively. The ultrasonographic techniques stated to be most important are as follows; echo/cardiac tamponade (95%), right upper quadrant ultrasonography/hepatobiliary disease (92%), pneumothorax/pleural effusion (75%), central venous access (61%), paracentesis (56%), and gastric content assessment for sedation (37%). Conclusion: Emergency medicine residency applicants are greatly influenced by an active ultrasonography program, and it is a major determinant in the decision to rank a program more highly.

Emergency medicine residency applicant educational debt: relationship with attitude toward training and moonlighting.

Heated debate persists regarding the role of resident moonlighting in emergency medicine (EM). The attitudes of EM residency applicants have not been assessed. The objectives of this study were to assess: 1) the level of educational debt among EM residency applicants, 2) their perception of increased risk potential to patients from unsupervised EM resident practice, and 3) their opposition to laws restricting moonlighting. The authors then report the relationship between the degree of indebtedness and these stated positions. Fifty-four EM residency programs returned 393 responses to a 1996 anonymous survey. Applicants recorded: 1) their indebtedness, 2) whether they believed that EDs should hire only physicians who have completed full training in an EM residency, and 3) whether they believed that unsupervised EM practice prior to completing EM training carries a higher risk of adverse patient outcomes. The authors used a t-test and logistic regression to determine whether there was any significant difference in debt between responders who answered yes and those who answered no to the various questions. A p-value < 0.05 was considered significant. The mean +/- SD debt was $72,290 +/- 48,683 (median $70,000). Most EM applicants (84.8%) agreed that unsupervised medical care by EM residents carries a higher risk of adverse patient outcomes. Paradoxically, only half the applicants opposed a moonlighting ban. Responses did not statistically correlate with educational debt. Emergency medicine residency applicant debt is large. The EM applicants' opposition to laws that would restrict moonlighting was mixed. This was inconsistent with the majority acknowledging an increased risk potential to patients. Nearly all EM applicants would still select EM as a career, even if moonlighting were to be banned.

Selection criteria for emergency medicine residency applicants.

To determine the criteria used by emergency medicine (EM) residency selection committees to select their residents, to determine whether there is a consensus among residency programs, to inform programs of areas of possible inconsistency, and to better educate applicants pursuing careers in EM. A questionnaire consisting of 20 items based on the current Electronic Residency Application Service (ERAS) guidelines was mailed to the program directors of all 118 EM residencies in existence in February 1998. The program directors were instructed to rank each item on a five-point scale (5 = most important, 1 = least important) as to its importance in the selection of residents. Followup was done in the form of e-mail and facsimile. The overall response rate was 79.7%, with 94 of 118 programs responding. Items ranking as most important (4.0-5.0) in the selection process included: EM rotation grade (mean +/- SD = 4.79 +/- 0.50), interview (4.62 +/- 0.63), clinical grades (4.36 +/- 0.70), and recommendations (4.11 +/- 0.85). Moderate emphasis (3.0-4.0) was placed on: elective done at program director's institution (3.75 +/- 1.25), U.S. Medical Licensing Examination (USMLE) step II (3.34 +/- 0.93), interest expressed in program director's institution (3.30 +/- 1.19), USMLE step I (3.28 +/- 0.86), and awards/achievements (3.16 +/- 0.88). Less emphasis (<3.0) was placed on Alpha Omega Alpha Honor Society (AOA) status (3.01 +/- 1.09), medical school attended (3.00 +/- 0.85), extracurricular activities (2.99 +/- 0.87), basic science grades (2.88 +/- 0.93), publications (2.87 +/- 0.99), and personal statement (2.75 +/- 0.96). Items most agreed upon by respondents (lowest standard deviation, SD) included EM rotation grade (SD 0.50), interview (SD 0.63), and clinical grades (SD 0.70). Of the 94 respondents, 37 (39.4%) replied they had minimum requirements for USMLE step I (195.11 +/- 13.10), while 30 (31.9%) replied they had minimum requirements for USMLE step II (194.27 +/- 14.96). Open-ended responses to "other" were related to personal characteristics, career/goals, and medical school performance. The selection criteria with the highest mean values as reported by the program directors were EM rotation grade, interview, clinical grades, and recommendations. Criteria showing the most consistency (lowest SD) included EM rotation grade, interview, and clinical grades. Results are compared with those from previous multispecialty studies.

Misrepresentation of Research Publications Among Emergency Medicine Residency ApplicantsGurudevan & Mower

Study objective: To assess the prevalence of misrepresented citations among emergency medicine residency applicants and to determine whether misrepresentation increases as the number of citations increases. Methods: We examined 350 consecutive emergency medicine residency applications and then reviewed all cited publications to determine whether they were genuine or misrepresented. Applicants with citations were divided into three groups: those who listed one citation, those with two to four citations, and those with five or more citations. The numbers of individuals and misrepresentations were then tabulated and compared among the groups. Results: Publications were cited on 113 applications (32.3%). Twenty-three applicants (20.4% of those who cited publications and 6.6% of all applicants) misrepresented citations. Misrepresentations were found in 8 of 56 applications listing single citations (14.3%), 8 of 46 applications (17.4%) claiming two to four citations, and 7 of 11 (63.6%) applications claiming five or more citations (P=.00081, Pearson χ2 test). Conclusion: Emergency medicine residency applications may contain misrepresented citations. The number of misrepresentations in this study increased as the number of citations increased. [Gurudevan SV, Mower WR: Misrepresentation of research publications among emergency medicine residency applicants. Ann Emerg Med March 1996;27:327-330.]See related editorial, Misrepresentation of Resident Credentials