EM-bound medical students must identify factors that will influence their selection of residency programs. They then rank programs using those criteria as well as information gained during the interview process. Love et al described the programmatic and geographical factors related to residency applicant program choice; however, we believe there are “red flags” that may cause an applicant to either lower their ranking of a program or not rank it at all. Our objective was to, therefore, describe the factors that medical students identify as “red flags,” during the EM residency recruitment process. We conducted a mixed-methods cohort study of graduates of US medical schools applying in emergency medicine (EM). We distributed our survey between the rank list certification (February 21st, 2020) and match day (March 20, 2020). As part of the survey, medical students were asked to provide a free text response to the following question, “Please describe any “red flags” that caused you to significantly lower the position of a program on your rank list or not rank it at all.” Two independent reviewers then performed a thematic analysis and discrepancies were addressed via consensus with third-party oversight. We received a total of 1,183 completed surveys that met inclusion criteria and comprised 42% of all US applicants. The median age of respondents was 27 years, 55% were male, 44% were female, and <1% were nonbinary or preferred not to answer. Our respondents were diverse with 23% of our cohort identifying as underrepresented in medicine (URiM). Applicants were 66% white, 13% Asian, 8% black, and 10% of our population identified Latino. A total of 11% of respondents identified as LGBTQIA+. Forty-one percent of applicants identified as nontraditional students. Of all respondents, 73% reported “red flags” that we grouped via thematic analysis into 6 key themes - “Resident wellbeing/program culture,” “leadership concerns,” “training environment/quality,” “program characteristics,” “interview day,” and “lack of diversity and discrimination” (Figure 1). An alarmingly high 73% of EM-bound medical students reported “red flags” during the application and recruitment process that fit within 6 key themes. While some factors such as “program characteristics,” are difficult to change, program leadership should focus on increasing wellness, maintaining a positive culture, focusing on quality, and confronting discrimination while supporting diversity.