The 2022 and 2023 Emergency Medicine Residency Match: A Cautionary Tale

Area of Science:

• Medical Education
• Residency Matching
• Emergency Medicine

Background:

• The emergency medicine (EM) residency match experienced notable shifts in 2022 and 2023.
• Programs observed a significant rise in open positions starting in 2022.

Purpose of the Study:

• To analyze National Resident Matching Program (NRMP) data over a decade to identify significant deviations in the EM match.
• To evaluate factors contributing to non-random changes in the EM match process.

Main Methods:

• Utilized Shewhart control charts to plot EM match results over a 10-year period.
• Established baseline values and control limits to detect deviations.
• Assessed residency program expansion, applicant numbers, and applicant types.

Main Results:

• The number of EM PGY-1 positions added was within the expected range.
• The number of unmatched positions and the change in total US MD applicants were outside control limits, indicating significant deviations.
• These changes suggest a non-random process shift in the EM match.

Conclusions:

• The precise causes for the recent EM match changes remain unclear.
• Potential factors include supply-demand imbalances, specialty perception shifts, COVID-19 effects, and workforce needs.
• Analysis of similar historical shifts in other specialties and exploration of potential solutions are discussed.