Defying the Downtrend: Factors Driving Medical Students to Pursue Emergency Medicine

In recent years, the number of medical students applying to Emergency Medicine (EM) has sharply decreased. Burnout and workforce projections within the specialty have been cited as contributing factors. Counter to this trend, our institution observed a higher percentage of students pursuing EM than the national average each year. This study sought to understand the factors driving these students to pursue EM.

We performed a cross-sectional survey of medical students from our institution who matched into EM from 2022 to 2024. Participants completed an electronic survey about influences on how they learned about EM and on their decision to pursue an EM career. The survey consisted of rating scale and short answer questions. A test of binomial proportions assessed differences between rating scale items using the item with the most positive results as the reference. Short answer responses were grouped into categories and ranked by frequency.

A total of 31 of 41 (76%) students responded. The factors found to be most useful for learning about EM as a specialty were "Participation in clinical electives" (n = 28, 93.3%, reference) and "Advising/mentoring from residents" (n = 27, 90%, p = 0.64). In terms of choosing EM, clinical exposure to the specialty, particularly within the fourth year (n = 28, 90.3%, reference), and advising from attendings (n = 23, 74.2%, p = 0.1) and residents (n = 25, 80.6%, p = 0.28) were among the most influential factors. Most students decided to pursue EM during their third year (65%, n = 15).

The most influential factors driving our medical students to pursue EM were clinical exposure to EM and individual advising, particularly from EM residents. Focused efforts in these areas are potential strategies for other institutions to foster student interest in EM and counter the national trend.