Differences in Residency Advising and Mentorship for Osteopathic and Allopathic Emergency Medicine Applicants

There has been a notable increase in osteopathic (DO) medical students applying to emergency medicine (EM) residency programs following the integration of the graduate medical education (GME) accreditation system. Despite this growth, DO students face significant challenges, including limited access to home EM residency programs and specialty-specific advising compared to their allopathic (MD) counterparts. Previous research indicates substantial dissatisfaction among DO students regarding the availability and quality of EM residency advising. Consequently, there is a critical need to identify specific advising disparities between DO and MD applicants to improve the residency application experience. The purpose of this study was to evaluate differences in residency application advising and mentorship between DO and MD medical students applying to emergency medicine.

Fourth-year medical students completing an EM sub-internship at a single Mountain West academic institution between June and December 2023 were invited to complete an anonymous 16-item survey assessing advising in three domains: EM sub-internship preparation, Electronic Residency Application Service (ERAS) application preparation, and interview preparation and communication. Demographic data included degree type (DO/MD) and gender. Categorical variables were summarized as n (%). MD and DO students were compared using chi-square or Fisher's exact tests, as appropriate. Statistical significance was defined as p < 0.05.

Twenty-nine of 41 eligible students completed the survey (71%), including 14 (48%) DO and 15 (52%) MD students; 16 (55%) were male and 13 (45%) were female. MD students were more likely than DO students to have a home EM residency program, 13 (87%) versus 4 (29%) (p = 0.003). No differences were identified in training on presentations, assessment and plans, or documentation. However, MD students were more likely to receive coaching on calling consultants/admitting services, 10 (67%) versus 1 (7%) (p = 0.002). MD students also more frequently received advising on residency program selection, 7 (47%) versus 1 (7%) (p = 0.035). Non-significant trends favored MD students for feedback on ERAS experiences, 7 (47%) versus 2 (14%) (p = 0.11), impactful experiences, 6 (40%) versus 2 (14%) (p = 0.21), mock interviews, 13 (87%) versus 7 (50%) (p = 0.050), and post-interview communication guidance, 10 (67%) versus 4 (29%) (p = 0.066). No significant differences were observed by gender.

This study demonstrates significant disparities between osteopathic and allopathic EM residency applicants in access to advising and mentorship, especially in home EM residency programs, communication training with consultants, and program selection guidance. The results highlight the necessity for targeted interventions and structured advising resources to support DO students, thereby promoting equitable opportunities for all applicants.