Emergency medicine residencies more likely to go unfilled at for-profit and newly accredited programs

• The number of unfilled positions in emergency medicine residency programs surged in 2022 and 2023, with the trend most pronounced at programs that were recently accredited or under for-profit ownership.
• The proportion of medical students applying for emergency medicine residencies dropped by 16.8% from 2021 to 2022 and declined another 18.1% from 2022 to 2023.
• Deepening the problem is the fact that the number of emergency medicine residency programs has grown at the same time.

No checks on the for-profit sector

• Currently, there are no limits on the number of residency programs or positions in emergency medicine.
• Despite the fact that positions are already going unfilled, eight new emergency medicine residency programs were accredited during the 2022-23 academic year.

More positions, lower demand

• In our recent paper, my team and I calculated the number of emergency medicine residency programs that filled all positions in the past two match cycles.
• Our study shows that in 2022, 277 emergency medicine residency programs offered 2,921 positions and had 219 unfilled positions.
• Third, emergency medicine residency programs with for-profit clinical sites were less likely to fill all residency positions.

Possible solutions

• In 1996, the anesthesiology specialty saw the proportion of filled residency positions drop to 45%, an all-time low.
• No research yet has evaluated board exam pass rates of emergency medicine residents graduating from newly accredited or for-profit clinic sites.
• And more female residents would be drawn into emergency medicine if disparities in pay and concerns over violence in emergency rooms were systematically resolved.

Cameron Gettel receives funding from the National Institute on Aging (NIA) of the National Institutes of Health and the American Board of Emergency Medicine / National Academy of Medicine Fellowship. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation or approval of the manuscript.