Do Medical Students Match into Emergency Medicine Programs where they Rotate? Andrew Micciche 1 ; Eric Reid, MD 2 ; Sameer Desai, MD 2 1 University of Kentucky College of Medicine, 2 University of Kentucky Healthcare Chandler Hospital, Department of Emergency Medicine

Abstract As matching into emergency medicine continues to become more competitive for medical students, examining the factors that increase the chances of matching becomes more important. This study was designed to determine how useful rotating at an institution was, and whether it increases your chances of matching to that program. We performed a cross-sectional survey of program administrators subscribed to the CORD listserv after the 2015 match was completed. Questions focused on how many incoming residents rotated at their institution as medical students, and whether away rotators were guaranteed interviews. A total of 67 separate institutions responded to the survey accounting for 757 residency positions. The majority of emergency medicine residency positions in this survey went to medical students that had not rotated at the program into which they matched. Participating as an away rotator however, is likely more advantageous then being a home rotator, and also appears to increase your likelihood of receiving an interview since many programs interview all away rotators that apply.

Introduction Anecdotal evidence from talking to students and faculty within Emergency Medicine suggests that matching into the specialty is becoming more competitive, and data released by the NRMP supports this notion. From 2010 to 2015, total applicants to Emergency Medicine rose from 2,055 to 2,352, (increase of 14.5%), and the number of spots offered rose from 1,556 to 1,821, (increase of 17%). However, the number of total ranked positions rose from 17,023 to 22,810, (increase of 34%). This means that applicants are interviewing at more programs, which makes getting an interview at any certain institution harder to obtain. With away rotations students are able to essentially audition at other programs before applying. Many programs offer interviews to all students who rotate at their institution, which students can use to their advantage in order to get their foot in the door at a desired program. We were interested in analyzing what effect away rotations have on matching within Emergency Medicine. Do they result in students being more likely to match at that institution, or is the effect the opposite?

Methods Our data was gathered through a cross-sectional survey of Emergency Medicine residency program administrators who were subscribed to the Council of Emergency Medicine Residency Directors (CORD) listserv. The survey was sent following completion of the 2015 match, and consisted of 8 questions. All of the question categories were mandatory, and incomplete survey responses were not included in the study. Participants were informed that all identifying information would be removed from the responses upon completion of the data collection. The survey was performed with IRB approval.

Results The survey results were collected over the course of 2 weeks, and 67 institutions responded. This represented 757 of the 1,821 available residency positions. The differences in the percentages of students matching into each category was statistically significant (p<.0001). Spots going to individuals from the home institution. 116/ % Spots to individuals who performed away rotations. 170/ % Spots to individuals who completed neither a visiting rotation nor home elective. 471/ %

Results Home rotatorsAway rotatorsAll others 42 programs that interviewed all away rotators at some time during the interview process. 72/478 (15.06%) 93/478 (19.46%) 313/478 (65.48%) 12 programs that interview students while on their visiting rotations. 23/144 (15.97%) 35/144 (24.31%) 86/144 (59.72%) 42 of the 67 respondents (62.7%) offered interviews to all away rotators at some time during the interview process, while 11 of these programs arranged to interview the students during their away rotation. One school would interview some of their visiting rotators during their 4 week elective, but not all. The differences in the percentages of the 3 columns in table 2 were not statistically significant, meaning away rotators were no more or less likely to match at a program if interviewed during the rotation.

Conclusions Students who perform visiting rotations in Emergency Medicine at a particular program are more likely to match there when compared to students who performed home electives at that institution. The majority of Emergency Medicine residency positions in this survey went to medical students that had not rotated at the program at which they matched. Our mean number of away rotators at programs in our survey was approximately 22 students, which means that about 9.1% of them may match at that program as opposed to the applicant pool at large. In our study, offering interviews to all visiting students, during the rotation or not, did not have a very appreciable effect on the matching numbers. Additionally, some programs matched no away rotators, while other programs had over 50% of their spots go to away rotators; this demonstrates the increasingly varied impact and utility of the visiting rotation amongst EM programs.

References National Resident Matching Program, Advance Data Tables: 2015 Main Residency Match. National Resident Matching Program, Washington, DC National Resident Matching Program, Results and Data: 2010 Main Residency Match. National Resident Matching Program, Washington, DC