March 17 was Match Day, the day when nearly 43,000 medical school graduates discovered where they would spend the next three to seven years finishing their graduate medical training. Residency is required before medical school graduates can practice medicine in the United States.
Around September applicants usually begin exploring residency programs at teaching hospitals across the United States. Applicants rank their preferred programs, while program directors rank applicants in the order of who they prefer to train. A computer algorithm processes the ranked preferences of applicants and program directors, finding the best match of applicants to programs. As I wrote in a previous post, there aren’t enough residency slots for all who apply. There were approximately 2,577 more medical graduates applying than residency slots in 2023.
Some cities with teaching hospitals are more popular among graduates than others. Some physician specialties earn more than others, while some have better working conditions. Thus, some residency programs are in higher demand and are thus more competitive. In years past a resident specialty that was highly sought after was emergency medicine, but that is changing.
Many medical school graduates consider emergency medicine exciting. It also pays well. The average salary is between $300,000 and $400,000 a year. However, the Washington Post confirms a trend that I noticed last year. Emergency medicine is losing popularity.
According to the Washington Post:
[M]ore than 550 emergency medicine positions were unfilled headed into Match Week, when graduating medical students are assigned to the hospitals that will train them. That was more than double the 219 unfilled positions at the same time last year.
Now students like Traylor — who were drawn to the unpredictability and challenges of emergency medicine and the opportunity to care for society’s most vulnerable — are having second thoughts.
In years past hospitals with emergency medicine residencies could command the best and brightest medical graduates but are now scrambling to find students willing to train in ERs.
Even well-known hospitals in major cities — Duke University School of Medicine in Durham, N.C., Einstein Medical Center in Philadelphia and Baylor University Medical Center in Dallas — had open emergency resident slots after the first round, according to a list circulated to students who did not match in the first round. The three hospitals said all of their positions were eventually filled.
Hospitals with open positions were able to ultimately fill them through a supplemental offer and acceptance program (SOAP), which is like a second-round match to fill unmatched residency slots. The SOAP is sort of a Plan B. Residents who failed to match in the first round may have to switch fields or study far away from friends and family. The SOAP is also a Plan B for residency program directors, who may have to settle for graduates who were not their first, second or even their third choice.
Why did emergency medicine fall from among the most popular residencies to among those who have to scramble to fill slots? Experts say there are a variety of reasons. Emergency medicine residency programs have expanded in recent years leading to fears of an oversupply that could limit job prospects and reduce wages. Then there are the working conditions. The Covid Pandemic laid bare the level of stress in emergency departments inundated with more patients than could be treated and too little staff to care for them. Burnout among doctors and nurses staffing the ER during Covid was common. Another reason that emergency medicine has lost its luster in recent years is that big, investor-owned emergency medical staffing firms have largely taken over management of hospital ERs. To boost profits ER staffing firms reduce staffing levels and try to hold the line on ER physicians’ compensation. The No Surprises Act of 2020, limiting surprise medical bills, also reduced the medical fees staffing firms could charge patients. Thus, doctors who are trained in emergency medicine are finding their career prospects are less lucrative than in years past and the workload heavier.
2 thoughts on “Washington Post: Medical Students Losing Interest in Emergency Medicine”
After I wrote this using the Washington Post as source material I later found nearly a dozen other publications discussing the same phenomenon. The Washington Post didn’t really mention private equity taking over ER management, although someone they interviewed did. Last year I read on Reddit where some medical students were discussing the decline in emergency medicine. The only reason they gave for it losing popularity was the new bosses ER docs would have to work for. There are undoubtedly many reasons but heavier workloads and lighter pay was primary.