Trends in NRMP Data from 2007-2014 for U.S. Seniors Matching into Emergency Medicine

Abstract

IntroductionSince 1978, the National Residency Matching Program (NRMP) has published data demonstrating characteristics of applicants who have matched into their preferred specialty in the NRMP main residency match. These data have been published approximately every two years. There is limited information about trends within these published data for students matching into emergency medicine (EM). Our objective was to investigate and describe trends in NRMP data to include the following: the ratio of applicants to available EM positions; United State Medical Licensing Examination (USMLE) Step 1 and Step 2 scores (compared to the national means); number of programs ranked; and Alpha Omega Alpha Honor Medical Society (AOA) membership among U.S. seniors matching into EM.MethodsThis was a retrospective observational review of NRMP data published between 2007 and 2016. We analyzed the data using analysis of variance (ANOVA) or Kruskal-Wallis testing, and Fischer’s exact or chi-squared testing, as appropriate to determine statistical significance.ResultsThe ratio of applicants to available EM positions remained essentially stable from 2007 to 2014 but did increase slightly in 2016. We observed a net upward trend in overall Step 1 and Step 2 scores for EM applicants. However, this did not outpace the national trend increase in Step 1 and 2 scores overall. There was an increase in the mean number of programs ranked by EM applicants over the years studied from 7.8 (SD4.2) to 9.2 (SD5.0, p<0.001), driven predominantly by the cohort of U.S. students successful in the match. Among time intervals, there was a difference in the number of EM applicants with AOA membership (p=0.043) due to a drop in the number of AOA students in 2011. No sustained statistical trend in AOA membership was identified over the seven-year period studied.ConclusionNRMP data demonstrate trends among EM applicants that are similar to national trends in other specialties for USMLE board scores, and a modest increase in number of programs ranked. AOA membership was largely stable. EM does not appear to have become more competitive relative to other specialties or previous years in these categories.

Comparison between Mexican and International Medical Graduates’ scores in the ENARM Competing for Clinical Specialities in Mexico during 2012-2019: Data Visualization, Trends and Forecasting Analyses

“…The limited information about trends for applicants matching into USA specialities has been previously addressed. Most foreign articles describe specific specialities' performance without comparing their nationals and IMG [34]. We learned from our findings that there is still missing information, and we do not know which scores at specialities are ruled by the applicants every year and which others by the level of difficulty of the exam; an additional analysis will be necessary to understand how the number of residency positions influences the scores at each medical speciality.…”

Medical School Resourcing of USMLE Step 1 Preparation: Questioning the Validity of Step 1

“…Although experts are brought together to develop this examination, the assertion that this exam provides a threshold for minimum competence in medical knowledge has not been challenged. Furthermore, in recent years, the mean for the exam continues to trend upward [9]. Additionally, the cottage industry of examination preparation has clouded the construct validity of USMLE Step 1 with concerns that test-taking ability, not medical knowledge, is truly being tested [15][16][17].…”

“…The single three-digit score and its misuse as the gateway to career choice and residency match have led to students' obsession in constantly striving for maximal numeric achievement. In fact, the national mean for USMLE Step 1 has continued to rise over the past 15 years from a mean of 216 to 230 [8,9]. This provoked a proverbial "arms race" with implications for medical schools attempting to be innovative and future-focused in preparing effective physicians for our changing health care landscape.…”

How well did our students match? A peer-validated quantitative assessment of medical school match success: the match quality score

“…Results of the residency match are another indication of the effectiveness of the medical education program [1]. While analysis of match results can be found in the literature [2][3][4], these are primarily from the perspective of graduate medical education programs (residencies), and quality estimations are limited to the number of programs/positions that did not fill, or from a basic comparison of overall applicant number to positions available [2][3][4][5][6][7]. Match results from undergraduate medical institutions, when reported at all, are comprised of qualitative assessments of the match performance that are subjective and prone to bias, making year-to-year comparisons between matches difficult, if not impossible.…”