Unfilled in emergency medicine: An analysis of the 2022 and 2023 Match by program accreditation, ownership, and geography

Abstract

BackgroundThe two most recent National Resident Matching Program (NRMP) Match cycles saw a high number of initially unfilled emergency medicine (EM) residency positions. We sought to identify the risk of EM residency program characteristics including accreditation duration, primary clinical site ownership status, and geography pertaining to not initially filling all positions.MethodsWe performed a repeated cross‐sectional observational study of EM residency programs participating in the 2022 and 2023 NRMP Match cycles and used publicly available data from the NRMP, the Accreditation Council for Graduate Medical Education, the Centers for Medicare & Medicaid Services, and the U.S. Department of Housing and Urban Development. Our primary outcome was the proportion of EM residency programs that did not initially fill positions, with analyses stratified by accreditation duration (>5 or ≤5 years), primary clinical site ownership status, and geographic core‐based statistical areas (CBSAs).ResultsA total of 219 of 2921 (7.5%) positions in the 2022 Match and 554 of 3010 (18.4%) positions in the 2023 Match were initially unfilled. Over the 2‐year period, EM residency programs accredited within the past 5 years had more than double the risk (relative risk [RR] 2.08, 95% confidence interval [CI] 1.69–2.57, chi‐square p < 0.001) of not filling all positions compared to those accredited more than 5 years previously. EM residency programs with a primary clinical site under for‐profit ownership had a 50% greater risk of not filling all positions when compared to those under nonprofit or governmental ownership (RR 1.50, 95% CI 1.14–1.98, chi‐square p = 0.009). In 2023, several CBSAs had a high number of both offered and unfilled positions.ConclusionsEM residency programs accredited within the past 5 years or those with a primary clinical site under for‐profit ownership had a greater risk of not filling all positions within the past two Match cycles.

Challenges surrounding the emergency physician workforce and their impact on the Emergency Medicine Match

“…Another key driver of the growth in EM residencies is the growing role of for-profit entities in academic EM [ 1 , 2 , 11 ]. As an example, the publicly traded hospital operator Hospital Corporation of America (HCA) accounts for a sizable share of all newly accredited EM residency programs in the United States.…”