Health and Wellness

Match Day reveals declining interest in emergency medicine


Daryl Traylor had always dreamed of being an emergency room physician since he was an ER technician during the mid-90s, helping doctors care for children who had broken their arms or almost drowned.

But now he’s a first-year medical student, and those same doctors are urging Traylor not to follow in their footsteps.

They warn of burnout after covid and patients’ increasing suspicion of doctors. They say that the pay is less than it used to be, particularly since hospitals now rely more heavily on physician assistants and nurse practitioners for staffing emergency rooms. The job prospects for emergency medicine residents have been expanding rapidly in recent years, which has led to a decline in employment.

Traylor, 51 was shocked to hear this. More than 550 emergency medicine jobs were vacant heading into Match Week. This is when medical students who have graduated are assigned to the hospitals where they will be trained. This is more than the 219 vacant positions from last year.

According to National Resident Matching Program data, emergency medicine applicants have dropped 35 percent from a high point of 3,734 students in 2021 to just 2,765 in 2018.

According to industry associations and doctors, the decline in interest is an indication that the medical field is struggling as the United States recovers from the worst effects of the pandemic. As they are overwhelmed with patients who wait for beds, veterans leave and violence against staff increases, emergency departments are feeling the strain. These factors are damaging the emergency room’s reputation as an ideal place to learn by caring for a steady stream of patients with a wide range of problems.

“When students see us super burned out and dealing with a health care system that treats the emergency department like a release valve, they see the toll it takes on us,” Jessica Adkins Murphy, president of Emergency Medicine Residents Association, is finishing her fourth year of residency at University of Kentucky Hospital, Lexington. “And in that environment we don’t always have the emotional bandwidth to teach students as much as we should.”

However, she stated that the learning experiences are still important. Many open residency positions can be filled once a supplemental process has been completed. This pairs programs that are not able to fill all slots with students who have not previously received offers. The process was successful in filling 501 of the positions. This week, there are still spots available for emergency residency.

The increasing number of vacancies in round one signals a shift in a specialty that was once highly sought after. Program leaders can be selective in selecting the best and brightest. The medical drama “ER” was America’s most viewed TV show in the mid-90s. Early pandemic heroes were the emergency doctors who risked their lives to help covid patients overwhelm hospitals.

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.

“Nothing really excites me as much as emergency medicine,” said Traylor, who studies at the University of the Incarnate Word School of Osteopathic Medicine in San Antonio. “But I have to keep an open mind because maybe I’ll find something that resonates more.”

Now, emergency departments have to look further than they did in the past to find the best medical students. 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 — According to the list distributed to students who didn’t match in the first round, there were still open slots for emergency residents. All three hospitals stated that all positions were filled.

Although there is a decline in interest in emergency medicine, this does not necessarily mean that the United States has a shortage of doctors to staff ERs. After peaking in 2021, emergency residency applications are now back at pre-pandemic levels. However, there has been an increase in emergency residency programs from 171 to 287 between 2015 and 2016, allowing them more than 3,000 slots, according to matching program data.

A report from 2021 that predicts an oversupply for emergency physicians, with 8,000 more by 2030, is actually one of the factors that appears to be dissuading students in medicine.

Industry groups are concerned that an overcorrection could lead to emergency departments being understaffed, if new doctors switch to other specialties or if burnout persists.

“With the current state of health care right now, there are more and more people leaving medicine and that may have us revisit oversupply,” said Chris Kang, president of the American College of Emergency Physicians.

Charlie, a third-year New England medical student, spoke on condition his last name would not be published to protect him job prospects. Charlie said that his experiences as an emergency physician in Colorado in the height of the pandemic forced him to rethink his career goal.

Charlie was told by emergency physicians that they had to work with less resources because burnt out nurses moved on to better-paying travel jobs. The emergency department bears the brunt of America’s public health failures, from uninsured people admitted with preventable conditions to people experiencing homelessness who do not receive basic care, he said.

Charlie said he still considers emergency department work as a “noble profession.” But as the end of his medical school career draws near, he said he is also considering residencies in psychiatry, internal medicine and family medicine.

“It’s just frustrating to watch some of these brilliant minds get ground down by just the pressures of the system that they have very little influence and control over,” Charlie said. “I really need to think about whether this is something sustainable that I can make a career out of.”

Directors of emergency residency programs have been exhorting each other to look at students who have graduated from international and osteopathic medical schools, if not already.

Thomas Cook, the director of Prisma Health’s emergency room residency program in Columbia, S.C. said that he interviewed 30 more applicants this year than usual because he expected more students would view emergency medicine as a backup option.

Cook, who analyzes and writes about trends in emergency residency, believes that there has been a rise in hospitals. Launching ER Programs Even though applications drop, programs will consider students with lower grades. But students who graduate at the top of their class don’t necessarily make the best emergency room He said doctors.

“This a blue collar job. We are the cops of medicine,” Cook said, noting how the emergency room guarantees treatment for All, uninsured and those in mental health or substance abuse crisis. “We’ve always been that safety net, and I think the biggest skill you have to have is a strong work ethic and an enormous amount of compassion.”

Bayhealth is a health system in southern Delaware that includes Bayhealth. Is Launch An emergency medicine residency program is available this year. However, it was unable fill any of the six positions it had applied for in the first round. It turned to international students this week as it tried to fill the remaining vacancies.

Dean Johnson, who is the program’s director, said that projections of an epidemic and oversupply in emergency physicians made recruitment more difficult.

“They are voting with their feet,” Johnson said.

He believes that in order to overcome the obstacles, he should highlight the job possibilities in underserved communities and the opportunities presented by the unexpected. High attrition rate and the importance of emergency room training for doctors.

Students who are dedicated to emergency medicine may also find the decline in interest in residencies of this specialty a blessing.

Drew Hopper, a medical student in Washington’s first year, has longed to be an Emergency Physician since he saw one in Portland as a high schooler. He saw emergency medicine as a way to be a father to his two children and have a better life.

On one hand, he’s happy to have less competition to end up in his dream job. But he also worries about the corporatization of American medicine and being pushed by administrators to work faster with fewer resources, compromising the mission of providing quality care for society’s most vulnerable.

“It’s really sad to see a field once so competitive have so many extraordinary issues,” said Hopper, 32. “I was told over and over again: ‘If you can see yourself doing anything other than medicine, do that thing.’ It’s the same with emergency medicine: If you can see yourself doing anything other than emergency, do that thing.”

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