EM Applicants Down 17% From Last Year

[2021Doctor]

---

Members don't see this ad.

 

[GatorCHOMPions]

I was initially encouraged by the huge drop in applicants but then I went to look at NRMP data to see the number of positions offered: 2840. Still a long, dare I say impossible, shot to curbing the future workforce trend. The race to the bottom is in full effect. These spots are going to be filled one way or another. Sucks

The comparison to other specialties is telling. Wtf was EM doing making the creation of new programs so easy. The answer to the question is probably self evident to those who have been following SDN the last few years.

 

[xaelia]

Thanks, I hate it.

 

[Rekt]

I was initially encouraged by the huge drop in applicants but then I went to look at NRMP data to see the number of positions offered: 2840. Still a long, dare I say impossible, shot to curbing the future workforce trend. The race to the bottom is in full effect. These spots are going to be filled one way or another. Sucks

The comparison to other specialties is telling. Wtf was EM doing making the creation of new programs so easy. The answer to the question is probably self evident to those who have been following SDN the last few years.

The spots still are only increasing year-to-year. The workforce report said we would need to reduce spots to around 1500-1800 or something like that. Almost a 40-50% reduction, but ACEP already said they would NOT do anything to shut down residencies are stop new ones from opening because "We'll get sued for anti-trust" which would never realistically happen, but ACEP is synonymous with CMG so they're all about opening as many as possible.

 

[Druggernaut]

The spots still are only increasing year-to-year. The workforce report said we would need to reduce spots to around 1500-1800 or something like that. Almost a 40-50% reduction, but ACEP already said they would NOT do anything to shut down residencies are stop new ones from opening because "We'll get sued for anti-trust" which would never realistically happen, but ACEP is synonymous with CMG so they're all about opening as many as possible.

To be fair, ACEP has nothing to do with residencies. ACGME is the accrediting body. I think they have said it would be an anti-trust issue.

 

[HoosierdaddyO]

Ok well then how about we Petition acgme to increase the standards of new programs becoming accredited lol?!?

 

[bravotwozero]

ACGME is not accountable to anyone so they won't care about what anyone says unless they are being sued.

 

[qwerty89]

I was initially encouraged by the huge drop in applicants but then I went to look at NRMP data to see the number of positions offered: 2840. Still a long, dare I say impossible, shot to curbing the future workforce trend. The race to the bottom is in full effect. These spots are going to be filled one way or another. Sucks

The comparison to other specialties is telling. Wtf was EM doing making the creation of new programs so easy. The answer to the question is probably self evident to those who have been following SDN the last few years.

The residency spots won't decline. Once an HCA program is up and running and the admin taste the benefits of that sweet cheap labor they will never let that go. Programs will always fill in the SOAP or post-SOAP with qualified FMGs (i.e. a pulse + appropriate VISA status).


Just look at RadOnc.

While you still have a few superstar confused stragglers applying the average quality has declined.

 

[Febreeze]

There should be data also on EM residents applying to fellowship, cause if it's anything like where I'm at, it's probably huge compared to what it is normally.

 

[bravotwozero]

ACGME should be AAEM’s next target. They need the lawsuit stick more than anyone else.

 

[gamerEMdoc]

Yeah until it dips below the spots offered in the match, it makes little difference. The numbers are pretty close to where they were in 2020. If anything it looks like 2021 saw an unexpected massive jump in applicants and 2022 regressed to where it was in 2017-2020. We need the ACGME to stop residency expansion in the worst way, but legally I don't know that they could without it becoming an anti-trust lawsuit.

 

[bravotwozero]

ACGME should be petitioned to raise accreditation standards.

This is justifiable in the face of HCA diploma mill programs in podunk hospitals with no trauma designation and residents being forced to rotate in urgent cares and freestanding EDs, which would make it difficult to argue that it’s all about controlling the job market/protecting turf.

Should they ignore the petition, then you can have justifiable grounds for a lawsuit.

 

[oldtown]

Yeah until it dips below the spots offered in the match, it makes little difference. The numbers are pretty close to where they were in 2020. If anything it looks like 2021 saw an unexpected massive jump in applicants and 2022 regressed to where it was in 2017-2020. We need the ACGME to stop residency expansion in the worst way, but legally I don't know that they could without it becoming an anti-trust lawsuit.

I’m guessing the jump in applicants in 2021 was a bunch of idealists buying into the healthcare heroes canard in the early pandemic?

 

[JAFERD_MD]

Probably takes a few years to have any effect. If your app was built around EM and you're an MS3/4 with no interest in anything else along with the mindset of "It's not going to be me," "that report says 10K excess in 10 years...it's only 2021 right now" as well as idealistic things like "100K is still a lot of money," "I can surely find a job in the boonies for a couple years" then of course you're still going to apply EM.

 

[HemeOncHopeful19]

Yeah until it dips below the spots offered in the match, it makes little difference. The numbers are pretty close to where they were in 2020. If anything it looks like 2021 saw an unexpected massive jump in applicants and 2022 regressed to where it was in 2017-2020. We need the ACGME to stop residency expansion in the worst way, but legally I don't know that they could without it becoming an anti-trust lawsuit.

IMO the best thing attending physicians can do in the future is try to lobby for better resident pay therefore giving the suits a reason to take pause and not expand. You might end up with more midlevels but I’d rather a flooded midlevel market than a flooded MD market.

I’d be interested to hear your take on it but in my experience the only thing limiting expansion at both programs I’ve trained at is “can we find someone to pay for the spot?”

 

[bravotwozero]

For every new EM program that anyone wants to open, they should have to build a new teaching hospital for it. Low probability of this happening, but if it does, it's win win for a lot of people.

If the powers that be play by the rule and manage to build new teaching hospitals, you now have more jobs. Or, competing hospitals in the area may lobby against the proposal and shoot it down. Or, they'll scrap the idea as no longer worth the cost/effort. Totally ok with all of these scenarios. Will put anyone who wants to start a new program in a nice catch-22.

 

[gamerEMdoc]

IMO the best thing attending physicians can do in the future is try to lobby for better resident pay therefore giving the suits a reason to take pause and not expand. You might end up with more midlevels but I’d rather a flooded midlevel market than a flooded MD market.

I’d be interested to hear your take on it but in my experience the only thing limiting expansion at both programs I’ve trained at is “can we find someone to pay for the spot?”

Maybe would make a difference, idk. But GME pay rates are across the board, so IDK how that would be implemented. For instance, you raise EM resident salaries to discourage residency expansion but does that have downstream effects on IM or FP and other fields that we may actually need more of, not less. IDK. Never really thought about it. In general, I'm all for residents getting paid more, but I never really thought about it as a way of trying to restrict the number of residency spots.

 

[nVictus]

Here's the next 10 years of EM: still too many programs, acgme continue to let poor programs open, smart students continue to look elsewhere, dumber students flock to EM, CMG dictating care, EM care goes down the hole, EM pay marches lower, EM continues its death spiral, CMGs make more money.

I'll quote this in 5 and then 10 years.

 

[sylvanthus]

IMO the best thing attending physicians can do in the future is try to lobby for better resident pay therefore giving the suits a reason to take pause and not expand. You might end up with more midlevels but I’d rather a flooded midlevel market than a flooded MD market.

I’d be interested to hear your take on it but in my experience the only thing limiting expansion at both programs I’ve trained at is “can we find someone to pay for the spot?”

Could just up the standards so these crap programs cant open.

 

[sylvanthus]

Here's the next 10 years of EM: still too many programs, acgme continue to let poor programs open, smart students continue to look elsewhere, dumber students flock to EM, CMG dictating care, EM care goes down the hole, EM pay marches lower, EM continues its death spiral, CMGs make more money.

I'll quote this in 5 and then 10 years.

Prob true of most of medicine to be honest. We now have independent nurse practitioner “hospitalists” and ive seen a handful of NPs signing off on new NPs notes. We have NPs doing endo, cards, etc. The future of medicine as a whole is not bright.

 

[GassYous]

Prob true of most of medicine to be honest. We now have independent nurse practitioner “hospitalists” and ive seen a handful of NPs signing off on new NPs notes. We have NPs doing endo, cards, etc. The future of medicine as a whole is not bright.

That is insane

 

[Apollyon]

Prob true of most of medicine to be honest. We now have independent nurse practitioner “hospitalists” and ive seen a handful of NPs signing off on new NPs notes. We have NPs doing endo, cards, etc. The future of medicine as a whole is not bright.

Idiocracy coming to pass in real life! Life imitating art (as much as you can call that movie "art")!

 

[JAFERD_MD]

Prob true of most of medicine to be honest. We now have independent nurse practitioner “hospitalists” and ive seen a handful of NPs signing off on new NPs notes. We have NPs doing endo, cards, etc. The future of medicine as a whole is not bright.

HAH egregious things I've seen:
1) Signature line: Nurse Practitioner Resident. Note co-signed by the NP.
--> By the way I diagnosed that patient with new ENT cancer after "mouth pain x3 weeks" was told to brush his teeth and see a dentist for periodontitis. There was a f-ing unmistakably large mass in there!
2) Note signed by intern. Co-signed by ICU attending. Which was then subsequently signed by PA who wrote that he agreed with the plan.