According to social media reports, this year's National Resident Matching Program left 555 unfilled positions in emergency medicine. While the positions will likely be filled in the Supplemental Offer and Acceptance Program, it is noteworthy because, as recently as three to four years ago, the specialty was among the most competitive. This year’s number of vacancies more than doubled last year’s 219 unfilled positions, but in 2021 just 14 vacancies remained post-match.
Several emergency medicine groups published a joint statement reacting to the open positions on the American College of Emergency Physicians website. In the statement, they noted that a combination of many factors likely influenced this year’s outcome. “Many have speculated about factors such as workforce projections, increased clinical demands, emergency department (ED) boarding, economic challenges, the impact of the COVID-19 pandemic, and the corporatization of medicine, among many others.”
An interview between Medscape and Robert McNamara, MD, Chair of Emergency Medicine at Temple University and Chief Medical Officer of the American Academy of Emergency Medicine, provided additional insight into two of the factors: workforce projections and the corporatization of emergency medicine. In December 2021, the Annals of Emergency Medicine published a study projecting an oversupply of emergency physicians by 2030. In McNamara’s view, the suggestion of an oversupply may have deterred prospective entrants into the field who worry about finding a job and repaying loans.
"Emergency medicine residents always have among the highest debt of any specialty," McNamara said. "They have a strong sense of social justice and often don't come from privileged backgrounds ... so they're likely to accumulate debt."
He also added that emergency medicine positions tend to fall under corporate entities more often than physician-run groups. The corporate focus on profit can lead to burnout and a lack of “physician autonomy.”
Moving forward, the joint statement announced the creation of a Match Task Force with heavy emergency medicine representation to further understand the reasoning behind the unfilled positions and create mitigation strategies for the future.