title: Factors that influence medical student selection of an emergency medicine residency program: implications for training programs.
abstract: OBJECTIVE
  An understanding of student decision-making when selecting an emergency medicine (EM) training program is essential for program directors as they enter interview season. To build upon preexisting knowledge, a survey was created to identify and prioritize the factors influencing candidate decision-making of U.S. medical graduates.
  
  
  METHODS
  This was a cross-sectional, multi-institutional study that anonymously surveyed U.S. allopathic applicants to EM training programs. It took place in the 3-week period between the 2011 National Residency Matching Program (NRMP) rank list submission deadline and the announcement of match results.
  
  
  RESULTS
  Of 1,525 invitations to participate, 870 candidates (57%) completed the survey. Overall, 96% of respondents stated that both geographic location and individual program characteristics were important to decision-making, with approximately equal numbers favoring location when compared to those who favored program characteristics. The most important factors in this regard were preference for a particular geographic location (74.9%, 95% confidence interval [CI] = 72% to 78%) and to be close to spouse, significant other, or family (59.7%, 95% CI = 56% to 63%). Factors pertaining to geographic location tend to be out of the control of the program leadership. The most important program factors include the interview experience (48.9%, 95% CI = 46% to 52%), personal experience with the residents (48.5%, 95% CI = 45% to 52%), and academic reputation (44.9%, 95% CI = 42% to 48%). Unlike location, individual program factors are often either directly or somewhat under the control of the program leadership. Several other factors were ranked as the most important factor a disproportionate number of times, including a rotation in that emergency department (ED), orientation (academic vs. community), and duration of training (3-year vs. 4-year programs). For a subset of applicants, these factors had particular importance in overall decision-making.
  
  
  CONCLUSIONS
  The vast majority of applicants to EM residency programs employed a balance of geographic location factors with individual program factors in selecting a residency program. Specific program characteristics represent the greatest opportunity to maximize the success of the immediate interview experience/season, while others provide potential for strategic planning over time. A working knowledge of these results empowers program directors to make informed decisions while providing an appreciation for the limitations in attracting applicants.
authors.affiliation: Department of Emergency Medicine, Georgetown University Hospital/Washington Hospital Center, Washington, DC, USA. jeffrey.n.love@medstar.net
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Love
authors.forename: John M
authors.initials: JM
authors.lastname: Howell
authors.forename: Cullen B
authors.initials: CB
authors.lastname: Hegarty
authors.forename: Steven A
authors.initials: SA
authors.lastname: McLaughlin
authors.forename: Wendy C
authors.initials: WC
authors.lastname: Coates
authors.forename: Laura R
authors.initials: LR
authors.lastname: Hopson
authors.forename: Gene H
authors.initials: GH
authors.lastname: Hern
authors.forename: Carlo L
authors.initials: CL
authors.lastname: Rosen
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fisher
authors.forename: Sally A
authors.initials: SA
authors.lastname: Santen
mesh_terms: D000328:Adult; D002321:Career Choice; D003430:Cross-Sectional Studies; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D011365:Professional Practice Location; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States