Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: Since the COVID-19 pandemic, many emergency medicine (EM) residencies have transitioned to virtual interviews, providing less in-person exposure for applicants. Away rotations offer applicants the opportunity to gain in-person exposure to residency programs beyond the virtual interview environment. Whether the away rotation is more important now and leads to higher rotator match rates in the virtual recruitment era remains unclear and warrants investigation. Our objective was to determine the percentage of EM interns who completed an in-person rotation at the residency program in which they matched and compare this to pre-COVID-19 match rates.

Methods: This was a multicenter pilot study of EM residency programs. We recruited a convenience sample of academic programs from the eight Society for Academic Emergency Medicine (SAEM) US geographic regions. Inclusion criteria included academic EM programs that conducted virtual-only interviews post-COVID-19. We collected data via a survey form for the 2017-2024 application years regarding the number of matched interns who completed an in-person rotation at the program and the number of matched interns who were “home” versus “away” rotators. The first three years were defined as pre-COVID and the last three as post-COVID. The 2020-2021 academic year was excluded given the elimination of most away rotations during this cycle. We compared proportions of matched interns before and after COVID-19.

Results: Eleven of 13 invited programs (representing seven of eight SAEM regions) participated in our analysis. Pre-COVID, 95 of 384 interns (24.7%; 95% CI, 20.5-29.4%) completed a rotation at their respective residency program. Post-COVID, this decreased by 2.86% (absolute risk difference; 95% CI, –6.13% to 4.02%; McNemar’s P = .06) to 84 of 384 (21.9%; 95% CI, 17.8-26.3%). Focusing solely on “away” rotators, 48 of the matched interns (12.5%; 95% CI, 9.4-16.2%) completed a rotation at their residency program pre-COVID compared to 47 interns (12.2%; 95% CI, 9.1-15.9%) post-COVID (P = .82). The absolute risk difference for the away rotators was 0.7% (95% CI, -10.6% to 9.1%, P = .82).

Conclusion: In this pilot study, we found no statistically significant difference in the proportion of matched interns who completed an in-person rotation in the pre- versus post-COVID-19 era.