Home Team Advantage: Do Students Perform Better on Home vs. Away SLOEs?

It’s that time of year again: There’s a nip in the air, it’s dark before dinner, and residency applications are piling up in drifts.  Trying to compare two applications on their merits can be like raking leaves on a blustery day—certainty swirling away just when you thought it was in the bag.  At such times, a bit of data helps, so we were happy to see Boysen-Osborn et al’s analysis of the effect of home vs away institution on candidates’ SLOEs.1

The study aimed to discern whether students perform better on their home institution’s SLOE versus those from away rotations. To that end, the authors reviewed the hundreds of applications submitted to their West Coast EM residency program and calculated a composite score, consisting of the sum of two values—a numerical representation of the “bucketing” required by question C1 (top 10%, top third, middle third, lower third) and a number representing the answer to question C2b (“How highly would you estimate the candidate will reside on your rank list: top 10%, top third, middle third, lower third, unlikely to be on our rank list”).

Using this technique, the authors compared students’ home SLOEs to their away SLOEs, finding that, overall, more students performed better on their home rotation than their away rotation (n = 250, 40%), with 35% performing  better on their aways, and 25% getting exactly the same composite scores.

Take Aways

  • Students perform slightly better on their home rotation compared to an away rotation.
  • Students with home rotations performed WORSE on a third EM rotation/SLOE
  • Orphan students (those without a home rotation) actually performed BETTER on their third rotation—in this group a third EM rotation could be advisable

Interestingly, in the cohort of candidates with a third SLOE, the mean composite scores for students’ first, second, and third rotations were 4.40, 4.63, and 4.77, which the authors point out means that students run the risk of getting a worse SLOE if they venture a third EM block (with one notable exception—see Take-Aways). 

1. Boysen-Osborn M, Andrusaitis A, Clark C, Saadat S, Billimek J, Paradise S, Wray A, Wiechmann W, Toohey S;A Retrospective Cohort Study of the Effect of Home Institution on EmergencyMedicine Standardized Letters of Evaluation. AEM Educ Train. 2019 Jul 30;3(4):340-346.


Lesley Walinchus-Foster, MD @lwalinchus, PGY3 and Chief Resident Physician, Cooper Health System Emergency Medicine Residency Program

Shannon Moffett, MD @BrickCityEM, Emergency Medicine Clerkship Director, Rutgers New Jersey Medical School, Rutgers New Jersey Medical School, Director of Undergraduate Medical Education, Department of Emergency Medicine, University Hospital–Newark

Written on behalf of the CORD Advising Students Committee in Emergency Medicine (ASC-EM)

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