The 2020-21 match season delivered an unprecedented level of uncertainty to students and the faculty advising them. As members of the CORD Advising Students Committee in Emergency Medicine (ASC-EM), we developed and sent out a small survey on the recently finished 2020-2021 advising season.  We are still processing the data, but thought it was important to share some preliminary findings, as the 2021/22 advising season has already begun, and we will all be forced—again—to advise in the face of uncertainty. 

The most remarkable theme across the responses was that of the cohesiveness and consistency of Emergency Medicine advisors. In a geographically diverse survey sample of nearly 100 EM advisors—representing a relatively even distribution of clerkship directors, program directors, and other roles—about 75% reported advising their students to obtain only a single traditional eSLOE this past year. In the same group, 100% reported using CORD, SAEM, and EMRA listservs and blogs to guide their advising in the 2020/2021 academic year. There is a likely skew among respondents toward a more active and engaged group of advisors, as a majority reported affiliation with an EM residency and over 4 years of advising experience.  Yet these data suggest a consistent and predictable advising message across our field.

A few other highlights:

Virtual Aways—less than a third of respondents reported creation of a virtual EM rotation at their institution.  While some reported offering a virtual experience to “away” students, it appears that only about a quarter of advisors recommended to their own advisees that they participate in such an elective. As this new advising season gets underway (with a single in-person away rotation allowed in most cases), and as the intern class matriculates and we all begin to understand the true impact of the last year, it will be interesting to see whether these virtual aways are offered again, and what value students, educators, advisors, and program directors credit them with. 

SLOEs—A large majority—approximately 75%–of respondents reported recommending a single traditional eSLOE to their students, with about the same fraction reporting that their students actually obtained only a single eSLOE. About 24% reported that their students obtained two eSLOEs, mainly from already-affiliated secondary “home” sites. Most respondents reported that their students used the O-SLOEs (off-service SLOE, new in the 2020/21 academic year) and that their students obtained more sub-specialty SLOEs than in prior years. 

Virtual Interviews—Most advisors recommended that their students watch online seminars to prepare for virtual interviews, and respondents showed marked agreement on sources for these seminars in their write-in answers. Here several sources cited as helpful by multiple of the responding advisors:

EMRA interview site: https://www.emra.org/students/advising-resources/interviews/ which includes a video with 5 tips for virtual interviews

SAEM resources (including this video on interview prep): https://www.saem.org/about-saem/academies/adiemnew/education/adiem-webinar-series-how-to-be-a-successful-em-applicant/the-interview

aliEM: https://www.aliem.com

Number of Interviews— Two potentially important themes emerged from responses regarding number of interviews.  Although very few respondents reported recommending that students go on more than 15 interviews, about 45% reported recommending a maximum of 10-12, with about the same number recommending a max of 13-15. There has been some pre-pandemic data reported regarding the optimal number of interviews/ranks to ensure a match in EM1, 2, which shows diminishing returns for students starting at around 12 programs ranked. We did not query our respondents as to whether they recommended more than they would have in prior non-pandemic years.

Our respondents seemed more clear on the number of interview invites their top-third advisees received than on the number obtained by the lower-third students. About 31% said they weren’t sure how many interviews their lower-third candidates received, while only 17% weren’t sure how many their upper-third candidates received. We ourselves aren’t sure if this reflected the fact that many of those less-competitive candidates may have been dual-applying, or if the timing of advisors’ data collection is such that later interviews aren’t captured well.  

Applicants: A majority of respondents felt that scores (on USMLE Step 1 and 2, and COMLEX) had a higher impact on competitiveness in the 2020/21 application cycle than in prior years. Given the short time remaining before the impending switch to a pass/fail Step 1, it will be interesting to see how advisors rapidly adjust their strategies (another survey for another time).

The final theme worth noting in this informal summary is that of the extreme stress on both advisees and advisors reflected in the responses. Although advisors were predominantly focused on their students’ difficulties, a large number also mentioned their own distress in the face of the unknowns of the 2020/21 residency application cycle. Other challenges cited included the increased burden at work and at home, the understanding that everyone in their professional circles was stretched thin, and a feeling of profound disconnect engendered by having mainly electronic interactions with students.  

As we head into the next advising season, it’s encouraging to note our specialty’s success at achieving and adhering to consensus, and at innovation in the face of adversity.  To the extent that efforts in these directions allow advisors to do their jobs more easily, such work may well also be considered a wellness activity, given the demonstrable strain of advising in the midst of unprecedented upheaval. 

1 National Resident Matching Program, Charting Outcomes in the Match: US Allopathic Seniors—Characteristics of US Allopathic Seniors Who Matched to Their Preferred Specialty in the 2018 Main Residency Match, 2^nd ed. July 2018

2 National Resident Matching Program, Charting Outcomes in the Match: US Osteopathic Seniors—Characteristics of US Osteopathic Seniors Who Matched to Their Preferred Specialty in the 2018 Main Residency Match, 1st ed. July 2018

Shannon Moffett MD @BrickCityEM; Melanie Camejo MD @Emelaniecamejo; Shruti Chandra MD, MEHP @shrutichandramd; Molly Estes MD @molly_estes and Jamie Shandro MD, MPH @jamie_shandro in conjunction with CORD ASC-EM (advising students committee in emergency medicine)