Forced Evolution: Emergency Medicine Match Advising During COVID-19

Camejo, M.; Estes, M.; Shandro, J.; Chandra, S.; Moffett, S.

Study Objectives: The COVID-19 pandemic impacted advisors and students participating in the emergency medicine (EM) 2020-21 National Resident Matching Program cycle. Students were removed from clinical experiences, barred from away rotations, left struggling to obtain Standard Letters of Evaluation (SLOE), and forced to interview virtually and make rank lists without visiting programs. Advisors struggled to provide effective advice with constantly evolving institutional and national guidelines while living through and working in the public health crisis. The primary objective of this study was to analyze advising patterns of EM advisors for EM-bound students during the COVID-19 pandemic. Methods: A 31-item survey with quantitative and qualitative questions was designed using an iterative process by a varied group of student advisors in the Council of Residency Directors (CORD) Advising Students Committee for EM (ASC-EM). This survey was distributed via the CORD list-serve during March 2021 to EM advisors (including program directors, assistant/associate program directors, clerkship directors and faculty advisors). Results: We analyzed 97 unique responses. Despite the need to convert to virtual learning, a majority of advisors (73.3%) did not recommend taking an online virtual EM away rotation. The majority of EM bound students obtained one SLOE (75%). 20% of advisors reported that compared to prior years they recommended more students to dual apply. 31% of respondents reported being unsure how many interviews their lower-third candidates received, while only 17% were unsure how many their upper-third candidates received. Respondents providing qualitative responses on the challenges of advising reported significant stressors of the novel uncertainty of the process (43.2%), the challenges of decreased in-person time with advisees (27%), the stress of balancing personal and professional responsibilities (16.2%), and SLOE-related stress (13.5%). 100% of advisors reported that EM educational blogs such as EMRA (Emergency Medicine Residents’ Association), SAEM (Society of Academic Emergency Medicine), and CORD guided how they advised students and all recommended students use those resources. Conclusion: The pandemic created unique advising challenges. Despite uncertainty in how to guide students, advisors were able to provide largely cohesive recommendations aligned with national consensus recommendations from EM organizations. Students also seemed to adhere to these recommendations, particularly in terms of obtaining a single SLOE. Advisors reported variation on clarity about how many interviews their students had received, specifically knowing less about their less competitive students. Our survey raises some concern for significant stressors faced by advisors, but most respondents were able to draw on a unified larger EM community for support in their advising roles. This study highlights just one aspect of a unique year faced by our specialty.