Which Applicant Factors Predict Success in Emergency Medicine Training Programs? A Scoping Review

Abstract

Background: Program directors (PDs) in emergency medicine (EM) receive an abundance of applications for very few residency training spots. It is unclear which selection strategies will yield the most successful residents. Many authors have attempted to determine which items in an applicant's file predict future performance in EM.

Objectives: The purpose of this scoping review is to examine the breadth of evidence related to the predictive value of selection factors for performance in EM residency.

Methods: The authors systematically searched four databases and websites for peer-reviewed and gray literature related to EM admissions published between 1992 and February 2019. Two reviewers screened titles and abstracts for articles that met the inclusion criteria, according to the scoping review study protocol. The authors included studies if they specifically examined selection factors and whether those factors predicted performance in EM residency training in the United States.

Results: After screening 23,243 records, the authors selected 60 for full review. From these, the authors selected 15 published manuscripts, one unpublished manuscript, and 11 abstracts for inclusion in the review. These studies examined the United States Medical Licensing Examination (USMLE), Standardized Letters of Evaluation, Medical Student Performance Evaluation, medical school attended, clerkship grades, membership in honor societies, and other less common factors and their association with future EM residency training performance.

Conclusions: The USMLE was the most common factor studied. It unreliably predicts clinical performance, but more reliably predicts performance on licensing examinations. All other factors were less commonly studied and, similar to the USMLE, yielded mixed results.

Figure 1

Flowsheet for inclusion and exclusion of studies in the scoping review.