Background: The CORD Advising Students Committee in Emergency Medicine (ASC-EM) recommends that EM-bound medical students complete two EM clerkship rotations. In recent years, the number of VSAS applications per applicant has increased, leading to increased demand for rotation slots.
Objective: To determine how many EM rotations medical students are completing during their fourth year. We hypothesized that medical students are scheduling more than the recommended two rotations, and that DO students are completing more rotations than MD students.
Methods: Fourth year medical students attending the EMRA Medical Student Forum at the 2018 Scientific Assembly were asked to complete a 24 question online survey. An observational, cross-sectional, convenience sample of 132 students were invited to complete the survey, for which there was an 80.2% response rate. Students who were IMGs, couples or military matching, had not taken Step 1, or had not completed or received their grade from at least one EM rotation were excluded. Descriptive, summary statistics were calculated for all questions (n=72).
Results: The mean number of EM rotations medical students scheduled for their fourth year was 3.30. The mean for MD students was 2.93 (95% CI 2.75-3.11) and the mean for DO students was 3.82 (95% CI 3.57-4.07). Only 15% of allopathic students limited themselves to two EM clerkships, compared to 0% of osteopathic students. The most frequently reported number of clerkships for MD applicants was three. More than two-thirds (68%) of DO applicants scheduled four or more rotations, compared to only 7% of MD applicants. There was no statistical difference in mean number of clerkships scheduled when groups were broken down by their self rating of competitiveness (p=0.712), confidence in evaluating their self competitiveness (p=0.553), or by step 1 score ranges (p=0.728). Means were compared with t-test and one way ANOVA.
Conclusion: Although CORD ASC-EM recommends that students of average competitiveness complete only two EM clerkships, the students in our sample scheduled more than two, with DO applicants completing more rotations compared to MD applicants. Further research is needed to describe the reasons behind this difference and to globally reduce the number of away rotations per student.