Dhimitri Nikolla, DO
RSO President
AHN Saint Vincent Hospital, Erie, PA.

On April 22, 2018, Kaitlin Bowers, DO (RSO Past-President), Kristen Kennedy, M.Ed. (ACOEP Director of Education Services), and myself attended and participated in the inaugural All EM Resident Organizations and Students (AEROS) Meeting at the CORD Academic Assembly in San Antonio, TX. This was the first meeting of its kind including representation from most, if not all, national resident and student organizations in emergency medicine (EM). Residents, students, and staff were present from the following organizations:

  • Accreditation Council for Graduate Medical Education – EM Review Committee (ACGME-EM RC)
  • American Academy of Emergency Medicine – Resident and Student Association (AAEM-RSA)
  • American College of Osteopathic Emergency Physicians – Resident and Student Organization (ACOEP-RSO)
  • American Medical Association – Residents and Fellows Section/Medical Student Section (AMA-RFS/MSS)
  • Association of American Medical Colleges – Organization of Resident Representatives (AAMC-ORR)
  • Council of Emergency Medicine Residency Directors (CORD)
  • Emergency Medicine Residents’ Association (EMRA)
  • Society for Academic Emergency Medicine – Residents and Medical Students (SAEM-RAMS)

The meeting was held to bring together the major EM resident and student stakeholder organizations to discuss relevant issues including:

  • Standardized Video Interviews (SVI)
  • New Anesthesia Procedural Sedation Guidelines
  • ACGME Scholarly Activity
  • Overapplication to Residency
  • EM Workforce issues
  • Maintenance of Certification
  • Opportunities for Collaboration

While some issues received more attention than others, we did collect a few takeaway points we wanted our RSO members to be aware of:

  • While the long-term fate of the SVI is not guaranteed, it will continue as a pilot for another year.
    • Many concerns about this portion of the application process were brought to the table by all parties. We made it clear that the RSO Board is in opposition to continuing this pilot for several reasons. In addition to the dissatisfaction expressed by our members, we voiced our concern that our osteopathic student members feel more pressure than ever after the ACGME Merger to invest in taking the USMLE in addition to the COMLEX. This is an unequal economic and time burden on our osteopathic students, and the SVI is another hassle placed upon us in an already unequal process. 
  • While you must participate in scholarly activity per the ACGME Common Program Requirements [1], the definition of scholarly activity will remain broad.
    • While efforts have been made this past year to more strictly define scholarly activity in the Common Program Requirements to items such as publications in peer reviewed journals, these efforts have been successfully suppressed. There is more to scholarly activity than publishing research, and the RSO Board agrees that you should be credited with innovative work, like quality improvement and education projects, that may fit outside a more strict definition of scholarly activity. 
  • Overapplication to residency is a problem.
    • As you can see here, overapplication to residency programs not only doesn’t help most applicants, but it puts a strain on the match system that likely leads to more unmatched spots [2]. While there is no definitive answer, we expressed our concern that this issue may worsen as most osteopathic students will eventually be entering the NRMP match post-merger. In addition, unique burdens felt by osteopathic students, like the ones discussed above, may encourage them to overapply. The RSO Board would like to remind all of our members that maximizing their resumes with EM related accomplishments and applying to programs within reach can be a much more successful match strategy than overapplying.

Overall, the inaugural AEROS Meeting was the first of its kind and a huge step forward for a unified voice from EM residents and students. While we are aware there are many osteopathic-specific issues and questions left unanswered post-ACGME Merger, we would like our members to know that the RSO Board is working hard to advocate for you.

References

  1. “ACGME Common Program Requirements.” ACGME. Accessed: 05/26/18. http://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRs_2017-07-01.pdf
  2. Berger JS, Cioletti A. Viewpoint From 2 Graduate Medical Education Deans Application Overload in the Residency Match Process. Journal of Graduate Medical Education. 2016;8(3):317-321.