Step 1: Explore the Specialty
Before you pursue a career in Emergency Medicine, it's important to be well informed about the specialty. We've put together a great collection of articles and resources which are essential reading for the aspiring emergency physician.
These articles will give you a better idea of the pros and cons of a career in the field, trends in the specialty, and hot-topic issues for trainees.
Hot Topics, Concerns, and Future Directions in Emergency Medicine
Step 2: Review Emergency Medicine Match Data
Emergency medicine has undergone a dramatic reversal in competitiveness. In the 2016 NRMP Match, there were 2,476 emergency medicine (EM) residency applicants, far more than the number of available residency positions (1,895). Most of these positions were filled with U.S. allopathic seniors.
By contrast, in 2023 almost 20% of EM residency programs went unfilled (54 out of 281 programs). In 2024, this number improved, but 4% of EM programs still went unfilled. This increase in match rate has been attributed to an increase in osteopathic and IMG applicants, with nearly double the number of IMG applicants. Overall, in 2024 35% of EM positions were filled by osteopathic students and 15% by IMGs.
Emergency Medicine-Charting Outcomes in the Match for U.S. MD 2024
Charting Outcomes™: Characteristics of U.S. MD Seniors Who Matched to Their Preferred Specialty: 2024 Main Residency Match®
Emergency Medicine-Charting Outcomes in the Match for U.S. DO 2024
Charting Outcomes™: Characteristics of U.S. DO Seniors Who Matched to Their Preferred Specialty: 2024 Main Residency Match®
Emergency Medicine-Charting Outcomes in the Match for IMGs 2024
Charting Outcomes™: Characteristics of International Medical Graduates Who Matched to Their Preferred Specialty: 2024 Main Residency Match®
Step 3: Understand Residency Selection Criteria
"We receive more than 500 applications annually for the six residency positions," writes the University of California Irvine Department of Emergency Medicine.
To maximize your chances of matching with your first-choice residency program in emergency medicine, you must become well informed as early as possible. In particular, you need to know the criteria residency programs use to select residents.
We recommend beginning with the following resources:
Emergency Medicine-2024 NRMP Program Director Survey
Charting Outcomes™: Program Director Survey Results, 2024 Main Residency Match®
Check out these other recommended resources
Step 4: Develop your Strategy for Success
The process of matching into the specialty and/or program of your choice begins well before it’s time to work on the residency application. Success is the culmination of many decisions and actions that take place over a period of several years.
Many medical students struggle to become strong residency applicants not because they are not talented or hardworking, but because they lack knowledge or guidance about the actions they should take to position themselves for future success.
Complicating matters even further is the rapidly changing landscape in residency admissions making it difficult for both residency applicants and mentors to stay well informed. A recent study showed that 75% of faculty advisors had advising concerns due to lack of knowledge of current practices or recent changes to the residency application.
As competition for positions in the emergency medicine residency match intensifies, it's more important than ever to be an informed candidate who has the "right" strategy for success. To develop the optimal strategy, use our book, The Successful Match. It's been designated recommended or required reading by the Association of American Medical Colleges, American Medical Women's Association, and numerous allopathic and osteopathic medical schools.
AMSA wrote the book "provides the medical student reader with detailed preparation for the matching process." Fully updated in 2025 with over 1,000 pages of powerful information, the book is a must-have resource to help you stand out from the competition.
This book will empower you to become a stronger emergency medicine residency applicant. Inside, you'll find answers to the following questions and much more:
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What is the standardized letter of evaluation (SLOE) for EM, why is it so important, and how you can you earn a strong SLOE during an EM rotation?
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How do EM programs evaluate your interview performance and how can you strategize to earn a high interview rating?
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What should your signaling strategy be in emergency medicine?
For more powerful information, sign up for our periodic updates.
Step 5: Make the Most of your Preclinical Years
The preclinical years of medical school are important for students considering a career in emergency medicine. “The knowledge gained during preclinical years provides the essential foundation for clerkship success,” writes Dr. Shahram Lotfipour, Associate Dean and Professor of Emergency Medicine at the University of California Irvine School of Medicine
Step 6: Apply for Scholarships and Awards
“It was a great honor. I was not expecting to win,” said Nathaniel Hunt when he won the Best Medical Student Presentation Award at the Society of Academic Emergency Medicine Regional Conference. “(I) didn't know there were even awards for medical students. I was proud to be able to represent my group’s work well.”
Winning medical school scholarships and awards can provide a major boost to your residency application, and set you apart from your peers. Awards can be placed in the application, MSPE (Dean's Letter), letters of recommendation, and CV. We have found that interviewers often ask about awards during residency interviews.
Step 7: Assess your USMLE Step 1 Score or COMLEX 1 Score
Your USMLE Step 1 or COMLEX 1 exam scores are a major factor used by EM residency programs in the selection process. In 2018, 24% of U.S. medical school seniors with USMLE Step 1 scores of less than 220 failed to match and 31% of osteopathic students with COMLEX 1 scores less than 500 failed to match.
Step 8: Strive for Success During Clerkships, Observerships and Externships
Grades in required or core clerkships are very important to emergency medicine residency programs. In a NRMP survey of emergency medicine residency programs, 75% cited "grades in required clerkships" as a factor in selecting applicants to interview." Emergency medicine rotations are also of obvious importance to international medical graduates seeking positions in the field.
Step 9: Prepare a Powerful Residency Application
Step 10: Develop a Powerful Personal Statement
In a survey of emergency medicine residency programs, 62% cited the personal statement as a factor in selecting applicants to interview. To better assess fit between the applicant and the program, some emergency medicine residency programs ask applicants to address specific questions in the statement.
Step 11: Deliver an Impressive Interview Performance
An invitation to interview is exciting news, and confirmation that you're considered a competitive candidate for a residency position. However, your work is not done, and you need to be diligent in your interview preparation to maximize your chances of success.
In a study done to determine applicant factors which best predict performance during emergency medicine residency, the interview was found to a strong predictor.
What if I didn't match?
If you were unsuccessful during your initial match cycle, you'll need to sit down with your dean or advisor to review your match strategy. In planning your reapplication, each of the steps above becomes even more important.
For those who seek additional expert assistance, we can provide that. Dr. Desai has had significant experience in helping re-applicants match successfully.
This is provided via a Strategy for Success Session. Dr. Desai will perform a comprehensive review of your credentials, assess your strengths and weaknesses, and provide you with a specific plan to implement tailored to your unique situation.