Trends in parallel application to emergency medicine residency between 2009 and 2023

Objectives: The residency match can be a stressful and costly period for applicants. A notable portion of applicants choose to apply to multiple specialties during the residency match process, known as "parallel applying." This study investigated the trends in parallel applications among emergency medicine (EM) residency applicants from 2009 to 2023.

Methods: This is a retrospective analysis on data obtained from the Association of American Medical Colleges (AAMC) Electronic Residency Application System (ERAS). The data set comprised applicants who applied either exclusively to EM or to EM in combination with other specialties. Variables analyzed included the number of applications submitted and the frequency of parallel applications across different applicant groups including international medical graduates (IMGs), U.S. international medical graduates (USIMGs), and graduates from U.S. allopathic and osteopathic institutions.

Results: The study included 64,095 applicant records corresponding to 57,572 unique individuals. The percentage of applicants to EM residency parallel applying decreased between 2009 (62.0%) and 2020 (43.0%) but subsequently increased through 2023 (62.6%). The total number of applications submitted by both single-specialty and parallel applicants increased over the same period. The mean number of applications to EM programs by parallel applicants rose significantly, reflecting a broader trend of increasing application volumes across all applicant groups while the proportion of applications that were to EM programs decreased, especially following 2021.

Conclusions: The trend of parallel applying among EM residency applicants slowly decreased from 2009 to 2021 and then increased through 2023, with the trend largely driven by an increase in the proportion of IMG applicants who were parallel applying. Understanding the motivations and impacts of parallel applications is crucial for developing strategies to support applicants and improve the matching process. Further research is needed to explore the factors influencing these trends and to inform policy and advising practices in medical education.