Applicant considerations associated with selection of an emergency medicine residency program.

Objectives: The primary objective of this study was to assess variables that residency applicants ranked as influential in making residency choices. The secondary objective was to determine if residents were satisfied with their residency choices.

Methods: A secondary analysis was performed on a cohort database from a stratified, random sampling of 322 emergency medicine (EM) residents collected in 1996-1998 and 2001-2004 from the American Board of Emergency Medicine Longitudinal Study on Emergency Medicine Residents (ABEM LSEMR). Residents rated the importance of 18 items in response to the question, "How much did each of the following factors influence your choice of residency program location?" The degree to which residents' programs met prior expectations and the levels of satisfaction with residency programs were also assessed. All analyses were conducted using descriptive statistics.

Results: Three-hundred twenty-two residents participated in the survey. Residents considered the following to be the most important variables: institutional reputation, hospital facilities, program director reputation, and spousal influence. Several geographic and gender differences were noted. Ninety percent (95% confidence interval [CI] = 86% to 93%) of residents surveyed in their final year answered that the residency program met or exceeded expectations. Seventy-nine percent (95% CI = 76% to 82%) of residents identified themselves as "highly satisfied" with their residency choice.

Conclusions: The most influential factors in residency choice are institutional and residency director reputation and hospital facilities. Personal issues, such as recreational opportunities and spousal opinion, are also important, but are less influential. Significant geographic differences affecting residency choices exist, as do minor gender differences. A majority of residents were highly satisfied overall with their residency choices.