Objective:

Emergency medicine program directors (PD) value the standardized letter of evaluation (SLOE) as the most important aspect of a residency application when making both invitation and ranking decisions. This study aims to determine whether the presence of any lower-third in either SLOE global assessment (GA) question impacted the ability of an applicant to match into EM. We hypothesized that any lower-third ranking would be associated with increased odds of not matching into EM.

Methods:

We conducted a retrospective cohort study evaluating allopathic applicants from medical schools in the United States (US allopathic applicants) to a single EM residency program during the 2018/2019 match cycles. GA SLOE rankings from all applications were tabulated and compared to the applicant’s National Resident Matching Program (NRMP) match outcome. Comparative analyses were conducted between SLOE groupings and odds ratios (OR) were calculated.

Results:

A total of 2,017 SLOEs from 781 US allopathic applicants were analyzed during the study period. Of the total, 277 (35%) applicants in our sample had any lower-third GA ranking, which significantly decreased an applicant’s odds of matching in EM by 79% (OR 0.21, 95% CI, 0.12-0.34). Having more than one lower-third GA ranking did not further statistically decrease the odds of a successful EM match (OR 0.60, 95% CI 0.31-1.17). As a secondary finding of the study, results demonstrate that those applicants having no lower-third GA rankings had a nearly 5 times increased odds of an EM match (OR 4.84, 95% CI, 2.91-8.03).

Conclusion:

Having any lower-third GA ranking significantly reduced an applicant’s chances of matching into an EM program. Faculty advisors should be aware of the increased risk of not matching for any applicant with any lower-third GA ranking and advise students appropriately, while maintaining the integrity of the SLOE and not divulging the confidential information contained within.

中文翻译：

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下三分之一的 SLOE 排名阻碍但不阻止急诊医学住院医师培训的比赛

客观的：

在做出邀请和排名决定时，急诊医学项目主管 (PD) 将标准化评估信 (SLOE) 视为住院医师申请的最重要方面。本研究旨在确定任何一个 SLOE 全球评估 (GA) 问题中存在任何低三分之一是否会影响申请人匹配 EM 的能力。我们假设任何低于三分之一的排名都与不匹配新兴市场的几率增加有关。

方法：

我们进行了一项回顾性队列研究，评估了 2018/2019 年比赛周期中来自美国医学院的对抗疗法申请人（美国对抗疗法申请人）到单个 EM 住院医师计划。将所有申请的 GA SLOE 排名制成表格，并与申请人的全国居民匹配计划 (NRMP) 匹配结果进行比较。在 SLOE 分组之间进行比较分析并计算优势比 (OR)。

结果：

在研究期间，共分析了来自 781 名美国对抗疗法申请人的 2,017 份 SLOE。在我们样本中的总数中，277 名 (35%) 申请人的 GA 排名低于三分之一，这显着降低了申请人在 EM 中的匹配几率 79% (OR 0.21, 95% CI, 0.12-0.34)。拥有超过一个低于三分之一的 GA 排名并没有进一步降低成功匹配 EM 的几率（OR 0.60，95% CI 0.31-1.17）。作为该研究的第二个发现，结果表明，那些没有低于三分之一 GA 排名的申请人获得 EM 匹配的几率增加了近 5 倍（OR 4.84，95% CI，2.91-8.03）。

结论：

任何低于三分之一的 GA 排名都会显着降低申请人匹配 EM 计划的机会。指导教师应该意识到任何申请人与任何低于三分之一的 GA 排名不匹配的风险增加，并适当地建议学生，同时保持 SLOE 的完整性，不泄露其中包含的机密信息。