Although the Supplemental Offer and Acceptance Program, which connects students who didn't match in the first round and programs with unclaimed spots, eventually filled 501 of the open emergency residency positions, the "growing number of vacancies in the first round signals an abrupt shift for a specialty once considered among the most coveted in medicine," the Washington Post  writes.

According to Elizabeth Datner, chair of the department of emergency medicine at Einstein Healthcare Network, several compounding factors likely pushed students away from the field over the last few years, including high burnout, staffing shortages, and a growing threat of violence against healthcare workers. "People talk about death by a thousand cuts," she said.

"When students see us super burned out and dealing with a health care system that treats the emergency department like a release valve, they see the toll it takes on us," said Jessica Adkins Murphy, president of the Emergency Medicine Residents Association and a resident at the University of Kentucky Hospital. "And in that environment we don't always have the emotional bandwidth to teach students as much as we should."

Charlie, a third-year medical student in New England, said he originally wanted to become an ED doctor, but working as an emergency medical technician during the height of the pandemic made him reconsider his goal, even though he still believes the work a "noble profession."

"It's just frustrating to watch some of these brilliant minds get ground down by just the pressures of the system that they have very little influence and control over," he said. "I really need to think about whether this is something sustainable that I can make a career out of."

Will there be a shortage of ED doctors in the future?

According to the Post, the declining interest in emergency medicine doesn't necessarily mean that the United States is about to face a shortage of ED doctors — at least not yet. In fact, a 2021 report estimated that there may be 8,000 more emergency physicians than needed by 2030.

Still, industry groups have expressed concerns that EDs could be understaffed in the future if burnout continues to grow and more med school graduates turn to other specialties.

"With the current state of health care right now, there are more and more people leaving medicine and that may have us revisit oversupply," said Chris Kang, president of the American College of Emergency Physicians.

Writing in STAT, ED doctors Christian Rose, Adaira Landry, and Kaitlin Bowers also note that the decline in interest in emergency medicine not only affects the workforce, but also patients.

"Emergency medicine is the safety net for all patients at all hours of the day," they wrote. Some potential solutions to improve interest and recruitment in the field going forward include providing physicians with resources to provide quality patient care, eliminating corporate pressure, ensuring the safety of healthcare workers, and evaluating the number and quality of training programs.

In addition, Dean Johnson, who leads Bayhealth's emergency medicine residency program, said he's working to overcome recruitment challenges by highlighting job opportunities in underserved communities and underscoring the value of ED training for any doctor.

"This is a challenging time for EM [emergency medicine]," said the American Academy of Emergency Medicine and other professional groups in a joint statement. "As we focus on solutions, we continue to work hard to support trainees, residency programs, and faculty." (Nirappil, Washington Post, 3/17; Dreher/Reed, Axios, 3/20; Rose et al., STAT, 3/20; Gutman, Philadelphia Inquirer, 3/17)