The results of this survey are very encouraging for those involved in international emergency medicine. The increase in the number of fellowships indicates that many of these medical students are pursuing advanced international work beyond what may be available during residency training.
When compared to prior research , our data are generally consistent with a strong measure of enthusiasm for IEM. Our respondents feel strongly that additional training is required to perform IEM (such as advanced training in either public health or tropical medicine), perhaps mirroring the trend in increased fellowships. This suggests that medical students understand the professionalization of IEM and the value of academic degrees in order to carry out a project effectively. We found approximately half of the respondents have had some international medicine exposure in the past, and it is notable that these particular respondents would consider future opportunities important in their matching. Medical student’s language skills predicted prior work in the field, but did not predict he or she would rank a residency program with IEM opportunities more favorably. This lack of association may be due to the relatively small sample size.
Compared to prior research, this survey indicates medical students still find IEM opportunities to be an important factor in the ranking of residency programs .
Two recent studies looked at factors affecting the rank list for applicants to emergency medicine. One found a balance of geographic location and program characteristics factors into the residency decision. . The second found the most influential variables in residency choice are the institutional and residency program director’s reputation and hospital facilities . However, IEM was not specifically asked about in either study, and as a result interest in the field was not considered. This was cited as a weakness of the latter study.
Recent data suggest medical students generally have a strong interest in global health. Our research indicates emergency medicine generates a very strong interest and is likely both a driving factor and result of the development of IEM as a subspecialty of EM.
One limitation of this study, as with all surveys, was the self-reporting nature of the data. In addition, our study was performed prior to the respondents’ rank list such that their preferences given may not be reflective of the final decisions made on their actual rank list. Furthermore, we have a small sample size. Another limitation of this study is related to potential selection bias introduced via the sampling methods used. Most survey recipients were captured during a rotation at a program with an active IEM department including a fellowship and a long history in the field, so the decision to rotate in this setting may reflect interest in IEM not found in the overall EM applicant pool. We supplemented our research by querying fourth-year medical students who were members of the American Academy of Emergency Medicine Residents and Students section, but did not obtain as many responses from this recruitment method. Additionally, student members of this group may be more proactive about their involvement in EM in general than non- members. Finally, a limitation is the data are 6 years old, and thoughts and perspectives may have changed since this survey was administered.