The concept of “program signaling” was introduced by ERAS two years ago to further this aim and is a way for applicants to show interest in programs before applying. Signals serve as a way for an applicant to indicate to a select few programs that they are highly interested. This year, applicants to EM could signal up to seven residency programs when submitting applications. On average, 13 percent of a program’s applicants used a signal when applying to the program. Preliminary 2024 ERAS data showed applicants to EM who used a signal received an interview offer roughly 55 percent of the time compared to 28 percent for those who did not signal the program.² Program directors can use applicant signals in various ways in order to focus their efforts on those most interested in their programs and, hopefully, this leads to a successful match.

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Benjamin Aiwonodagbon, MD, MPH, knew EM would be competitive this year, but for him, “it was EM or nothing.” He feels that the increase in IMG residents will positively impact the future of EM in meaningful ways. “Data has shown that the more diversity in a team or organization, the better the outcome,” he said. “When a managing team mirrors the patient population, the better the health outcomes for such patients.”

Dr. Aiwonodagbon added that the influx of IMG applicants to U.S. residency programs might be beneficial to workforce distribution challenges, noting that some visa sponsorships require board-certified physicians to practice in rural, under-served communities. Additionally, the impact could transcend the United States and have a global influence.

“The more IMG EM physicians we have in the future, the better for global EM and EM health systems in developing countries,” he said. “EM is the missing piece of health care in most sub-Saharan African countries, for example. I, for one, would love to contribute to building EM in my home country Nigeria in the future.”

While the 2024 Match numbers paint an optimistic picture, many of the factors that led to the 2023 drop off have not changed. Hospital boarding, workforce concerns, economic challenges, ED violence, corporatization of the practice of medicine, and payer and governmental administrative burdens still continue to plague emergency physicians. These systemic challenges require continued efforts to improve conditions for emergency physicians and their patients.

“I don’t think a few setbacks are going to deter what an ED represents at its core—humanity,” said Sreenidhi Vanyaa Manian, another student who successfully matched. “Only time will tell how everything works out but as long as people who are passionate about EM comprise it, I am not worried about the future of the specialty.”