A Personal History

I became an ED scribe my senior year of college while applying to medical school. Using a generic AI scribe has made me reflect on my time as an ED scribe and what a great influence that experience had in my overall decision to pursue emergency medicine. I first fell in love with the undifferentiated patient and the scope and excitement of emergency medicine when I was a scribe. I found role models and mentorship from the attendings I scribed for and made connections that have lasted throughout my career.

Would I have even gone into emergency medicine if I hadn’t had the opportunity to be exposed to the ED as a scribe? Probably not. My emergency medicine rotation wasn’t until my fourth year after sub-internship applications were due. According to the Association of American Medical Colleges (AAMC), in 2019 only 61 percent of medical schools required emergency medicine as a core clerkship. Unless we provide medical students with early exposure to emergency medicine, they might not realize that emergency medicine is their calling.

I have reviewed hundreds of emergency medicine residency applications and personal statements over the past few years. This experience leads me to believe that early exposure to emergency medicine through experiences such as EMS and ED scribing may play a crucial role in recruiting talented individuals to pursue emergency medicine. In the 2022 Match, emergency medicine residency programs were rocked by an unprecedented 219 unmatched positions; nearly one-quarter of programs were impacted before the SOAP. This trend worsened in 2023 with initially 554 unfilled positions prior to the SOAP.5 The decline in applications to emergency medicine programs is already concerning. Transitioning to AI scribes could potentially impact the pipeline of future applicants and further exacerbate the challenges faced by emergency medicine residency programs in filling their positions.

I worry that transitioning to AI and away from scribes, who have traditionally been premedical students looking to enhance their resumes to improve their chance of gaining acceptance to medical school, will influence future applications and interest of those ultimately wanting to apply to emergency medicine in a time when applications to emergency medicine are tenuous. Although I see the potential in AI scribes for ED documentation and expect that their use will become more widespread, I think our specialty should consider the broader implications and how AI might impact the pipeline of future applicants to emergency medicine. Strategies and pipeline programs may need to be developed to make sure that medical students continue to have early opportunities to gain exposure and mentorship in emergency medicine.