Is National Resident Matching Program Rank Predictive of Resident Performance or Post-graduation Achievement? 10 Years at One Emergency Medicine Residency.

INTRODUCTION: Each year residency programs expend considerable effort ranking applicants for the National Residency Matching Program (NRMP). We explored the relationship between residents' NRMP rank list position as generated at our institution and their performance in residency and post-graduation to determine whether such efforts are justified. METHODS: Faculty who were present for the 10 consecutive study years at an allopathic emergency medicine residency retrospectively evaluated residents on their overall performance, medical knowledge, and interpersonal skills. Residency graduates were surveyed regarding their current position, hours of clinical practice, academic, teaching and leadership roles, and publications. We compared match position to performance using graphical techniques as the primary form of analysis. RESULTS: Ten faculty evaluated the 107 residents who graduated from the program during these 10 years by class year. Eighty-four residents responded to the survey. In general, we found little correlation between NRMP rank and faculty rank of resident performance. There was also little correlation between position in the NRMP rank list and the probability of having an academic career, publishing research, or having a teaching or leadership role. CONCLUSION: We found that the position on our NRMP rank list was of little value in predicting which residents would do best in residency or take on academic or leadership roles once graduated. Residencies should evaluate the processes they use to generate their rank list to determine whether the ranking process is sufficiently predictive to warrant the effort expended.

Emergency department presentations of pediatric congenital heart disease.

Numerous studies have described the pathophysiology, clinical manifestations, and treatment of the many forms of congenital heart disease (CHD), but none has specifically addressed the reasons CHD patients present to the Emergency Department (ED). The objective of this study was to provide a descriptive analysis of the ED presentations of acute and seriously ill pediatric CHD patients. We intended to capture a subset of acutely ill CHD patients who had presenting signs and symptoms that were potentially attributable to their underlying CHD. Recognizing the more common presentation patterns for patients with CHD may be of benefit. Adhering to the basic principles of airway, breathing and circulatory (ABC) management is essential when caring for critically ill CHD patients. Patients with complex CHD are often very difficult to correctly diagnose and manage in the ED. They often require extensive inpatient observation and evaluation. A low threshold for inpatient management of these high-risk patients is warranted.

Evaluation of Orthotopic Liver Transplant Recipients Presenting to the Emergency Department.

Improved survival rates and more centers performing liver transplantation have resulted in increasing numbers of liver transplant recipients presenting to emergency departments. This article familiarizes emergency physicians with orthotopic liver transplantation and complications that cause liver transplant recipients to visit EDs. Savitsky EA, Üner AB, Votey SR: Evaluation of orthotopic liver transplant recipients presenting to the emergency department. Ann Emerg Med April 1998;31:507-517.].