Emergency departments and the specialty of emergency medicine are like the well-adjusted friend who is in need of help, but everyone assumes is doing just fine.

The specialty made headlines over the past few years for troubling reasons, including its high rate of burnout and boarding in emergency departments reaching a crisis level. COVID-19 placed an extra bright spotlight on EDs across the country, which have always been the front door of the U.S. healthcare system but took on renewed importance and even symbolism during the pandemic. It is one of the few remaining places in a divided society that cannot turn anyone away.

As a result of this pandemic-born exposure, the specialty is also grappling with some recency bias, in which the challenges and setbacks it faces are chalked up to COVID-19's strain. In reality, the problems date back far further. It is alarming how little has improved or changed. For instance, Time Magazine devoted a cover to depict a clinician and a patient with one word in capital letters: "EMERGENCY!" Overwhelmed and understaffed, medicine's front lines are collapsing across America. It was the May 28, 1990, issue of the magazine.

Nearly 33 years later, the specialty made news again, this time for a clunker of a Match Week. In 2023, more than 550 emergency medicine residency positions were unfilled, more than double the 219 unfilled positions a year prior. The Supplemental Offer and Acceptance Program ended up filling 501 of the open spots, reducing the near-term threat to EDs. But questions and concerns about the specialty's appeal and talent pipeline remain.

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