It has become fairly routine for competitive EM applicants to anesthesia-CCM programs to be offered match exceptions. Programs are allowed to offer these exceptions for EM applicants because they will be staying for more than 1 year. This particular exception was designed for anesthesiologists who plan to stay at an institution for additional training after CCM fellowship such as a cardiac anesthesia fellowship, but programs have been using it to their advantage to scoop up the more competitive EM applicants. This practice is to the applicant’s disadvantage and obviates the protections of a match because these exception offers are often “exploding“- meaning you have to decide within a time frame which may not allow you to hear back from other programs.
I cannot say that every EM candidate matches into an anesthesia CCM spot with a match exception. What I can say is that my program exclusively fills its EM spot this way, and acquaintances that I made who filled EM spots at places like Colorado, Emory, and WashU also did it with exceptions. While CCM spots are not especially competitive for anesthesiologists, that is decidedly not the case for EM applicants who are competing for a much smaller pool of 2-year spots. All of those fellowship vacancies are 1 year spots that are not funded for a 2-year EM applicant. So, be very careful if you are going to turn down a match exception because you may find yourself out of a seat in this game of musical chairs.
Go to the SOCCA website to read up on the rules for match exception. If/when you accept an exception, your name and program will be published on a list like this so that other programs know not to rank you:
SOCCA Match Exceptions - The Society of Critical Care Anesthesiologists