Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 4 2022 06 18 e50 e50 Abdulbary Alhalimi College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia Khalid Almulhim Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia 2022 04 30 2022 06 18 Objective: Emergency medicine (EM) is considered a competitive specialty worldwide with an acceptance rate of 57% in Canada but more competitive in Saudi Arabia with 18.7%. Factors that influenced the applicant’s acceptance include letters of recommendation, interview performance, research experience, and gender. This study aims to determine the factors playing a role in applicants matching to EM residency programs in Saudi Arabia from the view of program directors. Methods: A pilot study was done using a self-administered-questionnaire distributed to EM residency program directors (PDs) in Saudi Arabia in the period of 16-21 November 2021. The data were analyzed using SPSS, and all ethical considerations were ensured. Results: Twenty-seven PDs participated in the study, 19 (70.4%) were males, and most were former PDs (59.3%). The most crucial aspect in the applicant’s acceptance was the excellent impression in the interview (4.00 ± 1.00). The most crucial aspect of recommendation letters was a recommendation from a program director (29.6%), total duration of electives (40.7%) was superior; quality in EM research (29.6%) played a more critical role, and professionalism (29.6%) was the sought factor during the interview. There was no significant influence of the gender or the status of the PD and region of the program on the preference of the applicant’s gender. Conclusion: For those considering EM residency programs in Saudi Arabia, the chance of acceptance can be increased by getting a recommendation from a program director, increasing the duration of electives in EM, focusing on the research quality, and showing professionalism during the interview. https://fem.tums.ac.ir/index.php/fem/article/view/1003 https://fem.tums.ac.ir/index.php/fem/article/download/1003/411