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Education| Volume 48, ISSUE 4, P474-480.e4, April 2015

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Emergency Medicine Resident Clinical Hours: A National Survey

      Abstract

      Background

      Emergency medicine (EM) residency programs have significant scheduling flexibility. As a result, there is potentially significant variation in scheduling practices. Few studies have previously sought to describe this variation. It is unknown how this affects training time in the emergency department.

      Objectives

      The purpose of this study was to describe the current variation in clinical training practices through clinical hour, shift length, and rotation survey data.

      Methods

      A 21-item questionnaire was distributed to all allopathic EM training programs utilizing an online survey during the 2011–2012 academic year. Questions included demographic data, number of EM rotations per year, shifts, average hours, shift length, and scheduling practices.

      Results

      A total of 122 responses were received and 82 programs were analyzed (51.6% of 159 allopathic programs). EM residents work, on average, 45.50 h per week. Postgraduate year 1–3 programs utilizing 28-day schedules averaged two additional EM rotations and 338.2 more clinical EM hours compared with calendar-month rotations. The residents of 4-year programs work approximately 1300 additional hours during residency, with an average of 1279.26 h and 7.9 clinical EM rotations in the fourth year. Clinical hour ranges of 2670–5112 and 4248–6113 were observed for 3-year and 4-year programs, respectively.

      Conclusions

      There are different scheduling modalities used to create resident schedules. This flexibility results in a large amount of diversity in scheduling practices, with certain patterns allowing for significantly more clinical time. This may result in a vastly different training experience for EM residents.

      Keywords

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      References

        • Accreditation Council for Graduate Medical Education (ACGME)
        Special requirement for residency training in emergency medicine in essentials and information items 1993–1994.
        ACGME, Chicago1994
        • Petersdorf R.G.
        • Bentley J.
        Residents’ hours and supervision.
        Acad Med. 1989; 64: 175-181
        • Residency Review Committee–Emergency Medicine
        Special requirements for residency education in emergency medicine [draft].
        Accreditation Council for Graduate Medical Education, Board on Health Care Services, and Institute of Medicine, Chicago1992
        • Wagner M.J.
        • Wolf S.
        • Promes S.
        • et al.
        Duty hour in emergency medicine: balancing patient safety, resident wellness, and the resident training experience: a consensus response to the 2008 Institute of Medicine Resident Duty Hours Recommendations.
        Acad Emerg Med. 2010; 17: 1004-1011
      1. Accreditation Council for Graduate Medical Education (ACGME). ACGME program requirements for graduate medical education in emergency medicine. Available at: https://www.acgme.org/acgmeweb/Portals/0/PFAssets/2013-PR-FAQ-PIF/110_emergency_medicine_07012013.pdf. Accessed July 1, 2013.

        • Olson D.W.
        • Tonsfeldt D.J.
        60-hour work week.
        Ann Emerg Med. 1989; 18 ([letter]): 1134
        • Wols M.
        • Kramer D.
        • Strange G.R.
        Resident service hours in emergency medicine.
        Acad Emerg Med. 1995; 2: 124-127
      2. National Resident Matching Program. The match. Available at: http://www.nrmp.org/. Accessed February 9, 2014.

        • Lockley S.W.
        • Cronin J.W.
        • Evans E.E.
        • et al.
        Effect of reducing interns’ weekly work hours on sleep and attentional failures.
        N Engl J Med. 2004; 351: 1829-1837
        • Steele M.T.
        • Ma J.O.
        • Watson W.A.
        • Thomas H.A.
        • Muelleman R.L.
        The occupational risk of motor vehicle collisions for emergency medicine residents.
        Acad Emerg Med. 1999; 6: 1050-1053
        • Barger L.K.
        • Cade B.E.
        • Ayas N.T.
        • et al.
        Extended work shifts and the risk of motor vehicle crashes among interns.
        N Engl J Med. 2005; 352: 125-134
        • Landrigan C.P.
        • Rothschild J.M.
        • Cronin J.W.
        • et al.
        Effect of reducing interns’ work hours on serious medical hours in intensive care units.
        N Engl J Med. 2004; 351: 1838-1848
        • Steele M.T.
        • Ma J.O.
        • Watson W.A.
        • Thomas H.A.
        Emergency medicine residents’ shiftwork tolerance and preference.
        Acad Emerg Med. 2000; 7: 670-673
        • Koscove E.M.
        An applicant’s evaluation of an emergency medicine internship and residency.
        Ann Emerg Med. 1990; 9: 774-780