How many emergency medicine residents reselect their specialty if they could?

Objective@#The 2019 Korean Emergency Medicine Residents Survey (KEMRS) is the first survey by the Korean Society of Emergency Medicine (KSEM) on the comprehensive satisfaction of their residents. Satisfaction is important not only for the personal well-being of the residents but also for patient safety. @*Methods@#A total of 622 emergency medicine residents were surveyed, using both a paper and email questionnaire from May to August of 2019. Factors related to satisfaction were analyzed. @*Results@#Of the responders, 66% said they would reapply for the emergency specialty and 51% said that they would reselect the same training hospital. The group of residents who said they would choose emergency medicine again felt that their expectations had been met and that they were comfortable with the choice of the specialty. They felt that the factors of satisfaction with their shift schedule and personal health played a more important role in their reselection of the training hospital than the workload. @*Conclusion@#The satisfaction levels of the Korean emergency residents were low. Thus, training hospitals should provide a reasonable working environment to increase their satisfaction. Also, it is important to create an environment where residents can feel rewarded and proud of the work they do.

How many emergency medicine residents reselect their specialty if they could?

Objective@#The 2019 Korean Emergency Medicine Residents Survey (KEMRS) is the first survey by the Korean Society of Emergency Medicine (KSEM) on the comprehensive satisfaction of their residents. Satisfaction is important not only for the personal well-being of the residents but also for patient safety. @*Methods@#A total of 622 emergency medicine residents were surveyed, using both a paper and email questionnaire from May to August of 2019. Factors related to satisfaction were analyzed. @*Results@#Of the responders, 66% said they would reapply for the emergency specialty and 51% said that they would reselect the same training hospital. The group of residents who said they would choose emergency medicine again felt that their expectations had been met and that they were comfortable with the choice of the specialty. They felt that the factors of satisfaction with their shift schedule and personal health played a more important role in their reselection of the training hospital than the workload. @*Conclusion@#The satisfaction levels of the Korean emergency residents were low. Thus, training hospitals should provide a reasonable working environment to increase their satisfaction. Also, it is important to create an environment where residents can feel rewarded and proud of the work they do.

24-Hour shifts and frequent night shifts of Korean emergency medicine residents

OBJECTIVE@#The newly implemented Training Rule Standard limits the amount of resident working hours to serve the interests of the patients and residents alike. On the other hand, the law does not sufficiently protect emergency medicine residents from a long shift length and frequent night shift. Excessive shift work can cause physical and neuropsychological problems for residents. Therefore, this study examined the 24-hour shifts and night shifts status of emergency medicine residents at the training hospitals.@*METHODS@#The 30 training hospitals were divided into three groups according to the number of residents (≤4, 5-8, and ≥ 9) and the associations between each group and the 24-hour shifts, night shifts, number of working days, working hours, and annual patients per resident were checked. The associations between the resident grades and 24-hour shifts, night shifts, number of working days and working hours were also examined.@*RESULTS@#Hospital groups with fewer residents had the highest number of patients per resident with the highest number of 24-hour shifts and the highest number of night shifts. The first year residents had the highest number of 24-hour shifts, the highest number of night shifts, and the highest number of working hours.@*CONCLUSION@#More 24-hour shifts and more night shifts occur at hospitals that lack work force. Therefore, there is a need for new standards for limiting the working hours and frequency of night shifts in emergency rooms, and there is a need for discussions on reinforcing the work force.

Delta Neutrophil Index as a Predictive Factor of Prolonged Hospitalization in Emergency Department Patients with Acute Pyelonephritis

PURPOSE: The delta neutrophil index (DNI) corresponds to evaluated immature granulocyte counts and severity of sepsis. The aim of this study was to investigate the diagnostic value of DNI as a predictable laboratory marker for prolonged hospitalization in patients with acute pyelonephritis in the emergency department (ED). METHODS: We retrospectively analyzed medical records in two EDs and screened eligible adult patients who were admitted to the ED with acute pyelonephritis from July 2012 to July 2014. The DNI was calculated for all patients as a part of routine complete blood analysis, and diagnostic performance of DNI for predicting prolonged hospitalization (over 14 days) in patients with acute pyelonephritis (APN) was evaluated. RESULTS: A total of 308 patients with APN were enrolled in the study. Among them, 89 patients (29.9%) were hospitalized for more than 14 days. The initial DNI value was significantly higher in patients with more than 14 days of hospitalization than in those with less than 14 days of hospitalization (6% vs. 2%, p<0.001). The peak value of DNI was also significantly higher in patients discharged after 14 days of hospitalization than in those discharged before 14 days (8% vs. 2%, p<0.001). Multivariate Cox proportional hazard models showed that a DNI of more than 6.3 on ED admission day (hazard ratio [HR], 0.314; 95% confidence interval [CI], 0.191-0.515, p<0.001) and on peak day (HR, 0.37; 95% CI, 0.244-0.562, p=0.028) was an independent risk factor for hospitalization over 14 days. CONCLUSION: DNI is potentially useful as an independent factor for predicting hospitalization for more than 14 days.

A study on the current state of public health doctors

As the healthcare environment has changed both socially and politically importance of public health doctors' roles has increased and ongoing revision of their roles is also needed in Korea. However, many problems have decreased the job satisfaction of public health doctors. This study aims to determine the factors that influence public health doctors' satisfaction. The survey was conducted over the course of 2 months by questionnaire methodology. A total of 881 respondents (response rate, 90.1%) participated and 778 valid responses were analyzed using SAS version 9.1. Items about arranged organization, work task, employee welfare and services, education, public health doctor's system, and the role of public health doctors were included in the questionnaire. It was found that the satisfaction of many respondents was not high and they had negative perceptions of arranged organization, work, environment, employee welfare and services, education, system, and their own role. Although the public health doctors have professional knowledge of healthcare, they were not satisfied with their role because they were required to do inappropriate work, improperly arranged and found performing work difficult when treated unfairly or not paid fairly. Therefore, policies focused on financial compensation or system improvement must be established to increase the satisfaction of public health doctors. This study's limitation was that the survey was done through two modalities. However, it is meaningful that issues related to the public health doctors were dealt with more comprehen-sively in this study than other studies.