ABSTRACT
OBJECTIVE: Understanding the factors associated with attracting women to a residency program would help residency program leadership build programs that are appealing to women candidates. The objective of this study was to identify factors associated with the percentage of women residents in emergency medicine (EM) residency programs. METHODS: A list of 161 Accreditation Council for Graduate Medical Education-approved EM residencies was compiled. The public websites for each of the residencies was queried for information on the following variables: residency region (Midwest, Northeast, South, West), residency length (3 years vs. 4 years), sex of the department chair, sex of the program director (PD), percentage of women faculty, and the number of residents by graduation class and sex. RESULTS: The websites of 161 EM residencies were reviewed. Complete data were available from a total of 143 programs representing 4,547 residents from the studied classes of 2014, 2015, and 2016. Overall, 38% were women (n = 1,743). The percentage of women residents per program varied from 0% to 68% across residency programs. There was no association between the percentage of women residents and residency region, sex of the department chair, and sex of the PD. CONCLUSIONS: In this study, there was no evidence that EM residencies with a greater percentage of women faculty and women in select leadership roles had a greater percentage of women residents. There was also no evidence for regional variability in women's selection of residency programs. This study was limited to publicly available data and cannot address the many other complex factors which may play a role in women's decision making when choosing a residency.
ABSTRACT
OBJECTIVES: To determine the proportion of out-of-hospital cardiac arrest (OOHCA) patients who received chest compressions, before EMS arrival, from bystanders who called the EMS emergency telephone number (9-1-1) at dispatch centers that provided telephone CPR instructions and to describe barriers to following instructions. METHODS: A retrospective case series was conducted in 2004 at three dispatch centers all of which provided sequential airway, breathing and chest compression pre-arrival instructions. All calls for which the call-taker established that the patient was in OOHCA were identified, and the recorded interaction was reviewed using a structured data collection tool. Data included whether the caller performed compressions, the sequence of instructions, whether there were barriers to performing CPR and characteristics of the caller, call taker and patient. Descriptive statistics were used to evaluate the data. RESULTS: 343 calls were reviewed. 3 were excluded because it was unclear whether compressions were provided. 172 calls were not eligible for pre-arrival instructions (e.g. obviously dead, already receiving CPR). Of the 168 calls eligible for CPR instructions, chest compressions were actually given to 25 patients (15%, 95% confidence interval 10-21%) before EMS arrival. Leading reasons for not following CPR instructions included: caller disconnected phone before directions were complete (19%), caller's refusal (18%), emotional state of the caller (14%), inability to listen to telephone instructions and care for patient at the same time (13%) and physical limitations of the caller (8%). Failure to complete airway and breathing steps prevented 8% of callers from providing compressions. CONCLUSIONS: Few 9-1-1 callers provided chest compressions following telephone CPR instructions that included airway and breathing steps. The majority of callers were unwilling or emotionally or physically unable to follow the instructions.
