Survey of emergency medicine resident debt status and financial planning preparedness.

OBJECTIVES: Most resident physicians accrue significant financial debt throughout their medical and graduate medical education. The objective of this study was to analyze emergency medicine resident debt status, financial planning actions, and educational experiences for financial planning and debt management. METHODS: A 22-item questionnaire was sent to all 123 Accreditation Council on Graduate Medical Education-accredited emergency medicine residency programs in July 2001. Two follow-up mailings were made to increase the response rate. The survey addressed four areas of resident debt and financial planning: 1) accrued debt, 2) moonlighting activity, 3) financial planning/debt management education, and 4) financial planning actions. Descriptive statistics were used to analyze the data. RESULTS: Survey responses were obtained from 67.4% (1,707/2,532) of emergency medicine residents in 89 of 123 (72.4%) residency programs. Nearly one half (768/1,707) of respondents have accrued more than 100,000 dollars of debt. Fifty-eight percent (990/1,707) of all residents reported that moonlighting would be necessary to meet their financial needs, and more than 33% (640/1,707) presently moonlight to supplement their income. Nearly one half (832/1,707) of residents actively invested money, of which online trading was the most common method (23.3%). Most residents reported that they received no debt management education during residency (82.1%) or medical school (63.7%). Furthermore, 79.1% (1,351/1,707) of residents reported that they received no financial planning lectures during residency, although 84.2% (1,438/1,707) reported that debt management and financial planning education should be available during residency. CONCLUSIONS: Most emergency medicine residency programs do not provide their residents with financial planning education. Most residents have accrued significant debt and believe that more financial planning and debt management education is needed during residency.

Workplace AED resuscitation of a patient with a rare congenital anomalous coronary circulation.

We describe the case of a 44-year-old male with anomalous pulmonary artery origin of the left main coronary artery who was successfully resuscitated after sudden cardiac death with use of an automated external defibrillator (AED) in the workplace. The diagnosis was made on emergency cardiac catheterization and treated with surgical intervention. This case illustrates: 1) that congenital anomalies, although rare, must continue to be considered in the differential diagnosis of sudden cardiac death, and 2) that AEDs in the workplace can be a crucial, lifesaving intervention in the time-dependent condition of sudden cardiac death.