Emergency Medicine Interest Groups.

Emergency Medicine Interest Groups (EMIGs) serve as a bountiful resource for students interested in pursuing a career in Emergency Medicine (EM). In this article we elaborate on how medical students can get involved as members in an EMIG, discuss opportunities for leadership through these groups, detail how to make the most out of the EMIG (including a listing of important lectures, workshops/labs and opportunities for growth and advancement), provide a framework for how to institute a new EMIG when one does not exist, and discuss considerations for international EMIG groups.

The effect of emergency medicine residency format on pursuit of fellowship training and an academic career.

OBJECTIVES: To determine the association between emergency medicine (EM) program format (postgraduate year [PGY] 1-3, 2-4, or 1-4) and two dependent variables: fellowship training and academic career. METHODS: The authors conducted a mailed survey of 122 program directors (PDs) of U.S. EM residencies regarding the number of graduates from 1995 to 2000 who pursued fellowships, community practice, academics, or an advanced degree. The survey asked for initial postresidency position, as well as position three to five years later. RESULTS: Of those contacted, 67.2% of the programs responded regarding 3,521 graduates (70.4% of all graduates); 18.6% of 1-3-year program graduates chose academics versus 28.5% for 2-4 and 34.2% for 1-4. A greater proportion of four-year-format graduates pursued academics (PGY 2-4 vs. PGY 1-3, odds ratio [OR] = 1.74; 95% confidence interval [95% CI] = 1.44 to 2.11, PGY 1-4 vs. PGY 1-3, OR = 2.28; 95% CI = 1.81 to 2.85). The PGY 1-4 format was associated with academic practice versus the PGY 2-4 format (OR = 1.31; 95% CI = 1.02 to 1.67). The aggregate of the PGY 2-4 and 1-4 formats was associated with initial academics versus PGY 1-3 programs (OR = 1.92; 95% CI = 1.63 to 2.26). Of PGY 1-3 residents, 4.3% pursued fellowships versus 5.6% of 2-4 and 8.6% of 1-4. The PGY 1-4 format was associated with more common fellowship pursuit versus both 2-4 (OR = 1.59; 95% CI = 1.01 to 2.51) and 1-3 (OR = 2.08; 95% CI = 1.41 to 3.10). For 1995-1997 graduates, 74.2% (271/365) who started out in academics remained there three to five years later. Of all graduates, 5.2% pursued fellowships and 23.1% pursued academics initially. Sixty-seven of 271 (24.7%) academic physicians from the 1995-1997 classes were fellowship-trained. CONCLUSIONS: Four-year formats, especially 1-4, were associated with more common pursuit of fellowships and academics than the 1-3 format. Fellowship pursuit was uncommon (4% to 9% of graduates), whereas 18% to 34% initially chose academics.

Factors influencing analgesic use for skatepark-related musculoskeletal injuries.

OBJECTIVE: This study was designed to determine the proportion of patients with skatepark-related musculoskeletal injuries who were administered analgesics in the emergency department (ED) or at discharge, and to determine if differences in use of pain medication varied by injury type, anatomic location, or patient age. METHODS: This is a retrospective review of a cohort of consecutive patients with musculoskeletal injuries presenting to a large urban ED from a local skatepark over a 1-year period (1999-2000). Patients with non-musculoskeletal injuries were excluded. The outcome measure was analgesic use either in the ED or at discharge. Data included demographics, activity during injury, disposition, injury type (fracture or non-fracture), and injury location (upper or lower body). Analgesic data was abstracted from the medical records. Multivariable logistic regression was used to identify independent predictors of receipt of analgesic medications. RESULTS: 85 injured patients were enrolled. No differences in age, sex, activity, or disposition were found comparing those who received analgesics (n=68) to those who did not (n=17). Overall, analgesia was administered to 80% (95% CI = 70 to 88%) of patients; 67% (95% CI = 56 to 77%) in the ED and 64% (95% CI = 52 to 74%) at discharge. Fractures were more likely to receive analgesia (adjusted OR = 18.5; 95% CI = 4.0 to 86.1) than non-fracture injuries. Lower body injuries were more likely to receive analgesics compared to upper body injuries (adjusted OR = 9.2; 95% CI = 1.5 to 55.8). Age was not independently associated with analgesic use. CONCLUSIONS: A high proportion of skatepark-related musculoskeletal injuries were treated with pain medications either in the ED or at discharge. In this study analgesic medication use was influenced by injury type and location of the injury, but not age.