ABSTRACT
Introduction Emergency medicine (EM) residents throughout the United States are required to become skilled at performing a robust list of select orthopedic procedures, as well as learn how to diagnose and manage patients with musculoskeletal complaints. However, EM residency programs vary significantly in how they teach orthopedics and the content they cover. The purpose of this study was to profile the orthopedic education received by emergency medicine residents in United States residency programs. Methods We developed a survey based on accreditation requirements and The Model of the Clinical Practice of Emergency Medicine. The survey was designed to gather detailed information about the orthopedic education provided to EM residents. The survey was sent to EM program directors or their designees at all 263 accredited EM residency programs across the United States between October 2020 to January 2021. Results We attained a 34.6% (91 of 260) adjusted response rate with adequate representation of relevant program characteristics such as region, accreditation status, program length, size, and setting. Most (63.7%) responding programs required an orthopedics rotation during the intern year. These required orthopedic rotations were primarily four weeks in duration. The most common methods for teaching orthopedic topics included didactics (97.8%), procedures on live patients under supervision (73.3%), and assigned reading materials in textbooks or manuals (68.9%). Conclusion The orthopedic education received by EM residents in the United States is strikingly variable, with residency programs having to develop custom curricula to teach orthopedics content based on the resources available to them. Future efforts should be directed toward creating a universal curriculum that addresses accreditation and EM practice standards.
ABSTRACT
The rising numbers of residency applications along with fears of a constrained graduate medical education environment have created pressures on residency applicants. Anecdotal evidence suggests substantial challenges with the process of offering residency interviews. This narrative review is designed to identify and propose solutions for the current problems in the process of offering residency interviews. We used PubMed and web browser searches to identify relevant studies and reports. Materials were assessed for relevance to the current process of distributing residency interviews. There is limited relevant literature and the quality is poor overall. We were able to identify several key problem areas including uncertain timing of interview offers; disruption caused by the timing of interview offers; imbalance of interview offers and available positions; and a lack of clarity around waitlist and rejection status. In addition, the couples match and need for coordination of interviews creates a special case. Many of the problems related to residency interview offers are amenable to program-level interventions, which may serve as best practices for residency programs, focusing on clear communication of processes as well as attention to factors such as offer-timing and numbers. We provide potential strategies for programs as well as a call for additional research to better understand the problem and solutions.
