Emergency medicine resident work productivity and procedural accomplishment

The purpose of this study was to assess procedural accomplishment, work productivity, and efficiency for emergency medicine residents in a community-based, osteopathic emergency medicine residency. These data are compared with limited existing data from other training sites. The authors conducted a retrospective analysis of patient-encounter data logged into a computerized main-frame database over 8 years by 19 resident physicians. Only data from residents who had complete logs for all 3 years of residency were included. Procedures and diagnoses were from the core content areas defined in the basic standards for approval of residency training programs in emergency medicine. Approximately 98,000 patient encounters were logged during the study period. First-year emergency medicine residents saw an average of 1.06 patients per hour, second-year emergency medicine residents an average of 1.33 patients per hour, and third-year emergency medicine residents an average of 1.41 patients per hour. Residents performed an average of 65 intubations, 533 adult resuscitations, 144 pediatric resuscitations, 49 central line insertions, 47 lumbar punctures, and 280 laceration repairs. Residents tend to see more patients per hour as their training progresses. Residents in this program get significant experience in some procedures but little or no clinical exposure to other procedures. These results are consistent with the few other published reports attempting to quantify the emergency medicine resident experience. The data may assist in setting clinical objectives and establishing uniform tracking systems and coding terminology.