Qualification discrepancies between urban and rural emergency department physicians

The purpose of this study was to describe and compare the residency training and board certification credentials of physicians staffing rural and urban emergency departments (EDs) in the predominately rural states of the upper Midwest. EDs in Nebraska, North Dakota, and South Dakota with annual patient volumes greater than 10,000 met inclusion criteria for the study. ED administrators responded to surveys via mail, addressing physician training and board certification status and ED descriptive statistics. Thirty-four EDs met the inclusion criteria for the study with 26 responding (76%). ED physicians reported 50.6% American Board of Emergency Medicine (ABEM) certification and 33.1% residency training in Emergency Medicine (EM). Physicians staffing urban (metropolitan statistical area, MSA) EDs reported ABEM certification and residency training more frequently than those working in rural (non-MSA) EDs (65.2% vs. 30.8% and 48.3% vs. 12.3%, respectively). The results of this study reveal significant discrepancies between urban and rural EDs in physician board certification and residency training.