Emergency medicine resident clinical hours: a national survey

Emergency medicine (EM) residency programs have significant scheduling flexibility. As a result, there is potentially significant variation in scheduling practices. Few studies have previously sought to describe this variation. It is unknown how this affects training time in the emergency department.

The purpose of this study was to describe the current variation in clinical training practices through clinical hour, shift length, and rotation survey data.

A 21-item questionnaire was distributed to all allopathic EM training programs utilizing an online survey during the 2011-2012 academic year. Questions included demographic data, number of EM rotations per year, shifts, average hours, shift length, and scheduling practices.

A total of 122 responses were received and 82 programs were analyzed (51.6% of 159 allopathic programs). EM residents work, on average, 45.50 h per week. Postgraduate year 1-3 programs utilizing 28-day schedules averaged two additional EM rotations and 338.2 more clinical EM hours compared with calendar-month rotations. The residents of 4-year programs work approximately 1300 additional hours during residency, with an average of 1279.26 h and 7.9 clinical EM rotations in the fourth year. Clinical hour ranges of 2670-5112 and 4248-6113 were observed for 3-year and 4-year programs, respectively.

There are different scheduling modalities used to create resident schedules. This flexibility results in a large amount of diversity in scheduling practices, with certain patterns allowing for significantly more clinical time. This may result in a vastly different training experience for EM residents.