Emergency Medicine Resident Orientation: How Training Programs Get Their Residents Started

Area of Science:

• Medical Education
• Emergency Medicine Training
• Residency Programs

Background:

• Formal orientation programs for emergency medicine (EM) residents began in 1976.
• The last comprehensive review of EM orientation programs was in 1995.
• Current curricular content and structure of EM resident orientation programs are largely unknown.

Purpose of the Study:

• To describe the current composition of EM resident orientation programs in the United States.
• To identify the primary purposes of these orientation programs.
• To analyze the structure and content of contemporary EM resident orientations.

Main Methods:

• Survey distributed to all U.S. EM residency program directors (n=167) in autumn 2014.
• Survey instrument adapted from a 1995 study by Brillman.
• Assessment of orientation purpose, structure, content, and teaching methods.

Main Results:

• A 63% response rate (105 programs) was achieved.
• 99% of programs offer intern orientation, with an average duration of 9 clinical and 13 non-clinical days.
• Key content includes electronic medical records, physician wellness, procedural skills (ultrasound, airway), and certifications (ACLS, ATLS).

Conclusions:

• EM resident orientations are now nearly universal and have increased in duration since 1995.
• There is a notable increase in skills labs and specialty certifications.
• A significant gap exists in the implementation of baseline or milestone assessments for incoming residents.