Attending coverage in academic emergency medicine: a national survey

We surveyed the 66 accredited emergency medicine residency programs in the United States during 1986 on the issue of attending coverage. Responses were received from 411 residents and 288 faculty; this accounted for 42% of the residents and 56% of the faculty from the 56 responding programs. Seventy-three percent of emergency medicine residency programs had 24-hour attending coverage. According to residents, faculty from programs with 24-hour coverage spent a greater percentage of their shift doing primary patient care than faculty from programs without 24-hour coverage (35% vs 17%, respectively, P less than .0001), and a smaller percentage of their shift educating residents (21% vs 30%, respectively, P less than .0001). Ninety-five percent of faculty and 71% of residents thought that the quality of patient care was better when faculty were present in the ED (P less than .0001). Sixty-one percent of residents and 60% of faculty did not think that 24-hour attending coverage in academic emergency medicine should be mandated. The impact of night-time attending coverage in emergency medicine residency programs on patient care, resident education, and faculty development is unclear and minimally studied.