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Defining "county": A mixed-methods inquiry of county emergency medicine residency programs
Jennie A Buchanan1, Maria Moreira1, Taku Taira2
1Denver Health & Hospital Authority Department of Emergency Medicine & University of Colorado Department of Emergency Medicine Denver Colorado USA.
AEM Education and Training
|October 7, 2021
Summary
County programs in emergency medicine (EM) are defined by their commitment to underserved populations, urban settings, and public funding. These programs are typically larger, older, and have higher patient volumes than other training environments.
Area of Science:
- Emergency Medicine
- Medical Education
- Public Health
Background:
- The definition of "county programs" in emergency medicine (EM) lacks uniformity, impacting residency directories and applicant choices.
- The Council of Residency Directors EM County Program Community of Practice initiated this study to define unifying themes of county programs.
Purpose of the Study:
- To establish a clear definition and identify key characteristics of county emergency medicine programs.
- To understand the unique attributes and missions of programs serving medically underserved populations.
Main Methods:
- A mixed-methods inquiry using survey data and quantitative data from self-designated county programs.
- Qualitative descriptive analysis of themes derived from program leadership discussions and survey responses.
Main Results:
- County programs are characterized by a mission to care for the underserved, urban locations, and city/county funding.
- These programs are often larger, older, in metro areas, have higher patient volumes, and are more likely to be government-operated with a high proportion of disproportionate-share hospital patients.
- Key qualitative themes include mission, clinical environment, research, training, and applicant recommendations.
Conclusions:
- Recommended attributes for county programs include a mission for underserved patients, urban/public funding, high-volume EDs, resident autonomy support, and research in underserved populations.
- This framework aims to clarify the identity and role of county programs within emergency medicine training.
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