The current landscape of emergency medicine resident scheduling

The Accreditation Council for Graduate Medical Education (ACGME) and Residency Review Committee oversee resident physician work hours with additional specifics for U.S. emergency medicine (EM) residency programs. While there are maximum work hours, the regulatory bodies do not describe minimum work hours to achieve competency, leading to variable scheduling practices. This study aimed to understand the current landscape of U.S. EM residency scheduling given the expansion of programs, evolution of policies, and increased emphasis on wellness.

We conducted a cross-sectional study to assess current strategies of U.S. EM residency scheduling. The RedCap survey was sent to all ACGME-accredited EM residency programs across the United States via individualized emails between January 10, 2023, and March 15, 2023. Data were combined using Microsoft Excel.

A total of 138 of 278 (50%) programs responded to the survey. A total of 73.2% of programs were using thirteen 28-day blocks with the remainder using twelve 1-month blocks or reported "other" block scheduling. The number of blocks in the ED increases with each postgraduate year (PGY). For PGY-1 through PGY-3, the most commonly used shift duration was 9 h. The mean total shifts per ED block and hours worked per ED block are as follows: 19 shifts and 185.1 h (PGY-1), 18.2 shifts and 173.9 h (PGY-2), 17.3 shifts and 163.6 h (PGY-3), and 14.8 shifts and 157.2 h (PGY-4). Programs provide a median for 4 weeks of vacation per year of residency.

Given the expansion of U.S. EM residency programs, we reevaluated the landscape of resident scheduling. We described scheduling patterns related to night shifts, vacations, requested time off, conference coverage, charting time, and circadian rhythms. Programs should utilize these data as a starting point for setting a clinical experience for their residents.