Assessment of Emergency and Trauma Stabilization Training in Family Medicine Residency Programs: A CERA Study

Family physicians are central to the national emergency department workforce, especially in rural communities. However, the number of family physicians working in emergency departments is decreasing, perhaps due to lack of training.

We assessed emergency medicine and trauma stabilization curricula in US family medicine residencies to identify barriers to training in these areas. Council on Academic Family Medicine Educational Research Alliance (CERA) program directors' surveys were administered between September 26, 2023 and October 30, 2023. We stratified data according to community size (<30,000; 30,000-74,999; 75,000-149,999; 150,000-499,999; 500,000-1,000,000; and >1,000,000) to explore whether training differed based on training program rurality.

Of the 715 program directors, 271 responded (37.9%). Of the program directors who responded, nearly 76% reported that residents spend 100 to 299 hours training in emergency rooms, and more than 86% reported that residents lead 0 to 5 trauma stabilizations by the time their training is complete, which did not differ according to rurality. Only 3.0% reported that all their graduates were prepared to work independently in emergency rooms, and 3.4% reported that all their graduates were prepared to lead trauma stabilizations, which also did not differ according to rurality. Barriers to training included Accreditation Council for Graduate Medical Education (ACGME) emphasis on other practice requirements (58.3%) and a lack of emphasis on trauma stabilization (69.7%).

Most program directors reported that few of their residents were prepared to independently work in emergency departments. If ACGME wishes to increase family medicine graduates' entry into the emergency medicine workforce, system changes may be required to increase emphasis on emergency training and its core component of trauma stabilization.