Meeting Our Needs: Rural Training Experiences in Emergency Medicine Residencies

Area of Science:

• Emergency Medicine
• Medical Education
• Rural Health Workforce

Background:

• Board-certified emergency medicine (BCEM) physicians are underrepresented in rural emergency departments (EDs).
• The number of BCEM physicians entering rural EDs is declining, a trend projected to worsen.
• There is a need to identify residency-level interventions to address this shortage.

Purpose of the Study:

• To investigate the current landscape of emergency medicine (EM) residency rural rotations in the US.
• To identify barriers to offering rural rotations.
• To inform potential residency-level interventions to increase BCEM physicians in rural EDs.

Main Methods:

• Surveys were distributed to program directors of all 290 ACGME-accredited EM residencies in the US.
• Data collected included the availability and establishment of rural rotations and recent graduate job selection.
• Descriptive statistics and analyses were performed using IBM SPSS Statistics.

Main Results:

• Responses were received from 174 (60%) EM residencies, covering 3411 graduates over two years.
• 48% of programs did not offer rural rotations; 52% offered them (47% required, 52% elective).
• Graduates from programs with rural rotations were more likely to enter rural EDs (15% vs. 8%), especially if rotations were required (21% vs. 11%).

Conclusions:

• Rural ED rotation experience during residency is linked to a higher probability of graduates entering the rural workforce.
• Required rural rotations are more strongly associated with rural practice than elective rotations.
• Implementing or requiring rural rotations in EM residency programs may enhance the supply of BCEM physicians in rural settings.