Physicians in Greece's Emergency Departments: Attitudes, Readiness, and Need for Formal Training

Despite the recent recognition of emergency medicine (EM) as a distinct specialty in Greece, emergency departments(ED) there continue to be staffed by physicians with training in other medical specialties, although some hold EM certifications. In this study we aimed to evaluate the perceived level of competency and preparedness of physicians who work in EDs in Greece. We also sought to identify gaps in clinical EM expertise, solicit opinions on the need for EM residency training in Greece, and determine the well-being and job satisfaction of physicians practicing in Greek EDs.

This was a mixed-methods, cross-sectional, electronic, nationally representative survey of physicians working in EDs across all health districts in Greece. The survey was administered in Greek and anonymously conducted online. We used the Pearson chi-squared test to determine whether there was an association between EM certification and comfort with seeing subsets of patients. The study received institutional review board approval, and all participants signed an online consent form.

The study surveyed 105 of 263 physicians working in 52 Greek EDs (39.9% response rate). We found that of the 105 physicians surveyed, 63 (60.0%) were not certified in EM. A Pearson chi-squared test revealed a significant association between comfort level in seeing pediatric, trauma, and critically ill patients, and EM certification (X² = 13.37, P = .001). Qualitative analysis found that physicians had a desire to engage in training opportunities, with many citing cost, time, and age as barriers. Despite these challenges, 64.1% of physicians reported satisfaction with their decision to work in the ED.

Most frontline emergency physicians working in Greece are uncomfortable caring for the full breadth of ED patients. This survey represents the first assessment of the attitudes, clinical preparedness, and perceived need for EM residency training among emergency physicians in Greece. Critical next steps should include enhanced training on targeted aspects of emergency care for practicing emergency physicians in the nation and continued efforts to establish formal EM residency training in Greece.