Characteristics of Disaster Medicine Fellowship Programs in the United States

Disaster Medicine (DM) is an emerging subspecialty of medicine that functions in a variety of settings ranging from hospitals to non-conventional and austere environments. DM fellowships are the primary pathway for Emergency Physicians into this field. DM fellowships have grown in the U.S., and as of March 2026, are recognized by the American Board of Medical Specialties as an ABMS-approved subspecialty. This study describes the current characteristics of U.S. based DM fellowship programs with the goal of informing ongoing subspecialty development.

An online, 59-question survey was distributed from May to June 2024 to active civilian U.S. DM fellowship program directors that were identified through the SAEM website and ACEP's Disaster Medicine Fellowship Directors listserv. The anonymous responses were collected and then analyzed using Microsoft Excel. Descriptive statistics were generated. Inactive and military-only programs were excluded. A comprehensive description of the results is presented and discussed.

Fourteen fellowship programs were contacted and 13 (93%) completed the survey. Programs offered a median of 2 fellowship spots a year (range 1-10), 70% of which were filled. Most fellows were trained in Emergency Medicine (79%). Fellowship duration was varied: 38% offered 1-year only, and 54% offered 2-year tracks. Foreign candidates were accepted by 46% of programs; 15% accepted NPs or PAs. Most programs (92%) pay fellows, often permitting moonlighting. Didactics, simulation, and experiential learning (e.g., deployments, special operations, mass gatherings) were common, though curricular standardization was variable. Only 31% used a published curriculum.

The 2023 Model Core Content for DM provides curricular guidance; however, DM fellowships vary significantly in structure, educational delivery, and resources. Standardization will likely increase as the specialty continues to evolve following formal subspecialty recognition.