A Decade Later: Trends in Fellowship Training and Secondary Board Certification Among Emergency Medicine Residency...

Residency program leaders shape the academic pipeline in emergency medicine (EM). We assessed current demographics and postgraduate training among EM residency leadership in the United States.

We conducted a national, cross-sectional survey of all Accreditation Council for Graduate Medical Education-accredited EM residency program leadership via an online, confidential questionnaire. Primary outcomes were the prevalence of any postgraduate fellowship training and any secondary board certification (ie, additional board certification beyond EM) as a complementary marker of advanced credentialing distinct from fellowship training. Programs were grouped by National Resident Matching Program (NRMP) region.

We received 103 program responses (35.9%). Any fellowship training was reported by 25.5% of program directors (PD), 40.0% of associate program directors (APD), and 42.8% of assistant PDs. Compared with the 2014-2015 national survey, fellowship training increased from approximately 20-25% to 40-43% among APD and assistant PDs, while remaining similar among PDs (~25% previously vs 26% currently). Any secondary board certification was reported by 8.8% of PDs, 5.0% of APDs, and 8.2% of assistant PDs. Medical education was the most common fellowship (n = 54), followed by ultrasound (n = 24), toxicology (n = 16), simulation (n = 15), pediatric EM (n = 11), critical care (n = 7), emergency medical services (n = 5), and administration (n = 3). Programs in the western United States reported the highest proportions of leaders with either fellowship or secondary certification across roles.

Postgraduate fellowship and secondary board certification remain uncommon overall among EM residency leaders, but fellowship completion is more prevalent among junior leaders compared with a decade earlier. These data provide an updated, role-specific snapshot to inform leadership development and workforce planning.