The Emergency Medicine Capacity Assessment Study: anticipated impact of a major increase in intern numbers in Australian ED.

OBJECTIVE

To identify emergency medicine (EM) staff perceptions of EM intern rotation, the capacity of ED to accept an increase in intern numbers of 70%, attitudes of staff towards the increase, and its anticipated impact on management of ED, patient care and learning opportunities.

METHOD

A semistructured telephone interview was conducted with ED Directors, Directors of Emergency Medicine Training (DEMT), advanced trainees and interns in EM from a stratified sample of city, metropolitan and rural/provincial public hospitals in Australia.

RESULTS

Ninety-five interviews were completed with 100% participation from ED Directors. Most participants agreed that the ED rotation should remain compulsory for full medical registration, 67% disagreed that they would like 70% more interns in their ED; most ED Directors and DEMT indicated this could not occur without problems. Most felt it would be difficult for existing numbers of consultants and registrars to supervise 70% more interns, and more interns would not improve patient wait times and ED length of stay. Almost two-thirds felt the increase in interns would decrease their exposure to procedures; most Directors and DEMT felt that an increase in medical students would affect their ability to take medical elective students (78%) and Australian Medical Council observers (70%).

CONCLUSION

The increase in interns peaking in 2012 represents a significant change to the health system that will challenge the capacity of ED. Although ED internship is perceived as an indispensable learning opportunity, maintaining the ED experience with a rapid influx of interns will not occur without problems.