Department of Emergency Medicine, Denver Health Medical Center, Denver, CO, USA.
Acad Emerg Med. 2011 Mar;18(3):297-300. doi: 10.1111/j.1553-2712.2010.00987.x.
Increased exposure of emergency medicine (EM) residents to rural rotations may enhance recruitment to rural areas. This study sought to characterize the availability and types of rural rotations in EM residency programs and to correlate rotation type with rural practice after graduation.
Program directors from all 126 Accreditation Council for Graduate Medical Education (ACGME)-accredited EM residency programs with at least 2 years of graduates were surveyed. Directors were asked about availability of rural rotations, categorized as: 1) required, 2) elective (with or without predesignated sites), or 3) not available. Completion of rotations and initial practice location after graduation by rotation type were compared.
The 111 (88%) directors reported 2,380 graduates over the past 2 years. Rural rotations were required by six (5%) programs, elective at 92 (83%), and not available at 13 (12%). Overall, 197 (8%) residents completed a rural rotation during residency, and 160 (7%) selected their initial job in a rural area. More residents completed an elective rural rotation in programs with versus without a predesignated site (7% vs. 4%, respectively). EM residency graduates were more likely to select a rural job when rural rotations were required (22%), compared to other options: predesignated (7%) or no predesignated (6%) elective or not available (7%; p < 0.001).
Elective rural rotations at predesignated sites increase resident exposure to rural areas compared to programs without predesignated sites, but neither approach was associated with rural practice after graduation. EM residency programs that required a rural rotation had increased resident selection of rural jobs, but only 5% of programs had this requirement.
增加急诊医学（EM）住院医师对农村轮转的接触可能会增强对农村地区的招聘。本研究旨在描述急诊住院医师培训计划中农村轮转的可用性和类型，并将轮转类型与毕业后的农村实践相关联。
对所有 126 个经过认证的急诊住院医师培训计划的主任进行了调查，这些计划都有至少 2 年的毕业生。主任们被问到农村轮转的可用性，分为：1）必修，2）选修（有或没有指定的地点），或 3）不可用。比较了不同轮转类型完成轮转和毕业后初始实践地点。
111 位（88%）主任报告了过去 2 年的 2380 名毕业生。6 个（5%）计划要求进行农村轮转，92 个（83%）计划是选修，13 个（12%）计划不可用。总体而言，197 名（8%）住院医师在住院期间完成了农村轮转，160 名（7%）选择在农村地区开始他们的第一份工作。在有指定地点的计划中，住院医师完成选修农村轮转的比例高于没有指定地点的计划（分别为 7%和 4%）。与其他选择相比，农村轮转是必修的（22%），与其他选择相比，急诊住院医师毕业后更有可能选择农村工作：指定（7%）、没有指定（6%）或没有指定（7%）选修或不可用（p<0.001）。
与没有指定地点的计划相比，在指定地点进行选修农村轮转可以增加住院医师对农村地区的接触，但这两种方法都与毕业后的农村实践无关。要求进行农村轮转的急诊住院医师培训计划增加了住院医师选择农村工作的比例，但只有 5%的计划有此要求。
