Stowell Jeffrey R, Vohra Taher T, Luber Samuel D
Department of Emergency Medicine, The University of Texas Medical School at Houston, Houston, Texas.
Department of Emergency Medicine, Henry Ford Health System, Detroit, Michigan.
J Emerg Med. 2015 Apr;48(4):474-80.e1-4. doi: 10.1016/j.jemermed.2014.11.005. Epub 2015 Jan 24.
Emergency medicine (EM) residency programs have significant scheduling flexibility. As a result, there is potentially significant variation in scheduling practices. Few studies have previously sought to describe this variation. It is unknown how this affects training time in the emergency department.
The purpose of this study was to describe the current variation in clinical training practices through clinical hour, shift length, and rotation survey data.
A 21-item questionnaire was distributed to all allopathic EM training programs utilizing an online survey during the 2011-2012 academic year. Questions included demographic data, number of EM rotations per year, shifts, average hours, shift length, and scheduling practices.
A total of 122 responses were received and 82 programs were analyzed (51.6% of 159 allopathic programs). EM residents work, on average, 45.50 h per week. Postgraduate year 1-3 programs utilizing 28-day schedules averaged two additional EM rotations and 338.2 more clinical EM hours compared with calendar-month rotations. The residents of 4-year programs work approximately 1300 additional hours during residency, with an average of 1279.26 h and 7.9 clinical EM rotations in the fourth year. Clinical hour ranges of 2670-5112 and 4248-6113 were observed for 3-year and 4-year programs, respectively.
There are different scheduling modalities used to create resident schedules. This flexibility results in a large amount of diversity in scheduling practices, with certain patterns allowing for significantly more clinical time. This may result in a vastly different training experience for EM residents.
急诊医学（EM）住院医师培训项目在排班方面有很大的灵活性。因此，排班做法可能存在显著差异。此前很少有研究试图描述这种差异。目前尚不清楚这如何影响急诊科的培训时间。
本研究旨在通过临床小时数、轮班时长和轮转调查数据来描述当前临床培训做法的差异。
在2011 - 2012学年期间，通过在线调查向所有opathic EM培训项目发放了一份包含21个条目的问卷。问题包括人口统计学数据、每年的EM轮转次数、班次、平均小时数、轮班时长和排班做法。
共收到122份回复，分析了82个项目（占159个opathic项目的51.6%）。EM住院医师平均每周工作45.50小时。与按日历月轮转相比，采用28天排班的研究生第1 - 3年项目平均多了两次EM轮转和338.2小时的临床EM时间。4年制项目的住院医师在住院期间工作时间大约多出1300小时，第四年平均为1279.26小时和7.9次临床EM轮转。3年制和4年制项目的临床小时数范围分别为2670 - 5112小时和4248 - 6113小时。
用于制定住院医师排班的方式各不相同。这种灵活性导致排班做法存在大量差异，某些模式可提供显著更多的临床时间。这可能会给EM住院医师带来截然不同的培训体验。
