Columbia University, Department of Emergency Medicine, New York City, New York.
University of Florida - Jacksonville, Department of Emergency Medicine, Jacksonville, Florida.
West J Emerg Med. 2020 Oct 6;21(6):225-230. doi: 10.5811/westjem.2020.7.45999.
International emergency medicine is a new subspecialty within emergency medicine. International emergency medicine (EM) fellowships have been in existence for more than 10 years, but data is limited on the experiences of the fellows. Our goal in this study was to understand the fellowship experience.
The study employed a cross-sectional survey in which participants were asked about their demographics, fellowship program, and advanced degree. Participants consisted of former fellows who completed the fellowship between 2010-19. The survey consisted of both closed and open-ended questions to allow for further explanation of former fellows' experience. Descriptive analysis was conducted on the quantitative survey data while content analysis was conducted to ascertain salient themes from the open-ended questions.
We contacted 71 former fellows, of whom 40 started and 36 completed surveys, for a 51% response rate (55.6% women). Two-year fellowships predominated, with 69.4% of respondents. Prior to fellowship, a subset of fellows spoke the native languages of their service sites: French, Spanish, Haitian Creole, Mandarin, or Kiswahili. Half the respondents spent 26-50% of their fellowship in field work, with 83.3% of institutions providing direct funding for this component. Many respondents stated a need for further institutional support (money or infrastructure) for fieldwork and mentoring. Non-governmental organizations comprised 29.7% of respondents' work partners, while 28.6% were with academic institutions in country, focused mostly on education, health systems development, and research. The vast majority (92%) of respondents continued working in global EM, with the majority based in American academic institutions. Those who did not cited finances and lack of institutional support as main reasons.
This study describes the fellow experience in international EM. The majority of fellows completed a two-year fellowship with 26-50% of their time spent in fieldwork with 83.3% of institutions providing funding. The challenges in pursuing a long-term career in global EM included the cost of international work, inadequate mentorship, and departmental funding.
国际急诊医学是急诊医学的一个新专业。国际急诊医学（EM）奖学金已经存在超过 10 年，但关于研究员经验的数据有限。我们在这项研究中的目标是了解奖学金的经历。
该研究采用横断面调查，要求参与者提供他们的人口统计学、奖学金计划和高级学位信息。参与者包括在 2010-19 年间完成奖学金的前研究员。调查包括封闭式和开放式问题，以便进一步解释前研究员的经验。对定量调查数据进行描述性分析，同时对开放式问题进行内容分析以确定突出的主题。
我们联系了 71 名前研究员，其中 40 人开始并完成了调查，回复率为 51%（55.6%为女性）。两年制奖学金占主导地位，占受访者的 69.4%。在奖学金之前，一部分研究员会说服务地点的母语：法语、西班牙语、海地克里奥尔语、普通话或斯瓦希里语。一半的受访者在实地工作中花费 26-50%的奖学金，83.3%的机构为此提供直接资金。许多受访者表示需要进一步的机构支持（资金或基础设施）用于实地工作和指导。非政府组织占受访者工作伙伴的 29.7%，而 28.6%的机构在国内的学术机构，主要专注于教育、卫生系统发展和研究。绝大多数（92%）的受访者继续在全球 EM 工作，其中大多数在美国学术机构工作。那些没有这样做的人表示，资金和缺乏机构支持是主要原因。
本研究描述了国际急诊医学的研究员经验。大多数研究员完成了为期两年的奖学金，其中 26-50%的时间用于实地工作，83.3%的机构提供资金。在全球 EM 从事长期职业的挑战包括国际工作的成本、缺乏指导和部门资金。
