Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA.
New York University Grossman School of Medicine, New York, NY; Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Ann Emerg Med. 2022 Jul;80(1):3-11. doi: 10.1016/j.annemergmed.2022.03.007. Epub 2022 May 12.
To characterize the emergency medicine resident physician workforce and the residency programs training them.
We identified emergency medicine residents in the 2020 American Medical Association (AMA) Physician Masterfile, analyzed demographic information, mapped both county-level population-adjusted and hospital referral region densities, and compared 2020 versus 2008 resident physician densities. We also analyzed all Accreditation Council for Graduate Medical Education (ACGME)-accredited emergency medicine residency programs from 2013 to 2020, mapped state-level population-adjusted densities, and identified temporal trends in program location and state-level program densities. All population-adjusted densities were calculated using the US Census Bureau resident population estimates.
There were 6,993 emergency medicine residents in the 2020 AMA dataset with complete information. Most of them (98%) were in urban areas. Compared with 2008, per 100,000 US population, this represents disproportionate increases in urban areas (total [0.5], urban [0.5], large rural [0.2] and small rural [0.05]). We further identified 160 (2013) to 265 (2020) residency programs using the ACGME data. The new programs were 3-year training programs that were disproportionately added to states with an already higher number of programs (Florida [5 to 19], Michigan [11 to 25], New York [21 to 31], Ohio [9 to 18], Pennsylvania [12 to 21], California [14 to 22]).
The number of emergency medicine residency programs has increased; most new programs were added to the states that already had emergency medicine residency programs. There is an emergency physician "desert" in the rural United States, lacking both residents and residency training programs. This analysis provides essential context to the ongoing conversation about the future of the emergency physician workforce.
描述急诊住院医师队伍和培训他们的住院医师规范化培训项目。
我们在美国医学协会（AMA）医师主文件中确定了 2020 年的急诊住院医师，分析了人口统计学信息，绘制了县级人口调整后的密度和医院转诊区密度，并比较了 2020 年和 2008 年住院医师密度。我们还分析了 2013 年至 2020 年所有经认可的研究生医学教育委员会（ACGME）认可的急诊住院医师规范化培训项目，绘制了州级人口调整后的密度，并确定了项目位置和州级项目密度的时间趋势。所有人口调整后的密度均使用美国人口普查局居民人口估计数计算。
2020 年 AMA 数据集中有 6993 名完整信息的急诊住院医师。他们中的大多数（98%）在城市地区。与 2008 年相比，每 10 万美国人口中，城市地区的增长不成比例（总计[0.5]，城市[0.5]，大农村[0.2]和小农村[0.05]）。我们还使用 ACGME 数据确定了 160（2013 年）至 265（2020 年）个住院医师规范化培训项目。新的培训项目是为期 3 年的培训项目，主要分布在已经有更多培训项目的州（佛罗里达州[5 至 19]，密歇根州[11 至 25]，纽约州[21 至 31]，俄亥俄州[9 至 18]，宾夕法尼亚州[12 至 21]，加利福尼亚州[14 至 22]）。
急诊住院医师规范化培训项目的数量有所增加；大多数新项目都增加到了已经有急诊住院医师规范化培训项目的州。美国农村地区缺乏住院医师和住院医师规范化培训项目，形成了“医师荒漠”。本分析为正在进行的关于急诊医师劳动力未来的讨论提供了重要背景。
