Klas Joel, Puffer Cole, Klas Paul, Hollander-Rodriguez Joyce C, Carney Patricia A
Cascades East Family Medicine Residency, Sky Lakes Medical Center, Oregon Health & Science University, Klamath Falls, OR.
Northeast Georgia Medical Center (NGMC) Family Medicine Residency Program, Gainesville, GA.
Fam Med. 2025 Jul;57(7):465-470. doi: 10.22454/FamMed.2025.459247. Epub 2025 Jun 3.
Family physicians are central to the national emergency department workforce, especially in rural communities. However, the number of family physicians working in emergency departments is decreasing, perhaps due to lack of training.
We assessed emergency medicine and trauma stabilization curricula in US family medicine residencies to identify barriers to training in these areas. Council on Academic Family Medicine Educational Research Alliance (CERA) program directors' surveys were administered between September 26, 2023 and October 30, 2023. We stratified data according to community size (<30,000; 30,000-74,999; 75,000-149,999; 150,000-499,999; 500,000-1,000,000; and >1,000,000) to explore whether training differed based on training program rurality.
Of the 715 program directors, 271 responded (37.9%). Of the program directors who responded, nearly 76% reported that residents spend 100 to 299 hours training in emergency rooms, and more than 86% reported that residents lead 0 to 5 trauma stabilizations by the time their training is complete, which did not differ according to rurality. Only 3.0% reported that all their graduates were prepared to work independently in emergency rooms, and 3.4% reported that all their graduates were prepared to lead trauma stabilizations, which also did not differ according to rurality. Barriers to training included Accreditation Council for Graduate Medical Education (ACGME) emphasis on other practice requirements (58.3%) and a lack of emphasis on trauma stabilization (69.7%).
Most program directors reported that few of their residents were prepared to independently work in emergency departments. If ACGME wishes to increase family medicine graduates' entry into the emergency medicine workforce, system changes may be required to increase emphasis on emergency training and its core component of trauma stabilization.
家庭医生是国家急诊科劳动力的核心力量,在农村社区尤为如此。然而,在急诊科工作的家庭医生数量正在减少,这可能是由于缺乏培训所致。
我们评估了美国家庭医学住院医师培训项目中的急诊医学和创伤稳定课程,以确定这些领域培训的障碍。学术家庭医学教育研究联盟(CERA)项目主任的调查于2023年9月26日至2023年10月30日进行。我们根据社区规模(<30,000;30,000 - 74,999;75,000 - 149,999;150,000 - 499,999;500,000 - 1,000,000;以及>1,000,000)对数据进行分层,以探讨培训是否因培训项目所在地区的农村程度而有所不同。
在715名项目主任中,271人回复(37.9%)。在回复的项目主任中,近76%报告称住院医师在急诊室接受100至299小时的培训,超过86%报告称住院医师在培训结束时进行0至5次创伤稳定治疗,这在农村程度方面没有差异。只有3.0%报告称其所有毕业生都准备好在急诊室独立工作,3.4%报告称其所有毕业生都准备好进行创伤稳定治疗,这在农村程度方面也没有差异。培训障碍包括研究生医学教育认证委员会(ACGME)对其他实践要求的强调(58.3%)以及对创伤稳定治疗缺乏强调(69.7%)。
大多数项目主任报告称,他们的住院医师中很少有人准备好在急诊科独立工作。如果ACGME希望增加家庭医学毕业生进入急诊医学劳动力队伍的人数,可能需要进行系统变革,以加强对急诊培训及其创伤稳定核心组成部分的重视。