Willoughby P J, Suter R E, Williams D, Perina D G
Emergency Medicine Residents Association, EMS Subspecialty Task Force, USA.
Prehosp Emerg Care. 1998 Jan-Mar;2(1):47-51. doi: 10.1080/10903129808958839.
Emergency medical services (EMS) is frequently considered to be a subspecialty of emergency medicine (EM) despite the unavailability of subspecialty certification. An assessment of future interest in EMS subspecialization and the perceived educational needs of potential EMS physicians was performed in order to provide data to leaders responsible for development of this subspecialty area.
A survey concerning EMS subspecialization issues was distributed to 2,464 members of the Emergency Medicine Residents Association (EMRA). Questions addressed demographic information, interest in EMS, educational issues, and desired credentials. The response rate was 30% (n = 737). All surveys were analyzed by the Pearson chi-square probability and Mantel-Haenszel tests for linear association.
A moderate to very high interest in EMS medical direction was expressed by 84% of the respondents, with 14% interested in full-time EMS positions. This interest increased with years of training (p < 0.0001). Almost 89% believed that EMS physicians should have special preparations prior to practice beyond EM residency training. Fewer than half (44%) thought that an EM residency provided sufficient preparation for a significant role in EMS, and this perception increased in intensity with years of training (p < 0.0052). Interest in EMS fellowships (24%) would increase to 36% if subspecialty certification were available (p < 0.0001). Thirty-nine percent believed subcertification should be required of all EMS medical directors if available.
Many EM residents have an interest in active participation in EMS on either a part-time or a full-time basis. Most respondents think EMS is a unique area requiring focused education beyond an EM residency. Interest in EMS fellowships would greatly increase if subspecialty certification were available.
尽管尚无亚专业认证，但紧急医疗服务（EMS）常被视为急诊医学（EM）的一个亚专业。为了向负责该亚专业领域发展的领导者提供数据，我们对未来EMS亚专业化的兴趣以及潜在EMS医生的感知教育需求进行了评估。
向急诊医学住院医师协会（EMRA）的2464名成员发放了一份关于EMS亚专业化问题的调查问卷。问题涉及人口统计学信息、对EMS的兴趣、教育问题以及所需资质。回复率为30%（n = 737）。所有调查均通过Pearson卡方概率检验和Mantel-Haenszel线性关联检验进行分析。
84%的受访者表示对EMS医疗指导有中度至高兴趣，14%对全职EMS职位感兴趣。这种兴趣随培训年限增加而增加（p < 0.0001）。近89%的人认为EMS医生在执业前除了接受EM住院医师培训外，还应接受特殊准备。不到一半（44%）的人认为EM住院医师培训为在EMS中发挥重要作用提供了充分准备，并且这种认知强度随培训年限增加而增加（p < 0.0052）。如果有亚专业认证，对EMS专科培训项目的兴趣（24%）将增至36%（p < 0.0001）。39%的人认为如果有亚专业认证，所有EMS医疗主任都应具备亚专业认证。
许多EM住院医师有兴趣以兼职或全职方式积极参与EMS工作。大多数受访者认为EMS是一个独特领域，需要在EM住院医师培训之外进行针对性教育。如果有亚专业认证，对EMS专科培训项目的兴趣将大幅增加。
