Membership in the Council of Teaching Hospitals and Health Systems Among Emergency Medicine Residency Program–Sponsoring Institutions, 2001-2020

Abstract

This cross-sectional study identifies US institutions sponsoring residency programs and examines whether Council of Teaching Hospitals and Health Systems membership is associated with institution characteristics.

Challenges surrounding the emergency physician workforce and their impact on the Emergency Medicine Match

“…Second, there has been a rapid increase in the number of newly accredited residency programs [ 10 ]. This includes an increasing number of programs at institutions without a major teaching hospital affiliation and programs sponsored by for-profit hospitals [ 5 ]. These new programs are disproportionately added to areas with an already existing density of EM programs ( Fig.…”

“…These new programs are disproportionately added to areas with an already existing density of EM programs ( Fig. 1 ) [ 5 , 10 ].…”

“…The lack of major teaching hospital affiliation among newly accredited EM residency programs is troubling [ 5 ]. Teaching hospital EDs tend to have higher visit volumes and more often provide complex, higher acuity care by nature of their status as referral centers.…”

“…However, there are a finite number of teaching hospitals with the necessary infrastructure to create the academic environment for an EM residency. Compared to EM programs with a major teaching hospital affiliation, more recently launched EM programs based at hospitals without a major teaching hospital affiliation are less likely to be designated as a trauma, stroke, or burn center [ 5 ]. We acknowledge that teaching hospitals are less likely to be located in rural settings; thus, in medically underserved areas, teaching hospital affiliation may not need to be a prerequisite for EM residency accreditation.…”

“…However, alternate indicators of the breadth and complexity of training opportunities should be met. Unfortunately, annual ED visit volumes at some newly accredited residencies’ primary site—the ED where the program is based and where residents spend most of their time—are consistently below the ACGME’s minimum threshold for annual visit volumes [ 5 ]. These low volumes raise concerns about the quality of the educational environment for EM residents in these programs.…”