EDUCATION/SPECIAL CONTRIBUTION
American Board of Emergency Medicine Report on Residency Training Information (2013-2014), American Board of Emergency Medicine Rebecca Smith-Coggins, MD (Chair); Jill M. Baren, MD; Michael S. Beeson, MD; Francis L. Counselman, MD; Terry Kowalenko, MD; Catherine A. Marco, MD; Robert L. Muelleman, MD; Lewis S. Nelson, MD; Robert P. Wahl, MD; Robert C. Korte, PhD*; From the Research Committee, American Board of Emergency Medicine *Corresponding Author. E-mail: [email protected].
The American Board of Emergency Medicine gathers extensive background information on emergency medicine residency programs and the residents in them. We present the 2014 annual report on the status of US emergency medicine training programs. [Ann Emerg Med. 2014;63:637-645.] 0196-0644/$-see front matter Copyright © 2014 by the American College of Emergency Physicians. http://dx.doi.org/10.1016/j.annemergmed.2014.03.008
INTRODUCTION The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents training in those programs. Survey data are collected annually from all emergency medicine programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). Selected parts of the data are reported in this article.* Also included is information on accredited emergency medicine–sponsored fellowship programs reported by the ACGME. ABEM has several reasons for collecting and disseminating information on emergency medicine programs, residents, and fellows. As the evaluating and certifying arm of the specialty, ABEM seeks to meet the following goals: collect accurate and comprehensive information pertaining to residents and residency programs; disseminate information that will aid policymakers and educators in establishing guidelines to improve the quality of graduate medical education in emergency medicine; gather background information on residents and fellows to aid our understanding of diversity in training programs and among residents; facilitate hypothesis generation and support research related to emergency medicine training; and support the interface between residents and ABEM to facilitate applicants’ and candidates’ certification activities. This annual publication serves the specialty of emergency medicine and the medical community at large by documenting *This article reflects the status of data contained in the ABEM Residency Training Information Survey as of February 3, 2014. Data accuracy is contingent on survey compliance by all currently accredited emergency medicine residency training programs and known, accredited emergency medicine–sponsored fellowship programs.
Volume 63, no. 5 : May 2014
the progress of training in emergency medicine. It is intended to be a reference tool for evaluating the status and growth of emergency medicine residency training and inform decisions to enhance the quality of training for emergency physicians.
METHODOLOGY ABEM annually surveys all accredited US categorical emergency medicine residency programs. Categorical programs are residency programs in a single primary specialty such as emergency medicine. There are currently 2 types of emergency medicine categorical programs, based on the postgraduate year (PGY) that residents enter and exit the program: PGY 1 to 3 and PGY 1 to 4. Information about new residents and residency programs in terms of program type, number of approved positions, and other data is typically collected from July through October. Information about fellowship programs and fellows is also collected at this time. Information about all enrolled residents and fellows is verified from December through February. ABEM asks programs for the following information about each of their residents: name date of birth sex country of birth medical degree location of medical school (United States, Canada, international) year of medical school graduation dates of residency citizenship previous internships or specialty training ethnicity (not required) Annals of Emergency Medicine 637
Smith-Coggins et al
ABEM Task Force on Residency Training
Figure 1. The growth and development of residency training programs in emergency medicine (1975 to 2014).
Residency programs are also asked for the following information: type of program (PGY 1 to 3 or PGY 1 to 4) number of first-year positions in the National Residency Matching Program (NRMP) number of applications, interviews, approved positions, funded positions, and residents enrolled ABEM asks emergency medicine–sponsored subspecialty fellowship programs for the following information: previous training requirements length of fellowship date of accreditation number of applications, interviews, approved positions, funded positions, and fellows enrolled
Figure 2. The geographic distribution of accredited US categorical emergency medicine training programs (2013-2014; see Appendix 2).
Additional information on resident demographics is obtained from comparison data derived from the Graduate Medical Education report that is published annually in the Journal of the American Medical Association (JAMA). Data are used with permission.
RESULTS The ACGME reports that in academic year 2013-2014, there are 163 accredited US categorical emergency medicine residency programs. One hundred sixty-two programs were surveyed by ABEM in 2013. One program that was accredited to start in the 2013-2014 academic year was not surveyed because they will
Table 1. The number of first-year ACGME-approved positions, funded positions, applications received, interviews held, and NRMP positions available for all accredited US categorical emergency medicine training programs, as reported by programs. Academic Year Program format 1–3 2009–10 2010–11 2011–12 2012–13 2013–14 Program format 2–4 2009–10 2010–11 2011–12 2012–13 2013–14 Program format 1–4 2009–10 2010–11 2011–12 2012–13 2013–14
ACGME-Approved Positions
Funded Positions
1,249 1,293 1,356 1,386 1,414
1,204 1,251 1,304 1,334 1,339
47 47 39
45 45 37
†
†
†
†
328 393 420 458 477
304 384 399 439 460
Applications 40,604 52,004 68,682 76,072 83,967
(nr¼37) (nr¼28) (nr¼13) (nr¼11) (nr¼10)
680 (nr¼2) 305 (nr¼3) 253 (nr¼1) † †
11,806 15,246 21,654 24,248 29,238
(nr¼10) (nr¼8) (nr¼2) (nr¼3) (nr¼0)
Interviews 8,633 10,659 13,469 13,705 14,749
(nr¼37) (nr¼25) (nr¼12) (nr¼12) (nr¼11)
231 (nr¼2) 120 (nr¼3) 157 (nr¼1) † †
2,922 3,452 4,454 4,644 5,338
NRMP Positions* 903 1,138 1,312 1,290 1,341
(nr¼31) (nr¼20) (nr¼3) (nr¼10) (nr¼8)
58 (nr¼2) 27 (nr¼3) 17 (nr¼2) † †
(nr¼10) (nr¼7) (nr¼1) (nr¼3) (nr¼0)
382 355 498 447 564
(nr¼7) (nr¼7) (nr¼0) (nr¼4) (nr¼0)
nr, Number of programs not reporting. *US military programs do not participate in the NRMP. † All PGY 2 to 4 emergency medicine programs converted to PGY 1 to 4 format during the 2012-2013 academic year.
638 Annals of Emergency Medicine
Volume 63, no. 5 : May 2014
Smith-Coggins et al
ABEM Task Force on Residency Training
Figure 3. The number of residents graduated from accredited US categorical emergency medicine training programs during the last 5 academic years.
not begin training residents until 2014-2015. Two additional programs were newly accredited by the ACGME as of September 2013 to begin in the 2014-2015 academic year. All surveyed programs returned the requested information on residents (100% response rate). Twenty-one combined training programs were also surveyed, all of which returned the requested information on residents (100% response rate). ACGME reports that there are 87 accredited emergency medicine–sponsored fellowship programs, with a total of 207 filled positions. More than half of the programs surveyed returned the requested fellowship information. Emergency Medicine Residency Programs Of the 163 accredited US categorical emergency medicine programs, 125 have a PGY 1 to 3 program format (77%) and
Figure 4. Comparison of residents in accredited US categorical emergency medicine training programs, stratified by sex, for the last 5 academic years. An interactive version of this graph will be available in the future. Volume 63, no. 5 : May 2014
Figure 5. Distribution of age for residents currently training in accredited US categorical emergency medicine training programs by year and decade (2013-2014).
38 are PGY 1 to 4 (23%). Programs were first endorsed in the early 1970s by the Liaison Residency Endorsement Committee, and the ACGME began to accredit emergency medicine residency programs in 1981. A 36-month residency was first required in 1988. Figure 1 illustrates the change in number of residency programs since 1975 by program type. The PGY 2 to 3 format ended in 1988, and the PGY 2 to 4 format decreased from 31 programs in 1988 to 4 in 2012 and was discontinued in the 2012-2013 academic year. The number of PGY 1 to 3 programs and PGY 1 to 4 programs has continued to increase, as has the total number of residency programs. Figure 2 presents the geographic distribution of accredited US categorical emergency medicine training programs. Slightly more than half of the programs (53%) are found in 7 states: New York (N¼21), California (N¼14), Pennsylvania (N¼12), Michigan (N¼11), Texas (N¼11), Ohio (N¼9), and Illinois (N¼8). Table 1 presents information about ACGME-approved positions during the past 5 academic years. First-year funded positions have increased from a total of 1,553 to 1,799 since 2009-2010. Appendix 1 lists currently accredited US categorical training programs in emergency medicine. Appendix 2 presents additional information about the types of programs by state. Overview of Residents in Emergency Medicine In academic year 2013-2014, there are 5,910 residents in accredited US categorical emergency medicine programs, with Annals of Emergency Medicine 639
Smith-Coggins et al
ABEM Task Force on Residency Training
Table 2. Ethnic composition of residents in accredited US categorical emergency medicine training programs during the last 5 academic years, from the ABEM residency training information survey.* Ethnic Category
2009–2010 N (%)
2010–2011 N (%)
2011–2012 N (%)
2012–2013 N (%)
2013–2014 N (%)
White Asian or Pacific Islander Black Hispanic American Indian or Alaskan Native Other Unreported Totals
3,553 (70) 556 (11) 229 (5) 234 (5) 14 (
American Board of Emergency Medicine Report on Residency Training Information (2013-2014), American Board of Emergency Medicine Rebecca Smith-Coggins, MD (Chair); Jill M. Baren, MD; Michael S. Beeson, MD; Francis L. Counselman, MD; Terry Kowalenko, MD; Catherine A. Marco, MD; Robert L. Muelleman, MD; Lewis S. Nelson, MD; Robert P. Wahl, MD; Robert C. Korte, PhD*; From the Research Committee, American Board of Emergency Medicine *Corresponding Author. E-mail: [email protected].
The American Board of Emergency Medicine gathers extensive background information on emergency medicine residency programs and the residents in them. We present the 2014 annual report on the status of US emergency medicine training programs. [Ann Emerg Med. 2014;63:637-645.] 0196-0644/$-see front matter Copyright © 2014 by the American College of Emergency Physicians. http://dx.doi.org/10.1016/j.annemergmed.2014.03.008
INTRODUCTION The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents training in those programs. Survey data are collected annually from all emergency medicine programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). Selected parts of the data are reported in this article.* Also included is information on accredited emergency medicine–sponsored fellowship programs reported by the ACGME. ABEM has several reasons for collecting and disseminating information on emergency medicine programs, residents, and fellows. As the evaluating and certifying arm of the specialty, ABEM seeks to meet the following goals: collect accurate and comprehensive information pertaining to residents and residency programs; disseminate information that will aid policymakers and educators in establishing guidelines to improve the quality of graduate medical education in emergency medicine; gather background information on residents and fellows to aid our understanding of diversity in training programs and among residents; facilitate hypothesis generation and support research related to emergency medicine training; and support the interface between residents and ABEM to facilitate applicants’ and candidates’ certification activities. This annual publication serves the specialty of emergency medicine and the medical community at large by documenting *This article reflects the status of data contained in the ABEM Residency Training Information Survey as of February 3, 2014. Data accuracy is contingent on survey compliance by all currently accredited emergency medicine residency training programs and known, accredited emergency medicine–sponsored fellowship programs.
Volume 63, no. 5 : May 2014
the progress of training in emergency medicine. It is intended to be a reference tool for evaluating the status and growth of emergency medicine residency training and inform decisions to enhance the quality of training for emergency physicians.
METHODOLOGY ABEM annually surveys all accredited US categorical emergency medicine residency programs. Categorical programs are residency programs in a single primary specialty such as emergency medicine. There are currently 2 types of emergency medicine categorical programs, based on the postgraduate year (PGY) that residents enter and exit the program: PGY 1 to 3 and PGY 1 to 4. Information about new residents and residency programs in terms of program type, number of approved positions, and other data is typically collected from July through October. Information about fellowship programs and fellows is also collected at this time. Information about all enrolled residents and fellows is verified from December through February. ABEM asks programs for the following information about each of their residents: name date of birth sex country of birth medical degree location of medical school (United States, Canada, international) year of medical school graduation dates of residency citizenship previous internships or specialty training ethnicity (not required) Annals of Emergency Medicine 637
Smith-Coggins et al
ABEM Task Force on Residency Training
Figure 1. The growth and development of residency training programs in emergency medicine (1975 to 2014).
Residency programs are also asked for the following information: type of program (PGY 1 to 3 or PGY 1 to 4) number of first-year positions in the National Residency Matching Program (NRMP) number of applications, interviews, approved positions, funded positions, and residents enrolled ABEM asks emergency medicine–sponsored subspecialty fellowship programs for the following information: previous training requirements length of fellowship date of accreditation number of applications, interviews, approved positions, funded positions, and fellows enrolled
Figure 2. The geographic distribution of accredited US categorical emergency medicine training programs (2013-2014; see Appendix 2).
Additional information on resident demographics is obtained from comparison data derived from the Graduate Medical Education report that is published annually in the Journal of the American Medical Association (JAMA). Data are used with permission.
RESULTS The ACGME reports that in academic year 2013-2014, there are 163 accredited US categorical emergency medicine residency programs. One hundred sixty-two programs were surveyed by ABEM in 2013. One program that was accredited to start in the 2013-2014 academic year was not surveyed because they will
Table 1. The number of first-year ACGME-approved positions, funded positions, applications received, interviews held, and NRMP positions available for all accredited US categorical emergency medicine training programs, as reported by programs. Academic Year Program format 1–3 2009–10 2010–11 2011–12 2012–13 2013–14 Program format 2–4 2009–10 2010–11 2011–12 2012–13 2013–14 Program format 1–4 2009–10 2010–11 2011–12 2012–13 2013–14
ACGME-Approved Positions
Funded Positions
1,249 1,293 1,356 1,386 1,414
1,204 1,251 1,304 1,334 1,339
47 47 39
45 45 37
†
†
†
†
328 393 420 458 477
304 384 399 439 460
Applications 40,604 52,004 68,682 76,072 83,967
(nr¼37) (nr¼28) (nr¼13) (nr¼11) (nr¼10)
680 (nr¼2) 305 (nr¼3) 253 (nr¼1) † †
11,806 15,246 21,654 24,248 29,238
(nr¼10) (nr¼8) (nr¼2) (nr¼3) (nr¼0)
Interviews 8,633 10,659 13,469 13,705 14,749
(nr¼37) (nr¼25) (nr¼12) (nr¼12) (nr¼11)
231 (nr¼2) 120 (nr¼3) 157 (nr¼1) † †
2,922 3,452 4,454 4,644 5,338
NRMP Positions* 903 1,138 1,312 1,290 1,341
(nr¼31) (nr¼20) (nr¼3) (nr¼10) (nr¼8)
58 (nr¼2) 27 (nr¼3) 17 (nr¼2) † †
(nr¼10) (nr¼7) (nr¼1) (nr¼3) (nr¼0)
382 355 498 447 564
(nr¼7) (nr¼7) (nr¼0) (nr¼4) (nr¼0)
nr, Number of programs not reporting. *US military programs do not participate in the NRMP. † All PGY 2 to 4 emergency medicine programs converted to PGY 1 to 4 format during the 2012-2013 academic year.
638 Annals of Emergency Medicine
Volume 63, no. 5 : May 2014
Smith-Coggins et al
ABEM Task Force on Residency Training
Figure 3. The number of residents graduated from accredited US categorical emergency medicine training programs during the last 5 academic years.
not begin training residents until 2014-2015. Two additional programs were newly accredited by the ACGME as of September 2013 to begin in the 2014-2015 academic year. All surveyed programs returned the requested information on residents (100% response rate). Twenty-one combined training programs were also surveyed, all of which returned the requested information on residents (100% response rate). ACGME reports that there are 87 accredited emergency medicine–sponsored fellowship programs, with a total of 207 filled positions. More than half of the programs surveyed returned the requested fellowship information. Emergency Medicine Residency Programs Of the 163 accredited US categorical emergency medicine programs, 125 have a PGY 1 to 3 program format (77%) and
Figure 4. Comparison of residents in accredited US categorical emergency medicine training programs, stratified by sex, for the last 5 academic years. An interactive version of this graph will be available in the future. Volume 63, no. 5 : May 2014
Figure 5. Distribution of age for residents currently training in accredited US categorical emergency medicine training programs by year and decade (2013-2014).
38 are PGY 1 to 4 (23%). Programs were first endorsed in the early 1970s by the Liaison Residency Endorsement Committee, and the ACGME began to accredit emergency medicine residency programs in 1981. A 36-month residency was first required in 1988. Figure 1 illustrates the change in number of residency programs since 1975 by program type. The PGY 2 to 3 format ended in 1988, and the PGY 2 to 4 format decreased from 31 programs in 1988 to 4 in 2012 and was discontinued in the 2012-2013 academic year. The number of PGY 1 to 3 programs and PGY 1 to 4 programs has continued to increase, as has the total number of residency programs. Figure 2 presents the geographic distribution of accredited US categorical emergency medicine training programs. Slightly more than half of the programs (53%) are found in 7 states: New York (N¼21), California (N¼14), Pennsylvania (N¼12), Michigan (N¼11), Texas (N¼11), Ohio (N¼9), and Illinois (N¼8). Table 1 presents information about ACGME-approved positions during the past 5 academic years. First-year funded positions have increased from a total of 1,553 to 1,799 since 2009-2010. Appendix 1 lists currently accredited US categorical training programs in emergency medicine. Appendix 2 presents additional information about the types of programs by state. Overview of Residents in Emergency Medicine In academic year 2013-2014, there are 5,910 residents in accredited US categorical emergency medicine programs, with Annals of Emergency Medicine 639
Smith-Coggins et al
ABEM Task Force on Residency Training
Table 2. Ethnic composition of residents in accredited US categorical emergency medicine training programs during the last 5 academic years, from the ABEM residency training information survey.* Ethnic Category
2009–2010 N (%)
2010–2011 N (%)
2011–2012 N (%)
2012–2013 N (%)
2013–2014 N (%)
White Asian or Pacific Islander Black Hispanic American Indian or Alaskan Native Other Unreported Totals
3,553 (70) 556 (11) 229 (5) 234 (5) 14 (
