DIRECTING AN EMERGENCY-MEDICINE RESIDENCY - THE PROBLEMS AND THEIR POTENTIAL SOLUTIONS

Objective: To characterize the problems facing emergency medicine resi dency directors (EMRDs), to describe potential solutions, and to assoc iate perceptions with anticipated duration in the position of EMRD. Me thods: A confidential questionnaire was mailed to the EMRDs at all Acc reditation Council for Graduate Medical Education-approved programs. T he survey included a problem and solution list constructed by a panel of EMRDs. The respondents were asked to rate problems using a Likert-l ike scale and were asked to indicate which of the listed solutions the y had used and had found useful, or thought would be useful. Associati ons of these features and demographic variables with the intention to leave the position of EMRD within 5 years were sought.Results: Eighty- seven of 93 EMRDs (93.5%) completed the survey. Their mean age was 40 years; 50% had been EMRDs for <3 years, Most of the EMRDs (62%) had an associate EMRD, and 77% had at least one secretary. The EMRDs worked a median of 220 hours per month. Major problems included: insufficient time for the job (57%), career interfering with family needs (44%), a nd lack of adequate faculty help (38%). The most frequently cited and useful solutions included: attending education courses, self-reading o n education and management techniques, and discussing problems with an d seeking advice from others. Most (68%) of the EMRDs anticipated cont inuing as program director for less than or equal to 5 years. Neither age, gender, previous amount of time in the position, number of hours worked, nor nature of the problems faced on the job was a significant predictor of which of the EMRDs anticipated leaving. Conclusions: Half the responding EMRDs were <40 years of age, half had been EMRDs for l ess than or equal to 3 years, and 68% anticipated continuing in their position for less than or equal to 5 years. Major frustrations include d lack of knowledge and time. Family and career conflicts were frequen t. These problems are similar to those of program directors in other s pecialties, Some recommendations are made to assist EMRDs.