Training programs in emergency medicine differ from country to country. Thi
s article compares the allopathic training programs of Australasia and the
United States. The perceived advantages of these programs are highlighted,
but no attempt is made to determine which is the better program. The Austra
lasian program is significantly longer and places a greater emphasis on the
basic clinical sciences, physical examination skills, and academic output.
Australasian College for Emergency Medicine (ACEM) regulations are relativ
ely flexible and allow trainees to design their own programs. Trainees are
encouraged to arrange accredited positions in a variety of hospitals. Overs
eas and part-time training may be acceptable. In the United States, trainee
s rotate within and from one parent institution, which provides a rigid tea
ching structure for a "critical mass" of trainees, based on a "core" curric
ulum. Rotations tend to be much shorter but ensure exposure to a broader ra
nge of clinical experience. Evaluation of trainees and teaching faculty is
more frequent and documentation of procedural and resuscitation skills is r
equired. Trainees are under the close supervision of teaching faculty at al
l times when working in an ED.