Unique curriculum for emergency medicine residents as medical directors for rural out-of-hospital agencies

Background: Many rural communities have difficulty maintaining a medical di rector for their emergency medical services (EMS). Local physicians may be overwhelmed, be hesitant to take on additional responsibilities, and feel u nskilled in providing the necessary leadership. Without a medical director, rural EMS agencies are frequently forced to shut down, thus depriving the community of local out-of-hospital care. Objectives: To meet the needs of r ural EMS agencies for medical direction, to provide a unique opportunity fo r emergency medicine (EM) residents to acquire EMS medical direction skills , and to fulfill the obligation of EM residencies to provide both didactic and experiential training in EMS. Program Description: This article describ es a curriculum, now being used in Colorado, for placing Ehl: residents as EMS medical directors for rural out-of-hospital agencies that have lost the ir medical directors. Residents visit these rural communities 6-12 times a year, provide continuing education through interactive lectures, develop or revise EMS protocols and policies, perform quality assurance reviews, trou bleshoot problems, and assist in EMS planning for the community. Residents are supervised by the Colorado state EMS medical director. Conclusions: Thi s unique program enables local EMS agencies to continue their service while providing clear educational benefit for the EM residents. This paper demon strates how this program has been working successfully in the state of Colo rado by placing residents in four distinct rural and mountainous communitie s.