CHANGING STATUS OF ACADEMIC EMERGENCY-MEDICINE (1991-1996)

Objective: An SAEM national task force previously concluded that acade mic departments and residencies in emergency medicine (EM) had prefere ntially developed outside of the academic mainstream. This study was d esigned to determine whether EM has made significant inroads into acad emic medical centers over the past 5 years. Methods: The baseline data set (7/1/91) contained all 126 Liaison Committee on Medical Education (LCME)-accredited schools, and all 87 Residency Review Committee (RRC )-accredited EM residencies. The comparison data set (7/1/96) containe d all 124 LCME-accredited schools, and all 114 RRC-accredited EM resid encies. The 1991-96 increment in academic departments and university-h ospital residencies was examined in the aggregate, then stratified by medical schools grouped into quartiles and contiguous quartiles, accor ding to academic ranking. A-priori and post-hoc comparisons were expre ssed with 95% and 99% confidence intervals (CIs), respectively. Result s: Over the past 5 years, the proportion of academic departments of EM increased by 23%, from 18% to 41% of all LCME-accredited schools (95% CI 12% to 34%). The largest increase (58%; 99% CI 40% to 77%) occurre d among those schools academically ranked above the median. The propor tion of EM residencies at university hospitals increased by 17%, from 40% to 57% (95% CI 5% to 30%). Again, the largest increase (25%; 99% C I 3% to 47%) occurred at university hospitals affiliated with schools academically ranked above the median. Conclusion: EM has made substant ial inroads into academic medical centers over the past 5 years. This is reflected in quantitatively and statistically significant increases in academic departments and university-hospital residency programs, b oth occurring largely within institutions whose academic rankings plac e them among the upper half of all LCME-accredited medical schools.