The Emergency Medicine Capacity Assessment Study: anticipated impact of a major increase in intern numbers in Australian ED

Abstract

Objective: To identify emergency medicine (EM) staff perceptions of EM intern rotation, the capacity of ED to accept an increase in intern numbers of 70%, attitudes of staff towards the increase, and its anticipated impact on management of ED, patient care and learning opportunities.

Method: A semistructured telephone interview was conducted with ED Directors, Directors of Emergency Medicine Training (DEMT), advanced trainees and interns in EM from a stratified sample of city, metropolitan and rural/provincial public hospitals in Australia.

Results: Ninety-five interviews were completed with 100% participation from ED Directors. Most participants agreed that the ED rotation should remain compulsory for full medical registration, 67% disagreed that they would like 70% more interns in their ED; most ED Directors and DEMT indicated this could not occur without problems. Most felt it would be difficult for existing numbers of consultants and registrars to supervise 70% more interns, and more interns would not improve patient wait times and ED length of stay. Almost two-thirds felt the increase in interns would decrease their exposure to procedures; most Directors and DEMT felt that an increase in medical students would affect their ability to take medical elective students (78%) and Australian Medical Council observers (70%).

Conclusion: The increase in interns peaking in 2012 represents a significant change to the health system that will challenge the capacity of ED. Although ED internship is perceived as an indispensable learning opportunity, maintaining the ED experience with a rapid influx of interns will not occur without problems.