Characteristics and Diversity of ACGME Accredited Emergency Medical Services Fellowship Programs

Abstract

Introduction: There is a minimal amount of published data regarding to Emergency Medical Services (EMS) fellowship programs. The purpose of this study was to obtain program characteristics and diversity data regarding EMS fellowship programs. Methods: A survey was sent to program directors at all EMS fellowship programs accredited by the Accreditation Council of Graduate Medical Education (ACGME). Data collected included: year program started, year program accredited, unfilled fellow positions, number of EMS faculty, gender, and race/ethnicity. Gender and race/ethnicity data from EMS fellowships were compared to emergency medicine (EM) residencies using data from the American Association of Medical Colleges. Data were analyzed using IBM SPSS with descriptive statistics, and Chi-square tests. Results: The response rate for the survey was 88% (45/51) of all EMS fellowship programs that were accredited at the time of this survey. Most programs (71%) offer a one-year EMS fellowship, with the remaining offering an optional second year. The median number of physician response vehicles per program was 1.0 (IQR 0.0-2.0), with 24% (11/45) not having a dedicated physician response vehicle. This survey identified that 118 EMS fellows have graduated since inception of the accreditation process, while 34 positions went unfilled. The median number of EMS fellow positions per program was 2.0 (IQR 1.0-2.0), with a range of 1 to 4. It was noted that 31% of programs had no female EMS faculty, and 48% of programs had no under-represented minority EMS faculty. There was a significantly larger proportion of female faculty in EM residency programs (30.5%; 949/3,107) compared to EMS fellowships (19%; 53/274), OR = 1.8, 95% CI:1.3-2.5, p < 0.0001. There was a significantly larger proportion of female fellows in EMS (56%; 66/118) vs. female residents in EM (38%; 2,193/5,777), OR" = 2.1, 95% CI:1.4-3.0, p < 0.0001. There was a significantly larger proportion of under-represented minority faculty in EM residency programs (19.7%; 786/3,978) vs. EMS fellowships (12.0%, 33/274), OR = 1.8, 95% CI:1.2-2.6, p < 0.002. Conclusion: A significant number of EMS fellowship positions have remained unfilled since implementation of an accreditation process for EMS fellowships. The percentage of females and under-represented minority faculty in EMS programs was much lower than for EM residency programs.

Keywords: EMS; characteristics; diversity; education; fellowship.