Academic Career Selection in American Emergency Medicine Residents

Abstract

The future of academic emergency medicine (EM) is based on the continued successful recruitment and cultivation of new faculty from EM residents. Little data exist as to the current rate of residents initially choosing an academic career path or which residency programs are best situated to result in new faculty. Our study was designed to initially describe the current career demographics of graduating residents and then through statistical analysis investigate likely programmatic factors that affect academic career selection. Data were collected via an online survey sent to EM residency program directors. Responders were asked to describe their graduates and their program characteristics over the past 5 years. A total of 103 survey responses, with complete data from 65 (76 responses contained enough data for national career selection rates), were received. Relevant covariates were tested for association with academic career entry using t-tests or analysis of variance. An adjusted multivariable linear regression analysis model was then fitted. Survey responses indicated that 26.1% of residents chose an academic career (community 57.1%, fellowship 13.5%, military/Veteran's Administration [VA] 2.6%, other 0.6%) with an approximately normal distribution. There were no significant differences found between programs when presence of mentorship programs, career track programs, or city size were analyzed. Multivariable linear regression analysis demonstrated significantly greater academic career choice among programs located in the Northeast/Mid-Atlantic and the Midwest, larger programs (>12 residents/year), and programs with increased resident academic productivity (presentations given, non-peer-reviewed publications), but did not demonstrate a difference between 3- and 4-year programs. Overall, the model fitted using the above variables accounted for approximately 30% of the variation seen between programs (adjusted R(2)=0.295). Our data indicate that program region, size, and research productivity were best associated with academic career selection. Program length was not found to be significantly associated with academic career selection by residents, in contrast to previous studies. While many of these factors are not changeable, academic productivity can be cultivated by decision-makers wishing to increase their residents' academic career selection as opposed to changing program length to extend training for an additional year. It is our belief that our model provides a good description of programmatic factors affecting career choice. Additional research is necessary to further validate these findings, as well to provide important context to their general applicability for policy-makers and program directors.