Emergency Medicine Residency Training Programs Research Articles

Sued, Subpoenaed or Sworn in: Use of a Flipped-Classroom Style Medicolegal Workshop for Emergency Medicine Residents.

It is an unfortunate truth that Emergency Medicine (EM) physicians will, at some point, have contact with the medicolegal system. However, most EM residency training programs lack education on the legal system in their curriculum, leaving EM physicians unprepared for litigation. To fill this gap, we designed a high-yield and succinct medical legal workshop highlighting legal issues commonly encountered by EM physicians. We aimed to determine the effectiveness of this curriculum by measuring pre and post knowledge questions. A two-hour session included a case-based discussion of common misconceptions held by physicians about the legal system, proper steps when interacting with the legal system and review of legal documents. This session was developed with the involvement of our hospital legal counsel and discussed real encounters. The effectiveness of the session was determined using pre- and post-session surveys assessing participant knowledge and comfort approaching the scenarios. A total of 34 EM residents had the opportunity to complete this workshop as a part of their conference curriculum. A total of 26 participants completed the pre-survey and 19 participants completed the post-survey. No participants had previous training in the legal aspects of medicine, including handling a subpoena, serving as a witness, or giving a deposition. The pre-survey demonstrated that there was significant uncertainty surrounding the processes, definitions, and the legal system interaction. Many participants stated they would not know what to do if they received a subpoena (85.71%), were called as a witness in a trial (96.43%) or receive correspondence from a lawyer (96.43%). The post survey revealed an increased knowledge base and confidence following the session. 100% of residents reported knowing what to do after receiving a subpoena, being called as a witness and understanding the process involved in giving a deposition. All residents reported that the session was beneficial and provided crucial information. EM residents have limited baseline understanding of how to approach common legal scenarios. Educational materials available for this curriculum topic are limited. Based on the rapid knowledge increase observed in our residents, we believe our workshop could be adapted for use at other residency programs.

Development, implementation and evaluation of a novel quality improvement and patient safety curriculum in an emergency medicine residency training program.

Proficiency in Quality Improvement and Patient Safety (QIPS) methodologies has been identified as a standard of residency training. However, there is no consensus on how to achieve these competencies. We used Kern's model of curricular development to create a QIPS curriculum for the local Emergency Medicine (EM) residency training program. The curriculum was designed following best practice recommendations for QIPS education and took the form of a 10-h educational experience including two in-person live sessions. The curriculum was delivered to a mix of local transition to practice residents and faculty members. Participants reported favorable outcomes and objectively demonstrated QIPS knowledge acquisition. This curriculum serves as a model that could be adapted by other residency training programs seeking to implement their own QIPS curricula.

The state of emergency medicine in Greece: at critical momentum

Greece is a parliamentary republic in southeastern Europe populated by over 10 million permanent residents: 9 million reside on the mainland, with almost 4 million in the greater Athens area. The remaining 1 million populate the over 1200 Greek islands. In addition, more than 160,000 asylum-seekers reached Greece in 2022, and more than 25 million tourists have visited Greece in the last two years. Modern Greek Emergency Medicine (EM) is now in its 4th decade. The Greek government has focused the last few years on enhancing the quality of emergency services provided in public hospitals. Emergency Departments (EDs) are being modernized, undergraduate medical education gradually incorporates EM, and a specialty training program in emergency nursing has been established. However, the late recognition of the critical importance of EM as a specialty in Greece has resulted in the subsequent need to create three alternative pathways to EM, none of which are direct from residency. The first is a 24-month Emergency Medicine fellowship after completing a residency in another specialty and then passing the national exam. The second is for physicians who have worked in a public hospital ED (Gr: Ethniko Systima Ygeias (ESY) ESY for at least three years and successfully passed the national exam. The third, which no longer exists, is a ‘grandfather’ pathway for those physicians who worked in an ESY ED for five years prior to the creation of the fellowship training program. As a result, there is a critical shortage of EM-trained physicians, resulting in most care being provided by physicians without formal training in EM. This is further confounded by the country’s challenging geography, with frequent air transfers from the islands to mainland hospitals. Creating an EM Residency training program is a critical next step to overcoming many of the challenges facing EM provision in Greece today: it would address the shortage of EM-trained providers, decrease the need for costly ground and air transfers, and improve the quality of emergency care throughout Greece.

Early Emergency Medicine Milestone Assessment for Predicting First-Year Resident Performance.

The Accreditation Council for Graduate Medical Education (ACGME) requires emergency medicine (EM) residency training programs to monitor residents' progress using standardized milestones. The first assessment of PGY 1 resident milestones occurs midway through the first year and could miss initial deficiencies. Early assessment of PGY 1 EM resident milestones has potential to identify at-risk residents prior to standard midyear evaluations. We developed an orientation syllabus for PGY 1 residents followed by a milestone assessment. Assessment scores helped predict future milestone scores and American Board of Emergency Medicine (ABEM) In-Training Examination (ITE) scores for PGY 1 residents. From 2013 to 2020, we developed and implemented Milestone Evaluation Day (MED), a simulation-based day and written exam assessing PGY 1 EM residents during their first month on the 23 ACGME 1.0 milestones. MED stations included a history and physical with verbal presentation, patient simulation, vascular access, wound management, and airway management. MED, Clinical Competency Committee-generated (CCC-generated) milestone, and ABEM ITE scores were averaged and compared utilizing Pearson's correlation coefficient. Of 112 PGY 1 EM residents, 110 (98%) were analyzed over an 8-year period. We observed a moderate positive correlation of MED and CCC-generated milestone scores (r = .34, p < .001). There was a nonstatistically significant weak positive correlation of MED and ABEM ITE scores (r = .13, p = .17). An early assessment of EM milestones in the PGY 1 year can assist in the prediction of CCC-generated milestone scores for PGY 1 residents.

Using Natural Language Processing to Evaluate the Quality of Supervisor Narrative Comments in Competency-Based Medical Education.

Learner development and promotion rely heavily on narrative assessment comments, but narrative assessment quality is rarely evaluated in medical education. Educators have developed tools such as the Quality of Assessment for Learning (QuAL) tool to evaluate the quality of narrative assessment comments; however, scoring the comments generated in medical education assessment programs is time intensive. The authors developed a natural language processing (NLP) model for applying the QuAL score to narrative supervisor comments. Samples of 2,500 Entrustable Professional Activities assessments were randomly extracted and deidentified from the McMaster (1,250 comments) and Saskatchewan (1,250 comments) emergency medicine (EM) residency training programs during the 2019-2020 academic year. Comments were rated using the QuAL score by 25 EM faculty members and 25 EM residents. The results were used to develop and test an NLP model to predict the overall QuAL score and QuAL subscores. All 50 raters completed the rating exercise. Approximately 50% of the comments had perfect agreement on the QuAL score, with the remaining resolved by the study authors. Creating a meaningful suggestion for improvement was the key differentiator between high- and moderate-quality feedback. The overall QuAL model predicted the exact human-rated score or 1 point above or below it in 87% of instances. Overall model performance was excellent, especially regarding the subtasks on suggestions for improvement and the link between resident performance and improvement suggestions, which achieved 85% and 82% balanced accuracies, respectively. This model could save considerable time for programs that want to rate the quality of supervisor comments, with the potential to automatically score a large volume of comments. This model could be used to provide faculty with real-time feedback or as a tool to quantify and track the quality of assessment comments at faculty, rotation, program, or institution levels.

Emergency Medicine Resident Needs Assessment and Preferences for a High-value Care Curriculum.

Consideration of the cost of care and value in healthcare is now a recognized element of physician training. Despite the urgency to educate trainees in high-value care (HVC), educational curricula and evaluation of these training paths remain limited, especially with respect to emergency medicine (EM) residents. We aimed to complete a needs assessment and evaluate curricular preferences for instruction on HVC among EM residents. This was a qualitative, exploratory study using content analysis of two focus groups including a total of eight EM residents from a single Midwestern EM residency training program. Participants also completed a survey questionnaire. There were two themes. Within the overall theme of resident experience with and perception of HVC, we found five sub-themes: 1)understanding of HVC focuses on diagnosis and decision-making; 2)concern about patient costs, including the effects on patients' lives and their ability to engage with recommended outpatient care; 3)conflict between internal beliefs and external expectations, including patients' perceptions of value; 4)approach to HVC changes with increasing clinical experience; and 5)slow-moving, political discussion around HVC. Within the overall theme of desired education and curricular design, we identified four sub-themes: 1)limited prior education on HVC and health economics; 2)motivation to receive training on HVC and health economics; 3)desire for discussion-based format for HVC curriculum; and 4)curriculum targeted to level of training. Respondents indicated greatest acceptability of interactive, discussion-based formats. We conducted a targeted needs assessment for HVC among EM residents. We identified broad interest in the topic and limited self-reported baseline knowledge. Curricular content may benefit from incorporating resident concerns about patient costs and conflict between external expectations and internal beliefs about HVC. Curricular design may benefit from a focus on interactive, discussion-based modalities and tailoring to the learner's level of training.

Emergency medicine in Nepal: are we going the right way and fast enough?

Nepal is a landlocked country with variable topography including the world’s tallest mountains, tropical forests, and Gangetic plains. This topography leads to diverse healthcare needs, from tropical diseases in plains, to road traffic accidents in hills, and to disaster-related emergencies from floods and landslides during monsoon season and unpredictable earthquakes. Emergency medicine care is underdeveloped and is currently being provided by general practitioners. The capital city Kathmandu has a few tertiary healthcare centers with emergency medicine fellowship-trained general practitioners staffing them, but most of the hospitals outside of Kathmandu are staffed by minimally trained or untrained medical officers. Even though emergency medicine is recognized as a specialty, Nepal still does not have an emergency medicine residency training program. To improve emergency care in the country, the government of Nepal should be focused on facilitating the start of emergency medicine residency in Nepal.Graphical

Characterizing Air Medical Transport Experiences in Emergency Medicine Residency Training Programs

ObjectiveAir medical transportation (AMT) of patients plays a critical role in the prehospital care of the ill patient. Despite its importance, there is no requirement in emergency medicine training programs to have direct experience or education on the topic, and data detailing current AMT experiences across programs are limited. MethodsA survey detailing program characteristics, AMT experience characteristics, and curriculum factors relating to AMT experience was sent to all 275 credentialed emergency medicine residency training programs in the United States. Our outcomes were to describe the characteristics of AMT and non-AMT programs (proportions) and to evaluate associations (odds ratios with 95% confidence intervals) between program characteristics and 1) AMT experience opportunity and 2) level of resident participation among AMT programs. ResultsTwo hundred (73%) programs responded, with 135 of 200 (68%) offering some type of AMT experience. The majority of programs offering AMT were 3 years (113 [84%]), university based (63 [47%]), and located in small urban areas (57 [42%]). When AMT was offered, most programs reported that the overall resident participation was low (≤ 20%). Programs that did not offer shift reduction or additional pay for participation in AMT were significantly more likely to have low participation than those with incentives (odds ratio = 4.8; 95% confidence interval, 1.8-15.3). Around one third of AMT experiences allowed for direct patient care. Less than half of the responding programs reported a dedicated AMT curriculum. ConclusionThe majority of emergency medicine residency training programs offer an AMT experience, but this experience is highly variable, and overall participation by residents is low. Given the importance of AMT in the care of emergency patients, standardization and increased access to AMT experience and education should be considered by emergency medicine training programs moving forward.

RaT race: A standardized open-access education resource provides a structured resident-as-teacher experience.

There is no unified approach for training residents to be teachers. Foundations of Emergency Medicine (FoEM) is a national program that provides free resident education in emergency medicine (EM) utilizing small-group, case-based instruction delivered by individual program faculty and residents. This study seeks to explore the FoEM resident-as-teacher (RaT) experience. We conducted a mixed-methods study of FoEM faculty site leaders and resident teachers in 2022. Site leaders completed an online survey consisting of multiple-choice, completion, and free-response items. We calculated descriptive statistics and applied a thematic qualitative analysis to free-response items. We conducted semistructured interviews with resident teachers. Interview transcripts were analyzed using a thematic approach with a constructivist-interpretivist paradigm. A total of 133 of 180 (74%) site leaders completed the survey and 11 resident teachers were interviewed. Forty-nine (37%) programs utilize resident instructors. The frequency of residents teaching and degree of faculty supervision varied. Commonly identified advantages include reinforcement of core content for resident teachers (44/49), structured format (35/49), and reduced need for faculty instructors (30/49). The most commonly identified challenges include variable instruction by residents (33/49) and challenge to providing feedback on teaching (20/49). Resident teachers identified benefits including strengthening residency community, improved EM knowledge, and greater teaching skills. For nearly all resident participants, FoEM RaT impacted their career goals by affirming their interest in teaching. The FoEM curricular model appears to be a valuable and feasible method to incorporate a RaT experience into EM residency training programs.

Experience of emergency medicine residents toward an implemented modified teaching approach.

Lecturing has always been one of the traditional instructional methods in medical education. It is cost-effective, especially when it comes to conveying a large amount of information to many students at once. However, disadvantages are plenteous, one of which is its passive way of knowledge delivery and learning. Active learning, on the contrary, has better students' engagement and longer retention, and it results in better students' achievement. The emergency medicine residency training program at KAMC-Jeddah has modified the educational activity to become more aligned with the end-of-year assessment in the form of active learning. This study aimed to explore the experience of the residents regarding the implementation of the new educational approach. An exploratory-qualitative study utilizing constructive grounded theory was conducted, collecting our data through an in-depth 1:1 interview using semi-structured open-ended questions. Purposeful sampling was used, and saturation was reached after interviewing 24 residents. The general perception of residents toward the new teaching modes slightly varied, highlighting the positivity of the new educational environment, the desired impact on their learning, the challenges they encountered, and finally their high satisfaction level and support for this new experience. It was asserted that such experience could be permanently implemented to increase the efficacy of teaching and learning.

Perspectives and Attitudes of Emergency Medicine Educators Towards E-Assessment Technologies

Aim: The widespread use of distance education due to the pandemic has accelerated distance assessment and evaluation technologies (E-assessment). While educators and trainees promptly adapt to distance learning platforms, several factors can affect the adoption of e-assessment models. This study aimed to identify these factors affecting the perspectives and attitudes on e-assessment technologies among emergency medicine educators.&#x0D; &#x0D; Material and Methods: A survey on self-efficacy, self-confidence, and attitudes toward E-assessment technologies was conducted on ninety emergency medicine educators. In this questionnaire-based study, educators of emergency medicine residency training programs with different academic ranks who work in emergency departments involved in emergency medicine residency training were included. A pool of questions was created from the questionnaires with the concepts of “self-efficacy”, “self-confidence”, “attitude”, “educational need” and “computer-use self-efficacy”. The items were evaluated with a 7-point Likert scale. Correlation, validation, reliability and factor analysis were performed.&#x0D; &#x0D; Results: There was a statistically significant difference among computer-use skills, especially regarding self-confidence (p=0.02) and self-efficacy (p=0.01). No significant difference was found in terms of attitude (p=0.877). Advanced computer skills had higher levels of self-confidence and self-efficacy for E-assessment. There was a significant difference in self-confidence (p=0.001) and self-efficacy (p=0.001) regarding increased E-assessment experience. Forty-four percent of the participants had ethical concerns, 30% were not concerned about this issue, and 25.6% were partially concerned about screen sharing.&#x0D; &#x0D; Conclusion: Experience, computer-use skills and self-efficacy, and E-assessment education are the key factors that may be related to self-confidence and self-efficacy and may indirectly affect attitudes toward E-assessments in emergency medicine education. Since it is important to monitor and evaluate the training processes, the adaptation of the trainers to this technology is possible by increasing their computer skills and experience to ensure this continuity in conditions such as pandemics.

Comparison of performance data between emergency medicine 1-3 and 1-4 program formats.

This study compares performance data from physicians completing 3-year versus 4-year emergency medicine residency training programs. Currently, there are 2 training formats and little is known about objective performance differences. This was a retrospective cross-sectional analysis of emergency residents and physicians. Multiple analyses were conducted comparing physicians' performances, including Accreditation Council of Graduate Medical Education Milestones and American Board of Emergency Medicine In-training Examination (ITE), Qualifying Examination (QE), Oral Certification Examination (OCE), and program extensions from 3-year and 4-year residency programs. Some confounding variables were not or could not be considered, such as rationale for medical students to choose one format over another, as well as application and final match rates. Milestone scores are higher for emergency medicine 3 residents in 1-3 programs (3.51) versus emergency medicine 3 residents in 1-4 programs (3.07; P<0.001, d=1.47) and highest for emergency medicine 4 residents (3.67). There was no significant difference in program extension rates (emergency medicine 1-3, 8.1%; emergency medicine 1-4, 9.6%; P=0.05, ω=0.02). ITE scores were higher for emergency medicine 1, 2, and 3 residents from 1-3 programs and emergency medicine 4 residents from 1-4 programs scored highest. Mean QE score was slightly higher for emergency 1-3 physicians (83.55 vs 83.00; P<0.01, d=0.10). QE pass rate was higher for emergency 1-3 physicians (93.1% vs 90.8%; P<0.001, ω=0.08). Mean OCE score was slightly higher for emergency 1-4 physicians (5.67 vs 5.65; P=0.03, d=-0.07) but did not reach a priori statistical significance (α<0.01). OCE pass rate was also slightly higher for emergency 1-4 physicians (96.9% vs 95.5%; P=0.06, ω=-0.07) but also non-significant. These results suggest that although performance measures demonstrate small differences between physicians from emergency medicine 1-3 and 1-4 programs, these differences are limited in their ability to make causal claims about performance on the basis of program format alone.

Simulation in Emergency Medicine Residency Training Programs: A National Survey

Simulation in Emergency Medicine Residency Training Programs: A National Survey

The Status of Pediatric Critical Care (PCC) Experience in Emergency Medicine (EM) Residency Training Programs

The Status of Pediatric Critical Care (PCC) Experience in Emergency Medicine (EM) Residency Training Programs

Peripartum Cardiomyopathy.

This simulation is appropriate for emergency medicine (EM) residents of all levels. Peripartum cardiomyopathy (PPCM) is a rare, idiopathic condition that occurs in the mother around the time of childbirth. Heart failure with reduced ejection fraction and/or reduced systolic function diagnosed in patients during the last month of pregnancy or up to five months following delivery defines PCCM.1 Another broader definition from the European Society of Cardiology defines PPCM as heart failure that occurs "towards the end of pregnancy or in the months following delivery, where no other cause of heart failure is found."2 Though PPCM occurs worldwide, most data is extracted from the United States (incidence 1:900 to 1:4000 live births), Nigeria, Haiti, and South Africa.3,4Risk factors for PPCM include pre-eclampsia, multiparity, and advanced maternal age. Unfortunately, the complete pathophysiology of PPCM remains unclear. However, it is important for emergency physicians to be aware of this rare diagnosis because though 50-80% of women with PPCM may eventually recover normal left ventricle systolic function,5 positive outcomes depend on timely recognition of PPCM as a disease and the appropriate management of heart failure. Symptomatic PPCM is an emergent condition that requires an attentive and knowledgeable emergency medicine physician for rapid recognition and treatment. A simulation of this rare condition can give residents the experience of identifying and managing this disease that they might not otherwise see personally during their training. By the end of this simulation session, learners will be able to: 1) initiate a workup of a pregnant patient who presents with syncope, 2) accurately diagnose peripartum cardiomyopathy, 3) demonstrate care of a gravid patient in respiratory distress due to peripartum cardiomyopathy, 4) appropriately manage cardiogenic shock due to peripartum cardiomyopathy. This simulation was conducted as a high-fidelity medical simulation case followed by a debriefing. It could potentially be adapted for use as a low-fidelity case or an oral boards exam case. The educational content and clinical applicability of this simulation was evaluated by oral and written feedback from participant groups at a large three-year emergency medicine residency training program. Each participant completed the case and the facilitated debriefing afterwards. Case facilitators also provided their personal observations on the implementation of the simulation. The participants gave the simulation positive feedback (n=18). Seventeen EM residents and one pediatric emergency medicine (PEM) fellow participated in the feedback survey. Learners overall agreed (18.75%) or strongly agreed (81.25%) that participating in this simulation would improve their performance in a live clinical setting. Peripartum cardiomyopathy is a low frequency, high acuity illness that requires a synthesis of the learner's knowledge of complex physiology, navigation of logistical and systems-based challenges, and advanced communication and leadership skills to ensure the best possible patient outcome. All EM physicians will be expected to expertly manage this illness after completion of an EM training program, yet not every EM resident will encounter this type of patient during training. Supplementing the EM resident's standard training with this simulation experience provides a psychologically and educationally safe space to learn and possibly make mistakes without causing patient harm. Practically all residents were able to correctly diagnose the patient with a cardiomyopathy even if they were not familiar with the diagnosis of "peripartum cardiomyopathy." The residents particularly enjoyed the case to explore concepts of benefits and risks of medical therapeutics (ie, positive pressure ventilation, vasopressors/inotropes) and safe practice for the gravid patient. This case and the associated high yield debriefing session were effective teaching tools for emergency medicine residents about PPCM. Medical simulation, peripartum cardiomyopathy, pregnancy, respiratory failure, cardiogenic shock, emergent cesarian section.

The Impact of an Experiential Social Medicine Curriculum in an Emergency Medicine Residency Training Program: Mixed-methods Curricular Evaluation

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359 The Impact of an Experiential Social Medicine Curriculum in a County Emergency Medicine Residency Training Program: A Mixed Methods Study

Social medicine (SM) is an emerging field which focuses on the study of the social determinants of health. Despite widespread acknowledgement of its influence in patient care, SM is underemphasized in graduate medical education. Attempts to incorporate SM into residency curricula have shown promising results, though the impact of SM curricula and how to incorporate curricula into emergency medicine (EM) residency remains unclear.

Multimodal In-training Examination in an Emergency Medicine Residency Training Program: A Longitudinal Observational Study.

BackgroundIn-training examination (ITE) has been widely adopted as an assessment tool to measure residents' competency. We incorporated different formats of assessments into the emergency medicine (EM) residency training program to form a multimodal, multistation ITE. This study was conducted to examine the cost and effectiveness of its different testing formats.MethodsWe conducted a longitudinal study in a tertiary teaching hospital in Taiwan. Nine EM residents were enrolled and followed for 4 years, and the biannual ITE scores were recorded and analyzed. Each ITE consisted of 8–10 stations and was categorized into four formats: multiple-choice question (MCQ), question and answer (QA), oral examination (OE), and high-fidelity simulation (HFS) formats. The learner satisfaction, validity, reliability, and costs were analyzed.Results486 station scores were recorded during the 4 years. The numbers of MCQ, OE, QA, and HFS stations were 45 (9.26%), 90 (18.5%), 198 (40.7%), and 135 (27.8%), respectively. The overall Cronbach's alpha reached 0.968, indicating good overall internal consistency. The correlation with EM board examination was highest for HFS (ρ = 0.657). The average costs of an MCQ station, an OE station, and an HFS station were ~3, 14, and 21 times that of a QA station.ConclusionsMulti-dimensional assessment contributes to good reliability. HFS correlates best with the final training exam score but is also the most expensive format among ITEs. Increased testing domains with various formats improve ITE's overall reliability. Program directors must understand each test format's strengths and limitations to bring forth the best combination of exams under the local context.

Evaluation of Emergency Medicine Residency Programs' use of social media in the setting of the COVID-19 pandemic.

ObjectivesThe coronavirus disease 2019 (COVID‐19) pandemic significantly affected the ability of residency programs and applicants to interact using traditional methods of in‐person interviews and visiting rotations. We examined the social media presence of emergency medicine (EM) residency training programs and how programs responded to the COVID‐19 pandemic.MethodsThe Electronic Residency Application Service (ERAS) identified EM residency programs that participated in the 2021 match. Programs were reviewed for the presence of a website and social media accounts on Twitter, Instagram, and Facebook, as well as foundation date. Data were collected after the ERAS application deadline.ResultsAll programs, except one, had some sort of online presence. A total of 258 websites and 476 social media accounts were identified. The majority of programs maintained an account on Twitter (75%), Instagram (61%), or Facebook (38%). Most Twitter and Facebook accounts were established before the onset of the COVID‐19 pandemic. However, 46% of Instagram accounts were created after March 1, 2020. During 2020, there was a 34% increase in total social media account development, higher than in previous years.ConclusionEM residency training programs have a robust online presence. Account development continued to grow in 2020, after the onset of the COVID‐19 pandemic, and growth on Instagram was noted to be substantial. Interactions through online platforms may supplement the residency application process, but their efficacy is unclear.

The Impact of Global Health Experiences on the Emergency Medicine Residency Milestones.

OBJECTIVESIdentify the impact of experiences in global health (GH) on the Accreditation Council for Graduate Medical Education (ACGME) competencies in emergency medicine (EM) residents and describe the individual characteristics of EM residents with global health experience compared to those without.METHODSFrom 2015 to 2018, 117 residents from 13 nationally accredited United States EM residency training programs were surveyed. Specifically, the survey gathered demographic data and information regarding timing, type, location and duration of short term experiences in global health (STEGH). The survey collected both qualitative and quantitative data regarding resident experiences, including number of procedures performed and self-assessment of the impact on their residency milestones. ACGME milestone data from survey respondents was collected from each resident's training program coordinators. Chi-squared analysis and t-tests were conducted to assess differences between residents with STEGH and those without. A generalized linear model (GLM) was utilized to assess the effects of time and experience with interaction on achieving milestones in each of the competency domains, to compare milestone achievement over time between residents with STEGH and those without.RESULTSOut of 117 EM residents, 60 were female (44%), the mean age was 30 years (standard deviation = 3.1), and 84 (71.8%) reported STEGH in general, including prior to residency (64.5%). 33 (28.2%) reported having completed STEGH during residency. The results of the GLM analysis showed that residents with STEGH during residency had significantly higher scores compared to those without the experience or STEGH pre-residency across all six competenciesCONCLUSIONSSTEGH in EM residents was associated with higher milestone achievement in certain ACGME competency domains including medical knowledge, practice-based learning and improvement, and professionalism. Participation in STEGH during residency appeared to show the strongest effect, with higher scores across all six competencies.