Wendy C. Coates

BACKGROUND Background: Women physicians remain underrepresented at senior academic ranks in Emergency Medicine (EM), despite near gender parity among trainees and early-career faculty. Prior research has documented barriers to academic promotion; far less attention has been paid to the strategies women employ to navigate them successfully. A systematic, domain-specific account of these experiences may inform faculty development and institutional approaches to academic advancement. OBJECTIVE Objective: To describe the design, rationale, and methods of PROMOTED-EM, a multicenter qualitative research program examining promotion strategies across 14 domains of academic career life among women physicians who have achieved the rank of Associate Professor or Full Professor in academic emergency medicine. METHODS Methods: PROMOTED-EM is a multicenter, qualitative research program comprising 14 domain-specific individual interview or focus group studies conducted under a shared protocol (clinical shifts, household duties, maternity leave, network building, mentorship, professional collaboration, public speaking, leadership positions, academic publications, grant funding, conflict resolution, setting boundaries, harassment and bullying, and retention and career continuation). Participants will be enrolled via stratified purposive sampling of women physicians in academic EM who have achieved promotion to Associate Professor or Full Professor. The anticipated enrollment is 8–15 participants per domain, with up to 210 participant-study enrollments across the program. Participants may enroll in multiple domain studies. Individual discussion or focus groups will last approximately 60–90 minutes, be audio-recorded, and transcribed. Framework analysis will serve as the primary analytic approach, applying the 14 predefined domains as an organizing structure while allowing themes to emerge inductively within each domain until thematic sufficiency is achieved. Deidentified data will be managed in Dedoose. The Mass General Brigham (MGB) Institutional Review Board (IRB) has approved the study (Protocol # 2026P002507). RESULTS Results: This manuscript describes a prospective study protocol. Recruitment and data collection for the Grant Funding domain are planned to begin in November 2026. Findings are intended for dissemination through 14 domain-specific peer-reviewed publications, a cross-domain synthesis paper, national EM conferences, and specialty organizations, including the Society for Academic Emergency Medicine (SAEM), the Academy for Women in Academic Emergency Medicine (AWAEM), and the American Association of Women Emergency Physicians (AAEM). CONCLUSIONS Conclusions: PROMOTED-EM is a comprehensive initiative to examine strategies reported by women physicians who have achieved academic promotion across 14 domains of academic EM. By systematically documenting these experiences, the research program aims to generate empirically grounded findings that may inform individual faculty development and institutional approaches to academic advancement. CLINICALTRIAL N/A

Gender disparities in academic promotion persist despite decades of research documenting their scope. Women remain underrepresented at senior academic ranks in Emergency Medicine, with only 19% of full professors identifying as women. Existing literature has largely cataloged the barriers driving this gap—disproportionate clinical workloads, non‐promotable labor burden, sponsorship deficits, and caregiving responsibilities—but has devoted comparatively little attention to the strategies women use to successfully navigate these barriers. This commentary proposes a shift in research focus: From documenting the problem to systematically studying the hidden determinants of advancement among women who have achieved promotion. We introduce PROMOTED‐EM, a qualitative research framework organized across 14 domains of academic career life, designed to elicit the tactical, behavioral, and relational strategies that enabled promotion. By centering the experiences of successfully promoted women in Emergency Medicine while explicitly attending to intersectionality and the limitations of survivor bias, this agenda aims to generate actionable, evidence‐based guidance for women faculty, department leaders, and institutions committed to closing the promotion gap.

Peer review is central to scholarly publishing and academic advancement in medicine. However, many authors, particularly residents and early‐career faculty, receive limited formal training in navigating the peer review process. This Educator's Blueprint provides seven strategies to optimize journal publication success by improving submission quality and reframing rejection as part of the growth process, while also discussing how to build upon the experience to enhance long‐term scholarly productivity and impact. These include identifying potential journals, tailoring the manuscript to the target journal, crafting a compelling cover letter, responding to reviewer comments, turning rejection into progress, disseminating findings to broaden reach, and leveraging the experience to build a cohesive scholarly portfolio.

Background: Grant writing is a valuable skill for academic advancement in emergency medicine (EM). Yet, the high rejection rate can contribute to stress, burnout, and disengagement among early‐ and mid‐career faculty. While extensive literature exists on the technical aspects of grant writing, there is a notable gap in guidance on the emotional and psychological dimensions of navigating rejection. This conceptual paper explores resilience strategies, reflective self‐assessment, constructive feedback processes, and approaches to resubmission that support scholarly persistence in the face of grant rejection. Methods: We used a narrative conceptual approach, drawing on a panel discussion titled “Rejection, Resilience, and Resubmission: Learning from Grant Failure,” presented at the 2025 Society for Academic Emergency Medicine Annual Meeting. The panel featured experienced EM education scholars and funded investigators who shared personal experiences and insights. We analyzed session notes to identify recurring themes, which we reviewed with the panelists to refine the concepts. Results: Insights from the panel highlighted the value of individual resilience strategies, the importance of a strong support network, diverse external input, and the need for strategic self‐assessment. The discussion also underscored the need for resilience training and managing rejection, the need for greater transparency in academic narratives, and potential reconsideration of promotion and tenure criteria. Conclusion: The findings suggest a need for a cultural shift in academic EM, one that embraces persistence and transparency as core tenets of scholarly excellence. We recommend incorporating resilience training into faculty development and residency training programs to provide scholars with the tools to navigate challenges both academically and emotionally throughout the submission and resubmission process.

Importance: Unsolicited peer review requests have increased with the expansion of academic publishing, raising concerns about reviewer fatigue. Peer review is a critical component in disseminating scientific discovery requiring time and expertise, often uncompensated. Objective: We sought to quantify and analyze characteristics of the review solicitation burden on a group of senior faculty. Methods: We conducted a prospective mixed‐methods study of 6 senior academic physicians who are peer reviewers and editors. Each participant monitored their email inboxes (9/1–12/13, 2024) for peer review requests. We collected solicitation date, journal name, discipline, reviewer's existing relationship to journal, content relevance, response to request, immediate Plutchik Basic Emotions reaction, narrative comments, using hermeneutic phenomenology. We calculated descriptive statistics and performed a thematic analysis with a constructivist paradigm of narrative comments. Results: Participants (5 institutions, 3 males) received 139 solicitations. Over half (52.5%, 73) were requests from a journal with whom the physician had no or unknown previous contact. Less than 1/3 of solicitations were directly relevant (28.1%, 39); 43.2% (60) partially relevant; 28.8% (40) irrelevant. Only 2.3% (3) of requests were accepted; 55.4% (77) were declined and 42.4% (59) were ignored. Of the Plutchik Basic Emotions, most were surprised (36%, 48) or disgusted (31%, 41). Qualitative analysis identified four themes: (1) issues with review process/journal quality, (2) time/effort demands, (3) relevancy to expertise, (4) technology/administrative barriers. Conclusions: Academic faculty received copious peer review requests and declined or ignored many, citing frustration, surprise or disgust. Editors should optimize the review request process to avoid reviewer burnout.

Background: One in five emergency department (ED) visits is by older adults aged 65+ years. Clinical practice guidelines are needed to optimize patient care by translating the best available evidence into actionable recommendations to guide person‐centered management for this medically complex and growing patient population. Our objective was to understand contributors' experiences and share best practices to inform other guideline working groups. Methods: We conducted a qualitative study based on thematic analysis with an interpretivist paradigm in June–July 2025, using semi‐structured interviews of Geriatric Emergency Department (GED) Guidelines 2.0 contributors to understand their experiences. Interviews were transcribed, independently reviewed by team members, and reflexively coded to identify themes. Results: We interviewed 18 participants. Four main themes emerged: (1) motivations for participation, (2) varying opportunities to be involved, (3) personal benefits, and (4) challenges for improvement. Participants contrasted the strengths of shared learning and development with the burdens of organization and coordination. Conclusion: Contributors to the GED Guidelines 2.0 reported a positive experience. They joined because they wanted to contribute to better care of older patients and to achieve personal and professional goals. Many cited that their roles aligned with their strengths and expertise. They also gained skills and knowledge on systematic reviews and benefited from networking. Future groups planning a similar process should consider having multiple levels of leadership, experts in systematic reviews, regular reminders, and creative incentives to improve the process and foster improved networking opportunities within their disciplines.

Background: Although people with disabilities account for 40% of annual visits to U.S. emergency departments (EDs), physicians receive minimal training on caring for this population. The objective of this study was to explore emergency medicine (EM) resident preparedness and attitudes in caring for patients with disabilities and ease of providing accommodations in the ED.Methods: We developed and administered a cross‐sectional 32‐item survey to EM residents in the United States from November 2023 to January 2024. The primary outcomes were (1) self‐reported preparedness in caring for patients with disabilities, (2) attitudes toward individuals with disabilities, and (3) ease of providing accommodations. Frequency distributions for each item and associations between personal demographics and survey responses are reported.Results: A total of 209 participants completed the survey. The majority were female (51%) and White (70%). A minority (9.5%) identified with having a disability. Residents felt prepared to care for patients with physical disabilities (77%) and chronic illnesses (93%) and less prepared with patients who are nonverbal (34%) or blind/visual impairment (45%). Most residents (99%) believed that patients with disabilities deserved equitable care; however, most thought patients with disabilities had a poor quality of life (75%). Residents reported difficulty providing accommodations to patients who are blind/visual impairment (54%) and Deaf/hard of hearing (45%). For those who encountered acute care plans/health care passports for accommodations, 88% found them useful. The majority of residents (80%) desired improved disability health education, specifically on sensory and intellectual/developmental disabilities, communication skills training, and resources for accommodations.Conclusions: EM residents report feeling less prepared to care for patients with sensory disabilities and intellectual/developmental disabilities and report difficulty obtaining histories, performing physical examinations, and providing accommodations to this population. Implementing curricula focusing on disability health may improve skills, reduce bias, and provide more equitable care.

In 2024, over 50,000 applicants submitted their rank order list (ROL) to the National Resident Matching Program (NRMP, The Match), which uses these rankings to match candidates with residency programs. Recent years have shown that many applicants find emergency medicine (EM) a desired speciality. In 2024 and 2025, 95% and 98% of EM residency spots were filled, respectively. To match, applicants must understand every aspect of the application process, including rank order strategies. The ROL is an essential step in the residency application process where applicants rank programs based on personal and professional priorities. Applicants weigh both tangible factors—such as program size, location, and salary—and intangible factors—such as work–life balance, faculty support, and the overall “feel” of a program. Virtual interviews have limited opportunities to assess both tangible and intangible factors hindering the more comprehensive evaluation EM applicants previously had with in‐person interviews. We offer strategic advice to medical students and their mentors, on an approach to creating a ROL, evaluating the intangible and tangible aspects of each program, additional considerations for less common scenarios, and effective communication with program directors.

While medical educators are publishing more than ever, many barriers still exist, causing some to feel disheartened. Ongoing strategies are desirable to support educators who are facing challenges when submitting and revising their scholarly manuscripts to journals. Increasing publication rates can enhance an educator's promotion and tenure progress and career satisfaction and aid in the establishment of a community of practice. On a broader scale, increased publication encourages a diversity of voices contributing to and advancing the field of medical knowledge. In this article, we present a guide for those looking to engage more deeply in medical education (MedEd) research and scholarship. First, we describe the difference between MedEd research (which seeks to develop and/or answer a research question and expand general knowledge) and other forms of scholarship (which may include, but are not limited to, curricular innovations, infographics, educational downloads, commentaries, editorials, reviews, last pages, instruments, case scenarios, and instructional toolboxes). Next, we discuss an eight‐step process to prepare for publication: (1) formulate the idea, (2) implement the project, (3) select the appropriate journal, (4) write the paper, (5) submit the manuscript, (6) receive journal feedback, (7) revise the manuscript, and (8) resubmit the manuscript. It is the hope that with practice and mentorship, and the help of this guide, medical educators can more successfully publish their work moving forward.