Michelle D. Lall

Background: Physician wellness discussions often center on burnout and negative aspects of clinical practice. Less is known about what brings professional satisfaction to physicians, particularly among emergency medicine (EM) residents. Understanding drivers of professional satisfaction is important for the future of the specialty as they may influence residents' career decisions. This study aimed to identify drivers of professional satisfaction among a national cohort of EM residents. Methods: We conducted a mixed methods study using a survey administered following the 2024 ABEM In‐Training Examination to EM residents in ACGME‐accredited programs. The single‐item, free‐text survey question asked: “List the top 3 drivers of your professional satisfaction in EM.” Responses were linked to resident demographics, year in training, and program length. Using an exploratory, sequential mixed methods design, we developed a codebook via team‐based thematic analysis. We subsequently quantified theme prevalence, summarized the top 10 themes, and compared the top 5 themes across strata by demographics and program characteristics. Results: 3914 of 9820 eligible residents (39.9%) responded. Our team identified 41 unique themes from these responses. The top 10 drivers of professional satisfaction by frequency were: (1) EM community/team culture, (2) positive impact on patients, (3) work‐life balance, (4) bedside patient interactions, (5) clinical variety, (6) shift work flexibility, (7) financial compensation, (8) opportunities for procedures, (9) EM clinical skill set, and (10) critical care opportunities. The most prevalent themes did not vary by resident demographics. Conclusion: In a national cohort of EM residents, we identified a list of key drivers of professional satisfaction that clustered into a small number of highly prevalent themes. The most important factors were related to the people and culture of the program and making a positive impact on patients. These findings may inform strategies to strengthen EM resident professional fulfillment and support the future of the specialty.

Introduction: Competency‐based medical education (CBME) focuses on the attainment of defined skills independent of the time spent in training. Emergency Medicine (EM) is starting the long process of CBME implementation. Methodology: In preparation for the 2025 Society for Academic Emergency Medicine (SAEM) Consensus conference whose goal is to define the research agenda around CBME, a diverse workgroup of expert educators convened. They conducted a literature review and developed a large roster of potential research questions. Analysis: Through a modified Delphi process, they prioritized 10 research questions related to CBME implementation. The final group of questions fell into three broad categories: (1) Program evaluation, (2) Change management, and (3) System needs and resources. Implications: Implementation of CBME in EM will require intentional incorporation of change management strategies and systematic development of program evaluation. This will minimize the risk of negative outcomes resulting from ineffective implementation strategies and promote the successful uptake of CBME within the specialty.

Background: Scholarship is a requirement for Emergency Medicine (EM) residency training. However, there is limited understanding of the rigor and degree to which scholarly requirements are completed by EM residents. The objective of this study was to measure the proportion of residents that met the standards delineated by a newly‐proposed rubric for EM resident scholarship assessment. Methods: This was a cross‐sectional study of eight diverse EM residency programs. Each program collected data from their residents graduating in 2024 and assessed their scholarly project completion. The assessment utilized a previously‐published rubric that evaluates the rigor of a resident's scholarly project based on six criteria: clear goals, adequate preparation, appropriate methods, verifiable results, presentation/dissemination, and reflective critique. Data were de‐identified and combined to report the overall rates across programs. Results: A total of 114 residents participated in the study (96.6%), of which 59 residents (52%) fulfilled all of the rubric‐defined standards for resident scholarship. Of the six standards, setting clear goals (performed by 61%) and obtaining reflective critique (performed by 71%) proved most difficult to attain. Adequate preparation was done by 84%, methodology by 77%, results by 83%, and presentation by 99%. The median number of projects to fulfill all standards was one (IQR 0). Of the graduates in the eight programs, 45 (39%) presented an abstract at a conference and 31 (31%) published manuscripts during residency. Conclusion: We demonstrated that 48% of graduating residents in this pilot study did not complete the scholarship requirement as assessed by the rubric. This study highlights the need for clearly defined standards and highlights that the increased use of predefined standards for scholarship may enhance the educational value of this graduation requirement for EM residents.

Objectives: This study was designed to assess the impact of a break‐taking initiative for resident physicians to encourage nutrition and patient note writing during their shift in the emergency department (ED). The primary objective was to determine if the intervention improved hunger, fatigue, incomplete documentation in the medical record, and post‐shift exit time. Methods: We introduced an intervention titled the R.E.S.T. initiative, which consisted of encouraging residents to take a 15‐min break during their shift to eat and write notes, providing food in the resident break room, and encouraging disposition‐focused rounds with the attending physician approximately 1 h prior to the end of shift. An ecologic momentary assessment (EMA) tool was used to assess residents' hunger, fatigue, note burden, and participation in the intervention at three timepoints throughout their ED shift. Pre‐intervention baseline data were collected as well. Mixed‐effects models were used to assess changes pre‐ and post‐intervention. A post‐intervention survey collected feedback and opinions on the intervention from both faculty and residents. Results: A total of 44 residents participated in the intervention. On‐shift break frequency improved from 19% to 56% during the intervention ( p < 0.001). Post‐shift hunger and fatigue scores improved significantly during the intervention (OR 4.10, p < 0.001 and OR 2.53, p = 0.001, respectively), without a significant change in the number of new patients seen nor patients signed out to the oncoming team. All faculty and residents reported that there were no adverse effects on patients as a result of the intervention. Residents felt the breaks improved their efficiency and the quality of care they provided. Conclusions: An intervention to encourage breaks for eating and charting, along with disposition‐focused rounds near the end of shift, improved hunger and fatigue in emergency medicine residents without negatively impacting patient safety or perceived resident efficiency.

Background: Recent publications have shown that women are more likely to leave emergency medicine at a younger age than men. We aim to describe the prevalence of parental stress in academic emergency medicine and its association with scheduling practices and desire to leave medicine. Methods: Blinded survey sent to eight geographically diverse academic sites. Survey included five domains: academic rank and perception of progress, child and childcare characteristics, clinical scheduling practices, plans to leave medicine, and validated psychometric measures including the Parental Stress Scale (PSS: normal population score 35–45). Likert scale responses were dichotomized as either moderate/extremely likely versus less than moderately likely/unsure. Descriptive statistics were calculated, and linear and multivariate regression analyses were performed using STATA 16. Results: A total of 280 surveys were accessed, and 225 (80%) surveys had PSS completed. Of this cohort, there were 90 females, 123 men, 1 intersex, and 15 surveys had no sex reported. The median number of children was 2 (IQR 1–3), and the median age of the youngest child was 4 (IQR 1–9). The parental stress scale median score was 40 (IQR 35–46). There was no significant difference in the parental stress scale by sex. The number of children (B‐coeff −1.88, p = 0.007), age of the youngest child (B‐coeff −4.2, p = 0.000), use of daycare (B‐coeff 3.8, p = 0.027), ability to preference times of shifts (day, swing, night shift) (B‐coeff −2.4, p = 0.046), being a nocturnist (B‐coeff 2.75, p = 0.006), and being able to completely set their own schedule in terms of days and times worked (B‐coeff −2.19, p = 0.03) were associated with the PSS score. The parental stress scale was not associated with the likelihood to leave emergency medicine or leave the current job in 5 years. Conclusion: Academic emergency physicians had parental stress scale scores similar to the general population. Parental stress scale score was not associated with a plan to leave emergency medicine.

Introduction: Despite progress in promoting diversity, equity, and inclusion (DEI) in medical education, lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and more (LGBTQIA+) individuals remain underrepresented and often face barriers to equitable advancement. Emergency medicine (EM) residency programs are instrumental in creating inclusive environments that attract diverse applicants and support LGBTQIA+ trainees. Since the COVID‐19 pandemic's shift to virtual recruitment, residency websites have become vital tools for communicating DEI initiatives. This study examines LGBTQIA+ inclusivity on EM residency websites, focusing on the visibility of resident pronouns, diversity pages, and LGBTQIA+ subsections.Methods: We conducted a review of 282 EM residency program websites listed on the Electronic Residency Application Service (ERAS) between August and October 2023. Websites were assessed for the presence of pronouns on resident biographies, dedicated diversity pages, and LGBTQIA+ content. Data were stratified by geographic region and analyzed using descriptive statistics.Results: Among the websites reviewed, 4.3% displayed resident pronouns, 31.2% had dedicated diversity pages, and 3.9% included LGBTQIA+ subsections. The Midwest region had the highest proportion of programs featuring resident pronouns (5/70), while the West region led in diversity pages (14/32) and LGBTQIA+ content (4/32).Discussion: The limited visibility of LGBTQIA+ content and pronouns across EM residency websites suggests an underutilization of online platforms to promote inclusivity. With virtual recruitment now standard, these websites are critical for conveying program culture to prospective applicants. Displaying pronouns, DEI pages, and LGBTQIA+‐specific content can foster a welcoming environment and signal support to diverse applicants. Programs in regions with stronger DEI representation could serve as models for others, sharing best practices in promoting inclusivity.Conclusions: Enhancing DEI visibility on EM residency websites may positively influence perceptions and engagement among LGBTQIA+ applicants, fostering more inclusive and equitable training environments that align with the needs of diverse trainees in emergency medicine.