Newsletters

POSTED: September 22nd, 2023
POSTED IN: 2023 Quarter 3, EM Pulse - The Official Newsletter of MOCEP,

Emergency Medicine Training in the Post-COVID Era, a Veteran Program’s Perspective

Written by: James O’Brien MD – Assistant Clerkship Director, Assistant Program Director; Amy Stubbs MD- Senior Associate Program Director – UMKC Emergency Medicine Residency, University Health-TMC

As we approach our 50^th anniversary of training EM residents and enter a post (perhaps not completely post) COVID era with new challenges, our program remains enthusiastic and optimistic about the future of emergency medicine training.  The last few years forced us to be creative in how we practice, teach, and interview, highlighting our skillset as EM physicians to troubleshoot and navigate uncharted waters. Looking back, we hope to glean the benefits from becoming more virtual as we re-acclimate to the in-person world. We appreciate Zoom meetings in the comfort of our homes, while recognizing that there is no replacement for connecting with colleagues face-to-face to share experiences: good, bad, sad, comical, and flat-out ridiculous. 

Although not entirely unexpected, the 2023 Match data was a difficult pill to swallow for EM and a bit of a wake-up call. Medical students reeling from a job market scare, residency programs continuing to multiply, burnout boiling over, mix in a bit of #MedTwitter and suddenly EM went from one of the most competitive large specialties to being the “black sheep” of the specialty farm. Certainly, our graduates have had no tangible difficulty finding jobs. We have multiple stable employers nearby, and with a bittersweet farewell, new alumni have relocated to California, Illinois, Minnesota, Colorado, Utah, Texas, and even Alaska. We are also incredibly proud of our recent graduates furthering their expertise in Ultrasound, Critical Care, and staying home at UMKC for Medical Education! 

Similar to a difficult clinical case, it’s best to take a moment to reflect and debrief- but we also must learn the lessons and move on to the next patient. As another interview season rapidly approaches, it’s imperative that EM programs evaluate our methods, appeal, and recruitment tactics. After years of often having an abundance of quality applicants to choose from, many of us were likely lulled into a bit of a comfort zone. We will need to regroup, remember what drew us to EM to begin with, and ensure we are relaying this to our medical students and applicants. The many positive aspects of our profession – including the variety, flexibility, procedures, awesome colleagues, and lack of a pager still exist! We have bolstered medical student recruitment efforts with various virtual fairs and a strong social media presence. As a specialty we must also acknowledge the fact that diversity in recruitment remains a challenge and expand our definition of what makes a “good” EM applicant. Utilizing holistic methods for reviewing applicants, taking more than test scores into account, and considering applicants who truly fit in with the values of our individual programs will be vital to improve diversity in EM and match day success. 

The COVID-19 pandemic also highlighted the need for improved ED operations and wellness resources; medical systems and institutions are taking notice and acting. Our wellness program continues to expand, now offering an elective for residents looking for evidence-based practice to sustain a long and healthy EM career. We devote full didactic conferences to wellness-related topics and take resident feedback on what they will benefit from. 

EM has long been a leader in innovative, adult learning methods. Our curriculum is learner-centered and tailored to busy resident life. We have shorter lectures, abundant simulation, and small group sessions. We have suffused social determinants of health into regular teaching, as well as trauma informed care to best serve our most vulnerable patients. Faculty engage in diversity and equity training, striving to combat bias in the ER and in the classroom. 

To 50 years, and to another 50 ahead! To the frontline, the old and new problems, and to the people who gladly go to work to see the 2 AM toe pain. COVID exposed a fragile healthcare system, and we are still feeling its effects. As EM doctors we have the breadth of experience and the skillset to become leaders in hospitals, professional societies, and our communities. At this inflection point, we re-emerge, re-focused on human connection in patient care and resident training. EM will undoubtedly adapt to the current era and aim to remain malleable to current best practices. We hope to collaborate with other programs, in the great state of Missouri and nationwide, to recruit the best medical students and train them to be the best EM doctors!