Research Requirements for Emergency Medicine Residents

Research Requirements for Emergency Medicine Residents

[N.B Draft, still in progress, caveat lector]

The American Board of Emergency Medicine requires residents to complete a scholarly activity. Most Boards do. There is a conflict between this requirement and the desires, training, and time of a resident in Emergency Medicine. This requirement risks diluting the time and effort faculty have for productive research with a pro forma exercise.

Historical Background

1999 the Research Director’s Interest Group of the Society for Academic Emergency Medicine released a consensus statement that scholarly activity is a core component of residency training in Emergency Medicine1. In 2017 they updated their consensus statement, removing four types of scholarly activity (teach problem-solving skills; learn the art of medical writing; expose the resident to research for consideration of an academic career; help focus the resident on an area of interest or expertise) and (nearly) adding six others (writing a case report, developing a curriculum, being a listed member on a consensus policy statement, writing and presenting a lecture, publishing original research prior to residency, participating in or creating an online blog or podcast)2.

The items dropped and items proposed are illuminating. The original impetus for the requirement for scholarly activity was to increase the amount of clinical research germane to Emergency Medicine. Since 1999 the number of research articles indexed in PubMed with MeSH headings related to Emergency medicine has X.

The rationale for encouraging scholarly activity during residency is to teach the next generation of physicians how to critically read clinical research. The underlying assumption is that learning to do this is effectively done in small-group discussions. In my experience these sessions become a rushed exercise of the blind and uninterested leading the blind, pressed for time, and uninterested.

Journal clubs in graduate school (for MS or PhD students in the sciences) are 1-2 hour affairs. The paper is distributed to the class the week before. Ideally, these journal clubs allow an exploration of the content as well as the design. In residency, the paper is distributed sometimes too far ahead (i.e when the schedule is set out at the beginning of the year) or the day before. The discussion is lead by someone who may not have read the paper (can be true in grad school) and who may be reading off a prompt. Beyond naming the type of design (“this is a randomized double-blinded controlled trial”) there is rarely any discussion given to the less superficial aspects of experimental design (were the investigators measuring what they thought they were measuring; how else could this study have been accomplished).

The difference in the level of engagement is palpable, reflecting how this is a core part of graduate school education but, for medical trainess, just another requiremenet in a long list of checkboxes at which they have to demonstrate (not necessarily acquire or retain) proficiency.

Academic emergency physicians may find themselves with conflicting demands. (Seemss unrelated to encouraging residents to peform research, maybe put in another notebook).

What makes an activity scholarly is changing.


  1. 1.Kane, B. G. et al. Creating consensus: revisiting the emergency medicine resident scholarly activity requirement. Western Journal of Emergency Medicine 20, 369 (2019).
  2. 2.Summers, R. L., Fish, S., Blanda, M., Terndrup, T. & Group, S. A. E. M. R. D. Assessment of the “scholarly project” requirement for emergency medicine residents: report of the SAEM Research Directors Workshop. Academic emergency medicine 6, 1160–1165 (1999).