Pre-exposure Prophylaxis Provided in the Emergency Department: Physician Perspectives

Background:The Accreditation Council for Graduate Medical Education (ACGME) and Resident Review Committee (RRC) oversee resident physician work hours with additional specifics for US Emergency Medicine (EM) residency programs.While there are maximum work hours, the regulatory bodies do not describe minimum work hours to achieve competency, leading to variable scheduling practices.Objectives: This study aimed to understand the current landscape of US EM residency scheduling given the expansion of programs, the evolution of policies, and the increased emphasis on wellness.Methods: We conducted a cross-sectional study to assess current strategies of US EM residency scheduling.The RedCap survey was sent to all ACGME-accredited EM residency programs across the US via individualized emails between January 10, 2023, and March 15, 2023.Data was combined using Microsoft Excel.Results: 138 out of 278 (50%) programs responded to the survey.73.2% of programs were using 13 28-day blocks with the remainder using 12 one-month blocks or reported 'other' block scheduling.The number of blocks in the ED increases with each post-graduate year (PGY).For PGY-1 through PGY-3, the most commonly used shift duration was 9 hours.The mean total shifts per ED block and hours worked per ED block are as follows: 19 shifts and 185.1 hours (PGY-1), 18.2 shifts and 173.9 hours (PGY-2), 17.3 shifts and 163.6 hours (PGY-3), 14.8 shifts and 157.2 hours (PGY-4).Programs provide a median of 4 weeks of vacation per year of residency.Conclusions: Given the expansion of US EM residency programs, we reevaluated the landscape of resident scheduling.We described scheduling patterns related to night shifts, vacations, requested time off, conference coverage, charting time, and circadian rhythms.Programs should utilize this data as a starting point for setting a clinical experience for their residents.