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J Emerg Med. 2013 Feb;44(2):499-504. doi: 10.1016/j.jemermed.2012.05.034. Epub 2012 Oct 5.

Availability and potential impact of international rotations in emergency medicine residency programs.

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Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA.



Interest in international emergency medicine (IEM) is growing. With the globalization of medicine, IEM as a field has expanded from disaster relief efforts to opportunities for resident education. Numerous accounts have been published voicing the educational benefits of international rotations (IRs). As such, many residencies now offer opportunity for IRs.


To evaluate the availability and utilization of IRs in emergency medicine (EM) residency programs.


EM residency program directors were surveyed from the 126 Accreditation Council for Graduate Medical Education-accredited programs with ≥2 years of residency graduates. Directors were asked about availability of IR, categorized as: 1) required; 2) elective (with or without pre-designated sites); or 3) not available.


One hundred eleven (88%) program directors reported data on 2240 graduates over 2 years. IRs were offered by 101 (91%) programs. No program required an IR. Among programs offering IRs, most (69%) did not have pre-designated sites. Eighty-nine of 101 programs (88%) allowing IRs had at least one resident completing an IR; 23 of 111 programs (21%) had more than 30% resident participation in IRs. Programs offering IRs at pre-designated sites had 210 of 727 (29%) residents complete an IR, compared to 272 of 1469 (19%) in programs without pre-designated sites (p < 0.001). Four-year programs had twice as many IR participants (32%) compared to 3-year programs (17%; p < 0.001).


More residents participated in IRs when a pre-designated site was available compared to programs without. This suggests that programs interested in supporting IRs consider developing pre-designated sites to accommodate residents.

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