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West J Emerg Med. 2020 Feb 21;21(2):429-433. doi: 10.5811/westjem.2019.10.43830.

Innovative Approaches to Emergency Medical Services Fellowship Challenges.

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Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, Wisconsin.
University of Arizona, College of Medicine, Department of Emergency Medicine, Tucson, Arizona.
Arizona Emergency Medicine Research Center, Tucson, Arizona.
Houston Fire Department, Houston, Texas.
McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Department of Emergency Medicine, Houston, Texas.
Baylor College of Medicine, Texas Children's Hospital and Department of Pediatrics, Section of Emergency Medicine, Houston, Texas.



Since the development of an Accreditation Council of Graduate Medical Education (ACGME)-accredited emergency medical services (EMS) fellowship, there has been little published literature on effective methods of content delivery or training modalities. Here we explore a variety of innovative approaches to the development and revision of the EMS fellowship curriculum.


Three academic, university-based ACGME-accredited EMS fellowship programs each implemented an innovative change to their existing training curricula. These changes included the following: a novel didactic curriculum delivery modality and evaluation; implementation of a distance education program to improve EMS fellows' rural EMS experiences; and modification of an existing EMS fellowship curriculum to train a non-emergency medicine physician.


Changes made to each of the above EMS fellowship programs addressed unique challenges, demonstrating areas of success and promise for more generalized implementation of these curricula. Obstacles remain in tailoring the described curricula to the needs of each unique institution and system.


Three separate curricula and program changes were implemented to overcome specific challenges and achieve educational goals. It is our hope that our shared experiences will enable others in addressing common barriers to teaching the EMS fellowship core content and share similar innovative approaches to educational challenges.

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