The Impact of Due Process and Disruptions on Emergency Medicine Education in the United States

Author:

Alvarez Al'ai1,Messman Anne2,Platt Melissa3,Healy Megan4,Josephson Elaine5,London Shawn6,Char Douglas7

Affiliation:

1. Stanford University School of Medicine, Department of Emergency Medicine, Palo Alto, California

2. Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, Michigan

3. University of Louisville School of Medicine, Department of Emergency Medicine, Louisville, Kentucky

4. Temple University Lewis Katz School of Medicine, Department of Emergency Medicine, Philadelphia, Pennsylvania

5. Weill Cornell Medical College of Cornell University, Lincoln Medical and Mental Health Center, Department of Emergency Medicine, Bronx, New York

6. University of Connecticut School of Medicine, Department of Emergency Medicine, Farmington, Connecticut

7. Washington University School of Medicine, Department of Emergency Medicine, St. Louis Missouri

Abstract

Introduction: Academic Emergency Medicine (EM) departments are not immune to natural disasters, economic or political forces that disrupt a training program’s operations and educational mission. Due process concerns are closely intertwined with the challenges that program disruption brings. Due process is a protection whereby an individual will not lose rights without access to a fair procedural process. Effects of natural disasters similarly create disruptions in the physical structure of training programs that at times have led to the displacement of faculty and trainees. Variation exists in the implementation of transitions amongst training sites across the country, and its impact on residency programs, faculty, residents and medical students. Methods: We reviewed the available literature regarding due process in emergency medicine. We also reviewed recent examples of training programs that underwent disruptions. We used this data to create a set of best practices regarding the handling of disruptions and due process in academic EM. Results: Despite recommendations from organized medicine, there is currently no standard to protect due process rights for faculty in emergency medicine training programs. Especially at times of disruption, the due process rights of the faculty become relevant, as the multiple parties involved in a transition work together to protect the best interests of the faculty, program, residents and students. Amongst training sites across the country, there exist variations in the scope and impact of due process on residency programs, faculty, residents and medical students. Conclusion: We report on the current climate of due process for training programs, individual faculty, residents and medical students that may be affected by disruptions in management. We outline recommendations that hospitals, training programs, institutions and academic societies can implement to enhance due process and ensure the educational mission of a residency program is given due consideration during times of transition.

Publisher

Western Journal of Emergency Medicine

Subject

General Medicine,Emergency Medicine

Reference24 articles.

1. Berger E. A Contract Expires, an Emergency Medicine Residency Stands on the Brink: The Unexpected Transition from One Private Group of Emergency Physicians to Another Comes Under Scrutiny, Leaving its Emergency Medicine Residents Scrambling. Ann Emerg Med. 2017;69(4):A20-3.

2. Brubaker H. Hahnemann University Hospital closure upends career paths for 570 doctors-in-training. Available at: https://www.inquirer.com/business/hahnemann-university-hospital-residents-lose-training-grounds-20190703.html. Accessed July 2019.

3. Zheng E, Frishman WH. The Closing of St Vincent’s Hospital in New York City: What Happened to the House Staff Orphans? Am J Med. 2012;125(5):e5-6.

4. Riddick FA Jr. The Code of Medical Ethics of the American Medical Association. Ochsner J. 2003;5(2):6-10.

5. American Academy of Emergency Medicine. Position Statement on Due Process. 2000. Available at: http://www.aaem.org/resources/statements/position/position-statement-on-due-process. Accessed April 2018.

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