There are nearly 6,000 emergency residents in the United States, and around 2,000 of us are women.1 We work in a variety of practice environments, and learn unique methods of managing patients. Some of us have scarcely seen a patient with AIDS; some have never seen Lyme disease. We already know that our lives in emergency medicine are interesting to friends and family, but as we mature as professionals, we have grown more aware that each of us has something to teach our peers and patients as well.
For the duration of our training so far, we have had the responsibility of amassing knowledge, but less incentive to create it, capable as we may be. Residency is a time where we refine and focus our clinical skills, but it is also the period during which most women lose interest in academia.2 This loss of women’s potential contributions is a missed opportunity for the growth of our specialty at a time when the sustainability of emergency medicine research is already in jeopardy. The Director of the Office of Emergency Care Research at the National Institutes of Health has gone as far as to call emergency physician scientists an ‘endangered species.’3
Conscientious patient care requires a continually evolving understanding of clinical information, and so emergency medicine research matters. We know that informed patients and providers are crucial to the delivery of emergency care. Uncertainty is at the heart of our job, and research has given us the tools to approach clinical dilemmas confidently. We can tell a patient how likely it is that they will have a transfusion reaction, or communicate the risk of 30-day major adverse cardiac event for the patients we discharge with low-risk chest pain. It is new knowledge that has always pushed our specialty along.
We believe scholarship encompasses all the activities that generate new knowledge, beyond the (important) work of clinical research. Through published reports in journals, magazines, and social media, we have learned much to challenge our developing practice of emergency medicine. Even for those of us without academic ambitions, scholarship has become a means of deepening our expertise in specific subjects. The topics we have presented during residency are some of the ones we know the best.
Required projects notwithstanding, we know that undertaking research activity during residency is easier said than done. Making quality contributions to our fund of specialty knowledge requires time and expertise— neither of which is easy to come by as a resident. Nonetheless, with appropriate mentoring, residents can produce meaningful scholarly work4 that can encourage residents and junior faculty to remain in the academic pipeline.
When we talk to the physicians we most admire, a recurring theme is that they had their entire career trajectories changed by a presentation or educational project that they were encouraged to pursue. Attending physicians can mentor by recognizing the talents and abilities of residents and inviting them to participate in their academic activities, even ones that seem outside the resident’s depth. If invited to present at meetings or grand rounds, faculty may consider inviting a resident who made a ‘good catch’ on a similar topic, to introduce the talk with a case. These types of collaborations can be career-changing for both residents and faculty.
In the last several years, we have benefitted greatly from the clinical experience of our peers worldwide. It is time that we contribute. When we take an active role in academic writing, publishing and presenting, we can help to create the kind of data that helps patients, caregivers and other providers, and minimizes harm to us all.
1. Number of Active Residents, by Type of Medical School, GME Specialty, and Gender 2015-2016 Active Residents. AAMC2016. Accessed at: https://www.aamc.org/data/448482/b3table.html on March 10, 2017
2. Laurel E et al. Why do women choose or reject careers in academic medicine? A narrative review of empirical evidence. Lancet. 2016 Dec 10;388(10062):2948-2958. doi: 10.1016/S0140-6736(15)01091-0. Epub 2016 Apr 19.
3. Brown J. The crisis in the emergency medicine physician scientist workforce. In reply. Acad Emerg Med. 2015 Apr;22(4):493. doi: 10.1111/acem.12638. Epub 2015 Mar 13.
4. Holmes JF et al. Ten-year Experience with an Emergency Medicine Resident Research Project Requirement. Academic Emergency Medicine. Acad Emerg Med. 2006 May;13(5):575-9. Epub 2006 Mar 28.