ACEP is committed to ensuring those conversations happen and to the development and adoption of a multi-organization policy specific to stopping the expansion of new programs.

• Raise the bar to ensure consistency across emergency medicine residency training

The original number of required procedures for EM residencies was set decades ago. Some research exists, but more is needed to assess validity of the existing standard and what role simulation should play in competency. Based on such objective research, all emergency medicine organizations can work with the Residency Review Committee for Emergency Medicine to set appropriate requirements around such criteria as the number of procedures required on actual patients (versus simulation) and number of direct patient contact interactions (including primary responsibilities in such conditions as trauma, resuscitation, airway, pediatric critical care/trauma, etc.).

Emergency department volume requirements should impact competition for patient procedures and EM residents should have priority for critical care encounters and procedures. These deliberations, and any subsequent changes they lead toward, should help to strengthen the value of the residency-trained, board-certified emergency physician leading the ED team.

Further, the expected presence of core faculty should be required at the primary sites and minimum qualifications should be delineated, as should faculty academic and scholarly requirements. These requirements must ensure the best educational environment to prepare emergency physicians to provide the quality of care our patients deserve, both now and in the evolving future.

There should be consideration of transitioning to a consistent four-year EM residency training model while maintaining the same total complement of residents. More research is needed to determine if there is evidence that this potential move would addresses additional educational needs while also resulting in a decrease in graduates each year.

ACEP is just one stakeholder in this realm, but we are committed to working with key organizations closely to examine and to update the standards and qualifications of new and existing residency programs—while also protecting the residents and medical students who are counting on them.

• Ensure business interests are not superseding the needs of educating the workforce

There are a lot of voices who assert that the root cause of our workforce issue can be traced back to “pop-up” residencies funded by large, equity-backed management groups and the corporate practice of medicine. ACEP is committed to working with key stakeholders to closely examine the legality and ethics of organizations funding residency training programs. No business interests, whether from a not-for-profit organization or a for-profit organization, should supersede the service needs of educating a workforce, while also caring for our communities.