title: Lack of proficiency in musculoskeletal medicine among emergency medicine physicians.
abstract: OBJECTIVE
  Emergency medicine (EM) physicians are frequently responsible for evaluating and treating patients with urgent or emergent musculoskeletal conditions, so it is critical that they achieve a basic level of proficiency in musculoskeletal medicine. However, inadequacies in musculoskeletal education have previously been documented among medical students, residents, and attending physicians in a number of specialties. The goal of this study was to assess the proficiency with musculoskeletal medicine among EM physicians in particular.
  
  
  METHODS
  A validated musculoskeletal medicine competency examination was administered to the EM residents and faculty at a university-affiliated level 1 trauma center. Demographic data and satisfaction with musculoskeletal education were also surveyed.
  
  
  RESULTS
  Twenty-three EM residents and 21 attending physicians completed the survey. Thirty-five percent of residents and 43% of attending physicians failed to demonstrate proficiency on the examination. Pass rates were not significantly different among junior residents, senior residents, or attending physicians. Twenty-three percent of respondents indicated that they were dissatisfied with their musculoskeletal education.
  
  
  CONCLUSIONS
  Significant deficiencies in musculoskeletal education exist among EM physicians in training and attending staff. Given the frequency with which these physicians evaluate and treat acute musculoskeletal conditions, additional resources should be committed to their training.
authors.affiliation: Department of Orthopaedic Surgery, Stanford University School of Medicine, Palo Alto, CA.
authors.forename: Garet C
authors.initials: GC
authors.lastname: Comer
authors.forename: Emily
authors.initials: E
authors.lastname: Liang
authors.forename: Julius A
authors.initials: JA
authors.lastname: Bishop
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education* / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education / Q000592:standards; D009140:Musculoskeletal Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy