title: Fellowships in international emergency medicine in the USA: a comparative survey of program directors' and fellows' perspectives on the curriculum.
abstract: OBJECTIVE
  Experts have proposed core curriculum components for international emergency medicine (IEM) fellowships. This study examined perceptions of program directors (PDs) and fellows on whether IEM fellowships cover these components, whether their perspectives differ and the barriers preventing fellowships from covering them.
  
  
  METHODS
  From 1 November 2011 to 30 November 2011, a survey was administered to PDs, current fellows and recent graduates of the 34 US IEM fellowships. Respondents quantified their fellowship experience in six proposed core curriculum areas: emergency medicine (EM) systems development, EM education, humanitarian assistance, public health, emergency medical services and disaster medicine. Analysis was performed regarding what per cent of programmes fulfil the six curriculum areas. A paired t test determined the difference between PDs' and fellows' responses. Agreement between PDs and fellows within the same programme was determined using a κ statistic.
  
  
  RESULTS
  Only 1/18 (6%) (according to fellows) to 2/24 (8%) (according to PDs) of programmes expose fellows to all six components. PDs consistently reported higher exposure than fellows. The difference in mean score between PDs and fellows was statistically significant (p<0.05) in three of the 6 (50%) core curriculum elements: humanitarian aid, public health and disaster medicine. Per cent agreement between PDs and fellows within each programmes ranged from poor to fair.
  
  
  CONCLUSIONS
  While IEM fellowships have varying structure, this study highlights the importance of further discussion between PDs and fellows regarding delineation and objectives of core curriculum components. Transparent curricula and open communication between PDs and fellows may reduce differences in reported experiences.
authors: Department of Emergency Medicine, Johns Hopkins University School of Medicine, , Baltimore, Maryland, USA.
authors: Gabrielle A
authors: GA
authors: Jacquet
authors: Alexander
authors: A
authors: Vu
authors: William B
authors: WB
authors: Ewen
authors: Bhakti
authors: B
authors: Hansoti
authors: Steven
authors: S
authors: Andescavage
authors: David
authors: D
authors: Price
authors: Robert E
authors: RE
authors: Suter
authors: Jamil D
authors: JD
authors: Bayram
mesh_terms: D002321:Career Choice; D003479:Curriculum; D004635:Emergency Medicine / Q000193:education; D005257:Fellowships and Scholarships; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008486:Physician Executives; D012955:Societies, Medical; D014481:United States
keywords: Accident & Emergency Medicine; Education & Training (see Medical Education & Training); Medical Education & Training; Public Health