Rural Emergency Medicine: Patient Volume and Training Opportunities

Jeff Reames, Daniel A. Handel, A. Al-Assaf, Jerris R. Hedges

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: A paucity of board-certified Emergency Physicians practice in rural Emergency Departments (EDs). One proposed solution has been to train residents in rural EDs to increase the likelihood that they would continue to practice in rural EDs. Some within academic Emergency Medicine question whether rural hospital EDs can provide adequate patient volume for training an Emergency Medicine (EM) resident. Study Objectives: To compare per-physician patient-volumes in rural vs. urban hospital EDs in Oklahoma (OK) and the proportion of board-certified EM physicians in these two ED settings. Methods: A 21-question survey was distributed to all OK hospital ED directors. Analysis was limited to non-military hospitals with EDs having an annual census > 15,000 patient visits. Comparisons were made between rural and urban EDs. Results: There were 37 hospitals included in the analysis. Urban EDs had a higher proportion of board-certified EM physicians than rural EDs (80% vs. 28%). There were 4359 vs. 4470 patients seen per physician FTE (full-time equivalent) in the rural vs. urban ED settings, respectively (p = 0.84). Conclusions: Patient volumes per physician FTE do not differ in rural vs. urban OK hospital EDs, suggesting that an adequate volume of patients exists in rural EDs to support EM resident education. Proportionately fewer board-certified Emergency Physicians staff rural EDs. Opportunities to increase rural ED-based EM resident training should be explored.

Original languageEnglish (US)
Pages (from-to)172-176
Number of pages5
JournalJournal of Emergency Medicine
Issue number2
StatePublished - Aug 2009
Externally publishedYes


  • Oklahoma
  • emergency medicine
  • physician workforce
  • residency training
  • rural emergency medicine

ASJC Scopus subject areas

  • Emergency Medicine


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