Articles: emergency-medicine.
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The opinions and experiences of board-certified emergency physicians regarding employment structure and finances, professional society policies, and quality of patient care have never been formally studied. A survey questionnaire was sent to a random sample of 1,050 emergency physicians certified by the American Board of Emergency Medicine. The survey contained 29 multiple choice questions. ⋯ Fifteen percent have been terminated without due process/peer review, and 11% have been forced to leave a position, move, or pay compensation because of noncompete clauses. The majority reported encountering instances of substandard emergency medical care, most commonly in settings with multihospital contract company coverage. The majority also believe their specialty societies should address issues of employment structure and quality of patient care standards.
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We sought to describe the spectrum of illness and number of patients seen by pediatric residents rotating through a pediatric ED. ⋯ The number and type of patients seen by individual residents in this study showed significant variation. Many illnesses were not seen frequently enough for every resident to develop competence solely on the basis of clinical experience during ED rotations. A computerized, easily accessible ED database can be used to track the experience of individual residents or groups of residents. Such tracking would allow residents and program directors to identify areas that may require alternate educational strategies and would also document the residents' experience for future credentialing.
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Comparative Study
Evidence of methodologic bias in the derivation of the Science Citation Index impact factor.
The "impact factor" published in Science Citation Index (SCI) is widely used in the scientific community to measure the relative importance of a medical journal. In contrast to all other indicators of academic growth in emergency medicine, impact factors for emergency medicine journals have remained low and unchanged since the inception of the specialty. We wished to investigate this incongruity. ⋯ The apparent failure of emergency medicine journals, as measured by the SCI impact factor, to keep pace with other indicators of academic development of the field is at least in part attributable to a methodologic bias inherent in the derivation of this factor.