Combined Residency Training in Emergency Medicine and Internal Medicine: An Update on Career Outcomes and Job Satisfaction

Objectives: This study was designed to provide an update on the career outcomes and experiences of graduates of combined emergency medicine-internal medicine (EM-IM) residency programs. Methods: The graduates of the American Board of Emergency Medicine (ABEM) and American Board of Internal Medicine (ABIM)-accredited EM-IM residencies from 1998 to 2008 were contacted and asked to complete a survey concerning demographics, board certification, fellowships completed, practice setting, academic affiliation, and perceptions about EM-IM training and careers. Results: There were 127 respondents of a possible 163 total graduates for a response rate of 78%. Seventy graduates (55%) practice EM only, 47 graduates (37%) practice both EM and IM, and nine graduates (7%) practice IM or an IM subspecialty only. Thirty-one graduates (24%) pursued formal fellowship training in either EM or IM. Graduates spend the majority of their time practicing clinical EM in an urban (72%) and academic (60%) environment. Eighty-seven graduates (69%) spend at least 10% of their time in an academic setting. Most graduates (64%) believe it practical to practice both EM and IM. A total of 112 graduates (88%) would complete EM-IM training again. Conclusions: Dual training in EM-IM affords a great deal of career opportunities, particularly in academics and clinical practice, in a number of environments. Graduates hold their training in high esteem and would do it again if given the opportunity.