Changes in academic attributes associated with establishment of departments of emergency medicine

Objective: To test the hypothesis that establishment of academic departments of emergency medicine (EM) is associated with improvements in attributes valued by traditional academic medicine. Methods: Cross-sectional, observational analysis of academic departments of EM at all accredited allopathic medical schools, as of July 1, 1996. Nonrespondents were mailed questionnaires three times, followed by phone contact. All variables were examined as before-after comparisons associated with department formation. Findings were reported as absolute differences, bounded by 99% confidence intervals (99% CIs), adjusted for multiple comparisons. Results: Of 50 departments, 49 responded. Department formation was associated with a 25% (99% CI 5% to 46%) increase in accredited EM residencies, a 33% (99% CI 9% to 56%) increase in extramural grant funding, and 46% (99% CI 23% to 69%) and 34% (99% CI 8% to 58%) increases in departmental representation on medical school curriculum and promotions committees, respectively. The mean increase in academic faculty full-time equivalents (FTEs) was 6.7 (99% CI 3.3 to 10.1). There were average increments of 2.1 FTEs (99% CI 1.4 to 2.7) and 0.8 FTEs (99% CI 0.4 to 1.1) attaining senior ranks of associate professor and professor, respectively. With a top possible Likert scale score of 3, departmental status was associated with essentially identical improvements in the quality of faculty [2.6 (99% CI 2.4 to 2.8)], EM residents [2.6 (99% CI 2.4 to 2.8)], student teaching [2.7 (99% CI 2.5 to 2.9)], and overall academic productivity [2.8 (99% CI 2.7 to 3.0)]. Conclusion: Establishment of academic departments of EM at medical schools is associated with quantitatively and statistically significant improvements in many academic attributes that are mutually beneficial for both the institution and the specialty.