To evaluate the availability and utilization of IRs in emergency medicine (EM) residency programs.
EM residency program directors were surveyed from the 126 Accreditation Council for Graduate Medical Education-accredited programs with ¡Ý2 years of residency graduates. Directors were asked about availability of IR, categorized as: 1) required; 2) elective (with or without pre-designated sites); or 3) not available.
One hundred eleven (88 % ) program directors reported data on 2240 graduates over 2 years. IRs were offered by 101 (91 % ) programs. No program required an IR. Among programs offering IRs, most (69 % ) did not have pre-designated sites. Eighty-nine of 101 programs (88 % ) allowing IRs had at least one resident completing an IR; 23 of 111 programs (21 % ) had more than 30 % resident participation in IRs. Programs offering IRs at pre-designated sites had 210 of 727 (29 % ) residents complete an IR, compared to 272 of 1469 (19 % ) in programs without pre-designated sites (p?<?0.001). Four-year programs had twice as many IR participants (32 % ) compared to 3-year programs (17 % ; p?<?0.001).
More residents participated in IRs when a pre-designated site was available compared to programs without. This suggests that programs interested in supporting IRs consider developing pre-designated sites to accommodate residents.