According to a recent editorial from Emergency Medicine News, emergency residency programs are doing a poor job preparing their emergency residents for the real world.

The authors note that a typical, large urban academic emergency department comprise less than 5 percent of U.S. ERs, and that “residency programs train physicians in some of the most inefficient EDs in the land. Relative value units of emergency medicine work per hour in the teaching hospital setting is typically half that seen in private practice.”

I think this applies to primary care residencies, as well. Many academic medical practices cannot replicate the pace and volume that a typical private practice experiences. Compounded with the lack of any formal business training that doctors today need, it’s no wonder that newly graduated primary care doctors are woefully ill-equipped to practice real world medicine.

It’s surmised that this may be a reason why “nearly 50 percent of new graduates do not survive their initial practice choice for even five years. Perhaps they simply are not sufficiently prepared to deal successfully with the realities of the community emergency medicine practice.”

There’s no question this also explains the high primary care attrition rate for new doctors.

(via GruntDoc and Movin’ Meat)