Research Article
A Critical Appraisal of Emergency Medicine Specialty
Training and Resignation among Residents in Emergency
Medicine in Turkey
Murat Cetin ,
1
Sercan Bicakci ,
2
Mustafa Emin Canakci ,
3
Mevlut Okan Aydin ,
4
and Basak Bayram
5
1
Department of Emergency Medicine, Tekirdag State Hospital, Tekirdag, 59030, Turkey
2
Department of Emergency Medicine, Namık Kemal University, 59100, Tekirdag, Turkey
3
Department of Emergency Medicine, Eskisehir City Hospital, 26110, Eskisehir, Turkey
4
Department of Emergency Medicine, University of Health Sciences Bursa Yuksek
˙
Ihtisas Training and Research Hospital,
16330, Bursa, Turkey
5
Department of Emergency Medicine, Dokuz Eylul University, 35220,
˙
Izmir, Turkey
Correspondence should be addressed to Murat Cetin; muratcetinn@gmail.com
Received 1 December 2018; Accepted 27 January 2019; Published 17 February 2019
Academic Editor: Joe Nemeth
Copyright © 2019 Murat Cetin et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background and Aim. Te nonsatisfaction among emergency medicine specialty trainees is an underrated issue in Turkey. Several
previous studies have evaluated the burn-out and its consequences among physicians, but there is no study conducted with specialty
trainees. Te aim of this study is to evaluate the reasons for resignation among emergency medicine specialty residents in Turkey.
Method. A total of 41 participants, who resigned from emergency medicine residency, were contacted by phone and invited to
complete an online survey that included 25 questions about personal characteristics and departmental information. Results. Most
frequent reasons of resignation were violence/security concerns (63.4%), busy work environment (53.7%), and mobbing (26.8%).
Participants who reported that they have resigned due to inadequate training were mostly over 30 years old (p=0.02), continued
more than 6 months to EMST (p<0.001), reported that there was no regular rotation program (p=0.003) or access to full-text
scientifc journals (p=0.045) in their department. All participants thought that there were defcits in the training programs, and none
of them declared regret for resigning. Twenty-eight participants (68.2%) continued their specialty training at a diferent discipline
afer resignation. Conclusion. Major barriers against a high-quality and sustainable emergency medicine residency are violence in
emergency services, mobbing in academic or administrative bodies, and inaccessibility to scientifc resources. Tese obstacles can
only be removed by cooperation of multiple institutions in Turkey.
1. Introduction
Nonsatisfaction in emergency department (ED) physicians
is a signifcant issue in many countries, which had been
investigated in numerous studies [1, 2]. Current literature
data suggest that working in shifs, unpredictable work
environment, complex patient management, and violence
in healthcare facilities are among the key factors that pave
the way for physician burn-out. Te major consequences of
burn-out in ED are decreased work motivation, deteriorated
quality of care delivery, and attrition from ED labor [3, 4].
Attrition can be defned as refraining from emergency service
clinical practice. In cases of attrition, physicians may shif
to passive work positions or change their department of
care service. Literature data suggests that attrition rate from
emergency department practice is 1%-2% per year, and these
rates could increase to 50% for 5 to 10 years-period [2]. Te
literature on this issue is mainly based on the physicians’
conditions. But, burn-out and attrition among emergency
department residents is an underrated feld, and to the best of
our knowledge, no previous study had evaluated this critical
issue in Turkey.
Hindawi
Emergency Medicine International
Volume 2019, Article ID 6197618, 6 pages
https://doi.org/10.1155/2019/6197618