Emergency Medicine Around the World: Updates from the 2023 American College of Emergency Physicians International Ambassador Country Reports

Abstract

Objectives: The specialty of emergency medicine (EM) is in varying stages of development around the world. Members of the American College of Emergency Physicians (ACEP) international ambassador program were surveyed to document the growth and current state of emergency medicine around the world. Methods: This was a descriptive, cross-sectional survey with 66 items covering EM specialty development, training, and working conditions. Data were collected digitally from January to September 2023. We performed a descriptive statistical analysis and analyzed categorical data using chi-squared and Fisher's exact test. Results: Responses were obtained from 69/77 countries with ACEP ambassadors (90%). EM was a recognized specialty in 63/69 (91%) responding countries. Fifty-nine responding countries (86%) have a national EM society. A total of 113,254 EM residency-trained physicians (EMRTPs) were reported working in 77,563 emergency departments, caring for a total population of 6.05 billion. Sixty countries (87%) report EM residencies, totaling 1790 programs; 1 in 3 respondents have only 1 EM training program. Countries with higher income levels had more EMRTPs per capita; of those with at least 1 EMRTP per 100,000 population, 27 were upper-middle or high income, whereas only 1 was lower-middle or low income. Conclusion: The field of EM continues to gain traction globally, and the number of countries recognizing EM as a specialty is increasing. Most countries surveyed recognized EM as a specialty and many more EMRTPs were reported compared with 2019. The number of EM residency programs and EMRTPs in practice continues to grow. The 2023 ACEP ambassador reports highlight growth, expansion in EM training, and specialty professionalization around the world.