Abstract：
STUDY OBJECTIVE:In 2001, less than 20% of emergency medicine residents had more than $150,000 of educational debt. Our emergency medicine residents anecdotally reported much larger debt loads. Surveys have reported that debt affects career and life choices. Qualitative approaches are well suited to explore how and why such complex phenomena occur. We aim to gain a better understanding of how our emergency medicine residents experience debt. METHODS:We conducted individual semistructured interviews with emergency medicine residents. We collected self-reported data related to educational debt and asked open-ended questions about debt influence on career choices, personal life, future plans, and financial decisions. We undertook a structured thematic analysis using a qualitative approach based in the grounded theory method. RESULTS:Median educational debt was $212,000. Six themes emerged from our analysis: (1) debt influenced career and life decisions by altering priorities; (2) residents experienced debt as a persistent source of background stress and felt powerless to change it; (3) residents made use of various techniques to negotiate debt in order to focus on day-to-day work; (4) personal debt philosophy, based on individual values and obtained from family, shaped how debt affected each individual; (5) debt had a normative effect and was acculturated in residency; and (6) residents reported a wide range of financial knowledge, but recognized its importance to career success. CONCLUSION:Our emergency medicine residents' debt experience is complex and involves multiple dimensions. Given our current understanding, simple solutions are unlikely to be effective in adequately addressing this issue.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Young TP,Brown MM,Reibling ET,Ghassemzadeh S,Gordon DM,Phan TH,Thomas TL,Brown Ldoi
10.1016/j.annemergmed.2016.04.013subject
Has Abstractpub_date
2016-10-01 00:00:00pages
409-18issue
4eissn
0196-0644issn
1097-6760pii
S0196-0644(16)30081-6journal_volume
68pub_type
杂志文章abstract：:Although most clinical trials comparing therapies are analyzed using classical hypothesis testing and P values, such methods do not yield the information most useful to the clinician, that is, the probability that one treatment is more efficacious than another. Bayesian inference can yield this probability but only if...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80119-2
更新日期：1993-08-01 00:00:00
abstract：:There are currently 20 autonomous departments of emergency medicine in United States medical schools. EDs seeking autonomous status should institute a faculty development program to channel faculty energy into worthwhile research projects; establish protected time for clinical faculty to increase research productivity...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82395-9
更新日期：1991-06-01 00:00:00
abstract：STUDY OBJECTIVE:Emergency department (ED) patients with atrial fibrillation or flutter are at risk of stroke, and guidelines recommend anticoagulation for patients with increased cardiovascular risk. Emergency physicians have a unique opportunity to provide appropriate anticoagulation for such patients, and we wished t...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2013.04.004
更新日期：2013-12-01 00:00:00
abstract：:We describe the case of a 41-year-old man who suffered a bite to the tongue from the Western Diamondback rattlesnake (C atrox). Life-threatening obstruction of his upper airway secondary to massive edema of the tongue and other soft tissue structures quickly followed envenomation. Nasotracheal intubation, IV antivenin...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(87)80584-x
更新日期：1987-07-01 00:00:00
abstract：:The Bahamas is an archipelago of 700 islands with the majority of the population concentrated on just 2 islands: New Providence and Grand Bahama. Most emergency medical services are provided by Princess Margaret Hospital and Rand Memorial Hospital located respectively on those 2 islands. A detailed description of the ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2001.118865
更新日期：2001-12-01 00:00:00
abstract：:Although a number of studies have described endotracheal intubation of adult patients in the prehospital setting, there are few studies on prehospital endotracheal intubation of pediatric patients. The purposes of our study were to determine how frequently prehospital endotracheal intubation was used in pediatric card...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80830-3
更新日期：1989-05-01 00:00:00
abstract：:Recent investigations suggest that increased intrathoracic pressure causing compression of the heart and great vessels in the thorax plays an important role in providing blood flow during cardiopulmonary resuscitation. This communication reports the case of a four-year-old asphyxiated girl found to have a small amount...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(80)80474-4
更新日期：1980-12-01 00:00:00
abstract：:There are many infectious causes of fatigue, sore throat, and fever, including mononucleosis and toxoplasmosis. Toxoplasma antibody testing is rarely performed in most emergency departments; as a result, toxoplasmosis is diagnosed infrequently. We obtained Toxoplasma IgG IFA titers on ED patients who had mononucleosis...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80575-x
更新日期：1989-04-01 00:00:00
abstract：:OxyContin (oxycodone hydrochloride controlled release) is a long-acting preparation of oxycodone that is used as an opioid analgesic to treat chronic pain conditions. We report a patient who ingested a massive quantity of OxyContin and had altered mental status, noncardiogenic pulmonary edema, and hypoventilation that...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2002.128143
更新日期：2002-10-01 00:00:00
abstract：:Gifts to physicians by the pharmaceutical industry pose numerous ethical questions. Although individual patients and physicians may benefit financially and educationally from certain gifts, the risk of bias resulting from such gifts makes them ethically challenging. After a brief description of the nature and scope of...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2005.12.013
更新日期：2006-11-01 00:00:00
abstract：STUDY OBJECTIVE:Stress is an emergent occupational problem in modern societies. Among workers, medical practitioners are particularly exposed. However, data objectifying stress levels during work time are scarce. The aim of this study was to establish diurnal salivary cortisol levels in a highly stressful work environm...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2003.109
更新日期：2003-04-01 00:00:00
abstract：:In order to assess more rationally the requirement for anticoagulation during intraoperative autotransfusion, the clotting competence of blood collected from the body cavities of 31 trauma victims entering our emergency department with indications for intraoperative transfusion was assessed. Blood was collected at tho...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(81)80375-7
更新日期：1981-03-01 00:00:00
abstract：:Risperidone is an investigational antipsychotic agent currently being tested in an international multicenter drug trial. We report the first case of a risperidone overdose in an apparent suicide attempt. This was without serious clinical side effects and manifested mainly as ECG abnormalities. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80421-4
更新日期：1993-12-01 00:00:00
abstract：:Blunt abdominal trauma is a common presentation to the emergency department. Ischemic colitis is a rare complication of this and its possible sequelae are important for an emergency physician to recognize. A 21-year-old man presented to the emergency department with abdominal pain and hourly episodes of bright red blo...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2011.01.014
更新日期：2011-08-01 00:00:00
abstract：STUDY OBJECTIVE:To determine emergency department patients' behaviors during informed consent for an intimate partner violence survey. METHODS:We conducted a cross-sectional study during administration of informed consent. Research assistants recorded whether informed consent was read, time spent reading it, whether q...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2009.09.023
更新日期：2010-01-01 00:00:00
abstract：:The records of 50 patients with traumatic aortic rupture (Group I) and 50 patients with blunt chest trauma but negative aortograms (Group II) were reviewed retrospectively. Symptoms and signs referable to the chest and thoracic aorta were recorded and compared in Group I and Group II patients. Each patient's chart was...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(84)80659-9
更新日期：1984-10-01 00:00:00
abstract：:Ten healthy male volunteers were studied to compare the effects of simultaneous versus sequential inflation of antishock trousers (AST) and simultaneous inflation pressures of 20, 40, and 100 mm Hg on blood volume displacement centrally. Radioisotope scans were used to determine the change in blood volume distribution...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(85)80877-5
更新日期：1985-07-01 00:00:00
abstract：STUDY OBJECTIVE:To be able to adhere to discharge instructions after a visit to the emergency department (ED), patients should understand both the care that they received and their discharge instructions. The objective of this study is to assess, at discharge, patients' comprehension of their ED care and instructions a...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2008.05.016
更新日期：2009-04-01 00:00:00
abstract：:Excessive brain lactate, as may develop in cerebral ischemia, has been implicated as a major cause of irreversible cell damage. With an experimental model that produces cerebral ischemia by bilateral carotid ligation combined with systemic hypotension, previous studies have shown that treatment with 25 mg/kg sodium di...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(89)80054-x
更新日期：1989-11-01 00:00:00
abstract：STUDY OBJECTIVES:For many foodborne outbreaks, the pathogen and food vehicle never are identified. Delayed collection of epidemiologic and microbiologic information may contribute to this. We postulated that collection of this information from ill persons as they presented to the emergency department during a recent ou...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)80109-x
更新日期：1993-08-01 00:00:00
abstract：:Ethanol disrupts the physical structure of cell membranes. The most fluid membranes, including those that are low in cholesterol, are the most easily disordered by ethanol. Although the membrane-disordering effect is small, there is pharmacological, temporal, and genetic evidence that it is important. Animals that are...
journal_title：Annals of emergency medicine
pub_type： 杂志文章,评审
doi：10.1016/s0196-0644(86)80120-2
更新日期：1986-09-01 00:00:00
abstract：STUDY OBJECTIVE:To determine if intramedullary aspirate from intraosseous needle placement can be used as a source for evaluating blood compatibility. DESIGN:A prospective, nonrandomized, crossover study. SETTING/PARTICIPANTS:Patients admitted to the hematology/oncology service undergoing bone marrow aspiration for m...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82661-7
更新日期：1992-04-01 00:00:00
abstract：STUDY OBJECTIVE:We describe and analyze a recent rapid deployment of disaster medical assistance teams and other government agencies to provide medical screening and anthrax prophylaxis to New York City US Postal Service employees potentially exposed to letters contaminated with anthrax spores. METHODS:A description o...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1067/mem.2003.105
更新日期：2003-04-01 00:00:00
abstract：STUDY OBJECTIVE:Coronary computed tomographic (CT) angiography has excellent performance characteristics relative to coronary angiography and exercise or pharmacologic stress testing. We hypothesize that coronary CT angiography can identify a cohort of emergency department (ED) patients with a potential acute coronary ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2008.09.025
更新日期：2009-03-01 00:00:00
abstract：:A fatal case of ascending tonic-clonic seizure (ATCS) syndrome resulted from the inadvertent, unrecognized use of a hyperosmolar ionic contrast agent during myelography. The patient presented with lower-extremity myoclonic jerking, agitation, hyperthermia, rhabdomyolysis, and disseminated intravascular coagulation. Em...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(98)70045-9
更新日期：1998-11-01 00:00:00
abstract：:Increasing numbers of patients with diagnosed HIV infection are presenting to inner-city emergency departments. Unfortunately, there is little information available on the characteristics and emergency clinical problems of HIV-infected patients to guide physicians in patient care and strategies for resource use. Preli...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(05)82555-7
更新日期：1990-09-01 00:00:00
abstract：STUDY OBJECTIVE:The necessity for rapid administration of intravenous thrombolysis in patients with acute ischemic stroke may lead to treatment of patients with conditions mimicking stroke. We analyze stroke patients treated with intravenous thrombolysis in our center to characterize cases classified as stroke mimics. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2011.09.011
更新日期：2012-01-01 00:00:00
abstract：STUDY OBJECTIVE:We evaluate associations between pairs of discordant cardiac biomarkers (positive MB band of creatine kinase [CKMB] with negative creatine kinase, positive CKMB with negative cardiac troponin, and positive troponin with negative CKMB) and the presence of acute coronary syndromes in emergency department ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2006.05.016
更新日期：2006-12-01 00:00:00
abstract：:We examined the question of what determines the toxicity of alkaline solutions--pH, viscosity, or other factors. Our experiments have identified pH measurement as the simplest and most easily measured parameter for determining initial management of caustic ingestions. Viscosity is not a clinically useful measurement. ...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/s0196-0644(80)80264-2
更新日期：1980-03-01 00:00:00
abstract：STUDY OBJECTIVE:Previous studies have suggested that the initial emergency department (ED) lactate concentration may be an important prognostic indicator for inhospital mortality from acute drug poisoning. We conduct this cohort study to formally validate the prognostic utility of the initial lactate concentration in a...
journal_title：Annals of emergency medicine
pub_type： 杂志文章
doi：10.1016/j.annemergmed.2018.02.022
更新日期：2018-07-01 00:00:00
