Medical Student

If you developed an interest in emergency department (ED) administration as a medical student, you're already ahead of the game! If there is an area of specific interest, learn as much about it as you can and gain exposure. During your last two years of medical school, you should identify the residencies that will best prepare you for an ED administration career and work on strengthening your candidacy for those programs. Many of those can be identified by the level of administrative dedication present (i.e. fellowship in administration/leadership, active scholarship, continuous improvement projects, system growth, etc.). Consider the following based on your specific career goals and the opportunities available at your institution.

During MS3 Year

• Identify an Administrative Mentor at your Institution: Create a list of five-ten questions to generate discussion and inquire about their career path and decisions along the way. Discuss current and future projects and challenges. Ask if there is another mentor that you should know, and if they are willing to help make the connection.
• Seek Leadership Roles: ED administration is all about collaborative leadership and team-based management, so it's important to find out if this is something you like, love, or hate. Some options include leading an interest group or club (or starting one yourself), running for a position in student government, organizing an event or fundraiser for your medical school, or participating in a quality improvement project or initiative in your ED.
• Investigate More About ED Administration and Leadership: Join a local or national interest group through professional societies like SAEM, ACEP, or CORD. You should also explore ED administration literature. Look for operations, patient safety, risk management, or process improvement articles in major peer-reviewed EM journals and gauge whether you find the discussion interesting.

During MS4 Year

When exploring residency programs, look for the qualities that support an ED administration career. These include:

• A high level of resident involvement and engagement in administrative projects, committees (ED or medical center), and advocacy.
• ED or hospital committees with decision-making power to affect ED policies and practices on a timescale compatible with residency training (residents can see the real impact of their involvement within a three-four year timeframe).
• ED administration faculty with a track record of mentoring residents/fellows in administration or leadership.
• Presence of an ED administrative fellowship and/or a good track record of graduates with successful ED administration careers.

Residency Programs

While ED administration is a relatively new academic track, look for programs that have an administrative fellowship and inquire about their experience. Some have legacy in this area. Look for those with active engagement and recognize those with SAEM-certified programs have met a threshold not achieved by most.

There will be opportunities to grow in your expertise within ED administration regardless of the program match - recognizing that to be a great administrative team member starts with establishing your clinical acumen and management capacity. Don’t be too anxious about getting into one residency versus another based solely on their ED administration opportunities. There are numerous other factors to consider, including the faculty mix, location, and three- vs. four-year training, just to name a few. That being said, if you already developed an interest in ED administration in medical school, it makes sense to look at residency programs that can continue to support and nurture that interest. When you’re on the residency interview trail, ask programs about the qualities listed above, and take their answers into consideration when you’re making your residency rank list.