411 - Training Pediatric Emergency Medicine Physicians in EMS: National Insights from Physicians and Program Directors

Publication Number: 4402.411

Kathryn Schissler, The Warren Alpert Medical School of Brown University, North Kingstown, RI, United States; Kevin R. Gutermuth, Virginia Tech Carilion, Roanoke, VA, United States; Joelle Donofrio-Odmann, University of California, San Diego School of Medicine, La Jolla, CA, United States; Lara Rappaport, Denver Health, englewood, CO, United States; Nicholas Asselin, The Warren Alpert Medical School of Brown University, Providence, RI, United States

Background: There is increasing interest and demand for Pediatric Emergency Medicine (PEM) physicians to pursue formal training in Emergency Medical Services (EMS). However, little is known about the characteristics of PEM physicians who complete EMS training and the experiences of EMS Fellowship Program Directors (EMS-PDs) training PEM physicians.

Objective: This study aimed to explore the motivations, challenges, and current professional roles of PEM physicians who are board-certified/eligible in EMS (PEM-EMS), from the perspectives of both PEM-EMS physicians and EMS-PDs in the United States.

Design/Methods: An anonymous, electronic survey was distributed in Spring 2025 through national PEM and EMS listservs, with follow-up emails sent to 88 publicly available EMS-PD contacts. Respondents included PEM-EMS physicians and current/former EMS-PDs. Expedited IRB approval was obtained.

Results: 22 PEM-EMS physicians completed the survey; 64% female and 91% White, with most working in stand-alone children's hospitals (45%) or children's hospitals within general hospitals (41%). 91% completed Pediatric residency, 55% completed an EMS Fellowship and 45% were EMS board-certified through the Practice Pathway. 68% were currently serving as EMS agency medical directors and/or held leadership roles at the state (50%) or national (46%) EMS level. Motivating factors for EMS training included interest in pediatric readiness, desire for a subspecialty niche, and career opportunities associated with EMS board certification. 82% reported their EMS training and/or board-certification was useful in their current roles.

56 EMS-PDs responded, 88% of whom were currently serving in that role. Respondents were 77% male and 89% White. 23% of EMS-PDs reported having trained at least one PEM physician. Among EMS-PDs who had not yet trained PEM physicians, 63% expressed interest, 32% were unsure, and 5% were not interested. Interest was strongest among those actively serving as EMS-PDs and those with fewer than 5 years of EMS-PD experience. Reported benefits of training PEM physicians included their unique clinical perspective, pediatric expertise for EMS agencies, and contributions to national pediatric readiness. Common challenges were limited adult medical experience, institutional and financial barriers, and uncertainty around curriculum adaptation.

Conclusion(s): PEM-EMS training was associated with high rates of EMS agency and leadership roles and substantial career value. EMS-PDs recognized both the feasibility and benefits of integrating PEM fellows. Limitations include potential response bias and exclusion of incomplete surveys.

Demographic Characteristics of PEM-EMS and EMS-PDs