Emergency medicine questions on the entrance examination for medical internships and residency training in Spain: analysis of changes between 2010 and 2019

Objective.

To investigate the presence of fundamental concepts in emergency medicine on the entrance examination taken by candidates for medical internships and residency training in Spain, and to identify changes over time.

Methods.

Longitudinal retrospective study. Three independent researchers reviewed questions on the entrance examinations of the past 10 years (2010–2019) and classified them as directly, indirectly, or not related to emergency medicine. The topics of directly related questions were also classified according to the categories listed in Tintinalli’s

Emergency Medicine and subject areas in the Citation Index Expanded (SCIE) of the Web of Science. Changes in the number of questions and range of topics were analyzed with simple linear regression models.

Results.

A total of 2300 questions were reviewed; 487 (22%) were directly related to emergency medicine, and 313 of them specifically referred to an emergency or urgent care setting. The proportion of directly related questions held steady over the 10-year period (P=.172). The most frequently mentioned categories listed by Tintinalli were cardiovascular (12.2%), infectious (11.1%), and gastrointestinal (10.9%) emergencies, and no significant differences were noted over time. However, proportions assigned to the SCIE categories did change over time, as follows. Questions about emergency care in general (11.9% during the period overall) increased significantly with time (P=.005) whereas cardiovascular questions (11.3%) decreased (P=.037). The proportion of infectious disease topics

remained the same (10.7%).

Conclusion. Even though emergency medicine is not a recognized specialty for medical residency training in the public health system, questions on emergencies are considered important for evaluating candidates, judging by the

high percentage of questions on the examinations.