Clinical Scorecard: Association of Private Equity–Backed Faculty Employment With Emergency Medicine Board Exam Performance
At a Glance
Category
Detail
Condition
Private equity–backed physician-group employment at emergency medicine residency training sites and resident board examination performance
Key Mechanisms
The study assessed whether PE backing of physician groups at any residency training site was associated with residents’ written qualifying examination and oral certification examination outcomes, accounting for program and emergency department characteristics.
Target Population
Residents graduating from US emergency medicine residency programs during 2021–2023
Care Setting
US emergency medicine residency programs and their affiliated emergency department training sites
Key Highlights
Among 267 programs, 70 (26.2%) employed faculty through PE-backed physician groups; these programs represented 17.1% of graduates after weighting.
PE-backed programs were more often community based and founded after 2015, and less often located at level 1 trauma centers.
Unadjusted written qualifying examination pass rates were lower in PE-backed programs; unadjusted oral certification examination pass rates did not differ.
After adjustment for program and emergency department characteristics, PE backing was not significantly associated with either examination outcome.
Findings were similar in a sensitivity analysis defining exposure by current rather than any history of PE backing.
Guideline-Based Recommendations
Diagnosis
Not applicable: this cross-sectional study evaluated residency program characteristics and examination outcomes, not diagnosis of a clinical condition.
Management
The study did not evaluate or provide clinical management recommendations.
Monitoring & Follow-up
The study did not specify clinical monitoring recommendations.
Risks
Interpretation is limited by the observational design and by board examination outcomes being an inadequate proxy for educational quality.
PE-backed programs were disproportionately newer and community based and had fewer level 1 trauma centers; these characteristics may relate to the training environment.
Patient & Prescribing Data
No patient treatment or prescribing population was studied; the analysis included US emergency medicine residency programs with board examination results available for 2021–2023.
No treatments or prescribing interventions were evaluated.
Clinical Best Practices
Interpret the unadjusted examination differences alongside the adjusted analyses, which found no significant association between PE backing and QE or OCE outcomes.
Consider the study’s measured program and training-site characteristics when interpreting comparisons between PE-backed and non-PE-backed programs.
Do not treat board examination outcomes alone as a measure of overall educational quality, as the authors noted this proxy limitation.
