BACKGROUND: This study was undertaken to examine the current level of operations and management education within US-based Emergency Medicine Residency programs.METHODS: Residency program directors at all US-based Emergency Medicine Residency programs were anonymously surveyed via a web-based instrument. Participants indicated their levels of residency education dedicated to documentation, billing/coding, core measure/quality indicator compliance, and operations management. Data were analyzed using descriptive statistics for the ordinal data / Likert scales.RESULTS: One hundred and six (106) program directors completed the study instrument of one hundred and fifty-six (156) programs (70％). Of these, 82.6％ indicated emergency department (ED) operations and management education within the training curriculum. Dedicated documentation training was noted in all but 1 program (99％). Program educational offerings also included billing/coding (83％), core measure/quality indicators (78％) and operations management training (71％). In all areas, the most common means of educating came through didactic sessions and direct attending feedback or 69％-94％ and 72％-98％ respectively. Residency leadership was most confident with resident understanding of quality documentation (80％) and less so with core measures (72％), billing/coding/RVUs (58％), and operations management tools (23％).CONCLUSIONS: While most EM residency programs integrate basic operational education related to documentation and billing/coding, a smaller number provide focused education on the day-to-day management and operations of the ED. Residency leadership perceives graduating resident understanding of operational management tools to be limited. All respondents value further resident curriculum development of ED operations and management.