Background The aim of this study was to determine whether the current South African Emergency Medicine Curriculum is appropriate for the burden of disease seen by registrars in Cape Town Emergency Centres.

Method This is a cross-sectional retrospective audit of patients presenting to a range of secondary level emergency centres (ECs) in Cape Town. The type of clinical presentations, investigations done and procedures performed were analysed. Basic descriptive statistics are presented.

Results A total of 1283 clinical presentations from three secondary level ECs in Cape Town were collated. Of these clinical presentations, 47 were not included in the South African Emergency Medicine curriculum; in addition, two were only included in the paediatrics section. 115 procedures were tabled, of these, 11 were not included in the curriculum. 730 investigations were tabled; 527 were not included in the curriculum.

Conclusions The curriculum did not cover all the clinical conditions, procedures and investigations encountered by emergency medicine (EM) registrars in Cape Town. In addition, there were multiple categories in the curriculum that were not encountered in EM practice at all. The investigations section of the curriculum correlated particularly poorly with the skills needed for the burden of disease seen in ECs in Cape Town. The curriculum should be redrafted guided by a practice analysis of EM.