The Pulse- April 2018 by ACOEP

APRIL 2018

KEEPING YOUR SKILLS SHARP:

THE CHANGING WORLD OF MEDED

PRESIDENTIAL VIEWPOINTS

THE NEW FACE OF MENTORING PG 3

ACOEPâ&#x20AC;&#x2122;S CME PROGRAMS PG 15

BIG THINGS ON THE HORIZON WITH FOEM RESEARCH NETWORK PG 20

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The Pulse VOLUME XXXVIII No. 6

EDITORIAL STAFF Timothy Cheslock, DO, FACOEP, Editor Wayne Jones, DO, FACOEP-D, Assistant Editor Tanner Gronowski, DO, Associate Editor Drew A. Koch, DO, MBA, FACOEP-D, Board Liaison John C. Prestosh, DO, FACOEP-D Christine F. Giesa, DO, FACOEP-D Erin Sernoffsky, Editor Janice Wachtler, Executive Director Gabi Crowley, Digital Media Coordinator EDITORIAL COMMITTEE Timothy Cheslock, DO, FACOEP, Chair Drew A. Koch, DO, MBA, FACOEP-D, Board Liaison John C. Prestosh, DO, FACOEP-D Stephen Vetrano, DO, FACOEP Kaitlin Bowers, DO Tanner Gronowski, DO Dominic Williams, OMS-IV Erin Sernoffsky, Director, Media Services

The Pulse is a copyrighted quarterly publication distributed at no cost by the ACOEP to its Members, Colleges of Osteopathic Medicine, sponsors, exhibitors and liaison associations recognized by the national offices of the ACOEP. The Pulse and ACOEP accept no responsibility for the statements made by authors, contributors and/ or advertisers in this publication; nor do they accept responsibility for consequences or response to an advertisement. All articles and artwork remain the property of The Pulse and will not be returned. Display and print advertisements are accepted by the publication through ACOEP, 142 East Ontario Street, Chicago, IL 60611, (312) 587-3709 or electronically at marketing@acoep.org. Please contact ACOEP for the specific rates, due dates, and print specifications. Deadlines for the submission of articles are as follows: January issue due date is November 15; April issue due date is February 15; July issue due date is May 15; October issue due date is August 15. Advertisements due dates can be found by downloading ACOEP's media kit at www. acoep.org/advertising. The ACOEP and the Editorial Board of The Pulse reserve the right to decline advertising and articles for any issue. ©ACOEP 2018 – All rights reserved. Articles may not be reproduced without the expressed, written approval of the ACOEP and the author. ACOEP is a registered trademark of the American College of Osteopathic Emergency Physicians.

TABLE OF CONTENTS 3

PRESIDENTIAL VIEWPOINTS Christine Giesa, DO, FACOEP-D

THE EDITOR'S DESK Timothy Cheslock, DO, FACOEP

EXECUTIVE DIRECTOR’S DESK Janice Wachtler

ON DECK CIRCLE Robert Suter, DO, MHA, FACOEP-D

AN OPEN LETTER TO ACOEP MEMBERS Bryan D. Staffin, DO, FACOEP

WHEN OUR WORK HEALS US Frank Gabrin, DO, FACOEP

BEN FIELD, DO, FACOEP, MENTOR, TEACHER, PHYSICIAN, FRIEND Janice Wachtler

ACOEP’S CME PROGRAMS: THE FOREFRONT OF EMERGENCY MEDICINE Gabi Crowley, Digital Media Coordinator

FOAMED’S NEAT, SO YOU SHOULD TWEET Gabi Crowley, Digital Media Coordinator

BIG THINGS ON THE HORIZON WITH FOEM RESEARCH NETWORK Erin Sernoffsky, Director, Media Services

FOEM FOCUS

WHAT’S NEXT FOR ACOEP’S COUNCIL FOR WOMEN IN EMERGENCY MEDICINE? Gabi Crowley, Digital Media Coordinator

PRESIDENTIAL VIEWPOINTS

Christine Giesa, DO, FACOEP

THE NEW FACE OF MENTORING

he spring edition of The Pulse always comes at an exciting time. Winter is officially over, spring is breaking out around us, and both the NMS and NRMP matches are over. I would like to take the opportunity to congratulate and welcome a new class of resident physicians to the field of emergency medicine. As medical students, you worked hard to gain entrance into one of the most competitive specialties in the country. You should have a great feeling of accomplishment. The leadership of the ACOEP is proud and honored to call you a resident colleague. Our residents and young physicians are valued members of our College, and we expect you to lead us into the future. Historically, mentoring has played an important role in the development of a young physician. The more mature and experienced physician would provide valuable support and guidance to a younger physician, but this model is quickly becoming outdated. Recently, the concept of “reverse mentorship” has become popular. Reverse mentorship is when the younger generation serves as a mentor to someone from the older generation. This can be uncomfortable for both the mentor and the mentee, but should it? There is a cross-generational membership within our college. There are a few remaining Traditionalists, but most are Baby Boomers, Generation X, and Millennials. To best work together and mentor one another, we must first understand some inherent differences in how each generation views life.

Baby boomers were born immediately after World War II, and they experienced unprecedented opportunities for education, employment and prosperity. They value individuality and always strive to help improve themselves. They never think of themselves as getting old. Boomers want to be part of whatever fun challenge is coming next. Generation X has a reputation as being called the “middle child.” This generation falls between the two most distinct generations—the Boomers and Millennials. They are the latchkey generation. They grew up during double digit inflation, and thus are an economically conservative generation. They value self-reliance, and they can be very savvy. They solve their own problems.

MENTORS AND FRIENDS FROM A DIFFERENT GENERATION CAN OFTEN OFFER VALUABLE INSIGHT TO OUR EXPERIENCES THAT WE MAY NOT HAVE CONSIDERED.”

Millennials are the children of the Baby Boomers. They grew up fully engulfed in the age of information technology. This generation sees things as being very personal. They possess selfconfidence and are extremely tolerant of differences. They value work–life balance and although they enjoy working in teams, they value individual advancement.

generation of physicians must connect with the more experienced physicians and vice versa. We must learn how to mentor one another across generations as well as intragenerationally. Reverse mentorship not only helps all of us become the best physicians that we can become, but it also helps to develop the next generation of leaders.

There are three generations of practicing emergency medicine physicians in our membership. The interests and experiences of our membership are thus very diverse. In our ever-changing world of information technology and advancement of medical knowledge and procedures, it is imperative that all of us remain connected. The younger

All of us appreciate and prefer faceto-face contact. Digital CME and remote access live CME is becoming quite popular, but there is something to be said for attending a CME conference and sitting in the lecture hall. This affords us the opportunity to network with one another and to form bonds of friendship and mentorship. We can learn new tricks of the trade CONTINUED ON PAGE 28

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THE EDITORâ&#x20AC;&#x2122;S DESK

Timothy Cheslock, DO, FACOEP

CONTINUING MEDICAL EDUCATION, WHERE ARE WE HEADED?

ontinuing Medical Education (CME) is an integral part of our maintenance of certification, licensure, credentials, and any number of regulatory requirements. As emergency physicians, our learning needs have evolved as much throughout the years as they have remained the same. We need to maintain the most up-to-date information on standard of care as well as be on the cutting edge for what is new and trending in our specialty. There have been several changes to the CME requirement for osteopathic emergency physicians over the last few years. Some may be aware that AOA 1A credit is no longer a requirement for AOA membership. AOA is considering a measure in which membership is no longer a requirement for AOA board certification. As the AOA continues to make changes to longstanding policy, it will be our goal to keep the membership abreast of any additional changes regarding CME requirements. AOA 1A credit is still a requirement for many state licensing boards. It is important to understand those requirements in making your plans to attend CME offerings. AOA remains the accrediting body for osteopathic CME. AOA 1A credit is still being offered and the AOA continues to accredit and approve osteopathic CME sponsors. The most noticeable change in

the CME arena is the delivery of education via technology. The plethora of options for online CME have changed the landscape for how we receive our continuing education. Credits are easy to obtain; lectures and videos can be archived for future reference and there is more education than one can ever possibly absorb in the their lifetime. In addition to the typical online offerings, technology has spawned podcasts, YouTube videos, point of care CME through products like up to date which allow quick, easy and efficient review of focal topics and clinical questions. Despite all the technology available at our finger tips, live conference

world, physicians still like travelling for conferences? The idea of CME conferences and their value to physicians has long been debated. The government has scrutinized pharma funding in fear of unduly influencing our habits, yet how else do we improve knowledge of current therapy without hearing about it from the developers? Despite the financial challenges of putting together high-quality meetings, the opportunities for in person networking, mentoring and first-person dialogue cannot be understated. Lecture has long been the traditional method of instruction for CME, despite research that states

GRADUALLY OVER THE YEARS, CONFERENCES HAVE EVOLVED TO INCLUDE HANDS ON WORKSHOPS, SKILLS SESSIONS AND SMALL GROUPS SESSIONS.â&#x20AC;? programs continue to garner high attendance and academically renowned speakers. More and more applications are becoming available to deliver short bursts of information about specific topics. Whether the same CME credit will be allowed as for traditional lectures is also an ongoing debate. Can it be that despite all the advancement in our fast-paced

it is not the best way for adult learners to comprehend new information. It does allow to disseminate information to large groups in a collegial setting. Gradually over the years, conferences have evolved to include hands on workshops, skills sessions and small groups sessions. They have all been highly sought after given the usefulness in practice and the caliber CONTINUED ON PAGE 13

APRIL 2018 THE PULSE

EXECUTIVE DIRECTOR’S DESK

Janice Wachtler

NAILING YOUR INTERVIEW

t some point in everyone’s life they have go through a job interview; it’s something everyone dreads and afterward breathes a sigh of relief that its over. But you can take the angst out of the process by knowing the “Five Ps” for a successful interview: be Prepared; Professional; Practical; Punctual, and Polite. So, if you follow these rules, interviewing will be a breeze. Preparation is the first key to success. This occurs way before anything else; familiarize yourself with the institution, look at its website, the key players, its location, and your interest in going there. Get your references in order, have them done and filed online, and even better, have them with you, in the event there’s a problem. Also, the site for LOR’s for students only allows for a certain size letter, to have it posted most of the time signatures are removed, verbiage is amended, and logos removed. Have the letters in your file and remember to get LOR’s from people who know you and can reflect on your work ethic, character, personality. Letters from people who are acquaintances don’t tell the whole picture of you, and you want your interviewer to know you. Professional appearance counts greatly when you interview. This begins with your selection of a photograph— your photograph. You may think an acceptable photo is one where you’ve cropped out someone, or shows you enjoying a vacation in Maui, but your interviewer looks at it as someone who isn’t ready for prime time.

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A nice photo in business attire without visible tattoos, or piercings is great, and many times organizations, like RSO or ACOEP will sponsor professional photos onsite at meetings; watch for these events and take advantage of them. It’s always great to have a recent photo on hand.

a lot in your speech patterns this can make you sound like you are unable to communicate. Communication with superiors, peers, and patients is important to a good physician. So practice and listen to how you sound to others before you arrive at the interview.

Dress professionally, not provocatively. Men should wear a suit, with shined shoes; women should dress professionally, with sensible shoes. Four inch heals will mostly bring looks of distain, as will low-cut, bust bearing necklines. Piercings and tattoos should not be visible to interviewers.

Be Practical and truthful in your mission statement when stating why you want to be in the program or in medicine. A statement like, “I remember when I was a kid and my best friend and I were playing and he got hurt and we went to the ED

Splurge and have your dress shoes shined, pay a few bucks for a manicure, and brush your teeth. Also, don’t blow people away with your aftershave or perfume. Take time before the interview to listen how you speak. If you use vernacular, hesitation pauses, fillers, like ‘you know’

CONTINUED ON PAGE 7

THE ON-DECK CIRCLE

Robert Suter, DO, MHA, FACOEP-D

YOUR VOICE HAS BEEN HEARD

his edition of The Pulse is dedicated to “education,” which along with “family” are the first two words that come to the minds of many when we think about our College. They are also the crux of all of the recent activities and feelings surrounding ACOEP’s relationship with the American Academy of Emergency Nurse Practitioners (AAENP). For those of you who missed it, over the past two years or so, in response to initial inquiries by the AAENP, ACOEP cultivated a relationship with the AAENP as they sought a comfortable setting and partners to develop high quality educational experiences for their members. The AAENP leadership was immediately impressed with the educational quality of our meetings and our family atmosphere. The ACOEP leadership was impressed by the quality of the AAENP leaders and their intention to improve the quality of education for their members who often are an integral part of our physician led teams. As part of this process ACOEP reviewed the AAENP’s Mission and Values were reviewed (they can be found at http://aaenp-natl.org/ about.php) and found to focus on collaborations and partnerships, and free of advocacy for independent practice. For their part, the AAENP clearly understood that ACOEP is a physician organization with a strong, unwavering belief that all members of the emergency care team including NPs and Physician Assistants (PAs) should only supplement, and never replace emergency physicians. (ACOEP’s policy on “Role of Non-

Physician Practitioners in EM “can be accessed in the Bylaws and Policies section of our website. It was with this mutual understanding that a liaison relationship on both Boards was born and announced to the members of both organizations. Based on the success of these interactions, our Boards were prepared to go to our members to discuss creating a more formal relationship. In the direct democracy that we call ACOEP, that means no predetermined outcomes, it means going to the entire membership to hear their voice and their vote.

EVERYBODY WANTS TO GO TO HEAVEN BUT NOBODY WANTS TO DIE…..” UNKNOWN argument that NPs are engaged in the “advanced practice of nursing” rather than medicine, which is the rationale that has kept NPs free of medical board licensure oversight.

What neither organization anticipated was the major flare of the activities by other NP advocates concerning independent practice occurring over the past few months, to include the “cathopathic physician” movement. Those behind the “cathopathic physician” effort want to declare themselves to be physicians without having to go to the trouble of going to medical school; like the old adage, they want the benefits without following the required path.

While none of this had anything to do with the AAENP directly it has certainly been very ill-timed and we must and want to respect and recognize the impact of these unfortunate developments and how they have made many of our members feel. It also required ACOEP to pause and reassess how we need to adjust activities in our world in light of how events in the bigger world impact us and our members.

These efforts have justifiably upset physicians of all specialties, and the ridiculous logic of those advocating that NPs be independently licensed as “cathopathic physicians” should be especially offensive to us as osteopathic physicians given the historically twisted and inaccurate comparisons that are made to osteopathic medicine in the justification of this “philosophy.” In addition, it flies in the face of the

Due to an initial oversight the proposed Bylaws Amendment that would have allowed for a more participatory relationship with AAENP was determined by the ACOEP Board to violate other sections of the Bylaws. So it will not be voted on. That said, since the very beginning of the discussions with AAENP the leadership of ACOEP actively solicited feedback from members on the relationship; until last month only positive comments were received. CONTINUED ON PAGE 22

APRIL 2018 THE PULSE

“NAILING YOUR INTERVIEW” CONTINUED FROM PAGE 5

and the doctors were just awesome and took care of him and from that time I wanted to be an emergency physician,” will get you farther than something like, “I think I always wanted to be a doctor, but I just don’t know which specialty I want to go into. Emergency medicine sees it all, so I thought I try it.” While you may be a marathon runner or have fifteen cats you love and adore, your personal or mission statement needs to be about what made you take the step into emergency medicine or made you —you. If it’s filled with ‘I did this’ or ‘I did that’ it will be a complete snore, the world as a whole doesn’t care what you did, unless it pertains to that incident caused you to be the best most interesting person out there. Punctuality is the one thing that means a lot to an interviewer. First, it signals that time is important to you; it also shows that you respect their time. So, get to the site with plenty of time to spare. Use the time to prep yourself for the interview, to take that one last look in the mirror to see if your hair is combed and you look presentable. Being late for your interview is a sure sign to the interviewer that you will probably be late for shift. Politeness is a key element in an interview, and it starts with a handshake. You don’t want to arm wrestle with the interviewers, but you don’t want them to feel like they are shaking hands with a limp, dead fish either. A firm handshake is a good way of showing confidence. If you have sweaty hands, powder them down; cold hands explain you’re a little nervous, but be authentic with that handshake; it’s a good first step. Finally, send hand-written thank you notes to the interviewers. Yes we all know writing a thank you note is

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passé and everyone thinks email is universally acceptable, but sitting down, taking a few minutes to write a personal note may be the one thing that puts you over the person in front of you. It’s all about being sincere

and connected and saying thanks for taking time to see me. Good luck!

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ACOEP-RSO PRESIDENT AND DIRECTOR OF STUDENT AFFAIRS REPORT Dhimitri Nikolla, DO, PGY-3 ACOEP-RSO President AHN Saint Vincent Hospital Erie, PA RSOPresident@acoep.org

Christina Powell, OMS-3 ACOEP-RSO Director of Student Affairs LECOM â&#x20AC;&#x201C; Bradenton Bradenton, FL RSOStudentDirector@acoep.org

Welcome to the spring edition of The Pulse! The ACOEP Resident-Student Organization (RSO) has had a busy winter planning for a busy spring! As we write this, Spring Seminar is right around the corner in San Diego! The RSO will host Rapid Fire Student Lectures on topics ranging from common toxicology emergencies to ventilator management followed by EKG and ultrasound lectures, workshops, and competitions with prizes! We are also excited for the FOEM Case Study Poster Competition and to see some of our favorite speakers including Doctors Chris Hicks and Anand Swaminathan. In addition, the RSO board has supported a resolution to change the name and mission of the Undergraduate Medical Education (UGME) Committee to the Resident Student Advisory Committee (RSAC). In light of the transition to a single accreditation system and other changes to our training path including the standardized video interview, we saw a need for a new process to

address issues facing residents and students. This new committee will bring together other key members of the ACOEP including program directors, members of the CME committee, and members of the New Physicians in Practice (NPIP) committee to provide resources and support to our members to enact plans to ameliorate these issues. Next, we will head to the Council of Emergency Medicine Residency Directors (CORD) Saturday, April 21-24 in San Antonio, TX. We will be attending the All EM Resident Organizations and Students (AEROS) Meeting to discuss resolutions to critical issues affecting EM Residents today. In addition, we will be hosting a challenge at Chaos in the ED, an all-around skills competition put on by the Emergency Medicine Residentâ&#x20AC;&#x2122;s Association (EMRA). Lastly, the RSO is looking to host a couple more student symposiums this year! If you are a residency program director or faculty and would like to show off your program, please contact Lindsey Roden (lroden@acoep.org)!

AN OPEN LETTER TO ACOEP MEMBERS Dear Colleagues,

As you may know, a transition in the membership of at the AOBEM occurred at the beginning of this year. The current full board membership will be published on the new AOBEM website. The new AOBEM board contains members who have been previous board chairs, board secretaries, BOS chair as well as executive director. All functions of the AOBEM are continuing as they have in the past. It should be noted that certification in osteopathic emergency medicine is granted by the AOA; not AOBEM. AOBEM is the organization charged by the AOA to conduct and managed the certification and recertification processes. Change always brings questions and we look forward to answering your concerns. Of recent note, confusion has occurred as to the location of the COLA articles on the newly redesigned AOBEM website. They can be found

by clicking on the OCC overview link and then clicking on component 2. We truly look forward to your insights regarding improvements to improvement of the new website. Finally, on behalf of the AOBEM, I would like to extend my sincere gratitude to previous AOBEM members who have worked tirelessly to provide you with a quality certification process. Their principled integrity has continued to build upon the foundation that has distinguished the AOBEM as one of the premier specialty certifying boards in the country. Sincerely, Bryan D. Staffin, DO, FACOEP -D Interim Chair, AOBEM

APRIL 2018 THE PULSE

WHEN OUR WORK HEALS US

By Frank Gabrin, DO, FACOEP

recently gave the Welcome Lecture for the Wellness and Resiliency (WAR) Project to our first class of emergency medicine resident physicians. I launched with why I believe there should be a Surgeon General’s Warning clearly printed on the first page of every application to medical school. WARNING: The Surgeon General Has Determined That Caring for Others Is Hazardous to Your Health It’s a fact the more education you have, the more protected from burnout you should be—unless you are a physician. Recent surveys show the rate of burnout among physicians is 64% and it’s continuing to climb. It has jumped by almost 20 percentage points in the past five years alone.

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While I was going through the symptoms and effects of burnout with these young doctors, I experienced a PTSDlike flashback to my own personal severe case of burnout. I was reliving every one of those symptoms. I remembered exactly how awful I’d felt and how much I’d hated my job. If anyone asked how it’s going, I would snark out, “just living the dream…living the dream!” I remember how irritable I got when something, or someone, got in my way; preventing me from getting a successful patient outcome. How I simultaneously waged ‘war’ against our woefully inadequate and broken medical system; my clueless director, the incompetent and callous hospital administration and countless others who contributed to conditions in an over-crowded emergency department. I remembered how I felt like a victim of circumstance practicing medicine that way. I suffered from woefully low self-esteem levels even though I was simultaneously doing the heroic and impossible each and every shift.

Everything I did was motivated from a place of lack, or worse yet a place of fear. I lived in fear of the patient complaint and the 180-day letter. My focus was always on me and what I needed to do to get my patients what they needed and to avoid bad outcomes, lawsuits, and patient complaints. In the midst of this burnout flashback, I thought about how good it has felt for me to practice emergency medicine lately (even during the two years that I was ill). I’ve been healthy for a few months now, but when I was sick I was in pain all the time and I couldn’t eat. My world shrunk. I quit socializing. The only time I went out of the house was for doctor’s appointments, to run errands or go to work. Now and even then, I love going to work. Rather than feeling burnout from all the stress as I had earlier in my career, my professional life actually nurtures me now. What is different about my practice of emergency medicine from when I was burnt out and now? Why does one style of practice drain, frustrate and exhaust me, while the other style of practice energizes and fulfills me? The research, process, and practice it took to write my book, “Back from Burnout” has fundamentally changed me. My world view is very different than it was before. I now clearly understand the causes of burnout and recognize exactly what I need to do to step right over it. There is more to medicine than meets the eye. There are the things we do that are rooted in the physical world: the history, the physical

exam, the differential diagnosis, the diagnostic plan, the imaging studies, the treatment plan, the procedures, the consultants, the creation of a medico-legally defensible electronic medical record, the medicines and the devices or appliances…and we deliver all of these things as masters of our craft. This is the science of medicine. Then there are the intangibles. During my recent illness, I did not have very good experiences with the doctors (and nurses) who weren’t caring even though they delivered all the physical things as masters of their craft. As a patient, I could feel when the doctor that was taking care of me actually cared. I could tell when they wanted the best for me, when they were looking out for my best interests and when they weren’t. These are the intangibles. So what’s the difference between a doctor who cares and one who doesn’t? None of us would admit to being uncaring. For god’s sake, that’s why each and every one of us went into medicine in the first place. At the end of the day, most of us, even those of us who are suffering from burnout, feel that we’re the only ones who care and that we actually care too much! None of us would admit to being uncaring. We don’t recognize how we aren’t caring but our patients can feel when we care and when we don’t. There is a huge disconnect here: We have to realize that wanting to care, having the desire to care, having the

THE SPECIFIC PRACTICE OF MINDFULNESS SHOWS THE MOST PROFOUND EFFECT ON OUR OVERALL WELL BEING AND ACTUALLY WORKS TO REVERSE BURNOUT, OFFERING US THE PROMISE OF HOPE AND HEALING.” intention to care, does not make us caring. In order for our patients to feel our care, we must do the hard work of caring, and that has nothing to do with the hard work of making a diagnosis or writing a prescription. What are these intangibles of care that we seem to omit because we’re so busy with all the goods and services we provide? • • • • • • • • • • • • •

Presence Connection Focus Empathy (both affective and cognitive) Compassion Kindness Tolerance Hope Mercy Human Dignity Concern Comfort Understanding the Human Condition

APRIL 2018 THE PULSE

What about unconditional love, or love for no reason, and caring for our neighbor as we would like to be cared for? Have you used the “Favorite Uncle Rule recently?” When was the last time you thought about these things when you were working clinically in your Emergency Department? Why not? Because these are not things. These are specific energies which are blends of both our thoughts and emotions (our heart and our head) and they do not exist in the physical world we’re so focused on. All of the research that Tait Shanafelt has done along with the Medscape Surveys and Lifestyle Reports on Burnout and Bias show that there are three actions that we can take that show promise in relieving burnout: practicing mindfulness, volunteering outside the profession and exercise. Of the three, the specific practice of mindfulness shows the most profound effect on our overall well being and actually works to reverse burnout, offering us the promise of hope and healing. What’s the practice of mindfulness? According to the Greater Good Science Center in Berkeley California, “Mindfulness means maintaining a moment by moment awareness of our thoughts, feelings, bodily sensations and our surrounding environment.” Mindfulness also involves acceptance, meaning that we pay attention to our thoughts and feelings without judging them—without believing, for instance, that there is a right or wrong way to think or feel in a given moment. When we practice mindfulness, our thoughts tune into what we’re sensing in the present moment rather than rehashing

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the past or imagining the future.

logical and efficient.

Mindfulness has its roots in Buddhist meditation, but a secular practice of mindfulness has entered the American mainstream, in part through the work of John Kabat Zinn and his Mindfulness Based Stress Reduction [MBSR] program which he launched at the University of Massachusetts Medical School in 1979.

Mindfulness is about focusing our conscious awareness on our thoughts, feelings and bodily sensations in the present moment. According to Zinn, “If you don’t know anything about meditation, it’s about paying attention in a systematic way…for no reason other than to be awake…in the present moment…which is the only time we have to create, to be in a relationship or to love…actually to do anything.”

Since that time, thousands of studies have documented the physical and mental health benefits of mindfulness, inspiring countless programs to adapt the MBSR model for schools, prisons, hospitals, veterans centers and beyond. Why is this relevant to our practice of medicine today? Ever drive home after a long and busy shift in the ED and arrive in your driveway and realize that you “suddenly” were home and that you don’t remember any of the drive? You’d been on autopilot for the past 45 minutes. You were lost in your thoughts about what happened at work earlier and what you were going to cook for dinner when you got home. In other words, your consciousness, your mind, was focused on the past or the future. You at no time had any conscious awareness of what you were sensing or feeling in the present moment. I don’t know about you, but I know this was how I used to practice medicine. If a feeling or a personal thought came up, I quickly pushed it away, so I could stay objective, rational,

He goes on to say that “Mindfulness in Chinese is a combination of two ideograms. The ideogram for presence sits over the ideogram for the heart, so that when you hear the word for mindfulness, you have to understand it’s the presence of heart.” The essence of mindfulness is that you are constantly focusing on the present moment while you head is monitoring what’s happening in your body. When we practice mindfulness, when we pay attention to or focus our conscious

MINDFULNESS IS ABOUT FOCUSING OUR CONSCIOUS AWARENESS ON OUR THOUGHTS, FEELINGS AND BODILY SENSATIONS IN THE PRESENT MOMENT.”

awareness on our present thoughts and feelings. We step into a world that we’re not all that familiar with, and it can be scary, especially since we’re so distracted by our environment that we hardly ever go here. It’s only in the present moment that we can actually care for another and it’s only here that our care can be effective. This is where our care can change things. Care requires us to connect our thoughts to our feelings, or in other words, connect our head to our heart. Care requires us to connect to our patient. This is the place where we can really reap the benefits of presence, connection, focus, empathy, compassion and compassionate action. It’s only in this energetic space while we’re connected to our patients that we have the opportunity to create meaning, significance, and healing on both sides of our stethoscope. The beauty of mindfulness clinically is that it allows us to freely make the decision to consciously enter the space of compassion and I know beyond a shadow doubt that our compassion for others is the key to our own recovery from burnout. What’s compassion? Dr. Dacher Keltner defines compassion as our concern to enhance the welfare of another who’s suffering or is in need. I say it’s just our heartfelt desire for things to be better for our patient.

Compassion is not empathy. Empathy is a feeling that rises up from our brainstem and our amygdala, rooted in the primordial

brain, that allows us to feel another’s pain. It happens automatically. We are hardwired neurologically to recognize pain in others. The process runs under our conscious awareness and we have no way to shut it down.

IN ORDER FOR OUR PATIENTS TO FEEL OUR CARE, WE MUST DO THE HARD WORK OF CARING, AND THAT HAS NOTHING TO DO WITH THE HARD WORK OF MAKING A DIAGNOSIS OR WRITING A PRESCRIPTION.”

Our brain cannot tell the difference between physical and emotional pain. When our peripheral nervous system experiences a cut, our brain interprets those sensations as pain. When we are rejected by another our brain interprets the negative emotions we feel as pain. The same negative centers in our prefrontal cortex light up. Our brain is also incapable of distinguishing our own pain from someone else’s. When we see someone in pain, we feel their pain. If we do nothing to alleviate this pain, we’ll carry it with us. What happens to those of us who confront pain and suffering every single working day? We keep taking on more and more pain. The centers that register pain in our prefrontal cortex become overstimulated and elaborate negative neurotransmitters. These saturate and drain the rest of our brain leading to the intense levels of physical and emotional exhaustion we feel. Burnout is the result of this empathetic overload. The reason this happens to us is that we are trained to manage our

automatic empathy by maintaining some “professional” distance from our patients. We are taught to set firm boundaries and are warned not to get too close because their pain will overwhelm us and we won’t be able to stay rational and make appropriate medical decisions. The problem is this mandate doesn’t work. We can’t stop the cumulative effects of empathy because it is automatic. Only by practicing mindfulness and allowing the caring process to come to its natural conclusion can we override the empathetic overload we have been taught to carry. It’s in our own best interest to practice mindfulness and focus on compassion for others while we’re working clinically in our busy emergency departments. When I’m mindfully practicing medicine, I make the conscious effort to use my protocol for generating true care: 1.

I get present.

2. I connect to my patient.

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3. I generate a laser sharp focus on their needs. 4. Then I allow affective empathy to arise in my amygdala/ brainstem and engage in generating cognitive empathy by getting curious about their pain. This is where I move the experience from my brainstem to my prefrontal cortex. 5. This is where my compassion is activated and generates my desire that things were somehow better for my patient, or perhaps a family member who is sharing their suffering too.

Once I’m full of compassion, my overloaded, empathetic centers in my prefrontal cortex begin to relax and down-regulate. All the centers that are active in the full and rich experience of compassion begin to light up and drip dopamine, oxytocin, and other positive neurotransmitters that wipe my brain clean of pain and suffering augmenting my abilities of diagnosis, calculation, spatial perception and enhancing my physical strength.

not complete until we make that compassionate action. I most often do this while I’m performing the history and doing the physical exam. The whole process is usually complete before I order the tests or give the medicines. I feel fully awake and alive and for a brief moment in time, my physical pain and suffering is eased as well. No wonder I came to love going to work and why, when I was ill, it was the only place I could find relief. I can hardly wait until the day comes that this becomes part of the evidence based medicine we’re so fond of. I know with every fiber of my being that this is the cure for all of our collective suffering and it actually brings me to tears that so many of my colleagues are suffering needlessly. All I ask is that you give mindfulness and my protocol for generating pure care a try. Until next time, Go Care, Make a Difference and Change (y)our World!

When I finally feel full of compassion, my patient’s face usually relaxes and both our breathing slows and our pulse decreases.

6. It’s from here that I take the final step in the true care process and say, or do, something compassionate. It’s

“CME—WHERE ARE WE HEADED” CONTINUED FROM PAGE 4

of the education provided. High fidelity simulation and virtual reality seem to be poised to add value to these type of activities in the future. It will be interesting to see how realistic training and education can become without working on a live human for practice. Your college continues to strive to provide the most current information in an informative and engaging manner through its various CME offerings during the year. The two

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major CME events in Spring and Fall have been designed to meet all your CME needs. In addition to offering AOA CME credit, ACOEP has been able to offer ACCME credits for physicians through joint sponsorship programs. ACOEP is in the final stages of obtaining its own ACCME accreditation to be able to offer this credit to its members at all our CME events in the future. Additionally, we offer CME credit for our board review courses both

oral and written. In addition, our FOEM research competitions are eligible for 1A credit as well. ACOEP also offers online CME credits via its website that can help fulfill requirements any time you need, with plans in the works to offer more and different online opportunities. The COLA reviews are available here as well. The ACOEP CME committee engages in many hours of discussion and preparation in order to ensure the highest quality program for you, our members.

BEN FIELD,

DO, FACOEP MENTOR, TEACHER, PHYSICIAN, FRIEND By Janice Wachtler

f I had to describe Ben Field, I’d say he was awesome. I met Ben on the first day I came to work at ACOEP; it was September 28, 1992. He stood with his arms crossed and watched as I put about 200 papers in a box and finally said, “You could just have the copy service pick these up—you don’t have to bring them down to them.” Blowing a strand of hair out of my face, I said, “So now you tell me?” At that point we both just started to laugh; Ben made a call and, sure enough the papers were rolled away only to be brought back the next day to be mailed out to the reviewers. Little did I know from that day on for more than 12 years, I would talk to this man every day of the work week—even some weekends. Ben and I worked on the CME programs that are now the backbone of the ACOEP. The programs weren’t nearly as sophisticated as they are today—but for the time we were in they were damn good when compared to other specialty groups and we could hold our own in the education arena. We scoured medical magazines, articles, and lectures to get the best speakers to make the best programs, working remotely—using a fax—we proofread and developed the lectures, and questions for the Intense Review. And only Joe Kuchinski knows how many meals we ate in Ally’s Bakery at the Marriott at O’Hare, as the three of us ran the Intense Review. We lost Ben to a cerebral aneurism in July 2004—it was one of the hardest days of my life. I sat and waited by the phone to hear his condition and finally, his partner called to tell me it was over—I felt empty, knowing I’d lost a dear, dear friend. And that’s why I’m writing this article, it’s time we, as a College, work to remember Ben in more ways than a Mentor’s award. I’d like to establish a scholarship in his name at the Foundation, after all, he was the developer of that too.

Ben had a lot of sides to him; he was political, environmentally conscious, and believed in always being there for people in need, especially for his colleagues in emergency medicine. I’ve toiled with what kind of scholarship would best fit him, because he was so complicated; should it be a grant to help someone over a rough patch with loans? Should it be for gay physicians who have undergone prejudice in the workplace to get a new start somewhere else? Should it be for humanitarian missions only? And then I thought, no, it should be a fund to assist physicians to become better educators—because in the end, it’s the best way to pay it forward. So, I’d like to begin the Benjamin J. Field, DO, FACOEP Medical Education Scholarship, created through the Foundation for Osteopathic Emergency Medicine (FOEM). This would be available to physicians seeking degrees in education and evaluation. This would include, Master’s Degrees in Education (M.Ed.); Master of Science in Education (MS. Ed); Master of Arts in Teaching (MAT), Master of Arts in Teaching & Cultural Competency (MATLCC), or Masters in Medical Education Leadership (MMEL). Because this is a new scholarship, offerings will initially be limited to small amounts, perhaps $1,000 to $5,000, but as the funds grow from interest and donations it could possibly be more and that depends on you. Ben made an impact on the College and the field of emergency medicine. He, like others who worked diligently to define processes for not only residency training but for certification in emergency medicine. Physicians who are long-retired or passed away toiled to develop criteria for certification which was granted in 1980—nine years ahead of the medical community. These same people defined rotations and standards for residency training, taught others to be program directors, inspectors, and lecturers. And, we need to continue our dedication to excellence in education. I think this fund will do that. So please join me in donating to establish this Medical Education Scholarship by sending your donation to:

Benjamin A. Field, DO, FACOEP Medical Education Scholarship Foundation for Osteopathic Medicine 142 E. Ontario Street Suite 1500 Chicago, IL 60611

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ACOEP’S CME PROGRAMS:

THE FOREFRONT OF EMERGENCY MEDICINE By Gabi Crowley Digital Media Coordinator

hether it’s adding a new track, workshop, or highprofile speakers, ACOEP has made it a priority to provide the best in continuing medical education.

“Medical education is constantly evolving in how providers consume and integrate their knowledge into their practice. Adding different ways of delivering content to our attendees (i.e. Tachy Tracks, ICYMI, workshops, etc.) hopefully keeps them stimulated, but also increases the retention of the topics we discuss during the conference,” said Terry McGovern, ACOEP’s CME Committee’s

Associate Director. “I think we truly now offer some of the best CME and are at the forefront of emergency medicine practice. When people leave an ACOEP conference they can be confident that they are now up to speed with the latest and greatest concepts in EM.” One way that ACOEP’s programs have grown and become successful is by developing conference programming tailored to serve and satisfy member needs, which is often molded from member input. According to ACOEP’s Director of Education Services, Kristen Kennedy, “We look at the needs of our learners through survey feedback, trending topics, state requirements, and implement the best education possible for them. In completing the Needs Assessment for each conference, this allows us to better understand our learners and provide them with the best possible education to ensure they can go back to their practice and implement the most up-to-date information and techniques.” In addition to ACOEP’s conferences offering attendees Category 1A Credit, the College, in sync with today’s technology-driven society, created a digital learning classroom where members can receive Category 1B Credit by viewing various recorded lectures from past conferences. “It is gratifying to see the number of digital course offerings grow each year. Over the past 10 years, there have been rapidly developing innovative changes that have made each conference better than the one preceding it,” ACOEP’s President, Christine Giesa, DO, FACOEP-D said.

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And it doesn’t just stop at the College’s conference and online classroom platforms. ACOEP’s Education Department is actively working on offering other opportunities for medical professionals to attain CME throughout the year. “On top of our online learning classroom, we’re looking to expand our online educational offerings to provide learners with more options when it comes to obtaining CME credit throughout the year,” ACOEP’s CME Manager, Ty Jackson said.

While ACOEP’s programs and CME opportunities continue to expand and change, the unique camaraderie and close-knit feel seems to always remain the same. “No matter how big we get, there’s a warmth that our meetings have,” said Executive Director, Jan Wachtler. “They’re welcoming, people know your name, speakers talk to the participants, it’s someplace everyone from the students to the established physicians feel at home and welcome.”

THEY’RE WELCOMING, PEOPLE KNOW YOUR NAME, SPEAKERS TALK TO THE PARTICIPANTS, IT’S SOMEPLACE EVERYONE FROM THE STUDENTS TO THE ESTABLISHED PHYSICIANS FEEL AT HOME AND WELCOME.”

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FOAMed’s Neat, So You Should Tweet By Gabi Crowley, Digital Media Coordinator

echnology is constantly changing. It’s no surprise that today’s latest social media platforms have played a large role in advancing medical education.

While millions of people worldwide use social media platforms as a way to keep in touch with others, many medical professionals use these platforms to connect with colleagues, meet medical professionals, and to share medical advice while learning from others through Free Open Access Meducation, popularly known as FOAMed. From research, to podcasts, to blogs, to social media channels, FOAMed is made up various sources that are used as teaching platforms without any costs to the user. According to REBELEM.com, FOAM is defined as “an interactive collaboration of like-minded individuals, free of geographic hindrances and time zones, with one single goal…to make the world of medicine better.” Therefore, FOAMed, is the conversation that stems from the overall concept of FOAM. And although FOAMed is NOT simply just the use of social media, social platforms play a pivotal role in its distribution and reach. Out of all of the social platforms used today, Twitter is one of the top platforms when it comes to using FOAMed on social media. Unlike Facebook, Twitter allows users to connect with anyone that has a public profile, without requiring an invitation or acceptance. Using the hashtag #FOAMed on Twitter,

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allows FOAMed users to filter and scroll through various medical topics and opinions other FOAMed users are discussing online as well. Twitter is a constant stream of up-to-date, minute by minute information all coming from the accounts you choose to follow, making it a user-friendly source, that individuals can tailor exactly to meet their interests. If you’re not on Twitter yet, what are you waiting for? Setting up an account is a simple process, that will grant you access and connect you to fellow colleagues, as well as the most relevant medical information out there. RESOURCES Got FOAM? (2017, October 17). Retrieved February 20, 2018, from http://rebelem.com/got-foam

If you’d like help or have any questions creating a Twitter account, please feel free to reach out to ACOEP’s Digital Media Coordinator, Gabi Crowley at gcrowley@acoep.org for assistance.

ONCE YOU CREATE AN ACCOUNT, CHECK OUT THIS LIST OF SOME OF OUR FAVORITE TWITTER ACCOUNTS TO FOLLOW BELOW CREATED BY ACOEP’S RSO: Saint Emlyn’s @stemlyns

The American College of Osteopathic Emergency Physicians @ACOEP

Mel Herbert @MelHerbert

ACOEP Resident Student Organization @ACOEPRSO

Howie Mell @DrHowieMell Seth Treuger @MDAware

Nilesh Patel @nnpatel1291

Mark Reid @medicalaxioms

Salim Rezaie @srrezaie

Ryan Radecki @emlitofnote

Annahieta Kalantari @akkalantari

Scott Weingart @EMCrit Esther Choo @choo_ek

Rob Rogers @EM_Educator Michelle Lin @M_Lin Steve Carroll @embasic Anand Swaminathan @EMSwami Rob Orman @emergencypdx Reuben Strayer @emupdates Haney Mallemat @CriticalCareNow Rob Cooney @EMEducation CoreEM @Core_EM

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Are You Ready for the Launch of the FOEM Research Network? Calling residents, researchers, program directors, and pharma reps! The FOEM Research Network is launching this spring. This state-ofthe art, easy to use website connects researchers, residents, and research sites. Users can search by research topic, location, and more to help get your finger on the pulse of the most cutting-edge research in EM.

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BIG THINGS ON THE HORIZON WITH FOEM RESEARCH NETWORK By Erin Sernoffsky Director of Media Services

hat began as the brain child of Victor Scali, DO, FACOEP-D over 20 years ago is about to be fully realized—the FOEM Research Network (FRN) is nearly ready to launch. The FRN is a state-of-the-art, interactive platform linking researchers to national research opportunities, and research sites, such as hospitals and universities to funded research opportunities from pharma or device manufacturers. “The FOEM Research Network is a searchable database that consists of three components,” says FOEM Executive Director Stephanie Welter. “Researchers can search our national database for multicenter research opportunities; research sites can update their dashboard with current demographics and information and broadcast any research opportunities they may have; and clinical research organizations, such as pharma or device companies, can search the national database to find appropriate sites to pilot their products, creating a potential revenue stream for chosen sites.”

The FRN will compile research statistics and information from research sites across the country, creating one central location for students and residents in need of opportunities to fulfil their requirements, pharma companies, looking for streamlined site selection or attending physicians interested in connecting with similar or other relevant projects. “There really is no one-stop-shop to access opportunities on this scale,” says Welter. “Our network would compile data from over 100 research sites that can be used by researchers of all calibers, from students to big pharma. We want to be the place to go to link researchers and research opportunities.” The user-friendly interface makes it easy to search research projects based on area of interest and geographic location. This would allow a resident looking to get involved in a

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OUR NETWORK WOULD COMPILE DATA FROM OVER 100 RESEARCH SITES THAT CAN BE USED BY RESEARCHERS OF ALL CALIBERS, FROM STUDENTS TO BIG PHARMA. WE WANT TO BE THE PLACE TO GO TO LINK RESEARCHERS AND RESEARCH OPPORTUNITIES.”

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cardiology study in the Midwest instant access to all appropriate ongoing projects. Already over 90 prestigious programs have joined the FRN with many more to come as the new site launches. Programs will each have access to a unique log in and easy portal to update site statistics, ongoing projects, and needs. ACOEP RSO Member Aadil Vora has been an important member of the FRN planning committee. “The FRN is the only database and directory of its kind, dedicated solely to emergency medicine academics at emergency medicine residency programs. Additionally, it is free to use for students, residents and academicians,” says Vora. Vora, a fourth-year medical student at Nova Southeastern University College of Osteopathic Medicine knows firsthand of the pressures associated with fulfilling ACGME and AOA-mandated

research requirements for graduation. “I am most excited about the new student accessibility tool in the FRN that will enable medical students to find EM research opportunities,” he says. “Medical students at several schools that do not have a robust department of emergency medicine or an emergency medicine residency program could use the FRN to find research and mentorship opportunities. Medical students are educated and enthusiastic; they would love to be temporary or even long-term research assistants on EM research projects.” The FRN is on pace to launch this April, with more great things to come this summer. Check www.frn.foem.org to explore this cutting-edge tool.

“YOUR VOICE HAS BEEN HEARD” CONTINUED FROM PAGE 6

Bernard Heilicser, DO, MS, FACEP, FACOEP-D

What Would You Do? Ethics in Emergency Medicine

The following dilemma was presented to us by a paramedic. A crew was dispatched to a local Urgent Aid for a 70 year-old female who had fallen and struck her head, the patient was on anticoagulant medication. The treating physician had made arrangements to have her transferred to their affiliated hospital emergency department. Assessment by EMS demonstrated the patient to be “a little restless… complaining of a headache.” She was fully alert with normal vital signs. The patient then became slightly disoriented. The crew asked the physician if he would consider transferring the patient to a Level 1 Trauma Center, concerned for a possible intracranial bleed. The physician told EMS to run it by the accepting ED. In the ambulance, the patient deteriorated, becoming nonverbal and only responding to pain. The ED was contacted and a request for diversion to the Trauma Center was strongly expressed. The ETA was an additional eight minutes. This request was denied by medical control. You know the diagnosis, a large bleed. This same crew was later called to transfer the patient to a different Level I Trauma Center that had an arrangement with the initial receiving hospital. When questioned, the ED staff stated the first Trauma Center “was known to let their patients just sit around, anyhow.” This situation was most frustrating for the EMS crew. What could they have done to change the scenario? Should they have ignored the established transfer?

Given recent concerns we very much want to hear all member thoughts on our collaboration with any group. Therefore, we will continue to hold a Town Hall in collaboration with AAENP at Spring Seminar and will make arrangements for members who cannot be there to provide comments on-line or by skype. We are and always will be a physician-driven organization that places education at the center of our core values. We will not compromise on the necessity for our patients to have their care directly provided by physicians who have completed medical school and residency, or other team members under the supervision of those physicians. We will not compromise on the quality of the initial and continuing education of all members of the emergency care team, and we are committed to providing leadership to ensure that it is accessible to team members who share our family values. Indeed, all of us work as leaders of inter-disciplinary teams, and many consider them to be our work families and extensions of our ACOEP family. Many of us have non-physician emergency care providers in our biological or matrimonial families as well— spouses, parents, siblings, and children. In my own case, my wife is an emergency nurse who now practices under the supervision of a DO as a family nurse practitioner. So I for one hope that none of our various family relationships suffer longterm damage as a result of recent events. Perhaps I am overly optimistic, but I feel that they don’t have to if we all continue to show each other courtesy and mutual respect. Again, we absolutely want and need you to be a part of our successful navigation of the very complex environment we live in to create the future that we want. Our journey will always be as transparent as possible, and as this issue demonstrates we will highly value your contributions and keep you in the loop. Nothing has changed in the way ACOEP approaches our challenges. Together we will develop a shared vision of success, and together we will achieve it.

What would you do? Please visit www.acoep.org/newsroom and share your thoughts on this case.

If you have any cases that you would like to present or be reviewed in The Pulse, please email them to us at esernoffsky@acoep.org. Thank you. APRIL 2018 THE PULSE

SAVE THE DATE TUESDAY, OCTOBER 23RD 2018

Celebrate FOEMâ&#x20AC;&#x2122;s 20th Anniversary at the FOEM Legacy Gala: Dinner and Awards Show!

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FOEM FOCUS T

he team at FOEM is working harder than ever to provide exciting opportunities for ACOEP members and all hardworking students, residents, and physicians in emergency medicine. For the first time ever FOEM lifetime donors of $2,500 or more were invited to the FOEM VIP Donor Lounge at the 2018 ACOEP Spring Seminar. This fun thank you to our supporters is a chance to relax, enjoy food and drinks, and downtime with fellow FOEM champions. The Donor Lounge isn’t the only exciting event at Spring Seminar which also features two FOEM favorites—the FOEM 5K and 1-Mile DO Dash, as well as the FOEM Case Study Poster Competition . Speaking of celebrating FOEM’s supporters, plans for the 2018 Legacy Gala in Chicago are already underway! What better way to celebrate 20 years of FOEM in style than with a Roaring 20’s party? Don your pinstripe suits and flapper dresses as you enjoy our prohibition-style cocktails and entertainment! FOEM certainly has a lot to celebrate this year with more Scholarly Activity opportunities than ever. Are you a Program Director or Core Faculty looking for scholarly activity? Take advantage of what FOEM has to offer!

FOEM Competitions All five FOEM Competitions are now open to attending physicians, not just students and residents! Not ready to make an oral presentation? Serving as a judge will get you scholarly activity as well, so sign up today by contacting Stephanie Welter at swhitmer@foem.org! FOEM Research Network The FOEM Research Network is in its final stages of website design and is due to be launched in April. The site will consist of three sections: researchers can search the site to find multicenter research opportunities nationwide; research sites (hospitals and universities) can update their dashboard to include up-to-date demographics and information as well as research opportunities; and clinical research organizations (device manufacturers or pharma) can search the site for attractive research sites to pilot their products. Be sure to keep an eye out for this exciting opportunity to engage on multiple levels!

will soon be recruiting workgroup members to analyze the results, which is eligible for scholarly activity as well as monetary funding. If interested, contact Stephanie Welter at swhitmer@foem.org. Research Review Resource Each year, the ACOEP Research Committee reviews research papers submitted via the online portal. Papers are primarily submitted by senior residents, but the portal is now open to all researchers looking to have their work reviewed. There are two ways to get involved for scholarly activity—submit a paper for detailed feedback which boosts your chance of publication dramatically or volunteer as a paper-reviewer.

Grant-funded research FOEM funds research projects annually and is currently funding Dr. Mike Allswede’ s ACOEP-ACGME Paradigm Research Project. The goals of the project are to capture the costs, satisfaction, and quality associated with adopting a new accreditation paradigm. The project

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WHAT’S NEXT FOR ACOEP’S COUNCIL FOR WOMEN IN EMERGENCY MEDICINE? By By Gabi Crowley, ACOEP’s Media Services Coordinator

ith over 70 women in attendance at ACOEP’s Council for Women in Emergency Medicine meeting at the 2017 Scientific Assembly in Denver, CO, the Council has become a force in ACOEP, proving how needed this initiative is. While the Council’s boost in meeting attendance is significant, this year also expanded its executive board, naming Annahieta Kalantari, DO, as Vice Chair, and Angela Carrick, DO, as Public Relations Chair. And as if an expanding membership isn’t exciting enough, the Council is gearing up to have its first-ever specialized lecture track at the 2018 Spring Seminar in San Diego, CA. “The lectures will foster confidence and clarity in areas that women have no blueprint to follow such as ‘mom guilt‘ and feeling unworthy of our titles. We want the topics and the speakers to be relatable to our lives as female emergency physicians,” Dr. Carrick said.

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This specialized track will feature physicians Jamie Hope, MD, and Rebecca Elia, MD, and will include topics such as effective communication practices, overcoming Imposter Syndrome, and female leadership. With today’s ever-present battle for equality, and in this specific case, gender, the Council hopes to be a support system for women in the field of emergency medicine. “In addition to the everyday rules and metrics, we must overcome biases that exist. There are countless examples. We get paid less. We are expected to communicate in a fashion that meets other’s expectations of how we as women should communicate. Our hard work and degrees are ignored as we are often called ‘Mrs.,’ Sweetie,’ ‘Honey,’ and ‘nurse.’ We have the unique ability to birth children which leads to issues of scheduling, leave, and breast feeding,” Dr. Kalantari said. “Sharing stories is powerful. We plan to provide

SHARING STORIES IS POWERFUL. WE PLAN TO PROVIDE RESOURCES TO OUR MEMBERS TO BETTER EDUCATE THEM WHEN FACED WITH THESE ISSUES.”

resources to our members to better educate them when faced with these issues.” With members sharing their own experiences, the Council is building a community which female physicians can turn to when they’re in need of an outlet that shares common values, beliefs, and struggles other women in emergency medicine face. “We hope to bring camaraderie and mentorship to women physicians in an environment where we are often the minority. Our programs will teach women in emergency medicine how to become leaders in our job, effectively work through problems with gender biases, and prevent critical issues with burnout and suicide,” Dr. Carrick said. Dr. Carrick, who is involved with planning this year’s lecture track, says being a part of the Council has provided her with opportunity to meet women in every phase of their careers and lives, which ultimately led her to mentoring a medical student who will soon be joining Normal Regional Hospital’s residency program, where Dr. Carrick is employed. “I have developed friendships, but am also learning professional tools on how to empower myself and others as a female physician in areas of bias in our workplace.”

Please visit ACOEP.org/spring for more information and to register for ACOEP’s Council for Women in EM’s events at Spring Seminar.

APRIL 2018 THE PULSE

C H I C AG O Celebrating ACOEP’s 40th anniversary in our hometown

October 21 – 25, 2018 Chicago Marriott Downtown Magnificent Mile Visit acoep.org/scientific for more information

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“THE NEW FACE OF MENTORING” CONTINUED FROM PAGE 3

We can learn new tricks of the trade that may help us in the treatment of a patient. We form trusted friendships that may help us with stress and burnout. Mentors and friends from a different generation can often offer valuable insight to our experiences that we may not have considered. Most of all, we realize that we are not alone and our trials and tribulations are not unique to us. All of us are experiencing the same difficulties regardless of age. When I look at the Board of Directors, I see a cross representation of the generations. There are 9 Boomers, 5 Gen Xs, and 3 Millennials on the Board. The Millennials are the largest generation in the workforce.

We need these young physicians on our committees and advancing in leadership roles. We can offer these young physicians wisdom and guidance from our life experiences; however, they can offer us so much more. Age has no bearing on who is to be a mentor or a mentee. I have one Millennial and one Centennial living in my house, and I value their work ethic and approach to life. As a Boomer, I am never too old to learn something new. If I need help, I will always seek out those who can best teach me regardless of age. Gen Xers, you may be sandwiched between the parent–child generations, but you hold a unique position. As the intermediary group, you can have

a great impact on both generations. Your opinions and guidance will be more readily accepted and appreciated by those before and after you. Do not hesitate to offer your guidance. Millennials do not hesitate to share your thoughts and advice as to how the College needs to change as we move into the future. Seek out the more experienced physicians to be your mentor and accept the challenge to be a mentor to physicians who are your senior. Senior physicians do not be embarrassed to have a mentor much younger than you. These young physicians have so much to teach us if we just listen. I assure you that both mentors and mentees will be blessed.

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CALL FOR SUBMISSIONS

CPC-EM encourages submissions from junior authors and countries with developing emergency medicine programs

The Western Journal of Emergency Medicine is very happy to be celebrating

Check out our latest manuscripts at WestJEM.org

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