Official Publication of the Florida College of Emergency Physicians A Chapter of the American College of Emergency Physicians
FCEP: Strengthening our EM Community in 2024
Reflecting on a Year of Connection and Collaboration
› Flexible Scheduling › Competitive Pay
› Pre-tax CME Account › RVU Production Bonuses
› Partnership Opportunity › Occurrence Based Med Mal
› Company Paid Health Insurance Life, 401K & Disability
› Membership in Trade Organizations such as ACEP & FCEP
› Quality Lifestyle
Melissa Keahey, Executive Director
Volume 31, Issue 2
EMpulse Magazine is the official publication of the Florida College of Emergency Physicians
EDITOR-IN-
MANAGING
Latha Ganti, DO, FACEP, FAAEM Lganti@hotmail.com
Tatiana Martin tmartin@emlrc.org
Jennifer Finley, Greg Hunter Speedway Custom Photo Lab
PUBLISHER:
Johnson Press of America, Inc. 800 N. Court St. Pontiac, IL 61764 jpapontiac.com
EMpulse Online
In addition to the content in this magazine, there is even more online!
Online content includes:
• Fall 2024 Residency Program Updates
• Medical Student Council Report
• Case Reports
• Feature Articles
Call for Content: EMpulse is now publishing articles and updates online on a rolling basis. A print issue will be published once a year with content selected by the Editorial Committee.
Dr. Latha Ganti
FROM THE EDITOR’S DESK
By Latha Ganti, MD, MS, MBA, FACEP lathagantimd@gmail.com
Publishing at FCEP has expanded! Under direction of the board and the talented help of the editorial committee, FCEP will have not one, but two publications.
After much anticipation, we are pleased to reveal our new academic journal, the Florida Journal of Emergency Medicine (FJEM). FJEM was born out of a desire to support our members with fast, free, open access publication. The journal will focus on publishing members’ scholarly activity, including clinical images, case reports, research studies such as surveys, retrospective and prospective cohort studies, educational research, and reviews including narrative, systematic, and scoping ones. The website for submission is live! We invite you to submit an article by scanning this code:
The journal is fully open access and FREE to our members.
We are actively seeking content, as well as reviewers.
Our beloved magazine EMpulse (ISSN 1558-1101) will continue to publish both continuously online and once a year, in print. We are actively looking for submissions to EMpulse, which will feature member and program news, FCEP updates, legislative and advocacy pieces, and more. Submit your content to EM pulse here:
Thank you to my amazing editorial committee: Drs. Rajiv Bahl, Shayne Gue, Carmen Martinez, Caroline Molins, and Diana Mora—all rockstars!
EMpulse Fall/Winter
All advertisements in EMpulse are printed as received from advertisers. The Florida College of Emergency Physicians does not endorse any products or services unless otherwise stated. FCEP receives and distributes employment opportunities but does not review, recommend or endorse any individuals, groups or hospitals that respond to these advertisements.
Opinions stated within articles are solely those of the writers and do not necessarily reflect those of the EMpulse staff, the Florida College of Emergency Physicians, our advertisers/sponsors, or any of the institutions our writers are affiliated with.
Florida College of Emergency Physicians Board of Directors:
PRESIDENT
Todd Slesinger, MD, FACEP, FCCM, FCCP
PRESIDENT-ELECT
Saundra Jackson, MD, FACEP
VICE PRESIDENT
Blake Buchanan, MD, FACEP
SECRETARY-TREASURER
Shayne Gue, MD
IMMEDIATE PAST-PRESIDENT
FEMF/EMLRC
IS ACCREDITED BY THE ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION (ACCME) TO PROVIDE CONTINUING MEDICAL EDUCATION (CME) HOURS FOR PHYSICIANS.
We have worked with and accredited several events offered by ITLS, TCEP, NAEMSP, FADAA, and MARSI. FEMF/EMLRC also is accredited by the Florida Department of Health, Bureau of EMS; the Commission on Accreditation of Pre-Hospital Continuing Education (CAPCE); and the Florida Board of Nursing.
FEMF/EMLRC conducts a limited number of joint sponsorships to provide continuing medical education credits to outside organizations for their CME activities.
Joint sponsorship will be considered under the following basic conditions:
• CME activity is consistent with EMLRC’s CME mission.
• Organization is not an ACCME-defined commercial interest.
• Organization agrees to follow EMLRC’s terms, including its processes and policies, participation of EMLRC staff or physicians in the planning meetings, and payment of a fee based on the complexity of the activity.
• Upon fulfillment of these basic conditions, EMLRC’s Application for Joint Sponsorship will be forwarded for completion. Applications are then forwarded to EMLRC’s Medical Director and/or Education & Academic Affairs Committee for final approval.
For more information on EMLRC’s Joint Sponsorship process for CME activities, please contact:
Diane Bennett, CMP Director of Education & Events dbennett@emlrc.org, 407-281-7396 ext. 222
Jordan Celeste, MD, FACEP
EXECUTIVE DIRECTOR
Melissa Keahey
MEMBERS
Rajiv Bahl, MD, MBA, MS; Tom Bentley, MD, FACEP; Ricki A. Brown, MD; Latha Ganti, MD, FACEP; Kyle Gerakopoulos, MD, MBA; Jesse Glueck, MD; Eliot Goldner, MD, FACEP; Sara Kirby, MD; David C. Lebowitz, MD, FACEP; Kristin McCabe-Kline, MD, FACEP, FAAEM, FACHT; Brandy Milstead-Hollingsworth, MD; Diana Camila Mora-Montero, MD, FACEP; Jeremy K. Selley, DO, FACOEP; Michael Thompson, MD; Zach Terwilliger, MD; Josef Thundiyil, MD, MPH, FACEP; Christine Van Dillen, MD, FACEP; Cristina Zeretzke, MD, FACEP
Florida Emergency Medicine Foundation Board of Directors:
PRESIDENT
Ernest Page, MD, FACEP
VICE PRESIDENT
Roxanne Sams, MS, ARNP-BC, MA
SECRETARY-TREASURER
Jordan Celeste, MD, FACEP
MEMBERS
Jay L. Falk, MD, MCCM, FACEP; Vidor Friedman, MD, FACEP; Jaime Greene, BA, MS, EMT; James V. Hillman, MD, FACEP; Michael Lozano, Jr, MD, FACEP; Thom Mayer, MD, FACEP, FAAP, FACHE; David C. Seaberg, MD, FACEP; Bryan Spangler
The Florida College of Emergency Physicians (FCEP) and Florida Emergency Medicine Foundation (FEMF) are nonprofit organizations dedicated to advancing emergency care through education and advocacy.
FCEP BOARD OF DIRECTORS 2024 - 2025
EXECUTIVE LEADERSHIP
BOARD MEMBERS
RAJIV BAHL, MD, MBA, MS
KYLE GERAKOPOULOS, MD, MBA
JESSE GLUECK, MD
TOM BENTLEY, MD, FACEP
RICKI A. BROWN, MD
LATHA GANTI, MD, FACEP APPOINTED, NON- VOTING
ELIOT GOLDNER MD, FACEP
BRANDY MILSTEADHOLLINGSWORTH, MD
DIANA CAMILA MORA-MONTERO, MD, FACEP
SARA KIRBY, MD
DAVID C. LEBOWITZ, MD, FACEP
KRISTIN MCCABEKLINE, MD, FACEP, FAAEM, FACHT
JEREMY K. SELLEY, DO, FACOEP
CHRISTINE VAN DILLEN, MD, FACEP
CRISTINA ZERETZKE, MD
MICHAEL THOMPSON, MD
ZACH TERWILLIGER, MD
JOSEF THUNDIYIL, MD, MPH, FACEP
TODD L. SLESINGER, MD, FACEP, FCCM, FCCP PRESIDENT
SAUNDRA JACKSON, MD, FACEP PRESIDENTELECT
BLAKE BUCHANAN, MD, FACEP VICEPRESIDENT
SHAYNE GUE, MD SECRETARYTREASURER
JORDAN CELESTE, MD, FACEP IMMEDIATE PAST PRESIDENT
PRIORITIES FOR PROGRESS AND ENGAGEMENT IN EMERGENCY MEDICINE
By Todd Slesinger, MD, FACEP, FCCM, FCCP FCEP President
In July, I had the privilege of accepting the FCEP Presidents gavel from my esteemed colleague and predecessor, Dr. Jordan Celeste. During her presidency, Jordan demonstrated an incredible ability to view what others might see as issues, challenges, or threats as opportunities during times of change within our organization. I am deeply honored to continue building on these opportunities during my tenure as president and to identify new ones before passing the gavel next July at the FCEP Board meeting at Symposium by the Sea.
These are challenging times. We face increasing patient loads and, all too often, limited resources to provide the level of care we strive for. Yet, as emergency medicine professionals, we persevere. FCEP remains steadfast in its mission to enhance member benefits at the state level, ensuring we advocate effectively for our profession and patients. Additionally, we take pride in fostering a culture of engagement and appreciation for our members, who embody resilience and dedication.
Together, we will navigate these challenges, embrace opportunities, and continue to advance the future of emergency medicine.
24-25 Presidential Priorities
• FINANCE FUNDING Shift from stabilization of finances to fundraising efforts.
• ADVOCATE FOR THE COLLEGE Actively promote the association’s mission and purpose. Represent the organization in a positive light and engage with members, stakeholders, and the community.
• FOSTERING A CULTURE OF ENGAGEMENT Create an organizational culture that values member engagement.
• MEMBER APPRECIATION Infuse fun and positivity into emergency medicine physicians and the specialty.
Collaborating with the FCEP Executive Committee and our Executive Director, we have successfully drafted and secured Board approval for the 2024-2025 strategic priorities. These priorities will serve as our roadmap for the year ahead, ensuring that our efforts remain focused, impactful, and aligned with the needs of our members and the emergency medicine community.
My promise is to bring a renewed focus on growth, advocacy, and community within the organization. By prioritizing financial sustainability, fostering engagement, and celebrating the contributions of emergency medicine professionals, my goal is to guide the association toward a vibrant and impactful future. These initiatives seek not only to strengthen the organization but also to inspire its members and the specialty as a whole. The journey ahead holds the potential to achieve meaningful progress and create a lasting legacy. ■ Key Strategic Priorities
FCEP 24-25 STRATEGIC PRIORITIES
Vison: To support and promote the health and safety of the public by providing the emergency physician community with the necessary tools that ensure the availability and delivery of quality emergency care
Mission: The Florida College of Emergency Physicians exists to promote high-quality emergency medical care, empower emergency physicians and protect the patients they serve.
Influence healthcare legislation and public policy to improve emergency medical care.
Member Engagement and Support Foster a strong, engaged membership that feels valued and supported.
Education and Professional Development Offer high-quality education and training to advance emergency medicine practices.
Organizational Governance and Ethics Ensure strong governance and ethical standards to build trust and accountability.
Financial Stability and Fundraising Build financial resilience through diversified fundraising efforts and prudent management.
• Develop annual legislative priorities that align with the needs of emergency physicians and patients.
• Build relationships with key policy makers, government officials, and other health organizations.
• Increase member participation in advocacy activities (e.g., “EM Days” at the state capital).
• Establish programs to recognize and celebrate member contributions (e.g., “Emergency Physician of the Year”).
• Provide opportunities for professional development, networking, and membership.
• Improve communication channels (e.g., newsletters, webinars, town halls) for transparency and exclusivity.
• Organize annual conferences and regular continuing medical education (CME) sessions.
• Develop mentorship and leadership programs for emerging physicians.
• Partner with educational institutions to advance medical training for emergency care.
• Strengthen board oversight and clarify roles and responsibilities.
• Conduct regular bylaw reviews to align with evolving legal and ethical standards.
• Implement conflict-of-interest policies and promote an ethical workplace culture.
• Develop a donor engagement strategy to increase contributions and sustain long term partnerships.
• Organize fundraising events, such as annual galas, donation drives, or Online campaigns.
• Monitor and optimize the cost effectiveness of fundraising activities.
IMMEDIATE PAST PRESIDENT’S MESSAGE LOOKING BACK, MOVING FORWARD
By Jordan Celeste, MD, FACEP FCEP & FEMF Board Member
2024 is drawing to a close, and January 2025 is right around the corner. January, of course, is named for the Roman god Janus, who is depicted as having two faces. Being two-faced is usually a character flaw and synonymous with being duplicitous. It could also be the result of having acid thrown in your face by a mob boss (or if you’re Christopher Nolan, after oil drums catch fire while you’re face down on the floor...for those who are confused, these are Batman references). But Janus was revered and worshipped for his two faces, which lent him the ability to not only look back, but forward as well.
Looking back allows us to appreciate how far we have come. As I prepared to pass the gavel at Symposium by the Sea this past year, I was able to take a few minutes during our board meeting to reflect on the priorities that I had laid out for my presidential term, and to celebrate the accomplishments that we were able to achieve together. While I think that it is important for our members to know about the hard work of their board and leadership (and therefore have included a summary table), let’s be honest…it’s time to move on.
Simple optimism and empty words are not what we need right now. There must be sincere passion coupled with concerted effort. There was an old ad (for a long-forgotten product or service) that my 11th grade math teacher used to quote –“these are dangerous words: this will get better.” Of course, this was meant to scare us into learning the early lessons so that we wouldn’t stumble later on in the class…but the sentiment always stuck with me. Forward progress was not a given, it involved work.
And what are we working towards? Looking back often fills folks with nostalgia, but we are all very, very naïve if we think that there will be a return to “the good old days.” With evolving practice models, ongoing scope of practice challenges, endless reimbursement issues, the rapidly evolving educational landscape, and many other pressing issues, it is more important than ever to be able to visualize the future we want to see, and to advocate for it aggressively. These efforts will require all-hands-on-deck, and I guarantee that you can play a part and will be welcomed to the crew.
To simply say that we need to work together, though, ignores the reality in which we all currently find ourselves living. Interestingly, Janus was also the deity that presided over the beginning and ending of conflict, so not only the start of war but also the eventual peace. I know that I am not speaking out of turn when I say that there has been a lot of tension and in-fighting in emergency medicine. Our specialty is broad and diverse, and it
tends to attract very strong personalities. I urge us all to not lose the forest for the trees, though – we must work to establish core values and fight together for the good of our patients, our practice, and our future. The stakes are simply too high. In the words of Ben Franklin, “We must all hang together, or assuredly we shall all hang separately.”
Moving on from the imagery of our joint execution at the gallows, I do want to end on a positive note. I truly believe that emergency physicians are not only the most caring caregivers, but we are also the greatest creative problem-solvers and the fiercest advocates. Inspired by the duality of Janus, we can look to our past while envisioning our future, sporting both our thinking caps and our white hats simultaneously. ■
SECURING FINANCES
STABILIZING STAFF
FOSTERING A FUNCTIONAL – AND FUN! –LEADERSHIP EXPERIENCE
ENHANCING VOICE AND VISIBILITY
- Right-sized our physical footprint with our new headquarters
- Optimized our investments
- Approved a new financial compendium
- Melissa Keahey formally hired as Executive Director
- Each and every staff member’s skill set maximized to complete organizational operations and execute the board’s strategic vision
- Involved the entire board in the orientation process
- Utilized small workgroups to tackle areas of strategic priority
- Continued to build the FCEP leadership pipeline
- Collaborated with FHA and FMA, especially during the legislative session
- Established a VoterVoice Strike Team to inform FCEP members and call them to action for outreach to their senators and representatives about legislation that impacts EM
MEANINGFUL MEMBERSHIP
- Developed evergreen messaging about FCEP member benefits, focusing on advocacy, education, leadership, and support services
Envision Physician Services provides strong support, strong leadership and plenty of opportunity for growth within the company.
+ STEPHEN MITCHELL, DO, FACEP Florida Regional Medical Director
A More Gratifying Emergency Medicine Career
We know that emergency medicine requires tremendous skill, training and teamwork to treat patients with the care they deserve. Physicians dedicated to problem solving and quality EM care require a robust support system
Envision is at the forefront of providing systems-based clinician wellness support. We have been recognized for our commitment to clinician wellbeing as a 2024 Wellbeing First Champion by ALL IN: Wellbeing First for Healthcare.
Featured Emergency Medicine Opportunities
Jupiter Medical Center Jupiter, Florida
Cleveland Clinic Indian River Hospital
Vero Beach, Florida
Jupiter, Florida
Cleveland Clinic Indian River Hospital Vero Beach, Florida
Whether you are interested in research, mentoring or growing into a leadership role, Envision can match you with your ideal position. We offer leadership, academic, pediatric and staff opportunities at leading hospitals and health systems throughout Florida and nationwide.
TITLE | SUBTILE
GOVERNMENT AFFAIRS COMMITTEE REPORT
By Jeremy K. Selley, DO, FACOEP
Co-Chair
Board Member
This upcoming State of Florida Legislative Session is not likely to disappoint. Pending re-election, we expect Senator Ben Albritton to take over as the President of the Senate and Representative Daniel Perez take over as the Speaker of the House. Last year we were able to assist in Senator Passidomo’s Live Healthy agenda that was a legislative priority and with it the passage of the interstate medical licensure compact, expansion of telehealth, increase in rural hospital funding and other healthcare appropriations. FCEP will continue to prioritize blocking scope of practice expansions for non-physicians, holding insurers accountable for bad behavior, and improving the practice of emergency medicine in our state.
FCEP EM Days – March 24-26, 2025 in Tallahassee. Please mark your calendars as we will need all the help we can get this year to help prevent issues that come up yearly such as Personal Injury Protection repeal. While we battle against high-priced insurer lobbyists, our advantage is our presence in the emergency departments in every district.
By Blake Buchanan, MD, FACEP Committee Co-Chair
Board Member
By Ricki A. Brown, MD Committee Co-Chair FCEP Board Member
Physicians for Emergency Care Political Action Committee is how we get our foot in the door to get meetings with our legislators. Through your donations, we are able to establish a rapport and ongoing dialogue with state legislators by supporting their elections. This allows us to educate the legislators on both sides of the aisle on issues important to improving the practice of emergency medicine in Florida.
Please give monthly to help increase FCEP’s ability to support the candidates, both Republican and Democrat, that are emergency physician friendly! Every dollar counts! ■
Thank You!
For your support in advance and see you in Tallahassee in March!
Donate to Physicians for Emergency Care PAC (Individuals):
Donate to Emergency Care for Florida PAC (Groups):
FLORIDA IS NOW A MEMBER STATE IN THE INTERSTATE MEDICAL LICENSURE COMPACT
How will this impact my license renewal?
During the 2024 legislative session, the Florida Legislature approved the state’s participation in a multistate compact for medical licensure. Seen as a way to streamline the application process associated with what previously had been a state-bystate approach to granting a license to practice, the Interstate Medical Licensure Compact (IMLC or Compact) is one of the tools included in the “Live Healthy” legislation focused on attracting more physicians to and retaining more physicians in our state.
The IMLC is different than the nursing compact. Physicians participating in the Compact still must have a license in each state where they practice, but the Compact offers doctors a single electronic pathway to gain those licenses once they have met the qualifications of licensure in their home state. Now that Florida is a member state along with over 40 other jurisdictions, the good news is there is now the potential for a single point of entry should you as a Florida medical license holder need to be licensed in multiple states.
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Though implementation is ongoing, here is a first look into how the new licensing pathway will work. If you are currently licensed in Florida and plan to continue practicing in this state, in many ways nothing will change for you. You will need to biennially renew your license as usual. Want to seek licensure in another IMLC jurisdiction? It can all start with your existing Florida license.
The first step in your multistate journey is to head to the IMLC website and use your Florida license as your “ticket to entry” by choosing Florida as your “State of Principal Licensure” and applying for a “Letter of Qualification.” If granted, this letter is valid for 365 days and certifies you are licensed and in good standing in your home state, thus eliminating much of the duplicative administrative work to be completed by each additional state where you ultimately will seek licensure.
To designate Florida as your State of Principal Licensure (SPL), ensure AT LEAST ONE of the following are true:
• Your primary residence is in the SPL (in this case Florida)
• At least 25% of your practice of medicine occurs in the SPL (in this case Florida)
• You are employed to practice medicine by a person, business or organization located in the SPL (in this case Florida)
• You use the SPL (Florida) as your state of residence for U.S. Federal Income Tax purposes.
With your Letter of Qualification (LOQ) in hand, you can
now choose the state(s) where you would like to apply for an “expedited license.” Remember, upon receipt of an expedited license, you will have an unrestricted license in the new state.
To qualify to get an expedited license from another member jurisdiction in addition to your Florida medical license, you must have:
• Graduated from an accredited medical school, or a school listed in the International Medical Education Directory or its equivalent such as the World Directory of Medical Schools
• Successfully completed ACGME- or AOA-accredited graduate medical education
• Passed each component of the USMLE, COMLEX-USA, or equivalent in no more than three attempts for each component (note that passing the Canadian Licentiate of the Medical Council of Canada, or the LMCC, DOES NOT meet this requirement)
• Hold a current specialty certification or time-unlimited certification by an ABMS or AOABOS board
In addition, physicians must:
• Not have any history of disciplinary actions toward their medical license
• Not have any criminal history
• Not have any history of controlled substance actions toward their medical license
• Not currently under investigation
As for cost, if you choose to participate in the Compact by designating Florida as your SPL, the Compact Commission will collect $700 for the work associated with granting the SPL designation and issuing an LOQ. If you chose to pursue an expedited license through the Compact, each state will have costs associated with issuing a medical license. In Florida, this is the standard $355 licensure fee plus any NICA fees associated with your NICA status.
The Department of Health plans to roll out Florida’s Compact participation by the first of the year. Implementation details can be found on the Florida Board of Medicine website under the licensure tab as they are released. As with any new program, we will share information as it develops or changes but hope this gives you a quick overview of new ways to maximize one of your greatest assets – your medical license. Special thanks to Paul Vazquez, Executive Director at the Florida Board of Medicine, for his time and expertise in sharing the information included in this article. FCEP is happy to be a team partner with regulators working to address issues that affect our patients and our profession. ■
Toni Large FCEP Lobbyist
MEDICAL ECONOMIC COMMITTEE UPDATE
MERRY GRINCHMAS
Eliot Goldner, MD, MBA Committee Co-Chair, FCEP Board Member
MERRY GRINCHMAS
The Proposed 2025 Physician Fee Schedule
In what has become the most unpleasant of annual traditions, I am In what has become the most unpleasant of annual traditions, I am providing our membership with an update on the Center for Medicare & Medicaid Services (CMS) Physician Fee Schedule (PFS) for Calendar Year (CY) 2025. To recap this past year, the CY 2024 Conversion Factor (CF) of $32.7442 took effect without any congressional relief until March 9th, when President Biden signed the Consolidated Appropriations Act, 2024, that included a temporary 2.93% update and increased the CF to $33.2875. No retroactive relief was provided for payments made earlier in the year and this “temporary fix” expires at the end of this year. CY 2024 year marked the 4th year in a row of CF reductions caused by the statutory application of Medicare’s budget-neutrality adjustment, all of which were only partially mitigated by Congress (figure 1).
Without new intervention by Congress, the CY 2025 CMS PFS CF will be $32.3562, a 2.8% reduction from CY 2024. This extends to a 5th year the downward trajectory of the CF, contradictory to an expected 3.6% increase in medical practice cost inflation. The American Medical Association has well illustrated the disparity in Medicare physician payment growth compared to hospital payments and practice cost inflation, which continues to widen because of the PFS being the only payment system in Medicare deficient of an annual inflationary update (figure 2). Adjusted for inflation, physician reimbursement for Medicare patients is less than half what it was 30 years ago, and further decreases in physician reimbursement are expected to worsen existing access-to-care issues for Medicare beneficiaries.
ACEP and its partner organizations representing both physicians and patients have already begun advocacy efforts to obtain another year of congressional relief. In fact, bipartisan legislation has already been submitted that would provide a 4.73% boost to the now-finalized 2025 CF, eliminating the 2.8% reduction and providing a 1.93% increase to partially offset inflation. Additionally, thanks to ongoing advocacy efforts, there has been increasing congressional awareness of the need for a more permanent solution.
The Strengthening Medicare for Patients and Providers Act (H.R. 2474) is bipartisan legislation introduced in the House of Representative to add a permanent annual inflationary update to the Medicare PFS. Both chambers of Congress have pending bills that would modify the current budget neutrality requirements and provide payment stability in the Medicare PFS, the Provider
Reimbursement Stability Act (H.R. 6371) and the Physician Fee Stabilization Act (S. 4935). Medicare payment reform is especially important for the stability of healthcare in Florida, which has an aging population and already has the second-highest population of Medicare beneficiaries in the country. ■
It is imperative that every physician make their voice heard on behalf of their profession and their patients, which can be done utilizing the accompanying QR code link for the ACEP Advocacy Action Center.
Figure 1
Figure 2
EMRAF PRESIDENT MESSAGE
Michael Thompson, MD EMRAF President, FCEP Board Member
To my fellow Emergency Medicine Residents of Florida,
On behalf of the Emergency Medicine Residency Association of Florida (EMRAF), I’m thrilled to welcome you to our family! You’ve embarked on an incredible journey—one that will not only challenge you but also shape you into a skilled, compassionate emergency physician. As the president of EMRAF, I extend my warmest congratulations on this achievement and want to remind you of the importance of wellness as you navigate this exciting chapter.
Residency in emergency medicine is no small feat. It’s a high-energy, fast-paced environment where your adrenaline will often be pumping, and the stakes can be incredibly high. We are on the front lines of healthcare, treating everything from minor injuries to life-threatening conditions. It’s a rewarding but demanding job, and that’s why wellness must be at the heart of everything you do.
At EMRAF, we believe that to take care of others, you must first take care of yourself. Wellness isn’t just about physical health—it’s about nurturing your mental, emotional, and social well-being too. Throughout residency, we’ll face long shifts, stressful situations, and emotional challenges. But with the right tools and mindset, we can not only survive but thrive.
Here are a few tips I encourage you to embrace on your journey:
Prioritize Rest: I know it sounds impossible, but getting enough sleep will help you perform at your best. Sleep is essential for critical thinking and decision-making, which are vital in emergency medicine.
Stay Connected: Build a support network of colleagues, mentors, and loved ones. Lean on each other, share your experiences, and don’t hesitate to ask for help when you need it.
Set Boundaries: Emergency medicine will demand a lot from you, but don’t let it consume you. Make time for hobbies, relaxation, and moments that recharge your spirit.
Practice Mindfulness: Whether through meditation, yoga, or just taking a few deep breaths between patients, grounding yourself can make a world of difference in managing stress.
Remember, EMRAF is here to support you every step of the way. My initiative this year is to create and promote wellness programs, mentorship opportunities, and resources designed to help you succeed both professionally and personally. You are not alone in this journey, and we are committed to fostering an environment where your growth, well-being, and success are top priorities.
Once again, welcome to the EMRAF family. Let’s make this an incredible, fulfilling residency experience!
Welcome 2024- 2025 EMRAF Officers! VP of Recruitment: Mariel Michaels, MD, MPH (UCF/HCA North Florida) VP of Programming: Angela Patton, MD (UCF/HCA North Florida)
Work in an environment where your voice matters and you can make a difference in the future of healthcare.
+ RICARDO R. JIMENEZ, MD, FAAP, FACEP Site Medical Director
Pursue Your Passion in Pediatric Emergency Medicine
Children in our communities are leading healthier lives because of the skilled and innovative care provided by our PEM teams. Envision physicians at the frontline of the ED and in leadership roles at local, regional and national levels are guiding our mission to improve care.
Enjoy a Rewarding PEM Career
■ Unmatched professional development, including mentoring and leadership programs
■ Work-life balance with flexible and equitable schedules, including travel team options
■ Equitable, highly competitive compensation with comprehensive benefits
■ Clinical and scientific research, teaching, care quality and government affairs opportunities
Explore leadership and staff positions at leading children’s hospitals, academic medical centers and teaching hospitals throughout Florida and nationwide.
Explore Leaders and Staff Opportunities
Salah Foundation Children’s Hospital at Broward Health Medical Center Fort Lauderdale, Florida
The Children’s Medical Center at Summerlin Hospital Medical Center Las Vegas, Nevada
K. Hovnanian Children’s Hospital at Jersey Shore University Medical Center Neptune, New Jersey
The Children’s Hospital at St. Peter’s University Hospital New Brunswick, New Jersey
Medical City Children’s Hospital at Medical City Dallas Dallas, Texas
MEMBERSHIP AND PROFESSIONAL DEVELOPMENT
We recently weathered Hurricanes Helene and Milton, which caused significant damage to the west coast of Florida and surrounding areas. We hope that you and your loved ones are safe. If you are in need of assistance or able to donate, please contact the FCEP office.
The Membership and Professional Development (MPD) Committee is pleased to announce that Dr. Shayne Gue, Co-Chair of the MPD Committee, has transitioned to FCEP Secretary/Treasurer! We look forward to his continued presence and guidance at FCEP and thank him for his many years of commitment and service.
Symposium by the Sea 2024 (SBS24) at the Eden Roc Hotel Miami Beach was another spectacular event. SBS gives us a chance to reconnect with colleagues, friends, and family, and our venue and activities provide many opportunities. The excitement of the competitions, the enriching presentations, and the thoughtful collegial debates made for an experience all could enjoy. Did you attend SBS24? Which activities stood out to you? I look forward to seeing many familiar and new faces at SBS25 from July 31 to August 3, 2025.
As we have done throughout the years, our committee continues our Residency Visits to Florida’s 22 ACGME-accredited emergency medicine residency programs. With help from our members and the FCEP and ACEP Boards of Directors, we are able to support our Emergency Medicine Residency Programs in a variety of ways and share ACEP/FCEP resources with our learners and their faculty. Would you like to find out more about scheduling a visit for your program or participating in a Residency Program Visit? Please reach out to the FCEP office for a variety of resources and scheduling.
Our FCEP Leadership Academy continues its mission of curating a year-long program “designed to equip you with the organizational education, skills training, mentoring, and guided experiences you will need to succeed as a leader in emergency medicine.” Our Academy is led by Dr. Zachary C. Terwilliger and Dr. Stephen Viel, who customize the curriculum to include experiences that challenge and expose our participants to a variety of leadership training styles. We congratulate the 20232024 class: Stuart Bumgarner, MD; Elizabeth Calhoun, MD; Lara Goldstein, MD, PhD, FCEM(SA), Cert. Critical Care(SA); Harold Gomez Acevedo, MD; and Chrissy Zeretzke-Bien, MD, FACEP, FAAP, FAAEM. Are you interested in joining the next Leadership Academy class or do you know a colleague who may benefit from learning additional leadership skills? Please contact the FCEP office for more information and resources.
Our next committee and BOD meetings will take place on February 11, 2025. All meetings will be held in person in Winter Park. Visit the FCEP website and check your email for the most current information. As always, until next time, take care of yourself and each other.
LEADERSHIP ACADEMY
We are proud to introduce our newest Leadership Academy class:
Patrick Anderson, DO
Taylor Craig, MD
Joseph King, MD
René Mack, MD, FACEP, RDMS Committee Chair
Pictured: FCEP congratulates the 2023-2024 Leadership Academy class: Elizabeth Calhoun, MD; Stuart Bumgarner, MD; Harold Gomez Acevedo, MD; and Chrissy Zeretzke-Bien, MD, FACEP, FAAP, FAAEM standing with Immediate Past President, Jordan Celeste, MD, FACEP. Not pictured: Lara Goldstein, MD, PhD, FCEM(SA), Cert. Critical Care(SA)
PEDIATRIC EM COMMITTEE: PEDIATRIC TRAUMA
Yiraima Medina-Blasini, MD, FACEP Committee Member
By Amit Patel, MD, FAAP, FACEP Committee Member
Introduction: Trauma remains the leading cause of mortality in the pediatric population in the United States. At Symposium by the Sea 2024, the Pediatric Committee provided an engaging pediatric trauma workshop that included lectures as well as handson stations. The goal of this workshop was to highlight the importance of systematic evaluation and life saving interventions following the Advanced Trauma Life Support (ATLS) protocol, along with the application of validated clinical decision rules for a pediatric trauma patient. Additionally, the program emphasized recognizing red flags and sentinel injuries that may indicate non-accidental trauma.
1. ABCs
The management of the pediatric trauma patient follows the same standard ABCDE approach established for adults while taking into consideration age-specific or weight based equipment or medications and key pediatric anatomical and physiological differences. Airway assessment is the top priority during the primary survey. Cuffed endotracheal tubes are now recommended outside the neonatal period, as they provide a better seal, enhance ventilation, and reduce the risk of aspiration.Additionally, for children under 8 years old, needle cricothyrotomy is the preferred surgical airway technique. Keep in mind that children have more compliant chest walls, making them less susceptible to fractures but more vulnerable to pulmonary contusions.
2. CHEST TUBE PLACEMENT:
When inserting a chest tube in a child compared to an adult please remember these key points:
• Smaller Anatomy and Intercostal Spaces:
Children’s narrower intercostal spaces and more flexible ribs make anatomical landmarks harder to identify, requiring greater precision during insertion.
• Proximity of Vital Structures:
Due to their smaller size, vital structures (e.g., heart, lungs, diaphragm) are closer together in children, increasing the risk of complications if the tube is misplaced.
• Use of POCUS:
Point-of-care ultrasound (POCUS) is more critical in children to guide placement, as it helps visualize underlying structures and avoid injury, especially in cases where pathology may be less obvious on physical exam.
• Sedation and Discomfort: Pediatric patients often require sedation for chest tube placement, and minimizing discomfort is essential. A pigtail catheter is often preferred over a traditional chest tube for smaller effusions to reduce pain and complications.
3. E-FAST
The E-FAST exam is effective in children due to their thinner chest walls, but interpretation can be tricky due to smaller structures and non-traumatic findings like physiologic ascites. Combining the E-FAST with a thorough physical exam helps differentiate true pathology from incidental findings, especially in pediatric trauma. In adults, trauma patterns are more predictable, making interpretation easier. Despite these differences, E-FAST remains a key, non-invasive diagnostic tool for both groups.
4. CLINICAL DECISION RULES
Various clinical decision rules can be applied to specific pediatric trauma patients to help us identify which ones are at risk of having clinically important injuries that will require advanced imaging. At present, the Pediatric Emergency Care Applied Research Network (PECARN) has developed clinical decision tools that can be implemented for head, neck, and intra-abdominal injuries, which can help us minimize unnecessary radiation exposure. See Figure 1.
5. NON ACCIDENTAL TRAUMA
When evaluating a trauma patient, non-accidental trauma (NAT) should be considered as part of the differential diagnosis. While NAT can be challenging to identify, inconsistencies between the patient’s history and physical exam, the presence of patterned
bruising, and sentinel injuries can raise suspicion. The 6B’s and the TEN-4-FACESp rules will assist you in identifying patients at risk and those who may need to be reported.
• 6B’s - Bruises, Breaks (eg. bucket handle fracture, any fracture in non ambulatory child, posterior rib fractures), Bonks, Burns (immersion or contact burns), Bites, Baby blues (Irritability).
• TEN-4-FACESp (For children < 4 y/o) - Torso, Ears, Neck, < 4month with any bruise. Anywhere, Frenulum, Angle of the jaw, Cheeks, Eyelids or Subconjunctiva, Patterned bruising.
6. LACERATION REPAIR
Absorbable sutures are usually the best choice for laceration repair in pediatric patients. Wound closure strips and topical skin adhesive provide similar cosmetic outcomes for closure of simple facial lacerations.
It is probably safe to get wounds wet early after repair and keeping them clean with soap and water makes physiologic sense. There is not too much evidence that dressings improve healing but discuss with parents regarding comfort and cover lacerations that are still oozing for at least 24 hrs. See Figure 2. ■
Any Non absorbable
Any Non absorbable
Any Non absorbable
Face Absorbable
Scalp Skin laceration under cast or splints
Absorbable
Good Nylon (Ethilon, Unilon, Riverlon)
Good handling, requires at least 3 to 4 throws to make a secure knot
Stretches to handle wound swelling
Green color available for suturing in scalp or eyebrows
Good Polybuster (Novalfil) Similar to nylon
Polypropylene (Prolene, Synthalin, Unilene)
Slippery; requires at least 4 to 5 throws o make a secure knot
Stretches to hand wound swelling
Blue color available for suturing in the scalp or eyebrows
Low Fast Absorbing Gut Typically holds for 4 to 6 days
Breaks easily during tying (especially small diameter {eg, 6-0 or higher} suture) Tan color can be difficult to see Often used in young children Also used for nailbed laceration repair
Polyglactin (Vicryl Rapide) Typically holds for 7 to 10 days
Alternative to nonabsorbable suture when removal may be difficult or patient follow-up is not assured
Any Absorbable Good Polyglactin (Vicryl) Holds for 30 days
Braided synthetic; good handling
Any Absorbable Fair Poliglecaprone 25 (Monocryl) Holds for 7 to 10 days
Monofilament suture; easy to handle and tie Also used for subcutaneous closure of facial lacerations
Chromic Gut Typically holds for 10 to 14 days
More rapidly absorbed in the oral cavity
Drs. Medina-Blasini and Patel pose for a photo at the SBS 2024 Pediatric Track: Pediatric Trauma
Oral Mucosa Tongue
Figure 2
PEDIATRIC EM COMMITTEE: PEDIATRIC TRAUMA
“Held in conjunction with Symposium by the Sea 2024. The goal of this workshop was to highlight the importance of systematic evaluation and life saving interventions following the Advanced Trauma Life Support (ATLS) protocol, along with the application of validated clinical decision rules for a pediatric trauma patient.
Cont’d References from Page 17
References
1. Kornblith AE, Graf J, Addo N, Newton C, Callcut R, Grupp-Phelan J, Jaffe DM. The Utility of Focused Assessment With Sonography for Trauma Enhanced Physical Examination in Children With Blunt Torso Trauma. Acad Emerg Med. 2020 Sep;27(9):866-875. doi: 10.1111/acem.13959. Epub 2020 Apr 15. PMID: 32159909; PMCID: PMC8502256.
2. Holmes JF, Yen K, Ugalde IT, Ishimine P, Chaudhari PP, Atigapramoj N, Badawy M, McCarten-Gibbs KA, Nielsen D, Sage AC, Tatro G, Upperman JS, Adelson PD, Tancredi DJ, Kuppermann N. PECARN prediction rules for CT imaging of children presenting to the emergency department with blunt abdominal or minor head trauma: a multicentre prospective validation study. Lancet Child Adolesc Health. 2024 May;8(5):339-347. doi: 10.1016/S23524642(24)00029-4. PMID: 38609287.
3. Leonard JC, Harding M, Cook LJ, Leonard JR, Adelgais KM, Ahmad FA, Browne LR, Burger RK, Chaudhari PP, Corwin DJ, Glomb NW, Lee LK, Owusu-Ansah S, Riney LC, Rogers AJ, Rubalcava DM, Sapien RE, Szadkowski MA, Tzimenatos L, Ward CE, Yen K, Kuppermann N. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. 2024 Jul;8(7):482-490. doi: 10.1016/S2352-4642(24)00104-4. Epub 2024 Jun 4. PMID: 38843852; PMCID: PMC11261431.
4. Pierce MC, Kaczor K, Lorenz DJ, Bertocci G, Fingarson AK, Makoroff K, Berger RP, Bennett B, Magana J, Staley S, Ramaiah V, Fortin K, Currie M, Herman BE, Herr S, Hymel KP, Jenny C, Sheehan K, Zuckerbraun N, Hickey S, Meyers G, Leventhal JM. Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics. JAMA Netw Open. 2021 Apr 1;4(4):e215832. doi: 10.1001/ jamanetworkopen.2021.5832. Erratum in: JAMA Netw Open. 2021 Sep 1;4(9):e2130136. doi: 10.1001/jamanetworkopen.2021.30136. PMID: 33852003; PMCID: PMC8047759.
5. Al-Abdullah T, Plint AC, Fergusson D. Absorbable versus nonabsorbable sutures in the management of traumatic lacerations and surgical wounds: a meta-analysis. Pediatr Emerg Care. 2007 May;23(5):339-44. doi: 10.1097/01. pec.0000270167.70615.5a. PMID: 17505281.
6. Holger JS, Wandersee SC, Hale DB. Cosmetic outcomes of facial lacerations repaired with tissue-adhesive, absorbable, and nonabsorbable sutures. Am J Emerg Med. 2004 Jul;22(4):2547. doi: 10.1016/j.ajem.2004.02.009. PMID: 15258862.
7. Karounis H, Gouin S, Eisman H, Chalut D, Pelletier H, Williams B. A randomized, controlled trial comparing long-term cosmetic outcomes of traumatic pediatric lacerations repaired with absorbable plain gut versus nonabsorbable nylon sutures. Acad Emerg Med. 2004 Jul;11(7):730-5. doi: 10.1197/j.aem.2003.12.029. PMID: 15231459.
8. Luck RP, Flood R, Eyal D, Saludades J, Hayes C, Gaughan J. Cosmetic outcomes of absorbable versus nonabsorbable sutures in pediatric facial lacerations. Pediatr Emerg Care. 2008 Mar;24(3):137-42. doi: 10.1097/ PEC.0b013e3181666f87. PMID: 18347489.
9. Tejani C, Sivitz AB, Rosen MD, Nakanishi AK, Flood RG, Clott MA, Saccone PG, Luck RP. A comparison of cosmetic outcomes of lacerations on the extremities and trunk using absorbable versus nonabsorbable sutures. Acad Emerg Med. 2014 Jun;21(6):637-43. doi: 10.1111/acem.12387. PMID: 25039547.
Cont’d from Page 19
Above: “Advancing Pediatric Care: The Pediatric EM Committee gathered at SBS 2024 to drive innovation and collaboration, while attendees immersed themselves in a dynamic pediatric trauma workshop featuring expert-led lectures and hands-on training stations.”
INCREASED PREVALENCE OF ADVERSE EFFECTS RELATED
TO “MAGIC MUSHROOM” PRODUCTS
Psilocybin or psilocin-containing mushrooms are commonly referred to as “magic mushrooms” or “shrooms.” They presumably act at serotonin receptors and produce hallucinogenic, dissociative, and euphoric effects like lysergic acid diethylamide (LSD) when consumed.1 In 1970, the United States government designated psilocybin/psilocin as a Schedule I substance after the Controlled Substances Act was passed.2 Despite the schedule I designation, products that claim to contain psilocybin/psilocin are not strictly regulated and are readily available to the general public. These products are available in different dosage forms, including but not limited to, chocolates, gummies, or cones and can be purchased in a variety of retail settings such as smoke/vape shops, gas stations, or online stores.3
Over the past few years, psilocybin/psilocin-containing product exposures have increased across the country, as reported by United States poison centers.4,5 Psilocybin/psilocin is used recreationally for its hallucinogenic effects and has traditionally been used for religious rituals, ceremonies, and other practices. Recently, psilocybin has been studied and evaluated for novel indications by psychiatrists such as treatment-resistant depression, substance use disorder, anxiety, and smoking cessation.6 The rise in its use has caught the attention of many, and some people may look to self-treatment, especially with its ease of access.
There is a lack of studies evaluating the safety and efficacy of psilocybin/psilocin, due to its Schedule 1 designation. Although robust data is not available, many testimonies on public forums such as Reddit describe their use and effects. The major concern with these products is that some sold in retail settings may claim to contain psilocybin-containing mushrooms or a “proprietary blend” of psychoactive mushrooms when, in reality, the product does NOT include any at all.3 In fact, analysis of ingredients has revealed that these products in actuality contain unregulated products such as kavalactones, muscimol, and acetlypsilocin. These products can produce desirable effects similar to psilocybin/ psilocin but also harbor other serious adverse effects such as hepatotoxicity, seizures, and dystonic movements. Recently, the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) released a public recall of Diamond ShruumzTM brand chocolates, cones, and gummies, as there have been reports of serious adverse effects such as major CNS depression, seizures, and respiratory failure associated with use of this product.3 Although Diamond ShruumzTM brand products have been recalled, there are still other similar products available on the market that may produce similar adverse effects.3 Additionally, Diamond ShruumzTM brand products purchased by consumers before the recall may also lead to serious adverse effects.3 Psilocybin is not detected with usual toxicologic screening
methods. Common clinical effects include dilated pupils (develops in over 90% of cases), confusion, nausea, vomiting, tachycardia, hypertension, sense of exhilaration, hallucinations including vivid bright colors and shapes, euphoria, anxiety, perceptual distortions (may result in either a pleasant or apprehensive mood; “good” or “bad” trip), and/or impaired judgment.7 Patients with minor symptoms such as gastrointestinal discomfort or mild central nervous system depression can be managed with symptomatic supportive care and observation.7 If patients begin to develop hallucinations or agitation, placing the patient in a dimly lit room with low stimulation while calmly speaking with them may reduce their symptoms.7 If severe clinical effects occur, such as worsening agitation or seizures, benzodiazepines are the drug of choice.7 If seizures persist, barbiturates or propofol may be considered.7 Finally, hyperthermia can occur, where rapid cooling techniques may be required.7
Despite these products garnering national attention for their adverse effects, those who have previously purchased these types of products are still at risk for developing clinical manifestations. Additionally, the full range of adverse effects of these products is not completely understood. Due to increased public interest, accessibility, and utilization of these products, emergency medicine healthcare providers should be aware of the potential adverse effects, clinical course, and management of patients exposed to these products that contain or claim to contain psilocybin/psilocin. ■
The Florida Poison Information Center Network is available at 1-800-222-1222 for any questions regarding magic mushroom-containing products or any other potential toxin.
It’s been another exciting year in EMS! State EMS Medical Director, Dr. Angus Jameson, continues to lead EMS medical directors and educators in advancing National Education Standards and furthering EMS development in the state of Florida.
Updated DNR Order
Florida updated its Do Not Resuscitate Order (DNRO) form in 2024. The latest version, Form DH 1896, was revised in February 2024 and became effective on October 10, 2024. To ensure its validity, the form must be printed on yellow paper or with a full-page yellow background. This requirement helps emergency medical personnel quickly recognize and honor the DNRO. You can download the updated form from the Florida Department of Health’s website.
Florida Center for EMS
New DNRO Form Alert Scan to download Florida’s Updated Form DH@1896.
Established in 2024 with generous grant support from the State of Florida’s Department of Public Health, the Center for Emergency Medical Services (FL-CEMS) is housed at the University of South Florida’s Morsani College of Medicine. FL-CEMS is dedicated to advancing the field of emergency medical services through pioneering research, high-quality education, and innovation in collaboration with community partners.
Its mission is to enhance patient outcomes and refine EMS methodologies by leading advancements in prehospital emergency care, improving and modernizing EMS educational curricula, developing robust strategies for disaster preparedness, optimizing EMS systems, and promoting cutting-edge EMS research. Through these efforts, FL-CEMS aims to set new standards of excellence in emergency medical care and education.
Key Program Initiatives include:
• Evaluation and Enhancement of Mobile Integrated Health (MIH) Programs
• EMS Graduate Research Assistantship Program
• Curriculum Development for Paramedic and EMT Programs
• Defining Best Practices for Telehealth in EMS
• Statewide Learning Management System (LMS) for EMS Training – FREE
• Collection and Analysis of Demographic Data
• EMS Research & Data Analysis
EMS/TRAUMA COMMITTEE REPORT
By FCEP staff
Florida Resuscitation Center of Excellence
The Florida Resuscitation Center of Excellence (RCOE) certification is a statewide initiative launched in 2022 as a primary goal of the Florida Resuscitation Center Committee. This committee was formed to develop recommendations for increasing survival rates from sudden cardiac arrest. The initiative aims to establish a Resuscitation System of Care through performance improvement and data analysis, identify evidencebased interventions, designate hospitals as Resuscitation Centers, develop care guidelines, and create support networks for survivors and their families.
To achieve this recognition, hospitals must meet the statewide criteria set by the committee and apply for designation as either a Primary Resuscitation Center of Excellence (PRCE) or a Comprehensive Resuscitation Center of Excellence (CRCE). Hospitals must self-attest to the criteria and reapply every three years to maintain the designation. ■
To learn more or assist your facility in becoming a Florida Resuscitation Center of Excellence email Thomas DiBernardo at Thomas.DiBernardo@FlHealth.gov or Melissa Keahey at mkeahey@emlrc.org.
We hope to see you online or in person at our future meetings! Visit www.fcep.org to view the calendar and contact FCEP staff to be added to our email list and roster.
References
1. “Psilocybin and psilocin (Magic mushrooms) - Canada.ca.” Accessed: Aug. 29, 2024. [Online]. Available: https://www.canada.ca/en/health-canada/ services/substance-use/controlled-illegal-drugs/magic-mushrooms.html
2. H. Lowe et al., “The Therapeutic Potential of Psilocybin,” Molecules, vol. 26, no. 10, p. 2948, May 2021, doi: 10.3390/molecules26102948.
3. “Severe Illness Potentially Associated with Consuming Diamond ShruumzTM Brand Chocolate Bars, Cones, and Gummies | Environmental Health Studies | CDC.” Accessed: Sep. 12, 2024. [Online]. Available: https://www.cdc.gov/environmental-health-studies/outbreak-investigationdiamond-shruumz-products/index.html
4. R. Farah, A. F. Kerns, A. C. Murray, and C. P. Holstege, “Psilocybin Exposures Reported to U.S. Poison Centers: National Trends Over a Decade,” J. Adolesc. Health, vol. 74, no. 5, pp. 1053–1056, May 2024, doi: 10.1016/j. jadohealth.2024.01.027.
5. K. Madden et al., “Psilocybin for clinical indications: A scoping review,” J. Psychopharmacol. (Oxf.), p. 02698811241269751, Aug. 2024, doi: 10.1177/02698811241269751.
6. S. Kamal, M. K. Jha, and R. Radhakrishnan, “Role of Psychedelics in Treatment-Resistant Depression,” Psychiatr. Clin. North Am., vol. 46, no. 2, pp. 291–305, Jun. 2023, doi: 10.1016/j.psc.2023.02.004.
7. Mushrooms-Hallucinogenic. In: IBM Micromedex POISINDEX (electronic version). IBM Watson Health, Greenwood Village, Colorado, USA. Available at: www.micromedexsolutions.com/ (cited: September 26, 2024).
on behalf of Danielle DiCesare, MD, FACEP and Jason Jones, MD
EM DAYS 2024: ADVOCACY IN ACTION PROGRAM DATE:
JANUARY 29-31, 2024
2024 LEGISLATOR OF THE YEAR AWARDS
At EM Days 2024, FCEP proudly recognized the exceptional lawmakers who have gone above and beyond in advocating for policies that support emergency medicine and patient care in Florida.
Thank you to these leaders whose commitment has made a tangible difference in promoting health policy for the emergency medicine safety net of Florida:
Representative Shane G. Abbott
Senator Gayle Harrell
Representative Karen Gonzalez-Pittman
Representative Kaylee Tuck
Senator Colleen Burton
EM Days remains a cornerstone event for FCEP, bringing together emergency medicine professionals and state legislators to advocate for critical healthcare policies in Florida. This year’s advocacy efforts aligned with key legislative priorities, (see page 54 for more info) enabling FCEP to make a significant impact on healthcare policy across the state.
EM Days 2024 brought members together with policymakers like Representative Chuck Clemons (pictured), fostering partnerships for a stronger healthcare system.
Dr. Lara Dr. Lara Goldstein and Representative Marie Woodson come together at the Capitol for EM Days 2024.
From Classroom to Capitol: MSC students take their first steps into legislative advocacy during EM Days 2024.
LIFE AFTER RESIDENCY 2024: THRIVING BEYOND MEDICINE
PROGRAM DATE: APRIL 10 & 11, 2024
The 2024 Life After Residency program welcomed 72 residents, providing essential guidance to help them navigate the transition from training to professional practice. Throughout the event, residents participated in sessions on critical topics such as medical malpractice, employment contract negotiation, workflow optimization, financial wellness, and loan repayment strategies.
In addition to expert-led presentations, the program featured interactive discussions that explored career paths beyond the emergency department, academic fellowships, and staying current in the field. Residents also had the opportunity to network with seasoned professionals, including at-the-time FCEP President Jordan Celeste, MD, FACEP, and other key speakers.
By the end of the program, participants gained not only practical tools and career insights but also valuable connections and renewed confidence to thrive in their future roles as emergency medicine physicians. ■
Name Of Doctor Status
FLORIDA PEDIATRIC EMS SYMPOSIUM PROGRAM
DATE: MAY 15, 2024
Sara Kirby, MD Pediatric EM Committee Co-Chair
On May 15, 2024, we hosted the Florida Pediatric EMS Symposium at AdventHealth Tampa in collaboration with Florida EMSC. Thirty-two EMS providers from across the state of Florida braved thunderstorms, traveling from as far as the Florida Keys to attend the conference.
Expert Pediatric Emergency Physicians also traveled to volunteer their time and share their expertise with our EMS colleagues. The physicians delivered interactive lectures and Q&A sessions, along with scenario-based training to simulate real-world encounters.
The AdventHealth Tampa Simulation team, led by Chloe Martin and Dr. Sara Kirby, designed a unique hands-on experience using high- and low-fidelity equipment to teach essential infant and pediatric skills. Additionally, the AdventHealth Child Life team provided education on atraumatic care, incorporating audience volunteers into their demonstrations.
The event was a resounding success. Every attending EMS agency requested resources to share with their teams, and the feedback was overwhelmingly positive. Many participants even declared it the best conference they had ever attended!
The participating physicians included Drs. Sara Kirby and Tricia Swan, co-chairs of the FCEP Pediatric EM Committee, as well as FCEP members Drs. Vanessa Perez, Ariel Vera, Mark Yassa, and Laura Hummel. Joining them were Drs. Yelena Atlas, Amanda Saad, and Amber Hathcock from USACS/AdventHealth, all of whom generously volunteered their time and expertise for this event.
Special thanks to AdventHealth for providing the venue and meals, and to the FCEP/FEMF staff for their exceptional support of this program. ■
Faculty members of the Florida Pediatric EMS Symposium stand together at the event, which successfully integrated the EM physician and EMS communities.
Faculty physicians work with their EMS colleagues on hands-on sim stations during the pediatric symposium
Scan to View Photos
ACEP COUNCIL
PROGRAM DATE: SEPTEMBER 27- 28, 2024
FCEP is excited to share that our councillors did an incredible job representing Florida at ACEP Council 2024. The ACEP Council, which meets annually alongside the Scientific Assembly, plays a vital role in shaping the direction of emergency medicine. Over the course of two days, representatives from across the country came together to tackle some of the most pressing issues facing our specialty, from workforce challenges to clinical care improvements.
We’re proud to say that our councillors’ active participation ensured Florida’s voice was heard loud and clear. They were deeply engaged in policy discussions, decision-making, and the development of national guidelines—always keeping the needs and perspectives of Florida’s emergency medical community front and center. Their work highlights FCEP’s dedication to advancing the field and making a meaningful impact on a national scale.
Their efforts at ACEP Council 2024 reflect the best of what FCEP stands for: collaboration, advocacy, and leadership. By addressing critical issues and advocating for solutions that benefit both physicians and patients, they’ve brought valuable insights back to Florida while helping to shape the future of emergency medicine for everyone. We’re grateful for their commitment and the work they do to elevate our specialty every day. ■
Resident Taylor Craig (Aventura EM) attended ACEP Council as an alternate counselor and highlighted Florida’s 100% participation in EMF, as shown by the filled-in state on the map.
Left: National ACEP members vote on a resolution at ACEP council.
Below:
FCEP Councillors and Alternates enjoy gathering at ACEP Council 2024.
JULY 2024 EDEN ROC MIAMI BEACH, FL
ANNUAL MEETING RECAP
On July 25, the Florida College of Emergency Physicians convened for its annual Board meeting at Eden Roc Miami Beach. Alongside committee updates and routine business matters, the event marked the transition of leadership as the gavel was ceremoniously passed to incoming FCEP leaders. The meeting also served as an opportunity to honor distinguished guests, including prominent figures from the Florida Medical Association and the American College of Emergency Physicians, as well as to present various awards.
2024-2025 FCEP Officers
President: Todd L. Slesinger, MD, FACEP, FCCM, FCCP
President-Elect: Saundra Jackson, MD, FACEP
Vice President: Blake Buchanan, MD
Secretary/Treasurer: Shayne Gue, MD
Immediate Past-President: Jordan Celeste, MD, FACEP
New FCEP Board Members Elected 2024-2027
Kyle Gerakopoulos, MD, MBA, FACEP
Eliot Goldner, MD, MBA, FACEP
Sara Kirby, MD
Brandy Milstead Hollingsworth, MD
Outgoing Board Members
Damian Caraballo, MD, FACEP
Stephen Viel, MD, MBA, FACEP
Nicole Vuong, MD
FCEP 2024 AWARD WINNERS
FCEP is pleased to announce our 2024 annual award winners who were recognized during the Board of Directors meeting at Symposium by the Sea 2024 on July 25.
2024 William T. Haeck FCEP Member of the Year: Ernest Page II, MD, FACEP
The Bill Haeck Member of the Year Award is named for our first president and one of FCEP’s founding leaders who worked tirelessly to create FCEP and the specialty of Emergency Medicine. It represents an individual who has performed service of significant importance to the FCEP, its members and our state that spans years and whose impact has positively impacted the field of emergency medicine over that time, noted or unsung.
FCEP’s 2024 Champion of Change: Stephen Viel, MD, MBA, FACEP
The FCEP Champion of Change Award is given each year in recognition of a leading FCEP advocate and individual who has made a significant contribution to the advancement of emergency medicine issues and advocacy in Florida.
FCEP’s 2024 Cliff Findeiss Emergency Medicine
Lifetime Achievement Award: Charles Duva, MD, FACEP, CMM
This lifetime achievement award celebrates Dr. Duva’s unwavering dedication to improving healthcare and his inspirational role as a leader and role model in the medical community.
THANK YOU FACULTY!
A heartfelt thank you to our incredible faculty physicians for their dedication, expertise, and the time they generously contributed to making Symposium by the Sea 2024 a success.
Jason Adler, MD, FACEP
Xavier Albino, MD
Sara Baker, MD
Andrew Bobbett, MD
Laurel Bolton, DO, FAAP
Pranav Bommineni, DO
Andrea Brault, MD, MMM, FACEP
Damian Caraballo, MD, FACEP
Mary Cayley, MD, JD
Jordan Celeste, MD, FACEP
Jennifer Chapman, MD, MBA
Chase Clemesha, MD
L. Anthony Cirillo, MD, FACEP
Christian Cochrane, DO
Natalie Diers, MD
Drake Dixon, MD
Nicolas Erbrich, MD, FAAP
Jay Falk, MD, FCCM, FACEP
Latha Ganti, MD, MS, MBA, FACEP, FAHA
Juan Gonzalez, DO
Jeffrey Goodloe, MD, FACEP
Michael Granovsky, MD, CPC, FACEP
Erich Heine, DO, FACEP
Taryn Hoffman, MD, FACEP, FPD-AEMUS
Nicole Irizarry Del Valle, MD, FACEP
Jennifer Jackson, MD, FACEP
Paul Khalil, MD
Danya Khoujah, MBBS, MEHP, FACEP
Sara Kirby, MD, FACEP, FAAP
Andy Little, DO, FACEP
René Mack, MD, RDMS, FACEP
Thom Mayer, MD, FACEP
Mary McLean, MD, FACEP
Jean Carlo Medina, MD
Yiraima Medina-Blasini, MD, FACEP
Sarah Melendez, MD
Moises Moreno, DO, FACEP
Enola Okonkwo, MD
Amit Patel, MD, FACEP
Aatish Patel, MD
Vanessa Perez, MD, FAAP
Amanda Priddy, MD
Nicole Rettig, MD
Javier Rosario, MD, FACEP
Jamie Shoemaker, MD, FACEP
Todd Slesinger, MD, FACEP, FCCM, FCCP, FAAEM
Michael Simoes, MD
Ryan Stanton, MD, FACEP
Conner Svetly, DO
Tricia Swan, MD, MEd, FACEP, FAAP
Sindhuja Tatagari, DO
Ariel Vera, MD, FACEP
Nicole Vuong, MD
Jason Wilson, MD
Chrissy Zeretzke-Bien, MD, FAAP, FAAEM, FACEP
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EMERGENCY MEDICINE RESEARCH COMPETITION 2024
BEST MEDICAL STUDENT PROJECT
First Place:
“Turnaround Time for Time for Toxic Alcohol Testing Prolongs Hospital Length of Stay: A retrospective comparator study between two poison centers”
By: Steven Chen and Jacob YudionoUSF Morsani College of Medicine
Second Place:
“Recalibrating the HEART score with high sensitivity troponin: implications for rule-out decisions and guideline optimization in low risk chest pain patients.”
By: John Keefe- UF Health
Third Place:
“Is r-TEG a predictor of critical illness in emergency department patients with GI gbleeds?”
By: Zachary Schwartz, Medical Student- USF MCOM
Presented by Nathan Lapaix, Medical Student- USF MCOM
BEST MEDICAL STUDENT CASE REPORT (NEW CATEGORY)
“Two Children with Neurologic Manifestations of Mycoplasma Pneumonia in the Pediatric ED.”
By: Kelsey Clabby, Medical Student, UCF
BEST RESIDENT CASE REPORT
First Place:
“Angioedema turned Aortic Dissection.”
B: Shivani Ruf- Orlando Health
Second Place:
“A Good History Solves the Mystery - Thoracic Endometriosis.”
By: Ashley Wong- Broward Health
Third Place:
“Bee Envenomation-Induced Transient Coagulopathy in a Trauma Patient: A Case Report”
By: Christopher Wallace- UCF/HCA-Ocala
BEST RESIDENT PROJECT
First Place:
“Standardizing Pediatric Asthma Management at Orlando Health Freestanding ED by Improving Utilization of the Arnold Palmer Hospital for Children Asthma Guidelines: A Quality Improvement Project.”
By: Pooja Sarin, MD- Orlando Health
Second Place:
“Am I Injured or Infarcted? Who Can Tell? BNP: hs-cTN Ratios May be a Useful Tool.”
By: Andrew Hood- UF Gainesville
Third Place:
“Exhaled ETCO2 Measured at Triage is Associated with Positive Blood Cultures but Lactate is Not.”
By: Madison Rocetenwald- Orlando Health
BEST FELLOW PROJECT
“Gastric Ultrasound for Aspiration Risk Determination (GUARD): Safer Sedation for Patients on GLP-1 Receptor Agonist”
B: Brandon Buchel, MD- Prior Ultrasound Fellow (Graduated June 2024), USF EM
SBS 2024 COMPETITION WINNERS
EM RESEARCH POSTER COMPETITION:
FIRST PLACE MEDICAL STUDENT PROJECT
“Turnaround Time for Time for Toxic Alcohol Testing Prolongs Hospital Length of Stay: A retrospective comparator study between two poison centers”
By Steven Chen and Jacob Yudiono- USF Morsani College of Medicine
BEST MEDICAL STUDENT CASE REPORT
“Two Children with Neurologic Manifestations of Mycoplasma Pneumonia in the Pediatric ED.”
By Kelsey Clabby, Medical Student, UCF
BEST RESIDENT CASE REPORT
“Angioedema turned Aortic Dissection.”
By Shivani Ruf- Orlando Health
BEST RESIDENT PROJECT
“Standardizing Pediatric Asthma Management at Orlando Health Freestanding ED by Improving Utilization of the Arnold Palmer Hospital for Children Asthma Guidelines: A Quality Improvement Project.”
By Pooja Sarin, MDOrlando Health
BEST FELLOW PROJECT
“Gastric Ultrasound for Aspiration Risk Determination (GUARD): Safer Sedation for Patients on GLP-1 Receptor Agonist”
By Brandon Buchel, MD- Prior Ultrasound Fellow (Graduated June 2024), USF EM
CASE PRESENTATION COMPETITION (CPC):
BEST PRESENTER
“ Neurosyphilis” by Sheila Mallenahalli, MD
PGY2 - University of Miami/ Jackson Memorial
BEST DISCUSSANT
“A Sweet Case of Rash —Sweet Syndrome” by Rakael Brown, MD
PGY 2 - FSU/ Sarasota Memorial
BEST OVERALL PROGRAM FSU/ Sarasota Memorial
EM RESIDENT QUIZ BOWL:
CHAMPIONS:
UCF/HCA Florida Healthcare GME (Greater Orlando/Osceola) Second Place: Orlando Health
FIRST PLACE: JACKSON MEMORIAL
SECOND PLACE: HCA ORANGE PARK
BEST COSTUME: USF
EM RESIDENT DROP THE MIC:
FIRST PLACE:
“Communication about Communication: Approach to the Deaf Patient in the Emergency Department”
By Andrew Bobbett, MD - UCF/ HCA Florida Healthcare GME (Greater Orlando/Osceola
THIRD PLACE:
“My First Patient as a Doctor: A Guide to the Unexpected Critical Patient”
By Jean Carlo Medina, MD - HCA Kendall
SATURDAY’S KARAOKE PARTY
Hosted by
HOW YOU WANT PRACTICE
TeamHealth’s Emergency Medicine teams deliver care to millions of patients in practices large and small, academic and community, urban and rural. Apply today to become part of the leading Emergency Medicine team with staff and leadership opportunities nationwide.
As a clinician with TeamHealth, you won’t have to worry about administrative burdens. Instead, you will have the ability to practice in a supportive environment that values clinical quality, patient experience, and clinician well-being. Our culture of partnership with both clinicians and clients fuels our fire to achieve best-in-class clinical care and service.
Whether you’re interested in participating in the vibrant growth of a new facility, or learning from established practices at renowned hospitals, TeamHealth has it all in Florida.
Learn and grow alongside the best in Emergency Medicine, with mentors, education and avenues for professional development that feed into your career path at TeamHealth.
ROADMAP TO THE FUTURE WITH CBME
By Carmen J. Martínez Martínez, MD, MSMEd, FACEP
By Caroline M. Molins, MD, MSMEd, FACEP
Introduction: In today’s fast-paced, ever-evolving healthcare environment, the ability to adapt and excel in critical moments is essential—especially in emergency medicine (EM). As the demands on EM providers grow, so does the need for an educational framework that goes beyond traditional methods. Medical education is on the brink of a significant shift, with the next few years marking the transition to Competency-Based Medical Education (CBME). This evolution has been many years in the making and represents a global, cross-specialty effort to better prepare healthcare professionals. This article offers a roadmap to understanding CBME within the context of EM.
PATH TO CBME
The journey toward CBME began over two decades ago. In 1999, the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) introduced six core competencies for medical education: medical knowledge, patient care, interpersonal communication skills, professionalism, practice-based learning and improvement, and systems-based practice. These domains of competence (DOC) laid the foundation for a more structured, outcomes-focused approach to training. In 2012, the ACGME launched the Next Accreditation System (NAS), which introduced the concept of milestones—specific benchmarks illustrating the expected progression of an EM physician from residency to independent practice. Initially, 23 subcompetencies were created, and these were refined further in 2021. It is expected that by 2026, CBME and its components are expected to be fully implemented across medical education, offering a more holistic and individualized approach to learning.
CLOSER LOOK AT CBME
CBME is a structured, outcomes-based approach that centers on learners’ ability to apply their knowledge directly to patient care. Unlike the traditional focus on knowledge acquisition, CBME emphasizes competency in real-world clinical scenarios. It is built on five key components – outcome competencies, tailored learning experiences, sequenced progression, competency focused instruction and programmatic assessment. These elements aim for the “developmental acquisition of competencies,” ensuring that learners move through their training in a structured and goal-oriented manner.
Table 1 details some of the core components that define this educational model. Taking example from Pediatric Emergency Medicine (PEM), which created 6 EPA’s for their fellows. Each EPA is described, mapped to DOC and individual milestones. On any given shift, some or all of the EPA’s are observed and individualized feedback is given to the learner. The EPA’s are documented and inform the WBA of that day. At specific intervals, WBA’s are reviewed by the learner and educators which can inform and reassess ILP’s. Graphic 1 shows a schema of how these individual pieces interplay.
TERM
DEFINITION
Entrustment Scale How much the observer would trust the resident to perform the EPA task independently or how competent the learner is to perform an activity without supervision
Entrustable professional activities or everyday physician activities (EPA)
Work-based assessments (WBA)
Individualized Learning Plan (ILP)
Tasks that physicians perform daily. They are mapped from DOC’s and milestones and use the entrustment scale as their assessment.
Multiple real-time observed assessments that provide verbal coaching. Likely to include multiple EPA’s
Tailored educational road maps designed to focus on a learner’s specific strengths and areas for improvement. This personalized approach is central to CBME and includes learner and educator involvement.
EXAMPLES
Level 1: 1 - I had to do it (Requires constant direct supervision and myself or others’ hands-on action for completion)
*Created the management plan, did the procedure, allowed them to observe a discussion with the patient
Emergency Department Management: Manage the ED to Optimize Patient Care**
Attending completes from the discusses EPA’s using entrustment scale and describes feedback given to resident during and after shift
Resident struggling with ultrasound skills. After self-reflection, resident need more practice as the knowledge is acquired. Works with mentor and Ultrasound director to have scanning shifts scheduled to increase competence
IMPLEMENTING CBME
CBME implementation is already underway globally. Canada, for example, has been using CBME in medical education for several years, with numerous studies reporting on its successes and challenges. In the United States, pediatric emergency medicine has begun its transition as well. A recent literature review by Stoffman identified three critical areas for successful CBME implementation: stakeholder engagement and leadership, resident and faculty development on CBME tasks and requirements and importance of educational and technological support. In addition, learner engagement on their learning and tailoring learning activities to learner needs is essential to CBME implementation.
LOOK TO THE FUTURE
Looking ahead, CBME will increasingly rely on data-driven assessment systems. These systems will gather information from various sources, such as electronic medical records, clinical performance metrics, and quality improvement scores, to offer a comprehensive view of a learner’s progress. Residency management systems will play a key role in programmatic assessment, ensuring that all aspects of a learner’s development are measured and addressed. Technology will also be a game-changer, aiding both learners and educators. Learners will benefit from simulations and virtual platforms that provide real-time feedback, while educators will have access to sophisticated tools for tracking performance and tailoring instruction. Curriculums will become more adaptable, designed to meet learners at their individual stages of development. This learner-centric model ensures that trainees are continuously progressing and applying their knowledge in practical, patient-centered ways.
Competency-Based Medical Education represents the future of emergency medicine training. By focusing on the mastery of essential skills, CBME ensures that both new and experienced providers are equipped to handle the complexities of emergency care. As this model becomes the standard, it will undoubtedly shape the next generation of emergency medicine professionals, ensuring they are not only competent but exceptional in delivering care in the most demanding environments. CBME is more than just an educational model—it’s a commitment to continuous improvement and excellence in patient care.
For emergency physicians and nurse practitioners, this shift offers an opportunity to enhance their skills, embrace lifelong learning, and thrive in an ever-changing healthcare landscape.■
Graphic 1
EPA1:
Recognize and Provide Care for Acutely Ill and/or Injured Pediatric Patients Presenting to the Emergency Department (ED)
EPA2: Recognize and Provide Care for Medically and Technologically Complex Pediatric Patients in the ED
EPA5: Emergency Department Management: Manage the ED to Optimize Patient Care ** American Board of Pediatrics. Entrustable professional activities for subspecialties. https://www.abp.org/content/entrustable-professional-activities-subspecialties. Accessed October 1, 2024.
FCEP MEDICAL STUDENT COUNCIL UPDATE
As the new academic year commences, the Florida College of Emergency Physicians (FCEP) Medical Student Council (MSC) is pleased to announce its leadership for 2024-2025. This September, we welcomed new members: Maria Colon (MSIII, Nova Southeastern University) as Chair; Carolina Fernandez (MS-III, Florida International University) as Secretary-Editor; Lexington Lemmon (MS-III, Nova Southeastern University) as Advocacy Chair; and Kelsey Clabby (MS-III, University of Central Florida College of Medicine) as Immediate Past Chair. We also proudly introduce Dr. Abigail Alorda as our new faculty advisor, who will guide the Council in creating opportunities for medical students across Florida interested in emergency medicine.
We extend our gratitude to the previous MSC and recognize their accomplishments. Under the leadership of Dr. Robyn Hoelle and the 2023-2024 Council (Chair Kelsey Clabby, Secretary-Editor Alexnys Fernandez, and Advocacy Chair Bailey Brown), numerous impactful events were organized. Dr. Hoelle, who served as faculty advisor for over a decade, was instrumental in establishing the FCEP MSC board and creating enduring traditions, including the mentorship program for medical students statewide. Her dedication to supporting future emergency medicine leaders is unwavering. Reflecting on her tenure, Dr. Hoelle remarked, “Emergency medicine is a family, and together we will continue to invest in our next generation! FCEP continues to support and represent all of us, from students to retired EM doctors!”
In this spirit, the MSC aims to provide diverse educational opportunities, including participation in the annual FCEP Symposium by the Sea, which took place from July 25-28 at the Eden Roc in Miami Beach. During this conference, students presented on various emergency medicine topics at the Medical Student Forum and served as proctors for a Clinical Skills Pointof-Care Ultrasound (PoCUS) workshop. Presenters crafted engaging, case-based PowerPoint presentations on topics ranging from Florida wildlife emergencies to pediatric care in the ER. Our Secretary-Editor, Carolina Fernandez, delivered a presentation on initial trauma assessments utilizing the “ABCDE” mnemonic, while Advocacy Chair Lexington Lemmon presented research on traumatic intracerebral hemorrhage in geriatric patients treated with benzodiazepines. These presentations facilitated professional development and refined public speaking skills in emergency medicine.
For the PoCUS workshop, selected medical students underwent training in RUSH/FASTexam techniques and collaborated with emergency medicine physicians to lead hands-on sessions. This experience enhanced their proficiency in PoCUS, an essential tool for rapid patient assessment in the emergency department, while fostering peer engagement and knowledge sharing.
Looking ahead, we have an exciting agenda for the 2024-2025 academic year, featuring events such as FCEP Symposium by the Sea 2025, ACEP 2025, EM Days, and our ongoing Advocacy Series. Florida medical students interested in emergency medicine are encouraged to attend the upcoming Symposium by the Sea, scheduled for July 31-August 3, 2025. Further details regarding location and application opportunities will be shared soon.
The recently concluded ACEP 2024 in Las Vegas marked a significant event for our Advocacy Chair, Lexington Lemmon, who participated in the EMRA residency fair, research forums, poster presentations, and networking events. ACEP 2025 will take place from September 7-10 in Salt Lake City, Utah, marking the conference’s inaugural event in that location.
EM Days, FCEP’s annual advocacy event, provides members an opportunity to influence the future of emergency medicine directly. This three-day event at Aloft Tallahassee Downtown connects members with legislators to discuss key legislative priorities while offering continuing education credits and networking opportunities with peers passionate about emergency medicine advocacy.
Finally, our new Advocacy Series will feature discussions on the evolving legislative landscape affecting emergency medicine practice. Collaborations with UCF professors will address critical patient care topics, including substance use, mental health disorders, and gender-based violence.
We anticipate a productive year ahead and encourage everyone to stay informed about these initiatives. Follow us on the FCEP MSC Instagram page (@fcep.msc) for updates and involvement opportunities and scan the QR code below to join our student roster! ■
Authors: Maria Colon, BS, OMS-III Nova Southeastern University Dr. Kiran C Patel College of Osteopathic Medicine; Lexington Lemmon, BS, OMS-III Nova Southeastern University Dr. Kiran C Patel College of Osteopathic Medicine; Carolina Fernandez, BS; MS-III Florida International University Herbert Wertheim College of Medicine
References
1. Association of American Medical Colleges. Competencybased medical education. https://www.aamc.org/about-us/ mission-areas/medical-education/cbme. Accessed October 1, 2024.
2. Carraccio C, Wolfsthal SD, Englander R, Ferentz K, Martin C. Shifting paradigms: from Flexner to competencies. Acad Med. 2002;77(5):361-367.
3. Gopalakrishnan S, Catherine AP, Kandasamy S, Ganesan H. Challenges and opportunities in the implementation of competency-based medical education: a cross-sectional survey among medical faculty in India. J Educ Health Promot. 2022;11:1-5.
4. Goldhamer MEJ, Martinez-Lage M, Black-Schaffer WS, et al. Reimagining the Clinical Competency Committee to enhance education and prepare for competencybased time-variable advancement. J Gen Intern Med. 2022;37(9):2280-2290.
5. Hall, Andrew K. MD, FRCPC, MMEd; Rich, Jessica PhD; Dagnone, J. Damon MD, FRCPC, MSc, MMEd; Weersink, Kristen MD, MSc; Caudle, Jaelyn MD, FRCPC, EMDM; Sherbino, Jonathan MD, FRCPC, MEd, FAcadMEd; Frank, Jason R. MD, FRCPC, MA(Ed); Bandiera, Glen MD, FRCPC, MEd; Van Melle, Elaine PhD. It’s a Marathon, Not a Sprint: Rapid Evaluation of Competency-Based Medical Education Program Implementation. Academic Medicine 95(5):p 786-793, May 2020.
6. ICE Blog. Re-imagining medical training: a near-future vision of competency-based medical education. https:// icenet.blog/2023/11/16/from-the-archives-re-imaginingmedical-training-a-near-future-vision-of-competencybased-medical-education/. Accessed October 1, 2024.
7. Mahajan R, Saiyad S, Virk A, Joshi A, Singh T. Blended programmatic assessment for competency-based curricula. J Postgrad Med. 2021;67(1):18-23.
8. McGill University. Competency-based medical education in pediatrics. https://www.mcgill.ca/peds/educationtraining/pgme/cbme. Accessed October 1, 2024.
9. Miller D, Rider A. Should the trainee be trusted? A user’s guide to assessment with EPAs. ALiEM. https://www. aliem.com/users-guide-assessment-with-epas/. Published January 24, 2020. Accessed October 1, 2024.
11. Open Access Government. Medical education: past and present. https://www.openaccessgovernment.org/ medical-education-past-and-present/84013/. Accessed October 1, 2024.
12. Stoffman JM. Overcoming the barriers to implementation of competence-based medical education in postgraduate medical education: a narrative literature review. Med Educ Online. 2022;27(1):2112012. doi:10.1080/10872981.2022.21120
13. Triola MM, Burk-Rafel J. Precision medical education. Acad Med. 2023;98(7):775-781.Van Melle E, Frank JR, Holmboe ES, et al; International Competency-based Medical Education Collaborators. A core components framework for evaluating implementation of competencybased medical education programs. Acad Med. 2019;94(7):1002-1009.
14. Van Melle E, Frank JR, Holmboe ES, et al; International Competency-based Medical Education Collaborators. A core components framework for evaluating implementation of competency-based medical education programs. Acad Med. 2019;94(7):1002-1009.
TAKE A CHANCE
Jeremy K. Selley, DO, FACOEP FCEP Board Member
When a medical team member goes on a medical mission trip it is usually from a moment of “right timing” and a “familiar face.” There are so many different organizations out there that go to so many wonderful places and so many people that need help. Conflict zones and natural disasters are other moments of opportunity that arise when folks need care. There are also many religious organizations that execute a combination of evangelical and medical missions.
“How do I choose or maybe next year?” I hear all the time when I solicit for team members. The cost usually approaches $2000 and 8-9 days off is a lot to commit to. Thankfully most of these trips are tax-deductible secondary to organizations having 401(c)(3) status that includes your team fee and flight. In the 7 years that I have helped coordinate teams, one way I have tried to make it easier for schedule purposes was to schedule a trip over two calendar months. This is usually helpful for our partners so all 8-9 days are not in one calendar month.
“Is it unsafe?”
The first time you go on any mission trip out of the country can be nerve racking. I myself, wrote good-bye letters to my family members the first time I went 8 years ago. That seems really funny to me now, but it was an honest first-time jitters emotion. Large groups of missionaries traveling together and the places they go are usually all very safe.
If someone you know is coordinating a medical mission trip, take an honest self-reflection of why you wouldn’t be able to go and take a leap of faith to join them. “Take a Chance!” You may only know the one person coordinating the trip, but I promise you come home from the trip a changed person with an entire team of close friends. Aside from making new acquaintances on your team, the patients you will meet will forever change your life and heart toward medical missions. When you get on that plane ride home you will be overjoyed with emotions and I guarantee most of you will find yourself saying, “how do I sign up for next year?”
“The work goes on, the cause endures, the hope still lives and the dream shall never die!” This is one of my favorite Senator Edward Kennedy quotes as he ended his 1980s Presidential run, however it means a lot more to me because it is so much more than political. I feel this way about the Carolina Honduras Health Foundation or CHHF (www.chhf.org). We all get so busy in our day to day life, but missionary work is by far the single most rewarding aspects of healthcare. If you are looking to do something to help find that work-life balance or maybe in search of a mental break from the day to day stresses that we encounter, then consider a mission trip. The people you will work with and the patients you will encounter create a passion to do more!
Grace and Gratitude.
This is what you can expect by going on a mission trip and the experience you will gain by treating the patients. The patients are so grateful to see you. They will walk miles in the sweltering summer heat, some of which while carrying a baby and with additional 2-3 kids in tow. Most of the time, they don’t even have access to healthcare let alone the ability to pay. This is why, speaking with their religious leaders about their health concerns is sometimes the only place they have to turn. The grace you receive by helping those in need will be returned to you exponentially. So…Take a Chance! Commit to a team! It will change your life. For me, as Mark Twain stated, “The two most important days are the day you are born and the day you find out why!” Maybe CHHF is also your reason why? ■
Box 70657, Myrtle Beach, SC 29572 (843)772-0077 |
A BOLD MOVE FORWARD: FCEP’S NEXT CHAPTER IN A NEW HOME
After years of growth and service from our Conway Road location, FCEP is excited to reach a major milestone: the sale of our former office and the purchase of a brand-new headquarters. This transition marks a new chapter in our association’s journey to better serve our members and expand our impact.
The decision to move was not made lightly. After listening to members’ feedback and evaluating our operational needs, it became clear that a different space was essential to achieving our mission. Our former office, while full of memories, no longer served the purpose of FCEP and FEMF.
Our new location at 400 N. Wymore Road in Winter Park, FL is a modern, accessible space that reflects our commitment to serving members. Members can look forward to a brighter, more welcoming, and intimate setting strategically located near I-4, ensuring convenience for visitors.
A complete remodel was necessary to transform the building into a space that meets the modern needs of our association. These updates ensured the property is fully functional for our operations, while also creating an environment that reflects the professionalism and values of our members. This significant investment was designed not only to enhance day-to-day functionality but also to provide a welcoming, inspiring space for our members and guests.
Melissa Keahey FCEP Executive Director
We are deeply grateful to the members of both the FCEP and FEMF Boards of Directors under the leadership of FCEP Immediate Past President Dr. Jordan Celeste and FEMF President Dr. Ernest Page II, who worked tirelessly to ensure a smooth transition. From scouting locations and discussing terms to envisioning the future layout, their dedication made this move possible.
This move represents more than a change in address—it’s a bold step toward a brighter future for FCEP and FEMF. It is not just about a new building; it’s about creating a stronger foundation for our association’s future. Our new headquarters is designed to strengthen our ability to connect, collaborate, and innovate as we continue to serve our members and the communities we care for.
We look forward to celebrating this milestone with you at our open house on Tuesday, February 11, 2025 where you will have the chance to explore the new space, meet fellow members, and learn about upcoming initiatives. . Together, we’ll embrace new opportunities and continue building a legacy of excellence. Thank you for your unwavering trust and support—here’s to a stronger tomorrow. ■
Together, we’re building something extraordinary.
CHARTING A SUSTAINABLE CAREER:
FELLOWSHIP OPPORTUNITIES TO THRIVE BEYOND TRADITIONAL EMERGENCY MEDICINE
Shayne Gue, MD, MSMEd FCEP Secretary/ Treasurer
After completing an Emergency Medicine (EM) residency, many graduates seek to refine their expertise and pursue further specialization through fellowship programs. Fellowships offer a pathway for EM physicians to build on their foundational training, develop advanced clinical skills, and explore niche areas that can enhance both professional satisfaction and career longevity. Beyond expanding clinical knowledge, fellowships provide leadership opportunities, foster academic growth, and create a space for physicians to tailor their careers to personal interests and strengths.
In Florida, numerous fellowship programs exist, ranging from ACGME-accredited to non-ACGME-accredited offerings, allowing EM graduates to specialize in diverse areas like pediatric emergency medicine, medical education, ultrasound, critical care, and more. Engaging in these focused training opportunities not only opens doors to unique career paths but can also help combat physician burnout. By cultivating a passion for a specific area of medicine, EM physicians can find renewed purpose, improve work-life balance, and experience the intellectual stimulation that comes from continued learning and professional development.
Below, we explore the available fellowship opportunities in Florida, detailing what each program entails and the career opportunities that await after completion.
ACGME-ACCREDITED PROGRAMS IN EMERGENCY MEDICINE:
Addiction Medicine, Clinical Informatics*, Emergency Medical Services, Medical Toxicology*, Pediatric Emergency Medicine, Sports Medicine*, and Undersea and Hyperbaric Medicine*
1. ADDICTION MEDICINE
Addiction Medicine fellowships prepare physicians to address substance use disorders, often working in interdisciplinary teams that include mental health professionals and social workers. Fellows learn about evidence-based treatment approaches such as medication-assisted therapy (MAT), harm reduction strategies, and counseling techniques.
Career opportunities: Addiction medicine physicians may work in specialized clinics, public health sectors, hospitals, or rehabilitation centers, often serving as consultants or leaders of addiction recovery programs.
• University of Florida College of Medicine – Gainesville
• PD: Kent T. Mathias, MD
• HCA/USF Brandon
• PD: Abbas E. Sina, MD
2. EMERGENCY MEDICAL SERVICES (EMS)
EMS fellowships provide training in the administration and medical direction of prehospital care systems. Fellows are equipped to develop EMS protocols, oversee clinical operations, and manage large-scale events, disaster response, and mass casualty incidents.
Career opportunities: EMS-trained physicians often serve as medical directors for EMS systems, air medical programs, or disaster response teams, and many take on leadership roles in public safety and policy development.
• Orlando Health
• PD: Christian Zuver, MD
• University of South Florida Morsani College of Medicine
• PD: Rachel Semmons, MD
• University of Florida College of Medicine –Gainesville
PEM fellowships focus on the emergency care of infants, children, and adolescents. Fellows are trained to handle a wide spectrum of pediatric emergencies and develop skills in childspecific resuscitation and trauma care.
Career opportunities: Graduates may work in pediatric emergency departments, children’s hospitals, or academic centers, often serving as leaders in child advocacy, injury prevention, and pediatric trauma care.
• University of Florida College of Medicine – Jacksonville
• PD: Todd Wylie, MD
• Orlando Health
• PD: Efren Salinero, MD
• University of Florida College of Medicine – Gainesville
• PD: John Bahling, MD, MBA
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4. SPORTS MEDICINE
Sports Medicine fellowships focus on treating athletes and active individuals, addressing both acute injuries and chronic conditions related to physical activity. Fellows work with athletic teams and gain experience in musculoskeletal medicine, exercise physiology, and rehabilitation.
Career opportunities: Sports medicine physicians may serve as team doctors for professional or collegiate sports teams, work in sports rehabilitation centers, or take leadership roles in fitness and wellness programs.
• Orlando Health
• PD: Bruce Levy, MD
• University of Florida College of Medicine – Gainesville
• PD: James R Clugston, MD, MS
NON-ACGME-ACCREDITED PROGRAMS IN EMERGENCY MEDICINE (INCLUDES NONACCREDITED PROGRAMS AND ACGME-ACCREDITED PROGRAMS SPONSORED IN OTHER SPECIALTIES):
Medical Education, Ultrasound, Critical Care, Research, Administration, Simulation, Global Health, and more
1. MEDICAL EDUCATION
Medical Education fellowships train EM physicians to become leaders in academic medicine, focusing on teaching skills, curriculum development, and educational research. Fellows often develop scholarly projects aimed at improving medical education delivery. The focus is on developing educators who can train the next generation of emergency physicians and contribute to the academic community.
Career opportunities: Graduates of medical education fellowships typically work in academic settings, leading residency programs, designing medical curricula, or becoming deans or department chairs.
• University of Florida College of Medicine – Jacksonville
Ultrasound fellowships provide in-depth training in point-of-care ultrasound (POCUS) across multiple clinical scenarios, including trauma, cardiac emergencies, and procedural guidance. Fellows gain proficiency in teaching and research methodologies related to POCUS, while enhancing clinical care through advanced diagnostic techniques.
Career opportunities: Ultrasound-trained physicians may become ultrasound directors within emergency departments or serve as POCUS consultants for hospitals and healthcare systems.
• University of Florida College of Medicine –Jacksonville
• PD: Petra E. Duran-Gehring, MD
• University of South Florida Morsani College of Medicine
• PD: Charlotte Derr, MD, RDMS
• University of Florida College of Medicine – Gainesville
Critical Care fellowships train EM physicians in managing critically ill patients, with a focus on invasive procedures, ventilator management, and complex resuscitations. Fellows spend significant time in the ICU, refining their skills in advanced critical care techniques.
Career opportunities: Critical care physicians often work in intensive care units (ICUs) or hybrid roles that allow them to split time between the emergency department and ICU settings.
• Orlando Health
• PD: David Bostick, MD, MPH
• University of South Florida Morsani College of Medicine
• PD: W. Dwight Miller, MD, MS
• University of Florida College of Medicine – Gainesville
• PD: Rohit P. Patel, MD
4. RESEARCH
Research fellowships help EM physicians develop a foundation in clinical research, data analysis, and medical publishing. Fellows engage in independent research projects, often contributing to advancements in emergency medicine practices.
Career opportunities: Physicians with research training can lead clinical trials, pursue academic positions, or work with pharmaceutical or medical device companies to advance healthcare innovation.
• University of Florida College of Medicine – Jacksonville
• PDs: Jennifer Fishe, MD and Sophia Sheikh, MD
TeamHealth Earns Notable Recognition among America’s Top Workplaces for Diversity
By Dr. Stan Thompson, TeamHealth Chief Diversity Officer and Dr. Debra Lacy, TeamHealth Director of Diversity, Equity and Inclusion
In today’s healthcare landscape, diversity stands as a central pillar of success. It fosters compassion, innovation, and a dynamic work environment that benefits patients and those who work in all aspects of healthcare.
Underscoring our commitment to creating a positive and thriving work atmosphere, TeamHealth has been recognized as one of America’s Greatest Workplaces for Diversity by Newsweek. This exciting achievement highlights our unwavering commitment to an inclusive and supportive work environment where diversity is celebrated and all voices are heard. We believe embracing diversity strengthens our team and improves patient experiences and clinical outcomes.
TeamHealth Proudly Receives a Top Ranking
Newsweek and market data research firm Plant-A Insights Group conducted this survey with “HR professionals and received insights into corporate culture and work environments from employees who were surveyed anonymously. Respondents shared insights into corporate culture, working environments and other aspects of both their own companies and others they were familiar with, resulting in over 1.5 million company reviews.” Among the top-ranking companies, TeamHealth proudly received 5 out of a possible 5 stars which is a testament to our genuine commitment to supporting diversity and equity in healthcare.
Several key factors contribute to our recognition, including a culture of inclusion that extends into our training, mentorship programs, and hiring practices. We at TeamHealth have cultivated an environment where employees from diverse backgrounds feel welcome and empowered to contribute their unique perspectives. This commitment extends beyond internal practices, with TeamHealth actively engaging with external organizations that promote diversity and equity in the broader community.
Shared Recognition for All Team Members
TeamHealth’s inclusion as one of America’s Greatest Workplaces for Diversity 2024 underscores our focus on creating an environment where employees thrive both personally and professionally. This recognition is for all members of our TeamHealth family. Thank you for your passion, dedication, and unique perspectives that make TeamHealth an extraordinary place to work. You are the reason we have a workplace where everyone feels valued, respected, and empowered.
TEAM
Emergency Medicine
CLINICIAN EDITORIAL ARTICLE
Establish a Just Culture to Improve Patient Safety
— by Keenan Bora, MD, FACEP, Vice President, Safety and Quality Registries at Envision Physician Services
With the Institute of Medicine’s report, To Err Is Human: Building a Safer Health System, Centers for Medicare & Medicaid Services applied safety lessons gleaned from the aviation industry’s efforts to learn from defects. Under this new methodology, termed Safety I, human performance and errors are sorted into the following classifications:
■ Skill-based — Errors made due to inattention, considering one’s experience with an operation
■ Rule-based — Errors made from misinterpreting or deviating from standardized procedures
■ Knowledge-based — Errors made from lapses in judgment and decision-making
This framework is a helpful way to focus on the errors and how to eliminate them, but there are limitations. Emerging within the last 10 years as a response to those limitations is Safety II, an approach that focuses on the conditions that drive success. By complementing Safety I protocols, Safety II more fully realizes the concept of a Just Culture.
Developing a Just Culture: Tools and Considerations
A Just Culture is a non-punitive approach that attempts to evaluate human behavior in an unbiased manner with respect to errors. There are a variety of examples of Just Culture algorithms that you can use when developing a Just Culture at your hospital or health system, such as University of California, Irvine’s algorithm or University of Maryland Medical System’s tool.
With any Just Culture algorithm, the goal is to classify behavior into one of a few classes: human error, at-risk behavior and reckless behavior. The idea behind these classifications is that the systems and solutions put in place to mitigate or prevent the error will have to be tailored to the type of error. Very few medical errors are the result of reckless behavior that should require disciplinary action.
Before applying a Just Culture algorithm, ask yourself these questions:
■ What happened?
■ What normally happens?
■ What, if any, procedures are applicable?
■ Why did it happen?
■ Are there any forcing functions that prevent errors like this?
There are also a few tests or thought experiments you can use to evaluate errors when they occur:
■ Substitution test — Would any equivalently trained employee have done the same thing? Would you have committed the same error?
■ Intentionality test — Was there a knowing violation of care standards?
■ Impairment test — Were any people involved impaired by substance abuse, withdrawal or other physical or mental health issues?
Using the tools and processes above will help your healthcare facility more effectively reduce medical errors by advancing a system of safety and self-improvement.
CALL FOR PRESENTATIONS: SBS 2025
The Florida College of Emergency Physicians (FCEP), in conjunction with the Florida Emergency Medicine Foundation (FEMF), is requesting presentations for its 55th Annual Meeting: Symposium by the Sea 2025 on July 31- August 3, 2025 at the Ft. Launderdale Marriott Harbor Bech Resort and Spa Symposium by the Sea participants include emergency physicians, residents, nurses, physician assistants and medical students.
If you are interested in submitting a proposal to present at Symposium by the Sea 2025, scan here to learn more:
EMERGENCY PHYSICIANS ARE FACING NEW PAYMENT BARRIERS
Elijah Berg, MD, FACEP CEO of LogixHealth
Payers are increasingly putting up unfair barriers to prompt and seamless payment for high value emergency medicine services. While the motivations may be varied, the result is the widespread use of programs that inappropriately reduce and delay payment.
For decades, America’s health system involved physicians contracting with insurers and in return the payer agreed to pay for those services at a contracted rate. Payers largely paid for the services shortly after a claim was submitted, unless there was a very significant bonafide reason to withhold payment.
In contrast to this long-standing practice, payers now often decline to reimburse submitted claims based upon a prepayment computer algorithm. The refusal to pay allows the payer to hold on to the money while imposing administrative burdens on practices seeking full payment. Payers are refusing to pay some claims under the guise of a potential coding issue.
THERE ARE TWO COMMON PROCESSES:
1.
The payer requires more information before fully processing the claim.
2.
The payer is not denying the claim but rather states that more information (the medical record) is needed.
The payer’s Explanation of Benefits (EOB) indicates a potential coding disagreement.
The EOB correspondence indicates that the claim will not be paid at the full rate for the level submitted due to a vague reason such as “E&M level not supported.”
If the payer wants to review a record it should do so after paying the claim. Prepayment reviews of a significant number of claims and withholding payment is akin to holding payment hostage.
One of the latest payers to announce a program is Aetna, who announced that in July, 2024 it would be utilizing “new claim edits” which applied to emergency department services stating that the edits “support our continuing effort to process claims accurately” and that Aetna will “evaluate the proper use of the Level 4 and 5 E&M coding that you submit. We may adjust your payment if the claim details don’t support the level of service billed.” In this example, Aetna states that the payment may be adjusted rather than not reimbursed at all.
These payer programs are not always noticed. Be on the lookout for inappropriate prepayment programs, which come in different shapes and sizes. The key to developing an appropriate response to protect your revenue is to first gain a clear understanding of the details of the specific program the payer is using, and then to review your contract (if any) and legal options.
PAYER CODING AUDITS PERFORMED BY HUMAN CODERS HAVE BEEN REPLACED WITH PREPAYMENT COMPUTER ALGORITHMS THAT DELAY PAYMENT AND CAUSE PHYSICIAN GROUPS TO EXPEND RESOURCES ON WASTEFUL AND INEFFICIENT PROCESSES.
March 24-26, 2025
5. ADMINISTRATION
Administration fellowships focus on the business aspects of running healthcare organizations. Fellows gain experience in hospital administration, quality improvement, healthcare policy, and medical leadership. Of note, the American Board of Medical Specialties recently approved Health Care Administration, Leadership, and Management (HALM) as an official subspecialty and will by sponsored by the American Board of Emergency Medicine.
Career opportunities: EM physicians with administrative training often move into hospital leadership, medical director roles, or health system management.
• University of South Florida Morsani College of Medicine***
• PD: Reginald Saint-Hilaire, MD, MBA
• University of Florida College of Medicine – Gainesville
• PD: Brandon R Allen, MD
• HCA Kendall
• PDs: Jessica Quinones, MD
6. SIMULATION
Simulation fellowships train physicians to develop and run simulation programs for medical education and disaster preparedness. Fellows learn to design simulation scenarios, debrief participants, and use technology to improve medical training.
Career opportunities: Simulation-trained physicians often serve as directors of simulation centers, design curriculum for medical schools, or consult on disaster preparedness programs.
• University of South Florida Morsani College of Medicine
• PD: Normaliz Rodriguez, MD
• University of Florida College of Medicine – Gainesville
Global Health fellowships prepare EM physicians for work in international settings, focusing on healthcare delivery in lowresource environments. Fellows often work with international health organizations and participate in medical missions.
Career opportunities: Global health physicians may work with international NGOs, the World Health Organization (WHO), or in global health education and policy advocacy.
• University of Florida College of Medicine – Gainesville***
• PD: Torben K. Becker, MD, PhD, MBA
• Jackson Health System/University of Miami
• PDs: Rolando Valenzuela, MD
COMPREHENSIVE LIST OF EM FELLOWSHIP PROGRAMS IN FLORIDA
Here is a detailed list of the fellowship opportunities available in Florida for Emergency Medicine graduates:
University of Florida College of Medicine – Jacksonville: Pediatric Emergency Medicine, Medical Education, Research, and Ultrasound
Orlando Health:
Critical Care, Emergency Medical Services, Pediatric Emergency Medicine, Sports Medicine, Ultrasound, Administration****, Simulation/Education****, and Information Technology****
University of South Florida Morsani College of Medicine: Administration, Emergency Medical Services, Ultrasound, Simulation, and Critical Care
University of Florida College of Medicine – Gainesville: Addiction Medicine, Administration, Critical Care, Emergency Medical Services, Global Health, Pediatric Emergency Medicine, Simulation, Sports Medicine, and Ultrasound
AdventHealth East Orlando: Ultrasound and Critical Care****
UCF/HCA Florida Healthcare GME (Greater Orlando/Osceola): Medical Education, Simulation, Ultrasound, and Emergency Medical Services
Mount Sinai Medical Center: Ultrasound
Florida Atlantic University: Emergency Medical Services
Jackson Health System/University of Miami: Medical Education, Ultrasound, Global Health HCA Kendall: Ultrasound and Administration
Fellowship programs offer emergency medicine graduates the opportunity to shape their careers in exciting and meaningful ways. Whether focusing on clinical subspecialties, education, research, or leadership, fellowships provide a pathway to career longevity by allowing EM physicians to pursue their passions and avoid burnout. The diverse range of fellowships available in Florida ensures that graduates can find a program that aligns with their interests and long-term goals. By diving deeper into specialized areas, physicians not only enhance their skillset but also cultivate a career with lasting fulfillment and balance.
* no accredited programs in Florida
** SAEM-approved fellowship program
*** denotes program currently seeking ACGME accreditation in HALM (new)
**** denotes fellowship opportunities listed; however, no additional information is readily accessible on the respective program’s website
The author would like to acknowledge GPT-4o (OpenAI) for providing editorial assistance and refining the manuscript ■
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