2340 S. River Road, Suite 200 • Des Plaines, IL 60018 • 847-813-9823 • saem@saem.org • www.saem.org
MARCH/APRIL 2012
SAADIA AKHTAR, MD Program Director for the Emergency Medicine Residency at Beth Israel Medical Center
E-PROFESSIONALISM: Social Media and Medicine
ANNUAL MEETING JOIN US in Chicago May 9-12, 2012 for SAEM's Annual Meeting
ETHICS IN ACTION: Disclosing Medical Error
VOLUME XXVII NUMBER 2
SAEM STAFF Interim Executive Director Ronald S. Moen Ext. 212, rmoen@saem.org Education Coordinator Sandy Rummel Ext. 213, srummel@saem.org Accountant Mai Luu, MSA Ext. 208, mluu@saem.org Administrative Assistant Michelle Iniguez Ext. 206, miniguez@saem.org Grants Coordinator Melissa McMillian Ext. 203, mmcmillian@saem.org Help Desk Specialist Neal Hardin Ext. 204, nhardin@saem.org Web and Information Systems Jason Smith Ext. 205, jsmith@saem.org Marketing & Membership Manager Holly Gouin, MBA Ext. 210, hgouin@saem.org Meeting Coordinator Maryanne Greketis, CMP Ext. 209, mgreketis@saem.org Membership Assistant George Greaves Ext. 211, ggreaves@saem.org Receptionist Vicki Daly Ext. 201, vdaly@saem.org
SAEM M EM BERSHIP Membership Count as of February 15, 2012 2039 Active 39 Associate 2975 Resident/Fellow 130 Medical Students
4 International Affiliates 29 Emeritus 5225 Total
2012 SAEM DUES $560 Active $250 Associate $495 Faculty Group $460 2nd yr. Graduate $335 1st yr. Graduate $165 Resident
$165 Fellow $140 Resident Group $140 Medical Student $120 Emeritus $100 Academies $25 Interest Group
International – email membership@saem.org for pricing details. All membership categories include one free interest group membership.
ADVERTISEM ENT RATES The SAEM Newsletter is limited to postings for fellowship and academic positions available and offers classified ads, quarter-page, half-page and full-page options. The SAEM Newsletter publisher requires that all ads be submitted in camera-ready format meeting the dimensions of the requested ad size. See specific dimensions listed below. • A full-page ad costs $1250 (7.5” wide x 9.75” high) • A half-page ad costs $675 (7.5” wide x 4.75” high) • A quarter-page ad costs $350 (3.5” wide x 4.75” high) • A classified ad (100 words or less) costs $120 If there are any pictures or special fonts in the advertisement, please send the file of those along with the completed ad. We appreciate your proactive commitment to education, as well as to personal and professional advancement, and strive to work with you in any way we can to enhance your goals. Contact us today to reserve your ad in an upcoming SAEM Newsletter. The due dates for 2012 are: April 1, 2012 for May/June issue June 1, 2012 for July/August issue August 1, 2012 for September/October issue October 1, 2012 for November/December issue December 1, 2012 for January/February issue
HIGHLIGHTS
HEY NEWSLETTER READERS Are you looking for more from SAEM? More news, reminders, updates, and insight? Then become a fan of SAEM’s Facebook page, or follow us on Twitter! Just follow the links on the SAEM homepage to join.
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President’s Message
On our Facebook page, you’ll learn about upcoming events, reconnect with colleagues, browse photos and more!
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By following SAEM on Twitter, you can join in the conversation on current EM topics, follow links to important resources, and get updated on the latest SAEM news.
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Member Highlight
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2012 Annual Meeting
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Attention all Graduating Residents
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Ethics in Action
SAEM has always been a social group – now you can participate through social media!
Executive Director’s Message
JOIN TODAY.
REGISTRATION IS NOW OPEN! Have you heard? Registration for the 2012 Annual Meeting is open at http://www.saem.org/register-annual-meeting-2012! The Program Committee encourages you to take advantage of the early registration discount as well as a number of new discounts SAEM is now featuring. The meeting promises to be one of our most innovative to date and as always will feature the latest research and development putting you on the cutting edge of emergency medicine. In addition SAEM has made planning your schedule for the Annual Meeting even easier. You can now review didactic and abstract sessions at http://am2012.saem.org/Schedule and add them to your calendar for access on the go. You are able to access further information on each topic and the presenters by clicking on the session titles. The schedule will continue to grow as more events become available. Make sure to set the SAEM Annual Meeting page to your browser favorites. New and exciting announcements will continue to be featured as we move toward the meeting date and you won’t want to miss out! The Board and SAEM Staff know that Chicago is definitely the place to be May 9-12, 2012 – we hope you will be joining us and look forward to seeing everyone!
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AAAEM Meeting
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AACEM Meeting
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Academic Announcements
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Calls And Meeting Announcements
PRESIDENT’S M ESSAGE CHANGES IN CHICAGO: EXECUTIVE DIRECTOR TRANSITION Deb Houry, MD, MPH Emory University
Debra Houry, MD, MPH
As you are aware by now, Mr. James Tarrant left SAEM after having served as Executive Director since June 2007. Jim brought to SAEM over 20 years of experience in medical society and association management. In this time period of nearly five years he worked with the SAEM Board to accomplish a number of significant changes and we wish him well in his new endeavors!
During his tenure SAEM expanded staffing, forged external relationships, relocated the headquarters from Michigan to Des Plaines, Illinois, installed a new membership database, abstract platform and website. Jim worked in concert with the SAEM Board to create a new mission, vision and 5-year strategic plan, including international outreach and engaged membership through the establishment of internal academies for selected membership interests. Financial stability was established through his recommendations to leadership for Board Designated Funds including building, capital equipment and special projects and initiation of the first external audit in 30 years with successful outcome. Jim managed the formation of a separate 501(c)(3) SAEM Foundation to house the grants for research and education and implemented fundraising campaigns to increase donations. He and staff implemented improved accuracy of membership data, timely collection of dues and moved elections to an electronic platform. Jim also served as the Executive Director of the Association of Academic Chairs of Emergency Medicine, building a close relationship between SAEM and the chairs, assisting with AACEM’s Annual Meeting and external relationships. To maintain the organization’s momentum, the Board named an Interim Executive Director, Ronald Moen. Ron is an experienced association executive who has dedicated his life to serving in a variety of health care organizations. His professional training as a clinical psychologist who worked in both inpatient and outpatient care provided him a unique perspective as he developed mental health programs in a variety of settings. Ron has more than 30 years in association management and has a track record of excellence in building, revitalizing and maintaining complex structures needed to advance associations and he prides himself in being consistently responsive to leadership and members in facilitating direction and development of their associations. Mr. Moen served on the staff at The Joint Commission where he was instrumental in developing standards for mental health
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programs and for the ambulatory health care settings. He served as the first Executive Director for the Accreditation Association for Ambulatory Health Care, and later became the Executive Director of the American Association for Orthodontists. More recently he was the Chief Executive Officer of the American Dietetic Association, now the Academy of Nutrition and Dietetics. The Board of Directors looks forward to working with Mr. Moen in the coming year to meet the needs of SAEM members and in helping SAEM move forward to meet the challenges that exist in the health care environment, and in particular those in academic emergency medicine. Ron will be at the AACEM/AAAEM meeting as well as the SAEM Annual Meeting and looks forward to meeting many of you in person. He is already off to a great start this month and I know we will see continued improvements with member services, the website, and our meetings under his leadership. ◗
EXECUTIVE DIRECTOR’S M ESSAGE THIS IS A VERY EXCITING TIME TO BE INVOLVED IN SAEM.
Ronald S. Moen
This is a very exciting time to be involved in SAEM. Registration is now open for the Annual Meeting in Chicago, and the program is clearly one of the best ever. No member of SAEM should miss the opportunity to participate this year. How better to develop our skills, learn from colleagues and celebrate this wonderful specialty than to participate in this annual gathering?
Look at the Annual Meeting website to review the numerous didactic sessions, peruse nearly 750 abstracts of cutting edge research, marvel at the SIM Competition and have a chance to see old friends and make new friends among your emergency medicine colleagues from around the country and many from other countries as well. Clearly this is the place to be for research and education in Emergency Medicine. The Sheraton Chicago is our headquarter hotel and the site for almost all of the sessions and events. Plus, Chicago is known for its fine restaurants of almost every variety, beautiful parks, world class museums, vibrant theater, music of every genre and neighborhoods that represent a microcosm of the world. You will be hard pressed to find time to enjoy even just a smattering of what many have called the “Most American City” in the USA. As your new Interim Executive Director, it is my pleasure to work with a fine Board of Directors and Staff, some of whom are here in Des Plaines and some who work remotely from Michigan and Ohio. In a world of ever expanding technological marvels, we see ever increasing uses of technology for enhanced communication and an ability to connect with members, committees, task forces, interest groups, Academies and other related professional
organizations. Our goal is to provide excellent and timely service to all SAEM members and to facilitate your work and education as much as possible. We are only a phone call or email away and we look forward to meeting your needs whenever possible. I look forward to meeting you at the Annual Meeting and hearing your views on how SAEM can better serve you. Committees, Task Forces, Interest Groups, our Academies and other organizations like the AACEM and AAAEM (Association of Academic Chairs of Emergency Medicine and Academy of Administrators in Academic Emergency Medicine) all take on tasks which are important to the specialty and offer an opportunity for member input, leadership development and sharing of issues that are important to the specialty. I am also looking forward to being at the AACEM and AAAEM meetings in Washington, DC in April. Let me know if there is anything we can do to be of help to you as an SAEM member. The best way to contact me is via email at rmoen@saem.org . Finally, be sure to get your registration in for the Annual Meeting. This year we have several different discount offers available to SAEM members! Each institution that sends more than ten (10) total attendees for the complete meeting (full registration) will be sent VISA gift cards for $50, one for each attendee. Additionally, we are running a ‘Bring a Colleague for Free’ promotion (100 spots available); one colleague per SAEM member attending the Annual Meeting. Please contact our membership department for more details. This is an event you will not want to miss! Ronald S. Moen Interim Executive Director ◗
VIRTUAL ISSUES “Virtual Issues” will be a key feature of the journal’s new home page on our publisher’s recently implemented platform, Wiley Online Library (WOL). A virtual issue is basically just a collection of articles on a given topic - so the EMS virtual issue, for example, will be a running compilation of all EMS articles that we publish. The idea is that a reader will go there to look for a particular article, but then will see our other offerings on that topic as well - increasing our full-text download numbers and helping ensure the broadest dissemination of our authors’ work. The first Geriatrics Virtual Issue is online. Go to the journal’s home page on the WOL platform, see “Special Features” on the left-hand side and click on the feature. http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1553-2712 Stay tuned for updates!
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M EM BER HIGHLIGHT SAADIA AKHTAR, MD “I truly feel blessed and privileged to be a Program Director…” Dr. Saadia Akhtar is currently the Program Director for the Emergency Medicine Residency at Beth Israel Medical Center in New York City. She has dedicated her career to emergency medicine education and is very passionate about teaching residents. She enjoys being a mentor to various individuals at different stages of their professional career. Dr. Akhtar has had the good fortune to live and grow up in several countries around the world including Bahrain, Jamaica, Pakistan, Sri Lanka, Turkey, United Kingdom and the United States. After completing high school in New York City, Dr. Akhtar moved back to her native country of Pakistan. She obtained her medical degree from the Aga Khan University Medical College in Karachi. During her elective rotations in her last year of medical school, she was fortunate to gain clinical experience in emergency medicine at Beth Israel Medical Center in New York City.
After graduation from medical school, Dr. Akhtar acquired clinical research experience in the field of emergency medicine as a Research Associate in New York. In July 1996, Dr. Akhtar was successful in matching at the competitive combined residency program in Emergency Medicine and Internal Medicine at Beth Israel Medical Center, the Manhattan Campus of the Albert Einstein College of Medicine. Upon beginning the five year residency program, Dr. Akhtar developed a very keen interest in residency education. During her first year of residency, Dr. Akhtar made a career goal to one day become a residency program director in emergency medicine. In her last year of training, Dr. Akhtar was chosen to be a chief resident in emergency medicine. In addition to many new initiatives made in this academic leadership role, Dr. Akhtar implemented a journal club during the weekly resident conference which focused on teaching evidence-based medicine principles. Her excellent residency experience solidified her plan to remain in an academic setting as her future career goal. In July 2001, upon graduating from residency, Dr. Akhtar became a core faculty member in the Department of Emergency Medicine at Beth Israel Medical Center. At this time, Dr. Akhtar developed a great interest in emergency ultrasonography. She subsequently became the Ultrasound Director for the emergency medicine residency and remained in this role for the next seven years. In her desire to be intricately involved with residency leadership, Dr. Akhtar at the same time became the Assistant Program Director in 2004 for the emergency medicine residency program at Beth Israel Medical Center. She subsequently became the Associate Program Director and in November 2006, she was asked to become the Program Director for the residency program. Over this time, Dr. Akhtar has also received awards recognizing her dedication to residency education and her compassionate manner in delivering patient care in the emergency department. In addition to her role as a Program Director, Dr. Akhtar continues to participate in various activities at the local, regional
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and national levels. She is currently the Chair of the National Emergency Medicine CPC Task Force, a competition sponsored by CORD, SAEM, ACEP and EMRA. She is honored to be a member-at-large of the Board of Directors for CORD. As part of this leadership role, she is also the CORD Board of Directors liaison to EMRA. Dr. Akhtar is also the Co-Track Chair for the Program Leadership Development Track and member of the planning committee for the CORD Academic Assembly. She is honored to be an ABEM oral board examiner. Dr. Akhtar is also an active member of SAEM Academies- the Academy of Emergency Ultrasound and Academy for Women in Academic Emergency Medicine Regional Advisory Committee. In addition, Dr. Akhtar is a fellow of The New York Academy of Medicine and a key member of the Section on Evidence Based Health Care and the TEACH conference. She also enjoys her role as a Medical Team Captain for the ING New York City Marathon. Throughout her career, Dr. Akhtar has had several mentors and continues to strive to be a role model and mentor for the future of emergency medicine. She is very passionate about emergency medicine and residency education. “I truly feel blessed and privileged to be a Program Director. I am very proud of our residency program and residents. I thank the members of the emergency medicine community for all their continued guidance, mentorship and support.”. ◗
2012 SAEM ANNUAL MEETING Michael Hochberg, MD
Chairman, SAEM Program Committee Change is a horrible word. It implies so much yet can mean so little. It gets tossed around so often like so many dandelion seeds on a windy summer day that it usually generates the same response as said dandelion: it makes the eyes watery, the head stuffy, and ensures that we want to be medicated against it. There’s a reason why Ferris Bueller will have a commercial during the Super Bowl: people like nostalgia and the feeling of connection to the past. Change is a horrible word. It means what we used to like will be gone simply because someone thought new meant better. As I write this, it has been approximately seven months since I took over as Program Committee Chair. Prior to this role, I had been the Scientific Sub-Committee chair in charge of abstracts for two years under Andra Blomkalns, MD. During that time, we installed lightning orals to the Annual Meeting. This was a change; and feedback suggests it was a very positive one because more folks had the opportunity to present their research to a larger forum in an oral format. Essentially this change took what was inherently good about the meeting---research presentation and colleague interaction---and gave it a new shine. This year, although change is everywhere, we still cling to past successes. On May 10th, SAEM will be presenting the Resident Leadership Forum. We evaluated the great content of the Chief Resident Forum, tweaked it, added to it, and created a brand new experience not just for the chiefs but for all residents. The forum is an all-day event for the chief residents (including a networking lunch) but then opens up to every resident of any year during the afternoon, so that they too can have the opportunity to learn and interact with our field’s stars, mentors, and experts. Throughout the meeting, in addition to their business meetings, each academy will have newly designed spotlight sessions. The academies started from humble beginnings, and now are a prominent voice within not just SAEM, but emergency medicine at large. To honor what that they have accomplished, these spotlight sessions will give each academy the opportunity to share their wealth of knowledge with the general SAEM audience. GEMA will be hosting an EM in Europe session; AWAEM will present two stellar didactics back to back on gender specific emergency care and the hidden threats of unconscious bias; Simulation will share their insights on simulation certification while also presenting the best of the current simulation research; AEUS is planning an ultrasound event called SonoGames; AGEM will focus on a didactic that lays out the foundation for the changes (there’s that word again) that must occur to teaching and infrastructure as we treat an aging population; CDEM will present their Best of CDEM (more info to follow). Traditionally IEME was presented in a moderated poster format. However similar to the lightning oral, the program committee wanted to provide the opportunity for people to experience IEME in different ways. This year, we have US IEME, Simulation IEME, and Faculty-Resident Collaborative IEME along with three general moderated IEME sessions. The themed sessions will be presented in an oral presentation format.
As many of us can attest to, what makes SAEM’s Annual Meeting truly special is the chance to interact with the various thought leaders in our field. Whether you are a chair of a department or a burgeoning researcher or a medical student interested in emergency medicine, SAEM’s Annual Meeting breaks down the wall of titles and encourages people who wouldn’t normally meet to share ideas. The program committee expanded upon this concept with the creation of three mid-day networking events. Held May 10th-12th, from 11a-12p, these events are based upon theme as well, where one can mingle and network while at the same time learning. More info will be forthcoming in the coming weeks as to the specifics of these events. Ultimately, the annual meeting strives to present content for everyone based upon submissions from the membership. This year, in tribute to that philosophy we created the Junior Faculty Forum, to be held on May 12th. This is an all-day event designed specifically to help answer the fundamental question junior faculty have when they start as attendings: What am I going to do now and how do I get there? Sessions in the junior faculty forum will focus on how to begin that climb in administration, education, and research. A talk on reimbursement and RVUs from a faculty standpoint will be given; and the day will close with a panel of senior leadership lending their perspective. So too three didactics, one per day, will be specific to the challenges program directors, assistant program directors, and those interested in being a program director face each day---focusing on budget, the new paradigm of continuous accreditation, and building systembased practice curriculums. A new pilot program is being designed for the oral presentation format whereby the moderator will provide teaching points for the abstracts being presented. Think of it as a Guided Oral Presentation. A new iPhone/Droid app will enable you to navigate the meeting in a friendly fashion; our new SAEM AM website will have a built-in schedule and info updated on a real-time basis; an e-posters module will allow you to take an uploaded poster with you so that you can peruse it at a later time. Overall this year, we have more hours of didactics, more hours of abstracts, more hours for IEME, more hours for networking, more hours of resident and medical student content. I am pleased to invite you to the 2012 SAEM Annual Meeting in Chicago, May 9th to May 12th. ◗ -Michael Hochberg, MD Chairman, SAEM Program Committee Associate Clinical Professor of Emergency Medicine, Drexel University College of Medicine Chairman, Department of Emergency Medicine, Saint Peters University Hospital
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ALERT! ALERT!
Attention all graduating residents!
From Jonathan Valente and Jeremy Branzetti, on behalf of the SAEM Membership Committee You are almost done. Wow! Time flies. It is amazing how fast your residency has gone. You will be done with your residency soon and there are so many things to do. Job interviews, fellowship interviews, moving, buying a house, starting a family, paying debts, applying for new medical licenses and hospital privileges, DEA applications, maybe even research grants, … What? There’s more you say? Are you serious? Yes. Chances are your residency program has been providing you with some incredible benefits that you have taken for granted, and now is the time to continue those benefits and not let your SAEM membership expire. You have had the fantastic opportunity to be a part of SAEM – a place to collaborate, to obtain exposure to cutting-edge emergency medicine research and education, and to meet colleagues and mentors in our field. SAEM membership does not just give you all of the great things that are listed below; it provides the forum to network with national and international leaders in emergency medicine. By staying involved, this will allow you to grow as a clinician, educator, researcher, administrator, or any combination of the above. It may help you get promoted some day! The variety of special interest groups, committees, and academies is broad. Getting involved by making connections at the meetings and/or serving as a member in these groups within SAEM could lead to opportunities for collaborative research, more efficient ways to manage your department and improve quality of care, improved methods to teach your students/residents, and opportunities to lecture. Membership in SAEM is its own career development opportunity, and will prepare you for any job you seek. Act now and save! No, we cannot give you a free set of knives. It gets even better! As a “Young Physician” you save big time! The first year is only $335.00 as a Young Physician – a 40% discount! Not only do you get a whopping discount, but this payment actually buys you 1.5 years of membership during Year 1 to put you on track with the faculty renewal period. But wait there’s more… we even throw in a special interest group of your choice for FREE! Call now, operators are standing by! No other promotions accepted with this special offer just for you! Supplies are unlimited and valid nationally in all states and internationally. Call (847) 813-9823.
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Young Physician Year 1 $335.00 - First-year following residency graduation. Young Physician Year 2 $465.00 - Second year following residency graduation. Publications: Academic Emergency Medicine Journal (online access) SAEM Newsletter and eNews Newsletters from Academies Society Involvement: Academies - 7 structured groups with independent activities and goals supported by SAEM with Listserv of members, website capabilities, meeting space and lecture time at national meeting, and direct access to SAEM BOD and administration via assigned liaisons. Interest Groups – 24 representing all EM subspecialties (one IG membership included in annual membership fee) Consultation Services: SAEM/AACEM Academic Medical Center Consultation Services (often used by new residency programs) Ethics Consultation Services Resident and Medical Student Opportunities and Services Residency Directory and Residency Vacancy Directory Fellowship Directory Medical Student Clerkship Directory Electronic Advising Service Inclusion in the Committee or Task Force of choice (faculty members must be appointed) Opportunity to serve as Resident Member on the SAEM Board of Directors Resident and Medical Student eNews EMF/SAEM Medical Student Research Grant opportunity Resident and Medical Student Advisory Committee Annual Meeting Educational / Research Topics given by leaders in field Innovative Exhibits in Medical Education Research and Education Abstracts AEM Consensus Conferences SAEM Leadership Forum Intensive Grant Writing Workshop Resident Leadership Forum / Medical Student Symposium NIH Roundtable SAEM Foundation SAEM/Physio-Control Research Fellowship Grant EMF SAEM Medical Student Research Grants Emergency Medicine Interest Group Grant ACMT/SAEM Michael P. Spadafora Medical Toxicology Scholarship SAEM/ECCC Emergency Care Sabbatical Educational Fellowship Grant Career Development Bridge Grant
ETHICS IN ACTION Ethan Cowan,MD,MS
Department of Emergency Medicine, Jacobi Medical Center Department of Epidemiology & Population Health, Albert Einstein College of Medicine A 54 year old male with a history of insulin dependent diabetes, seizure disorder and intravenous drug use presents after a seizure. Obtaining peripheral intravenous (IV) access proved difficult. Just before giving up, the physician saw what appeared to be an accessible vein on the patient’s wrist and inserted a catheter without difficulty. After IV insertion the patient was found to have a fingerstick glucose of less than 50 and the physician asked the nurse to push 2 ampules of D50. The patient immediately started moaning and became more alert, screaming that his arm felt like it was on fire. The nurse stopped the infusion, but not before the patient had received almost a full ampule of dextrose. Although the patient’s pain eased immediately after the infusion stopped, his arm looked dusky. When the attending went to check the radial artery he noticed that the pulse was strongest at the supposed IV catheter insertion site. A blood gas drawn from the catheter confirmed the suspected intra-arterial placement and the catheter was promptly removed. Medical errors are common in hospital settings. Some of these errors result in grave harm while other “near misses” may cause no harm at all. The scope of the problem was illustrated in a landmark Institute of Medicine report in 2000 showing that between 44,000 and 98,000 people die in hospitals each year as a result of avoidable medical errors.(1) Once an error occurs, most clinicians are uncertain about how they should respond. A 2010 policy statement from the American College of Emergency Physicians offers some guidance. It states that “if…an emergency physician determines that…an error has occurred…he or she should provide information about the error and its consequences to the patient, or if the patient is incapacitated, to the patient’s representative in a timely fashion, in accordance with hospital policy on medical error disclosure”.(2) The basis for this policy statement, and for the disclosure of medical errors generally, is rooted in medical ethics and supported by empirical evidence. Ethical Basis for Disclosing Medical Error Multiple ethical arguments favor the disclosure of medical errors to patients. Even when no harm occurs, disclosing a medical error respects a patient’s autonomy by acknowledging the patient’s right to control what happens, and, by extension, know what has happened, to their own body. Withholding information about medical errors makes it impossible for patients to make fully informed decisions about their care, a mandatory component of the informed consent process. In addition to respect for autonomy, the fiduciary relationship between the physician and the patient, which comes with ethical obligations of honesty, integrity, trust and professionalism, mandates disclosure. Non-disclosure directly threatens the fiduciary relationship and undermines professional integrity. Finally, if the patient is harmed by a medical error the principle of justice supports compensating the patient fairly and equitably. Empirical Basis for Disclosing Medical Errors Empirical evidence also supports the disclosure of medical errors. Studies show that the majority of patients want to know when an error has occurred, regardless of how minor. (3)
Contrary to the fear many physicians have that disclosing an error increases the likelihood of litigation, full disclosure either reduces or has no impact on malpractice claims. (4) Even when medical errors result in no harm, disclosure can improve patient safety, enhance learning and optimize the physician-patient relationship. Disclosure Steps Once the decision is made to disclose an error, the logistics of the disclosure need to be considered. Health care institutions should have readily accessible disclosure policies. In any error that results in harm, the first step is usually a call to risk management. The goal of risk management is not to impede or prevent disclosure but to assist in the investigation of the error and help with the disclosure process. Risk management can also facilitate compensation and work with the institution to defray medical costs resulting from the error. Timing of the disclosure is important. Whenever possible, the disclosure should occur shortly after the error has been identified, even before all the facts may be known. A delay in disclosure may generate skepticism and hostility. In most cases, the senior healthcare provider, usually the responsible attending physician should make the disclosure. The patient should be told all the known facts in lay terms and have his or her questions answered. Most importantly, the patient should be offered a sincere apology. In cases where the disclosing physician bears some responsibility for the error an apology can also ameliorate some of the emotional distress and guilt that comes with making a harmful medical error. The aforementioned procedural steps offer a general outline, but it is important for clinicians to be aware of and adhere to their own institution’s disclosure policies. Resolution of the Case: Poison control recommended elevation of affected arm and 24 hours of observation. The physician informed risk management of the error and asked for assistance. Both risk management and the physician felt the error should be disclosed to the patient. Once stable, the attending sat with the patient, explained the error and apologized for what had occurred. The patient was informed that as a result of the error he would need to be admitted to the hospital but any costs associated with the hospitalization would be covered. The patient’s initial anger was shortly replaced by appreciation for the physician’s honesty. All of the patient’s symptoms resolved after a few hours and he was discharged the next day with no lingering ill effects. ◗ 1. Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. Washington, D.C.: National Academy Press; 2000. 2. American College of Emergency Physicians. Disclosure of Medical Errors (2010) http://www.acep.org/Content.aspx?id=29178&terms=Disclosure%20 of%20Medical%20Errors. 3. Gallagher TH, Waterman AD, Ebers AG, Fraser VJ, Levinson W. Patients' and physicians' attitudes regarding the disclosure of medical errors. JAMA. 2003; 289:1001-7. 4. Gallagher TH, Studdert D, Levinson W. Disclosing harmful medical errors to patients. N Engl J Med 2007;356:2713-9.
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Fourth Annual AAAEM Meeting April 2-4, 2012 Madison Hotel, Washington DC
Day 2: Tuesday April 3, 2012
Pre Conference: Sunday April 1, 2012 3:00 6:00
Hopkins ED Tour (tentative/chair optional) Social Hour DAY 1: Monday April 2, 2012
7:15 8:00 9:30 10:15 10:30 11:30
Registration AAAEM Breakfast, new officers, and business meeting AAAEM Session “Clinical ops/front end re-design/ patient satisfaction/mid-levels” Linda Davis-Moon, MSN, CRNP, APN-BN Break AAAEM Session: Panel Discussion (Scribes, EMRs, Documentation, Audits-RAC, additional topics and panel members TBD) Opening of AACEM/AAAEM Meeting Lunch and Discussion “Evolution of the Role of the Chair in the Academic Emergency Medicine Depart- ment - Where have we come from, where are we at?”
Theme for the afternoon: “Current Challenges and Priorities of Academic Departments of Emergency Medicine” “What are we dealing with now, how are we managing, where are we going? 1:15 2:00 3:00 3:15 4:15
Group Break Out What are your biggest challenges in: A. Clinical Operations B. Managing Faculty and other personnel C. Developing and maintaining a research program D. Student Education/medical school affairs E. Resident Education F. Financial Management G. Strategic planning, managing community sites H. Setting priorities, managing workload, other Summarize & rank the priority issues Break Group Break Out Taking the priority issues as identified, answer “What are your ‘best practices’ or best advice to manage the major issues?” Report back on best practices for the priority issues identified
Large Group Discussion 5:30 6:30 7:30
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Break Cocktail reception Dinner at Hotel
8:00 8:30 10:30 10:45
Breakfast and Networking AAAEM 2011 Benchmark Survey, Jim Scheulen, MBA Break AACEM/AAAEM Benchmarking Panel Discussion David N. Gans, MSHA, FACMPE. VP MGMA; UHC and AAMC Representatives (TBD). 12:00 AACEM/AAAEM Lunch – Dr. Francesco Mannelli – Levy Family Visiting Professor 1:00 AACEM Leadership Workshop (AAAEM attendance op tional) Facilitators: David Bachrach, MBA. President, The Physician Executive’s Coach, Inc. R. Kevin Grigsby, MSW, DSW. Senior Director, Leadership and Talent Development at As- sociation of American Medical Colleges.“Foundations of Leadership – The Critical Importance of Integrity, Authenticity, Commitment to some- thing Bigger than Self, and Awareness” 2:00 AAAEM Session: Authentic Leadership. Linda Davis-Moon, MSN, CRNP, APN-BC 3:00 Break 3:15 AAAEM Session: “Revenue Cycle Redesign” Brian Spector, MPA & Ashlee Melendez, MSPH 4:00 AAAEM Session: (Speaker TBD) “Coding and Billing – maximizing proce- dures, critical care, and observation medicine” 5:00 AAAEM Session: Panel discussion (presenters TBD) Faculty Compensation, incentive plans, and productivity 6:15 Dinner on your own (local options to be provided) Day 3: Wednesday April 4, 2012
7:30 8:15 10:15 10:30 10:30 11:15
Breakfast and Networking AACEM National Affairs: session 1: Research Break AACEM National Affairs: session 2: Regulatory Affairs AAAEM committee meeting breakouts AAAEM Lunch, closing remarks and facilitated table discussions Peer-to-Peer Research Strategic lobbying for hospital funding Philanthropy (add’l topics TBD)
REPORT FROM THE SAEM/AACEM SESSION AT THE AAMC ANNUAL MEETING Kate L. Heilpern, MD
At the annual Association of American Medical Colleges (AAMC) meeting in Denver, CO from November 4-9, 2011, SAEM and AACEM sponsored an emergency medicine session which was moderated by Dr. Kate Heilpern. This session concentrated on the value of emergency medicine, the impact and opportunities for emergency medicine both as a consequence of the Affordable Care Act and the governmental drive to reduce expenditures on healthcare. Dr. Arthur Kellermann kicked off the session with a broad overview of the US healthcare system with an emphasis on the increasing healthcare costs that were not correlated with increasing quality of care. Emergency medicine has been identified as an expensive and potentially avoidable part of healthcare costs for some conditions. Dr. Kellermann asked the audience to consider what value emergency medicine added to the healthcare system, in addition to the important safety net function. How does emergency medicine rank in areas of access, cost and quality of care? Dr. Dennis Beck continued this theme and described current mechanisms under consideration to value healthcare, which include quality measures; value based purchasing and bundled payments. He asked us to contemplate how emergency medicine would fit into these various new schemes in terms of paying for acute care. Dr. David Magid provided information about variations in the utilization of resources (e.g., imaging, laboratory or procedural) for similar problems, sometimes in geographically disparate locations, and sometimes between emergency departments and hospital systems in the same city or town. Does variance in resource utilization impact quality or value? He asked the audience to consider possible explanations and whether these variations represented an opportunity to carefully analyze emergency medicine practice. He suggested that the data will be available at national and regional levels that will allow emergency medicine physicians to analyze their group and individual practices and identify outliers that could help to improve quality and reduce cost. Dr. Christopher Urbina, Director of Public Health for the State of Colorado put the emergency care system into an overall context of population health and suggested that much of the value of emergency medicine might relate to participation in prevention activities, coordination
of chronic care in high user populations and continuing to provide disaster and safety net activities for the healthcare system. Following these presentations, Dr. David Seaberg, President of ACEP, presented a comprehensive model that he is developing with ACEP that might better define the role of emergency physicians in terms of serving as a central coordination hub for patients with chronic disease and social issues. This would be a novel role for emergency physicians and would address the importance of emergency medicine as part of the medical home for complex patients with multiple chronic illnesses. In addition to the diagnosis and treatment of time sensitive illnesses, value in emergency care would also be measured by our participation in the coordination of care for acutely decompensated patients with multiple chronic illnesses, and prevention of illness and injury in high-risk populations. Future payment mechanisms do not currently align to support emergency physicians in these efforts, and this will require advocacy and research. Following these presentations, Dr. Atul Grover, Chief Advocacy Officer of the AAMC, described current threats and opportunities for emergency medicine that are a consequence of possible budgetary reductions under discussion in Washington D.C. In particular, the sustainable growth rate is slated to reduce initial payments by 27% by the end of this year. GME funding through CMS could be cut by billions of dollars. Dr. Grover encouraged emergency physicians, and specifically leaders in emergency medicine, to reach out to their senators and congressmen to explain the possible devastating effect that such funding cuts might cause. Following the emergency medicine presentation, emergency medicine leaders from around the country provided their own unique institutional perspectives. There was a general agreement that advocacy efforts at state and national levels were more important now than ever before, and emergency physician unity on these matters imperative. Following the emergency medicine presentations numerous groups convened including the Council of Teaching Hospitals, Continued on Page 12
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Continued from Page 11 the Council of Deans, Council of Academic Societies, groups representing medical students, residents, GME and UME deans, researchers in medical education and other significant representatives of academic medical center functions such as libraries, etc... Key themes from these meetings included impending reductions in federal support for clinical care and education and research in medicine. Dr. Francis Collins from the National Institute of Health (NIH) discussed concerns that NIH funding will go down in the coming years. The response to these reductions will require creative thinking and development of new collaborations between specialties, between the professions and with our communities. Another theme was a need to do more to address disparities in healthcare and disparities in training opportunities for underrepresented minorities. Although progress has been made, it continues to lag behind our goals and societal
need. Another theme was the recognition that the biological science foundation for healthcare must be joined with a systems re-engineering and improvement emphasis focused on quality and safety. Just as the basic mechanisms of disease can be understood through basic research, the basic mechanisms of care delivery can also be understood and improved through rigorous analysis and concentrated effort. Finally, the theme of leadership and engagement of academic physicians to improve quality of care for our populations was emphasized. Such leadership activities may require new areas of engagement, new topics of study and moving out of our comfort zones to engage with policy makers, the business community and our diverse patient populations. It will also require changes in how we educate our students and residents so they have the skills to succeed in a healthcare system that will be substantially different from what exists currently.
PEER-REVIEWED LECTURES (PERLS) ARE HERE! Academic Emergency Medicine (AEM) is now publishing a series of videos of lectures on topics in emergency medicine. These are intended to represent the state of the art in emergency medicine education. Residents, practicing physicians, and medical students may use them for didactic education. The videos will contain both the presented audiovisual material for the lectures (such as Power Point slides) and live video of the presenter. The PeRLs lectures themselves will be “open access” right away. Look for the first one, “The Millennial Generation and ‘The Lecture,’ “ by Danielle Hart and Scott Joing in the November issue on the journal’s web page.
Cocktails & Dreams
Wednesday, May 9, 2012 ~ Annual Meeting, Chicago 4:30pm - 6:30pm
Enjoy FREE wine/beer and hors d’ oeuvre while viewing the premier of the Foundation Awareness video, participating in random trivia, competing for prizes, music and much more! You won’t want to miss thee event to kick off the 2012 Annual Meeting. Say you are joining us at the event on facebook and receive an extra ticket for our door prizes.
Sponsored by SAEM Foundation Development Committee
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E-PROFESSIONALISM: IMPLICATIONS OF SOCIAL MEDIA ON PROFESSIONALISM IN MEDICINE
Karen Serrano, M.D. Attending Emergency Physician, Beloit Memorial Hospital, Beloit, Wisconsin (Affiliate Training Site for University of Wisconsin EM Residency Program) Social media is fast becoming ubiquitous in our society. Social networking sites like MySpace, Facebook, Linkedin, and Twitter allow users to communicate electronically with friends, family, and colleagues all over the world. Facebook alone has more than 400 million active users. Social media has evolved over the past few years from an outlet of adolescents and college students to a standard mode of communication that spans all ages, professions, and socioeconomic strata. Not surprisingly, social media use is common in the medical profession. A national survey on social media use among physicians and physicians-in-training reported that 93%, 79%, and 41.6% of responding medical students, resident physicians, and practicing physicians, respectively, admit to using social media sites. A study by Thompson et al reported that 45% of medical trainees at a single institution had a Facebook account. Use of social media sites among older physicians lags slightly behind that of the lay public, but is also on the rise. By allowing fast, convenient sharing of information, social media facilitates communication and connection with others. Users of social networking sites like Facebook are prompted to create individualized web pages that contain personal data such as place of residence, information on education and employment, relationship status, sexual orientation, and political and religious affiliation, among others. Users can share comments, post digital media like photographs and videos, and other online content to a broad audience. Social media can bring clear benefits for physicians in training, both personally and professionally. Posting photographs of a recent vacation or new baby can be an easy way to maintain ties with family and friends in the midst of hectic work schedules. It also can provide a forum for creativity and personal expression, foster a sense of camaraderie and collegiality with other coworkers, and can serve as a means of disseminating information for social events or political movements.
In addition, social media is increasingly being used to advance public health and improve clinical care. For example, Facebook has multiple groups dedicated to raising awareness about breast cancer, lung cancer, smoking cessation, AIDS, and many other healthrelated topics. Online community groups support members with chronic diseases such as diabetes and cystic fibrosis. Physicianonly social media sites like Sermo allow health professionals to discuss clinical cases, healthcare reform, practice management, and other pertinent topics. In a dramatic example of an online medical consult, a physician blogging about a patient’s puzzling symptoms (posted with the patient’s permission) on the popular blog KevinMD, ultimately led to the correct diagnosis of a rare disease. And in the case of an amnestic patient, physicians were able to locate family members by using Facebook. Blurred boundaries and challenges in the medical field Despite its benefits, social media also brings challenges for those working in clinical settings. By blurring the boundaries between a physician’s professional and personal roles, social media raises numerous professional issues. A resident may blog about a difficult patient encounter, not realizing that the patient’s cousin is a “friend of a friend” on the resident’s social network, who in turn reads the post and recognizes her family member. Likewise, a patient may look up his/her physician on Facebook, and lose confidence in the doctor’s clinical judgment when he sees photographs from a holiday party showing progressive stages of inebriation. E-Professionalism Professionalism is one the six core competencies mandated by the Accreditation Council for Graduate Medical Education, and has been a topic of much debate in recent years. However, the subset of professionalism in electronic communication, termed “e-professionalism,” is still in its infancy, and the medical community is just beginning to grapple with the questions raised by social media. Many feel that the rise of social media use among physicians and physicians-in-training has not been paralleled by appropriate training in e-professionalism. In November 2011, The American Medical Association (AMA) Council on Ethical and Judicial Affairs published a report entitled “Professionalism in the Use of Social Media,” with the goal of providing guidance on the numerous professional and ethical issues raised by social media. Below is a discussion of the recommendations contained in the report. 1. Patient Privacy and Confidentiality. Standards of patient privacy and confidentiality must be maintained in all environments, including online forums. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule mandates that all communication involving an individual’s health information is transmitted in a protected manner. While most medical trainees know not to discuss patient details in a public place like an elevator, they may forget that blogging about a patient from the comfort of their living room could be equally (if not more) public. An emergency physician in Rhode Island recently had her emergency department privileges revoked when she posted information online about a trauma patient. . Although she did not mention the patient’s name, there was still enough information, according to the state medical board, for community members to identify the patient. In another example, a hospital employee who “tweeted” that the governor had received preferential treatment was terminated due to this breach of patient confidentiality. Any posts with patient data should be scrutinized to ensure that Continued on Page 14
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no personally identifiable information is present. It is recommended that, in order to maintain the highest standards of professionalism, physicians obtain a patient’s consent before posting any type of patient-related content online. In addition, it is important to remember that these standards do not just apply in the United States. Posting photographs of patients from an overseas medical trip without permission also qualifies as a breach of confidentiality.
context might misinterpret this as a negative commentary about the institution actually being understaffed. Medical professionals should be aware of their institution’s social media policy, as they may be held responsible for online comments that reflect negatively on their institution. Cain reports that up to 20% of U.S. companies have formally disciplined employees for violating social media policies.
2. Use Privacy Settings. Personal privacy is a major concern in use of social media. Thompson et al report that among medical trainees at a single institution who use social media, 83% had at least one form of personally identifiable information on their account, and only a third used privacy settings. Posted comments or photographs on social media sites, though intended only for friends and family, may, in fact, be viewable by a much wider audience. Privacy settings are notoriously difficult to set up, may change without notice from the social networking site, and are subject to hacking. Even if an individual has enough technical savvy to arrange foolproof privacy settings, it is impossible to control users in the individual’s social network who choose to print or forward his/her posts. It should always be assumed that anything posted is publicly viewable.
The field of e-professionalism is in its infancy, and thoughtful reflection is needed to guide physicians in navigating the new issues social media brings to the field of medicine, as well as in cultivating positive uses of social media. Many institutions are creating social media policy committees to tackle these questions, and residents should consider volunteering. Being the more junior members of the health care team, residents likely have greater familiarity with social networking sites compared to more seasoned physicians. As such they are ideally suited to help craft informed, relevant policies which guide physicians in the judicious and ethical use of social media.
3. Maintain appropriate online content. In analyzing social media web pages of medical trainees, Thompson et al noted that many had content that could be potentially interpreted negatively, such as 70% with photographs involving alcohol, with up to 50% with images that portrayed excessive drinking. While a picture of a physician happily enjoying a beer at a backyard barbecue may represent responsible drinking, it could easily be misconstrued as showing inebriation. Medical professionals should review their “digital footprint” periodically, and make sure there is no unprofessional or objectionable content, including vulgar language, racist or sexist comments, images depicting drug or excessive alcohol use, overt sexuality, or other inappropriate material. This includes reviewing photographs or other content about them posted by others in their social networks. 4. Notify colleagues about unprofessional content. The AMA Council on Ethical and Judicial Affairs recommends that physicians who observe unprofessional online content involving colleagues ‘have a responsibility to bring that content to the attention of the individual, so that he or she can remove it and/or take appropriate actions.” If appropriate action is not taken, they recommend reporting the matter to appropriate authorities. 5. Maintain appropriate boundaries of the patient-physician relationship. The traditional patient-physician boundaries can become blurred with social media. For example, is it appropriate for a physician to accept a “friend request” from a patient? The AMA Council on Ethical and Judicial Affairs discourages this practice since it may lead to breaches in the patient-physician relationship. Instead, they recommend that physicians who use social media for professional purposes should consider creating separate profiles for personal and professional use. 6. Protect your reputation and that of your institution. Any online content has the potential to affect, negatively or positively, a medical professional’s reputation. Students at Drexel University College of Medicine are warned about future repercussions for postgraduate education and employment: “Programs/employers are increasingly gaining access to social networking sites...to see what they can learn about candidates.” In addition, online actions may tarnish the reputation of an individual’s institution and the reputation of the medical field in general. For example, a resident “tweeting” about feeling overworked is perfectly understood by other residents as harmless venting after a long day. Yet, individuals unfamiliar with this
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Conclusion
In addition, the intersection of social media and medicine provides multiple avenues for research. Residents looking for a novel research project have near limitless possibilities to explore facets of e-professionalism, positive applications of social media in medical care, health information dissemination, and other related topics. In conclusion, residents can enjoy using social media for its many positive benefits, but should exercise caution to avoid its inherent risks. They should monitor their digital footprint closely, and remove any content that could be perceived as inappropriate. Rigorous privacy settings should be maintained. If the decision is made to discuss patient care online, either on personal or professional sites, patient privacy and confidentiality should be ensured. It is not worth risking a hard-earned career and professional reputation over a “post.” ◗ Facebook Press Room. Accessed June 1, 2010.
http://www.facebook.com/press/info.php?statistics.
Bosslet GT, Torke AM, Hickman SE, et al. The patient-doctor relationship and online social networks: Results of a national survey. J Gen Intern Med 2011;10:1168-74. Thompson LA, Dawson K, Ferdig R, et al. The intersection of online social networking with medical professionalism. J Gen Intern Med. 2008 Jul;23(7):954-7. Farnan JM, Arora VM. Blurring boundaries and online opportunities. J Clin Ethics. 2011;22(2):183-186. Farnan JM, Arora VM. Blurring boundaries and online opportunities. J Clin Ethics. 2011;22(2):183-186. Ben-Yakov M, Snider C. How facebook saved our day! Acad Emerg Med. 2011;18(11):1217-9. Shore R, Halsey J, Shah K, Crigger BJ, Douglas SP, AMA Council on Ethical and Judicial Affairs (CEJA). Report of the AMA council on ethical and judicial affairs: Professionalism in the use of social media. J Clin Ethics. 2011;22(2):165-172. Conaboy C, “For doctors, social media a tricky case.” 20 April 2011, Boston Globe, http://articles.boston.com/2011-04-20/lifestyle/29451939_1_social-media-patientemergency-room. Accessed Dec. 14, 2011. Hader AL, Brown ED. Patient privacy and social media. AANA J. 2010;78(4):270-274. Lagu T, Greysen SR. Physician, monitor thyself: Professionalism and accountability in the use of social media. J Clin Ethics. 2011;22(2):187-190. Thompson LA, Dawson K, Ferdig R, et al. The intersection of online social networking with medical professionalism. J Gen Intern Med. 2008;23(7):954-7. Thompson LA, Dawson K, Ferdig R, et al. The intersection of online social networking with medical professionalism. J Gen Intern Med. 2008;23(7):954-7. Shore R, Halsey J, Shah K, Crigger BJ, Douglas SP, AMA Council on Ethical and Judicial Affairs (CEJA). Report of the AMA council on ethical and judicial affairs: Professionalism in the use of social media. J Clin Ethics. 2011;22(2):165-172. Jain SH. Practicing medicine in the age of Facebook. N Engl J Med. 2009;361(7):64951. Cain J. Social media in health care: the case for organizational policy and employee education. Am J Health Syst Pharm. 2011;68(11):1036-40
Fourth Annual AACEM Meeting April 2-4, 2012
Madison Hotel, Washington DC
Day 2: Tuesday April 3, 2012
DAY 1: Monday April 2, 2012 11:30
Opening of AACEM/AAAEM meeting Lunch and Discussion “Evolution of the Role of Chair in the Academic Emergency Medicine De partment –Where have we come from, where are we at?”
8:00 8:30 10:30 10:45
Theme for the afternoon: “Current Challenges and Priorities of Academic Departments of Emergency Medicine” “What are we dealing with now, how are we managing, where 12:00 are we going?” 1:00 1:15 Group break out What are your biggest challenges in: A. Clinical Operations B. Managing faculty and other personnel C. Developing and maintaining a research program D. Student Education/medical school affairs E. Resident Education 5:00 F. Financial Management G. Strategic planning, managing community sites H. Setting priorities, managing workload, other 2:00 Summarize and rank the priority issues 7:30 3:00 BREAK 8:15 3:15 Group Break Out 10:15 Taking the priority issues as identified, answer 10:30 “What are your ‘best practices’ or best advice to 11:45 manage the major issues?” 4:15 Report back on best practices for the priority is sues identified.
Breakfast and networking Benchmark Survey, Jim Scheulen, MBA BREAK Benchmarking Panel Discussion David N. Gans, MSHA, FACMPE VP Medical Group Management Association. University Health System Consortium Representative (TBA), AAMC Representative (TBA) Lunch – Dr. Francesco Mannelli – Levy Family Visiting Professor Leadership Workshop: Facilitators: David Bachrach, MBA. President, The Physician Executive’s Coach, Inc. R. Kevin Grigsby, MSW, DSW. Senior Director, Leadership and Talent Development at Association of American Medical Colleges,“Foundations of Leadership – The Critical Importance of Integrity, Authenticity, Commitment to something Bigger than Self, and Awareness”. . Dinner on your own (local options to be provided) Day 3: Wednesday April 4, 2012 Breakfast and Networking AACEM National Affairs: Session 1 Research BREAK AACEM National Affairs: Session 2 Regulatory Affairs AACEM Closing Remarks and Lunch (box lunch provided)
Large Group Discussion. 5:30 6:30 7:30
BREAK Cocktail reception Dinner at Hotel
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SAEM INSTITUTIONAL RESEARCH FELLOWSHIP PROGRAM The next deadline for institutional applications is April 1, 2012. Please visit http://www.saem.org/institutional-researchfellowship-program for application instructions. The following approved institutions have demonstrated excellence in research fellowship training in emergency medicine, and their fellows have shown great potential for success.
SAEM-approved Research Fellowship Programs FALL 2011 Brown University/Rhode Island Hopsital, Providence, RI • Gregory D. Jay, MD, PhD • Brian J. Zink, MD Washington University, St. Louis, MO • Lawrence M. Lewis, MD SPRING 2011 Beth Israel Deaconess Medical Center at Harvard University, Boston, MA • Nathan I. Shapiro, MD, MPH Emory University, Atlanta, GA • David Wright, MD • Debra E. Houry, MD, MPH Hennepin County Medical Center, Minneapolis, MN • Michelle H. Biros, MD, MS Medical College of Wisconsin, Milwaukee, WI • Tom P. Aufderheide, MD Northwestern University, Chicago, IL • D. Mark Courtney, MD • James G. Adams, MD Oregon Health and Science University, Portland, OR • Craig Newgard, MD • John McConnell, PhD University of California, Davis, Sacramento, CA • Nathan Kuppermann, MD, MPH • James F. Holmes, Jr., MD, MPH University of Cincinnati, Cincinnati, OH • Christopher J. Lindsell, PhD University of Michigan, Ann Arbor, MI • John G. Younger, MD, MS
University of Pennsylvania, Philadelphia, PA • Judd E. Hollander, MD University of Pittsburgh, Pittsburgh, PA • Donald M. Yealy, MD • Clifton W. Callaway, MD, PhD University of Rochester, Rochester, NY • Manish N. Shah, MD, MPH Vanderbilt University Medical Center, Nashville, TN • Alan B. Storrow, MD • Douglas B. Sawyer, MD, PhD Yale University, New Haven, CT • Gail D’Onofrio, MD, MS
Registered Fellows
Emory University Tamara Espinoza, MD, Anitha Mathew, MD Hennepin County Medical Center Johanna Moore, MD Northwestern University Scott Dresden, MD, Danielle McCarthy, MD Oregon Health & Science University Derek Richardson, MD University of California, Davis Jeffrey Green, MD, Bryn Mumma, MD University of Cincinnati Michael Ward, MD, MBA University of Pennsylvania Anna Marie Chang, MD, Nate Irvin, MD, Kalpana Narayan, MD, MSc, Anand Shah, MD University of Pittsburgh Jestin Carlson, MD, Adam Frisch, MD, Joshua Reynolds, MD Vanderbilt University Candace McNaughton, MD Details of each fellowship can be found online in the SAEM Fellowship Directory.
ACADEMIC EMERGENCY MEDICINE ON THE WILEY ONLINE LIBRARY PLATFORM Make sure you keep checking the journal’s home page on the recently implemented platform, Wiley Online Library (WOL) - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1553-2712. Many new features appear in the form of “modules” and will be updated on a regular basis. The new platform is more robust and easier to navigate, with enhanced online functionality. Visit often and stay tuned for updates!
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ACADEM IC ANNOUNCEM ENTS Clifton W. Callaway, MD, PhD, Executive Vice Chair and Ronald D. Stewart Endowed Chair of Emergency Medicine Research has been promoted to Professor (with tenure.) Clif is an outstanding clinician, investigator, teacher and partner – this is the culmination of high level accomplishment across all spheres.
James J. Menegazzi, PhD has been appointed
as Professor (with tenure) and UPMC Endowed Professor of Resuscitation Research. Jim has made seminal contribution to the care of those suffering from cardiac arrest, and he has been a superlative teacher and mentor to many.
David P. Hostler, PhD has been appointed as
Associate Professor (with tenure) and UPMC Endowed Professor of First Responder Health and Safety. Dave’s focus on the biology and practical import of illness and injury in our front line public safety partners has already impacted deployment and thinking. He also is an outstanding teacher and mentor.
Sara Nelson, MD and Robert Anderson, MD were promoted to Assistant Professor of Emergency
The CDEM-developed “National EM M4 Examination,” available at http://www.saemtests.org , will remain a no-cost option for clerkship directors interested in administering a standardized, high-stakes exam to fourth-year EM students.
David E. Manthey, MD, Professor and Vice Chair of Education in the Department of Emergency Medicine, has been named the new Associate Dean for Medical Education of Wake Forest School of Medicine, effective February 1, 2012. In this administrative role, Dr. Manthey will oversee the medical school educational curriculum as well as assessment and grading of the students and courses. He will also participate in leading the current curriculum revision that is underway.
accepted the position of Director - Global Health Programs, Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health.
Dr. Manthey has been a leader in medical education, serving in numerous local and national positions and actively participating in the previous LCME site visit. In addition to his record of developing new organizations and new curricula at the local and national level, Dr. Manthey has received numerous teaching awards. He has participated in numerous professional development programs for medical educators and brings a wealth of knowledge and enthusiasm to the job.
Update on Medical Student Testing: NBME to Develop EM Subject Examination
Dr. Manthey received his undergraduate and medical degree from the University of Virginia and completed an internship at the Dwight D. Eisenhower Army Medical Center in Augusta, GA, and a residency at the Joint Military Medical Centers in San Antonio, TX.
Medicine at Tufts University School of Medicine/Maine Medical Center in January 2012.
Janis P. Tupesi, MD, FACEP, FAAEM has
The National Board of Medical Examiners (NBME) convened a taskforce in November 2011 to develop a subject examination for students completing a 4th year Emergency Medicine (EM) clerkships. NBME subject examinations exist for many required and several elective clerkships (Internal Medicine and Surgery Sub-Internships), but this will be the first EM examination available from the NBME. The taskforce consists of EM student educators and NBME staff. This new exam will be an important milestone for EM education in the medical school. The proposed examination will be geared towards senior medical students, although potentially could find use for thirdyear students as well. The examination will consist of 100 multiple-choice questions and will be available only in a webbased format as the NBME is transitioning to entirely web-based examination administration. The taskforce generated a blueprint for the examination to cover topics set forth in the revised EM4 curriculum (Manthey et. al. Acad Emerg Med 2010:17:638-43). The goal for live release of the first EM NBME subject examination is early 2013. The cost of this examination is unknown at this time. Updates on its development and implementation will be provided as they become available.
He has been a member of the WFSM Core Teaching Faculty for five years and served on numerous internal committees, including the Faculty Representative Council. He is a fellow of the American College of Emergency Physicians and the American Academic of Emergency Medicine. Welcome David Manthey, MD to his new role as Associate Dean for Medical Education and look forward to working with him to continue providing outstanding education to our students, supporting our education faculty and developing a highly innovative curriculum that will maintain and enhance Wake Forest’s reputation as a nationally and internationally recognized leader in medical education. ToxTalk (URL: toxtalk.org), the toxicology podcast from the University of Massachusetts, Division of Medical Toxicology, is now featured on the National Science Foundation’s website Science 360. The ToxTalk podcast, the only Emergency Medicine media carried by the National Science Foundation, is the creation of Matt Zuckerman, MD, first year toxicology fellow at UMass. Continued on Page 18
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Continued from Page 17 A new report from the Institute of Medicine says “public health actions are urgently needed to tackle the vast and growing toll of chronic illness on individuals and society. The report’s recommendations focus on optimizing efforts to better understand the burden and needs of people with chronic diseases, improving the dissemination of effective community-based interventions and preventive clinical guidelines, promoting the testing of an aligned health system to help people live well with chronic illness, and promoting the creation and implementation of public health policies in emerging legislation.” http://tinyurl.com/82zset9
2012 SAEM ANNUAL MEETING RESIDENCY & FELLOWSHIP FAIR FRIDAY, MAY 11, 2012 4:30PM – 6:30PM SHERATON CHICAGO HOTEL AND TOWERS, RIVER EXHIBITION HALL A
Residency and Fellowship Directors are invited to participate in the SAEM Annual Meeting Residency & Fellowship Fair in Chicago on May 11, 2012.
Brian O’Neil, M.D., the Edward S. Thomas Endowed
Professor and associate Chair of Research for the Wayne State University School of Medicine’s Department of Emergency Medicine, has been named interim Chair of Emergency Medicine. Dr. O’Neil succeeds Suzanne White, M.D., who is stepping down to devote her full time to her position as chief medical officer of the Detroit Medical Center system and her faculty position in Emergency Medicine. http://prognosis. med.wayne.edu/article/dr-brian-oneil-named-interim-chair-ofemergency-medicine
Calling all EM Residency Programs! Announcing the Inaugural Competition of the Emergency Medicine
SAEM Annual Meeting in Chicago Friday, May 11 8am-12pm Sponsored by EMRA Organized by the Academy of Emergency Ultrasound of SAEM We are recruiting teams to compete in the first ever SonoGames to be held at the SAEM Annual Meeting in Chicago, Friday, May 11th. The purpose of the competition is to allow residencies to demonstrate their skills and knowledge of point-of-care ultrasound. All aspects of ultrasound competence will be assessed, including image acquisition, image interpretation, and incorporation into clinical practice. 3 residents from the same residency program will compete in 3 rounds of exciting competition. All team members must be available and willing to compete during the entire session. Limited number of spots available. Enter your team today! 1) Name of your residency 2) Faculty captain sponsor and email 3) 3 team member names, email addresses and PGY year For more information, email: SonoGames2012@gmail.com SonoGames Committee: Resa Lewiss MD, chair; Andrew Liteplo MD, chair; Fernando Lopez, MD; Teresa Liu, MD; Alice Murray, MBChB, Cameron Decker, MD
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Don’t miss out on this unique opportunity to advertise your programs to hundreds of medical students interested in the specialty of Emergency Medicine and residents in search of a promising fellowship. For the 2012 SAEM Annual Meeting, the Residency Fair and Fellowship Fair will be combined as one event. This offers your institution the opportunity to showcase your Residency and Fellowship programs as a group or as separate exhibits. The Residency/Fellowship Fair will be conducted as follows: • Each participating institution will be assigned one table, which is 6 ft. long by 18 in. wide. *Please be sure to note on your registration form if your Residency and Fellowship programs will be sharing a table or needing separate tables. • Tables will be arranged in geographic regions by alpha order. Registrations received after April 1, 2012 may not get assigned to their geographic area. • Tables will be in rows, so there is no opportunity for standalone exhibits. However, you may bring in small displays, brochures, or modest giveaways. Materials may not be attached to walls and the use of electrical outlets is prohibited. • A maximum of 3 representatives per table is allowed. • Registration and set-up begin at 3:00pm. • Programs may NOT distribute/serve alcoholic beverages of any kind. Any food distributed must be prepackaged, i.e. candy/gum/snacks. • No refunds on cancellations after April 1, 2012. Cancellations received prior to April 1, 2012, must be in writing, and a 50% service fee will be applied. • Faxing or emailing the application form does NOT guarantee registration until payment is received. The early registration fee is $125 per table until April 1, 2012. After April 1, 2012, including on-site registration on May 11, 2012, the fee is $200. The fee is used to cover the cost of the table rental and refreshments for the participants. Space is limited, and applications will be accepted on a first come, first served basis. For more information, please visit our Annual Meeting page at http://am2012.saem.org/ To apply online or find more information visit http://rwjcsp.unc.edu. The deadline for all applications (and reference letters) is February 29, 2012.
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NIH CAREER DEVELOPM ENT AWARDS: EMERGENCY MEDICINE OVER THE LAST DECADE
The National Institutes of Health (NIH) and the Agency for Heathcare Research and Quality (AHRQ) provide career development awards, or “K” awards, to advance the independence of new investigators conducting biomedical research through mentorship, salary and research support, and protected time. K awards play a crucial role in developing and maintaining the research workforce. K awardees are more likely to apply for and receive a NIH research project grant (RPG) and have a higher percentage of years with NIH support than comparable unfunded K applicants. Since 1987, the NIH has made over 19,000 career development awards at a cost of more than $8 billion.
NIH & AHRQ Career Development Awards 2000-‐2011 (K08 & K23) 12
600
10
500
8
400
6
300
4
200
2
100
0
0 2000
The primary individual K awards for EM investigators are the K23 and K08 awards (http://grants.nih.gov/training/ careerdevelopmentawards.htm). Both awards are mentored, career development awards that usually last three to five years and provide salary support for protected research time.5 The K23 award focuses on patient-oriented research while the K08 award is for biomedical or behavioral research that is not patient-oriented. The exception is AHRQ, which uses the K08 activity code for patient-oriented research (http://grants.nih. gov/grants/guide/pa-files/PAR-09-085.html).
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Award Year
K23 in EM
K08 in EM
Total Awards (EM & non-‐EM)
REFERENCES 1. F uture of Emergency Care—Hospital-Based Emergency Care at the Breaking Point. In: System. CotFoECitUSH, editor. Washington D.C: National Academies Press; 2007. 2. B essman SC, Agada NO, Ding R, Chiang W, Bernstein SL, McCarthy ML. Comparing national institutes of health funding of emergency medicine to four medical specialties. Academic emergency medicine : Acad Emerg Med. 2011; 18(9): 1001-4. 3. K aji AH, Lewis RJ, Beavers-May T, Berg R, Bulger E, Cairns C, et al. Summary of NIH Medical-Surgical Emergency Research Roundtable held on April 30 to May 1, 2009. Ann Emerg Med. 2010; 56(5): 522-37. 4. N ational Institutes of Health Individual Mentored Career Development Awards Program. NIH Office of Extramural Research. Retrieved December 1, 2011 from http://grants.nih.gov/training/K_Awards_Evaluation_FinalReport_20110901.pdf.
Prior studies have demonstrated that mentored career awards increase the likelihood participating investigators will pursue research careers and contribute to their subsequent research success.3, 6 However, characteristics and the success of career development awardees within EM in obtaining subsequent independent grant funding have not been previously described.
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5. T eo AR. The development of clinical research training: past history and current trends in the United States. Academic medicine : Journal of the Association of American Medical Colleges. 2009; 84(4): 433-8. 6. Carter GM, Winkler JD, Biddle-Zehnder AK. An Evaluation of the NIH Research Career Development Award: Rand; 1987. 7. NIH RePORTER. Retrieved December 1, 2011 from http://projectreporter.nih.gov/reporter.cfm.
Total # NIH & AHRQ Awards (EM & non-‐EM) [line plot]
In 2004, the Institute of Medicine Committee on the Future of Emergency Care in the United States Health System recommended specialized research training for emergency medicine (EM) physicians to strengthen clinical evidence in emergency care and improve patient outcomes.1 The relative paucity of emergency physicians who have undergone formal research training may contribute to the fact that, compared to other specialties, EM receives less proportional federal research funding.2 Numerous barriers in EM research have been identified, including the lack of experienced mentors and training opportunities, inadequate protected research time and research infrastructure, and poorly-defined research based career tracks.3
Our Sub-Committee of the SAEM Research Committee is conducting an evaluation of prior and current emergency medicine investigators with NIH and AHRQ K23 and K08 career development awards. We searched the NIH RePORTER for new K23 and K08 awards using the search term “emergency” from 2000 to 2011. Individuals that matched this search criteria were reviewed through academic websites to determine if the awardee was residency or fellowship trained in emergency medicine prior to receiving the K award. A total of 63 awardees that met eligibility criteria were identified. As demonstrated in the figure below, the number of new EM career development awardees has increased since 2006, especially the number of K23 awardees. Future steps in our study include evaluating the success rate of EM applicants during the study period, completing a survey describing characteristics of awardees, and evaluating subsequent postaward federal funding mechanisms. Methodology of this study may serve as a template for ongoing evaluation of EM career development awardees. ◗
# EM Awardees [bar graph]
By Daniel Nishijima, MD, MS, Kabir Yadav, MD, MS and Larissa May, MD, MS for the SAEM Research Committee
CALL FOR PROPOSALS
2014 AEM CONSENSUS CONFERENCE SUBMISSION DEADLINE: APRIL 16, 2012 The editors of Academic Emergency Medicine are now accepting proposals for the 15th annual AEM Consensus Conference, to be held on May 14, 2014, the day before the SAEM Annual Meeting in Dallas. Proposals must advance a topic relevant to emergency medicine that is conducive to the development of a research agenda, and be spearheaded by thought leaders from within the specialty. Consensus conference goals are to heighten awareness related to the topic, discuss the current state of knowledge about the topic, identify knowledge gaps, propose needed research, and issue a call to action to allow future progress. Importantly, the consensus conference is not a “state-of-the-art” session, but is intended primarily to create the research agenda that is needed to advance our knowledge of the topic area.
Previous topics have included and will include (2012 and 2013): • 2000: Errors in emergency medicine • 2001: The unraveling safety net • 2002: Quality and best practices in emergency care • 2003: Disparities in emergency care • 2004: Information technology in emergency medicine • 2005: Emergency research without informed consent • 2006: The science of surge • 2007: Knowledge translation • 2008: Simulation in emergency medicine • 2009: Public health in the emergency department: surveillance, screening, and intervention • 2010: Beyond regionalization: integrated networks of emergency care • 2011: Interventions to assure quality in the crowded emergency department • 2012: Education Research in Emergency Medicine • 2013: Global Health and Emergency Care: A Research Agenda Well-developed proposals will be reviewed on a competitive basis by a subcommittee of the AEM editorial board. Proceedings of the meeting and original contributions related to the topic will be published exclusively by AEM in its special topic issue in December 2014. Submitters are strongly advised to review proceedings of previous consensus conferences, which can be found in past November and December issues of AEM, to guide the development of their proposals. These can be found open-access on the journal’s home page on Wiley Online Library - http:// onlinelibrary.wiley.com/doi/10.1111/acem.2011.18.issue-10/ issuetoc. Submitters are also welcome to contact the journal’s editors or leaders of prior consensus conferences with any questions, or for copies of submissions from prior years.
Proposals must include the following: 1. Introduction of the topic • brief statement of relevance • justification for this topic choice 2. Proposed conference chairs, and sponsoring SAEM interest groups or committees (if any) 3. Proposed conference agenda and proposed presenters • plenary lectures • panels • breakout topics and questions for discussion and consensus-building 4. Anticipated audience • stakeholder groups/organizations • federal regulators • national researchers and educators • others 5. Anticipated budget, to include such items as: • travel costs • audiovisual equipment and other materials • publishing costs (brochures, syllabus, journal) • meals 6. Potential funding sources and strategies for securing conference funding. How to submit your proposal. Proposals must be submitted electronically to aem@saem.org no later than 5 pm Eastern Daylight Time on April 16, 2012. Late submissions will not be considered. The review subcommittee may query submitters for additional information prior to making the final selection. Questions may be directed to aem@saem.org or to the editor-in-chief at editor@saem.org. ◗
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Clinical Director / Assistant Clinical Director The Department of Emergency Medicine at the University of California, Davis School of Medicine, is conducting a faculty search for a mid-career Emergency Medicine physician to serve in a leadership role as either Clinical Director or Assistant Clinical Director, commensurate with experience and qualifications. For the qualified individual, there are substantial opportunities for leadership and growth within the Department and the School of Medicine. Candidates must be residency trained and board certified in Emergency Medicine, eligible for licensure in California, and have at least two years of clinical operations experience. Expertise in performance improvement, quality, patient safety and electronic health records is desired. Candidates are expected to enter at the Assistant, Associate or Professor level, commensurate with experience and credentials. The University of California, Davis, Medical Center is one of the nation’s “Top 50 Hospitals.� It is a 576 bed academic medical center with approximately 65,000 annual Emergency Department visits. In 2010 we moved to a new, state-of-the-art ED, which provides comprehensive emergency services to a large local urban and referral population as a level 1 trauma center, paramedic base station and training center. The Department serves as the primary teaching site for a fully accredited Emergency Medicine residency program, which began more than two decades ago and currently has 42 residents. In addition, we provide advanced training through five emergency medicine fellowships, including research, ultrasound, toxicology, medical simulation, and advocacy/policy. The Department is a national leader in emergency medicine research, especially federally-funded, multicenter research. Our department is also a recent recipient of an NHLBI K12 programmatic award to train the next generation of Emergency Medicine researchers. Salary and benefits are competitive and commensurate with training and experience. Sacramento is located near the northern end of California's Central Valley, with close proximity to Lake Tahoe, San Francisco, and the "wine country" of the Napa and Sonoma Valleys. Sports enthusiasts will find Sacramento's climate and opportunities ideal. Interested candidates should submit a letter outlining interests and experience, and curriculum vitae to Nathan Kuppermann, MD, MPH; Chair, UC Davis Department of Emergency Medicine; 2315 Stockton Blvd., PSSB 2100; Sacramento, CA 95817. Applications must be received by 3/31/12 to be fully considered. The University of California is an affirmative action/equal opportunity employer.
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CALLS AND M EETING ANNOUNCEM ENTS For details and submission information on the items below, see www.saem.org and look for the Newsletter links on the home page or links within the Events section of the web site.
Call for Residents who are attending the 2012 Annual Meeting
The Social Media Committee is looking for residents who will be attending the SAEM 2012 Annual Meeting, use Twitter, and want to build their CV. All you have to do is send out tweets with pearls from the conference sessions you attend with the #SAEM12 hash tag. We will recognize you as a Resident Social Media Contributor on the SAEM Social Media webpage. Just email Jason Nomura, MD at jnomura@comcast.net, so the committee has your information for recognition. If you don’t use Twitter maybe now is the time to take the plunge.
2012/2013 SAEM Grant and Scholarship Information
SAEM is pleased to offer a variety of grants available for competitive application. SAEM/Physio-Control EMS Fellowship – This grant awards $60,000 over a 12-month period to support a fellowship Emergency Medical Services (EMS). The Emergency Medical Services Research Fellowship Grant strives to foster teaching, education, and research in emergency medicine. Through the generous support of Physio-Control, this fellowship in emergency medical services (EMS) provides an opportunity for a qualified emergency physician to acquire important skills and begin to develop expertise as part of an academic career with a focus in EMS. The mission of the grant is to develop the academic potential of the selected fellow by providing support for a oneyear training fellowship that develops both EMS leadership and
research. Potential for, and experience with, EMS leadership and research will be weighted equally when evaluating applications. Leadership will include, but will not be limited to, involvement with administration, education, and prehospital medical direction. Application Deadline: August 1, 2012 (new deadline) SAEM / ACMT Michael P. Spadafora Toxicology Scholarship ($1,500) - Scholarship fund to encourage Emergency Medicine residents to pursue Medical Toxicology fellowship training. Application Deadline: August 1, 2012 SAEM Institutional Research Training Grant ($75,000/yr. for 2 years) - The Institutional Research Training Grant (IRTG) is intended to identify, develop, and fund promising institutions dedicated to providing high quality training to research fellows in emergency medicine. Application Deadline: August 1, 2012 SAEM Research Training Grant ($75,000/yr. for 2 years) - The Research Training Grant (RTG) is intended to provide funding to support the development of a scientist in emergency medicine. Application Deadline: August 1, 2012 For more details as well as detailed application instructions, please go to the SAEM website (www.saem.org) and click on “Grants” under the “Education & Careers” tab.
CALLS AND ANNOUNCEM ENTS …CONTINUED ON PAGE 24
ATLANTA, GA DEPARTMENT OF EMERGENCY MEDICINE
Bring your skills in diagnosis, healing, teaching and inquiry to one of Emergency Medicine’s largest and best programs. Faculty: Emory University seeks exceptional clinician-educators and clinician-scholars to advance our broad teaching and research missions. We provide clinical care, teaching and research support for 5 academic metro Atlanta emergency departments encompassing 250,000 patient visits. These include 3 Emory Healthcare sites, the Atlanta VA Medical Center, and Grady Memorial Hospital with its new state of the art Marcus Trauma Center. Fellowships: Emory offers an exceptional environment for post-residency training. We will be considering applicants for 2013 for the following fellowships: Emory/CDC Medical Toxicology, Pre-Hospital and Disaster Medicine, Clinical Research, Injury Control & Prevention, Neuro-injury, Administration/Quality, Ultrasound, Biomedical Informatics and Observation Medicine. Candidates must be EM residency trained or Board certified. For further information, visit our web site at www.emory.edu/em, then contact: Katherine Heilpern, MD, Professor and Chair Department of Emergency Medicine 531 Asbury Circle , N-340, Atlanta, GA 30322 Phone: (404)778-5975 Fax: (404)778-2630 Email: ida.jones-render@emory.edu Emory is an equal opportunity/affirmative action employer. Women and minorities are encouraged to apply
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CALLS AND M EETING ANNOUNCEM ENTS CONTINUED...
Call For Papers
2012 Academic Emergency Medicine Consensus Conference “Education Research in Emergency Medicine: Opportunities, Challenges and Strategies for Success” The 2012 Academic Emergency Medicine Consensus Conference, “Education Research in Emergency Medicine: Opportunities, Challenges and Strategies for Success,” will be held on May 9, 2012, immediately preceding the SAEM Annual Meeting in Chicago, Illinois. Original papers on the conference topic, if accepted, will be published together with the conference proceedings in the December 2012 issue of Academic Emergency Medicine. A divide has traditionally existed in academic medicine between the educator and the researcher. The goal of this conference is to bridge this gap, by exploring the principles that guide these two allied disciplines in order to create a unified focus on education research science that will benefit our teachers, our learners, and, ultimately, our patients. Emergency medicine (EM) educators have long perceived the need for better research to guide the frequent challenges encountered in the academic environment. These include identifying best practice teaching methods, validating assessment tools, evaluating competency, and preventing cognitive errors. Efforts to address these challenges have begun; however, the historical use of suboptimal study designs, subjective outcomes, small samples sizes, and lack of expertise in methods useful in other domains can limit the success of education research studies. A coordinated agenda for EM education research is needed to address these topics and streamline our research efforts. The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project now mandates that training programs demonstrate the effectiveness of educational interventions and show evidence of trainee aptitude and achievement in the core competencies. The American Board of Emergency Medicine (ABEM) now requires its diplomates to provide evidence of Assessment of Practice Performance in order to receive continuous certification. These and other requirements highlight the current paucity of available evidence to inform our instruction and evaluation of emergency physicians, and call for our field to develop high-quality education research. A systematic approach to education research in EM is essential for the continued improvement of clinical emergency care, even for providers beyond residency training. In the decade since the Institute of Medicine’s 2001 “Crossing the Quality Chasm” report identified the failure of health care environments to consistently deliver evidence-based care, the increased emphasis on translational research and patient safety has identified even broader needs for education-based research. Without welldesigned studies to investigate the most effective methods to teach and evaluate emergency physicians, scientific discoveries cannot be effectively disseminated to physicians in training or in practice, nor can the benefits be fully realized by our patients. This Consensus Conference on “Education Research in Emergency Medicine” proposes to build a solid foundation upon which EM education researchers can build interdisciplinary scholarship, networks of expertise, discussion forums, multicenter collaborations, evidence-based publications and improved learner education. Such efforts will enable us to make significant
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contributions to the state of knowledge in medical education and, ultimately, to optimize patient care. Consensus Conference Goals: • Provide an overview of the current state of education research in EM • Identify and examine the barriers that educators face in conducting well-powered, rigorous education research, and develop recommendations for overcoming these barriers • Define most appropriate and effective methods for conducting education research studies • Identify priority agenda areas within specific education research domains, such as: o Establishing the effectiveness of clinical and didactic curricula in educating EM trainees in each of the six ACGME core competencies
o Evaluating performance of learners across the continuum of medical education, from medical student to practicing emergency physician
o Validating educational assessment tools
o Teaching and evaluating non-cognitive ACGME core competencies, such as “Professionalism” and “Interpersonal and Communication Skills” o Measuring the impact of educational interventions to improve patient safety o Research designs conducive to studying education outcomes • Develop a framework to increase collaboration, access to research support and potential funding sources and promote faculty development in education research Original contributions describing relevant research or concepts on this topic will be considered for publication in the December 2012 issue of Academic Emergency Medicine if received by Monday, March 12, 2012. All submissions will undergo peer review and publication cannot be guaranteed. For queries, please contact Nicole DeIorio, MD (deiorion@ohsu.edu), Joseph LaMantia, MD (JLaManti@nshs.edu), or Lalena Yarris, MD (yarrisl@ohsu.edu), Consensus Conference Co-chairs. Information and updates will be regularly posted in Academic Emergency Medicine, the SAEM Newsletter, and the journal and SAEM websites.
Call For Papers
Consensus Conference Follow-Up Manuscripts Submissions in any category (Original Contributions, Brief Reports, etc.) that describe research that was initiated to address a research agenda topic generated at one of the prior Academic Emergency Medicine consensus conferences should be identified as such in the cover letter that accompanies the manuscript, when the manuscript is submitted for review. Authors should state to which consensus conference the manuscript relates, and should also state which issue(s) discussed or raised at that consensus conference is/are addressed by the manuscript. Attempts will be made to publish consensus conference follow-up manuscripts as a group, rather than individually, and if authors are aware of other papers underway from that same conference’s research agenda, they are encouraged to coordinate submission with the authors of those other papers. Contact: Gary Gaddis, MD, PhD (ggaddis@ saint-lukes.org).
CALLS AND M EETING ANNOUNCEM ENTS CONTINUED...
Call For Papers
Call For Papers
Evidence-based Medicine
The Evidence-Based Diagnostics section of the Academic Emergency Medicine journal is seeking submissions. These manuscripts will evaluate a single emergency medicine-relevant diagnosis using a systematic review and meta-analysis to summarize high-quality clinical research focusing on history, physical exam, readily-available lab tests, and common imaging strategies. Evidence quality will be graded using the Quality Assessment Tool for Diagnostic Accuracy Studies. The highestquality evidence will then be summarized to report point-estimates or ranges for pre-test probability, diagnostic accuracy including interval likelihood ratios, and test-treatment thresholds for definitive tests. Authors are encouraged to contact the section editor, Christopher Carpenter, MD (carpenterc@wusm.wustl.edu) with specific questions for this series.
Academic Emergency Medicine is soliciting authors for writing structured Evidence-based Medicine (EBM) review articles on topics relevant to the practice of emergency medicine. These reviews are designed to provide answers to the clinical questions raised by emergency physicians in their day-to-day practice. These reviews are expected to identify and appraise high-quality studies with designs most appropriate for the research question at hand. The structured format and methodical approach of these manuscripts ensure a unified stepwise evidence-based approach to translate the research findings into clinical practice. In the absence of high-quality systematic reviews and metaanalyses, these reviews can cast light on numerous dilemmas that emergency physicians encounter in their practice. The instructions for preparing structured EBM reviews can be found under the “Progressive Clinical Practice” section (http://www. wiley.com/bw/submit.asp?ref=1069-6563&site=1). The authors will be guided through the manuscript preparation by one of the editors with experience in writing EBM and/or systematic reviews. The editors also welcome topic suggestions for such reviews. These suggestions will help generate a topic list that would be made available to interested authors. The format of EBM reviews can be viewed in some of the published manuscripts from these series: Hom J. The risk of intra-abdominal injuries in pediatric patients with stable blunt abdominal trauma and negative abdominal computed tomography. Acad Emerg Med. 2010;17:469-75. Palamidessi N, Sinert R, Falzon L, Zehtabchi S. Nasogastric aspiration and lavage in emergency department patients with hematochezia or melena without hematemesis. Acad Emerg Med. 2010;17:126-32. Wilkerson RG, Stone MB. Sensitivity of bedside ultrasound and supine anteroposterior chest radiographs for the identification of pneumothorax after blunt trauma. Acad Emerg Med. 2010;17:11-7. Zehtabchi S, Nishijima DK. Impact of transfusion of fresh-frozen plasma and packed red blood cells in a 1:1 ratio on survival of emergency department patients with severe trauma. Acad Emerg Med. 2009;16:371-8. To get started on your EBM review, or with questions or suggestions, please contact Shahriar Zehtabchi, MD (Shahriar. zehtabchi@downstate.edu).
ACADEMIC EMERGENCY MEDICINE (AEM) TO LAUNCH MOBILE AND IPAD APP! COMING SOON: Free AEM mobile and iPad app. Stay tuned for further information and consult the journal’s web page on Wiley Online Library to know when it is available. Check on the SAEM Facebook and Twitter pages as well.
ACADEMIC EMERGENCY MEDICINE NOW OFFERS CME CREDIT ACADEMIC EMERGENCY MEDICINE is now offering continuing medical education (CME) credits for reading select articles in the journal and successfully completing a test on the content. Physicians interested in completing the exam should log on to www.wileyblackwellcme.com. Upon successfully finishing the activity, physicians will receive an electronic certificate of completion, which can be printed and saved online under the user’s profile. The program is free to subscribers of the journal. Stay tuned for updates!
ACADEMIC EMERGENCY MEDICINE NEWS ON FACEBOOK PAGE Please be sure to regularly visit and follow many activities of the journal on SAEM’s Facebook page. Comments on articles are featured there, as well as journal announcements. Another way to keep up to date with the latest information relevant to Academic Emergency Medicine, as well as other emergency medicine topics, happenings, etc!
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Academic Emergency Medicine. Everywhere you are.
Now one of the leading journals in emergency medicine brings you content wherever you are, whenever you want it. Download the Academic Emergency Medicine app for your mobile device and access instant, realtime updates from the journal, including article abstracts and events. You can also easily tag select content for convenient reading and share with your friends and colleagues through e-mail, Twitter, Facebook and more!
The research you need, when you need it. Download the FREE Academic Emergency Medicine app today!
http://aem.mwap.at 26
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Announcing the Academic Emergency Medicine app. Download it now for FREE!
◊filled. Clinician Educator ◊ Clinical Researcher ◊ ◊ Pediatric Emergency Medicine ◊ Ultrasound ◊ The Department of Emergency Medicine at the University of Alabama School of Medicine is seeking talented residency trained Emergency Medicine physicians at all academic ranks to join our faculty. The University offers both tenure and non tenure earning positions. The University of Alabama Hospital is a 903-bed teaching hospital, with a state of the art emergency department that occupies an area the size of a football field. The Department treats over 75,000 patients annually and houses Alabama’s only designated Level I trauma center. The Department’s dynamic, challenging emergency medicine residency training program is the only one of its kind in the State of Alabama. The University of Alabama at Birmingham (UAB) is a major research center with over $440 million in NIH and other extramural funding. The Department of Emergency Medicine is a site for the NIH-funded Resuscitation Outcomes Consortium (ROC) and for the Protocolized Care of Early Sepsis Shock trial (ProCESS). The Department has been highly successful in developing extramural research support in this warmly collaborative institution. Birmingham Alabama is a vibrant, diverse, beautiful city located in the foothills of the Appalachian Mountains. The metropolitan area is home to over one million people, who enjoy recreational activities year round because of its mild southern Climate. Birmingham combines big city amenities with Southern charm and hospitality. A highly competitive salary is offered. Applicants must be EM board eligible or certified. UAB is an Affirmative Action/Equal Opportunity Employer. Women and minorities are encouraged to apply. Please send your curriculum vitae to: Janyce Sanford, M.D., Associate Professor & Chair of Emergency Medicine, University of Alabama at Birmingham; Department of Emergency Medicine; 619 South 19th Street; OHB 251; Birmingham, AL 35249-7013
The Department of Emergency Medicine at East Carolina University, Brody School of Medicine seeks BC/BP emergency physicians and pediatric emergency physicians for tenure or clinical track positions at the rank of assistant professor or above, depending on qualifications. Through this expansion we will increase our cadre of clinician-educators and further develop programs in pediatric EM, ultrasound, and clinical research. Our current faculty possesses diverse interests and expertise leading to extensive state and national-level involvement. The emergency medicine residency is well-established and includes 12 EM and 2 EM/IM residents per year. We treat more than 105,000 patients per year in a state-of-the-art ED at Pitt County Memorial Hospital. PCMH is a rapidly growing level I trauma, cardiac, and regional stroke center. The ED will expand into a new pediatric ED in spring 2012, and a new children’s hospital is also under construction. Our tertiary care catchment area includes more than 1.5 million people in eastern North Carolina, many of whom arrive via our integrated mobile critical care and air medical service. Greenville, NC is a fast-growing university community located near beautiful North Carolina beaches. Cultural and recreational opportunities are abundant. Compensation is competitive and commensurate with qualifications; excellent fringe benefits are provided. Successful applicants will possess outstanding clinical and teaching skills and qualify for appropriate privileges from ECU Physicians and PCMH. Confidential inquiry may be made to Theodore Delbridge, MD, MPH, Chair, Department of Emergency Medicine (delbridget@ecu.edu). ECU is an EEO/AA employer and accommodates individuals with disabilities. Applicants must comply with the Immigration Reform and Control Act. Proper documentation of identity and employability required at the time of employment. Current references must be provided upon request
www.ecu.edu/ecuem
EMERGENCY MEDICINE PHYSICIAN The Division of Emergency Medicine at the University of Vermont College of Medicine in alliance with Fletcher Allen Health Care is seeking an Emergency Medicine Physician desiring to pursue a career in academic emergency medicine, to be appointed at the rank of Assistant Professor or Associate Professor (Clinical Scholar Pathway) commensurate with years of experience and accomplishments. Fletcher Allen Health Care is the teaching hospital of the University of Vermont College of Medicine and is an ACS verified Level I Trauma Center for both adult and pediatric patients, and a major tertiary referral center for the state of Vermont and upstate New York. With an annual census of 60,000 patients, the emergency department is known for high quality patient care and dedicated teaching faculty. The applicant must be board certified or board eligible in Emergency Medicine and eligible for licensure in the State of Vermont with experience in teaching, clinical, and research activities of an academic division of emergency medicine. The University is especially interested in candidates who can contribute to the diversity and excellence of the academic community through their research, teaching, and/or service. Applicants are requested to include in their cover letter information about how they will further this goal. The University of Vermont is an Affirmative Action/Equal Opportunity Employer. Applications from women and people of diverse racial, ethnic and cultural backgrounds are encouraged. Applications will be accepted until the position is filled. Interested individuals should submit electronically their curriculum vitae, a cover letter and contact information for four references to: Ray E. Keller, MD, FACEP Email: Ray.Keller@vtmednet.org Or apply on-line at: https://www.uvmjobs.com
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DEPARTMENT OF EMERGENCY MEDICINE MASSACHUSETTS GENERAL HOSPITAL A Major Teaching Affiliate of Harvard Medical School The Department of Emergency Medicine at Massachusetts General Hospital is seeking candidates for a faculty position within the Division of Emergency Ultrasonography. Special consideration will be given to those with an established track record in research in addition to a commitment to excellence in clinical care and teaching. Academic appointment is at Harvard Medical School and is commensurate with scholarly achievements. The MGH Department of Emergency Medicine has a faculty of 37 academic emergency physicians, is co-sponsor of the 4-year BWH/MGH Harvard Affiliated EM Residency Program, and has active research and teaching programs including fellowship programs in research, global health, medical simulation, and wilderness medicine in addition to ultrasonography. The ED at MGH is a high volume, high acuity level 1 trauma and burn center for both adult and pediatric patients, and includes a 14-bed Observation Unit. The successful candidate will join a highly productive Division of Emergency Ultrasonography with an established fellowship program, extensive national and international teaching responsibilities, and a broad-based research agenda. Candidates must be ABEM certified and advanced training in ultrasonography is expected. Inquiries should be accompanied by a curriculum vitae and may be addressed to: David F. M. Brown, MD, FACEP Vice Chairman Department of Emergency Medicine Massachusetts General Hospital, Founders 114 55 Fruit Street Boston, Massachusetts 02114 e-mail: dbrown2@partners.org Massachusetts General Hospital is an equal opportunity/affirmative action employer.
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Emergency Medicine Ultrasound Education Specialist The Department of Emergency Medicine at the Perelman School of Medicine at the University of Pennsylvania seeks candidates for an Assistant or Associate Professor position in the non‐tenure academic‐clinician track. Rank will be commensurate with experience. The successful applicant will have experience in the field of Emergency Medicine/ Ultrasound. Responsibilities include the further development and expansion of emergency medicine bedside ultrasound skills and practice across the clinical faculty at both institutions. This faculty member will be expected to advance education and clinical acumen in ultrasound bedside evaluation of emergency medical conditions, with a strong focus on the use of bedside ultrasound in the resuscitation of critically ill or injured patients. This education leadership position will provide guidance for invasive procedures, monitoring of pathologic states, and the use of bedside ultrasound as an adjunct to therapy. This position will also support resident, fellow and faculty emergency physician training and education. The faculty member will also be a partner in PENN Emergency Medicine Global Medicine education program development, will join an internationally renowned research faculty and be expected to contribute with research endeavors in the fields of critical care ultrasonography and its use in global health settings. Applicants must have an M.D. degree and have demonstrated excellent qualifications in education and clinical care. This Academic Clinician Track position will be based at both the Hospital of the University of Pennsylvania and PENN Presbyterian Medical Center. The Department of Emergency Medicine at Penn has a highly competitive emergency medicine residency and an outstanding emergency ultrasound fellowship with nationally recognized faculty. The Division of Emergency Ultrasound currently has two full‐time faculty and two full‐time ultrasound fellowship positions and is looking to expand through this position. The University of Pennsylvania Department of Emergency Medicine provides services to over 130,000 patients per year at our 3 facilities. HUP manages over 60,000 patients per year and Penn Presbyterian Hospital manages over 38,000 patients per year. The University of Pennsylvania is an equal opportunity, affirmative action employer. Women and minority candidates are strongly encouraged to apply. Apply for this position online at: http://www.med.upenn.edu/apps/faculty_ad/index.php/g321/d2803
MEDICAL DIRECTOR OF EMERGENCY MEDICINE The Division of Emergency Medicine at the University of Vermont College of Medicine in alliance with Fletcher Allen Health Care is seeking both applications and nominations for outstanding candidates for the position of Chief of the Division of Emergency Medicine, to be appointed at the rank of Associate Professor or Professor (clinical scholar pathway) commensurate with years of experience and accomplishments. The Chief will be responsible for clinical program development, medical student teaching, residency training and development of research programs. The Chief will also serve as clinical leader of Emergency Medicine in our affiliated medical center, Fletcher Allen Health Care. Fletcher Allen Health Care is the teaching hospital of the University of Vermont College of Medicine and is an ACS verified Level I Trauma Center for both adult and pediatric patients, and a major tertiary referral center for the state of Vermont and upstate New York. With an annual census of 60,000 patients, the emergency department is known for high quality patient care and dedicated teaching faculty. The applicant must be board certified in Emergency Medicine and eligible for licensure in the State of Vermont with experience in the administrative, teaching, clinical, and research activities of an academic division of emergency medicine. The University is especially interested in candidates who can contribute to the diversity and excellence of the academic community through their research, teaching, and/or service. Applicants are requested to include in their cover letter information about how they will further this goal. The University of Vermont is an Affirmative Action/Equal Opportunity Employer. Applications from women and people of diverse racial, ethnic and cultural backgrounds are encouraged. Applications will be accepted until the position is filled. Interested individuals should submit electronically their curriculum vitae, a cover letter and contact information for four references to:
Steven M. Grant, MD Email: Steven.Grant@vtmednet.org Or apply on-line at: https://www.uvmjobs.com
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Director, Emergency Medicine Clinical Informatics
The Department of Emergency Medicine at the Medicine at the Perelman School of Medicine at the University of Pennsylvania seeks candidates for an Assistant or Associate Professor position in either the non-tenure clinician-educator track or the non-tenure academic-clinician track. Track and rank will be commensurate with experience. The successful applicant will have experience in the field of emergency medicine/medical informatics. Responsibilities include assisting the ED Information Systems Director, Penn Medicine CMIO and other members of the Information Technology (IT) Leadership Team in developing and maintaining IT Strategic Plans, with particular emphasis on Clinical Information Systems (CIS) and Electronic Medical Records (EMR). This individual will act as the primary liaison between IT, Nursing Staff and Physician Staff to insure that CIS/EMR implementations are optimized based on clinical workflow redesign. S/he will develop plans and strategies for gaining physician acceptance and ongoing use of CIS/EMR. Partnering with the ED IS Director, the Informatics Director will assist in developing, reviewing, and implementing CIS policies and procedures and collaboratively plan strategies for realizing CIS ROI including hard and soft dollar benefits. The Clinical Informatics is a newly formed position in the Director of Emergency Medicine. This position reports to the Chair of Emergency and has clinical and education components as well as an expectation for scholarly work. Applicants must have an M.D or M.D./Ph.D. degree and have demonstrated excellent qualifications in education and clinical care. While evidence of scholarship is required in the clinician-educator track, research is not required in the academic clinician track. The preferred candidate's background includes progressively more responsible clinical information systems (CIS) selection and implementation experience in areas such as clinical data repositories, electronic medical records, clinical documentation, computerized order entry / results reporting, and physician access systems; experience with clinical systems software is required. The position requires an accomplished team-oriented leader with demonstrated achievements in implementing CIS projects in a complex healthcare/academic organization. S/he must possess strong skills in project management, business and clinical process redesign, written /verbal communication, physician relations, and patient satisfaction. The University of Pennsylvania is an equal opportunity, affirmative action employer. Women and minority candidates are strongly encouraged to apply. Apply for this position online at: http://www.med.upenn.edu/apps/faculty_ad/index.php/g321/d2801
The Department of Emergency Medicine at the University of Michigan is seeking motivated faculty with an interest in medical education and residency leadership for Associate or Assistant Residency Director Position (APD). The APD responsibilities will include mentoring residents, supervision of the didactic curriculum, and direction of the Longitudinal Professional Development Tracks in Research, Education, Clinical Excellence and Administration. The APD will report to the Program director and share in the leadership and responsibilities of the residency. The residency has a well-developed simulation curriculum. There is potential for professional development in medical education research working with PhDs in education and actively involved faculty. The Department of Emergency Medicine has nationally recognized clinical expertise in brain injury, sepsis, injury prevention and pediatric emergency medicine. The Department is a Level 1 adult and pediatric trauma center. The residency is a four-year joint program with St. Joseph Mercy, a well-resourced community Hospital, and Hurley Hospital which serves Flint, MI. It is dedicated to providing a diverse training experience with an emphasis on clinical excellence. Academic rank will be determined by credentials. Clinical responsibilities will include patient care activity in the Emergency Department at University of Michigan Health System and include shift reduction commensurate with responsibilities. Applicants should have residency training and board certification in Emergency Medicine. Excellent salary and fringe benefit package. If interested, please send curriculum vitae to: William G. Barsan, M.D., Professor and Chair, Department of Emergency Medicine, UMHS, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5301. The University of Michigan is an equal opportunity affirmative action employer.
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□ Active - $560.00 Individuals with advanced degree university appointment actively involved in EM teaching or research. □ Associate - $250.00 Open to those with interest in EM □ Young Physician Year One - $335.00 First year following
□ International - email membership for pricing □ *Active/Associate/YP1 or YP2 Academy - $100.00 ea. □ AEUS □ AWAEM □ CDEM □ Simulation □ GEMA □ Geriatrics
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□ *Medical Student/Resident/Fellow Academy - $50.00 ea. □ AEUS □ CDEM □ Simulation □ Geriatrics □ Young Physician Year Two - $460.00 Second year following
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□ Resident/Fellow - $165.00 Open to residents/fellows interested
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□ Medical Student - $140.00 Open to medical students interested □ *GEMA Resident/Fellow - FREE
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*must be a current SAEM member to join an academy
Interest Groups: Society members are invited to join any of the dedicated Interest Groups listed below. Each membership category includes ONE Interest Group free of charge. Additional Interest Groups can be added for $25.00 □ Academic Informatics □ Airway □ CPR/Ischemia/Reperfusion □ Clinical Directors □ Disaster Medicine □ Diversity □ ED Crowding
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□ Educational Research □ EMS □ Ethics □ Evidence-Based Medicine □ Health Services & Outcomes □ Neurologic Emergencies □ Palliative Medicine
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□ Patient Safety □ Pediatric EM □ Public Health □ Observational Medicine □ Quality Medical Mgt □ Research Directors □ Sports Medicine
□ Toxicology □ Trauma □ Triage □ Uniformed Services □ Wilderness Medicine
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SAEM, 2340 S. River Rd, Suite 200 Des Plaines, IL 60018. email: membership@saem.org You may also join at member.saem.org
Rev. Date 10/26/2011
Society for Academic Emergency Medicine 2340 S. River Road, Suite 200 • Des Plaines, IL 60018 • 847-813-9823 • saem@saem.org • www.saem.org
Board of Directors Debra E. Houry, MD, MPH President Cherri D. Hobgood, MD President-Elect Deborah B. Diercks, MD, MSc Secretary-Treasurer Jeffrey A. Kline, MD Past President Brigitte M. Baumann, MD, DTM&H, MSCE Andra L. Blomkalns, MD Robert S. Hockberger, MD Alan E. Jones, MD Brent R. King, MD Sarah A. Stahmer, MD Melinda J. Morton, MD, Resident Member Interim Executive Director Ronald S. Moen Send Articles to: newsletter@saem.org Send Ads to: mgreketis@saem.org The SAEM Newsletter is published bimonthly by the Society for Academic Emergency Medicine. The opinions expressed in this publication are those of the authors and do not necessarily reflect those of SAEM. For Newsletter archives and e-Newsletters Click on Publications at www.saem.org
FUTURE SAEM ANNUAL M EETINGS 2012 May 9-12 Sheraton Hotel and Towers, Chicago, IL 2013 May 15-19 The Westin Peachtree Plaza, Atlanta, GA 2014 May 14-18 Sheraton Hotel, Dallas, TX 2015 May 13-17 Sheraton Hotel and Marina, San Diego, CA AEM Consensus Conference May 9, 2012 Topic: “ Education Research in Emergency Medicine: Opportunities, Challenges and Strategies for Success” Co-chairs: Nicole DeIorio, MD Joseph LaMantia, MD Lalena Yarris, MD, MCR