May-June 2002

S A E M

NEWSLETTER

Newsletter of the Society for Academic Emergency Medicine

PRESIDENT’S MESSAGE Myths Regarding the Federal Funding of Emergency Medicine Research Compared to most academic medical specialties, emergency medicine is young and we are still working to establish, and to understand, our place within the house of medicine. Of the three Roger Lewis components of the “triple threat” (clinical care, clinical education, and research), we have achieved both excellence and confidence in two: clinical care and clinical education. While our status in the research arena may be unclear to some, I believe our self image in this area is even more suspect.

The purpose of this column is to address our own perceptions regarding the status of emergency medicine research, by discussing some commonly-held beliefs or myths regarding federal support of emergency medicine research. The term “myth” is defined by Webster’s Seventh New Collegiate dictionary as “…an ill-founded belief held uncritically especially by an interested group.” I believe many commonly-held beliefs regarding federal support of emergency medicine research are actually myths.

Since we are clearly an interested group, the only way to dispel a myth is to look at it critically. Consider the following statements: 1. Federal agencies don’t like to fund clinical studies, especially in emergency medicine; 2. The NIH funds PhDs, not MDs; 3. Emergency medicine investigators are rarely successful in securing federal funding for their research; and 4. Emergency medicine proposals, especially clinical research, will not be evaluated fairly nor will they be funded consistently, until the NIH has a study section devoted to emergency medicine.

I would assert that many academic emergency physicians, while they may not consciously believe these statements, either believe them at some level or at least behave as if they are true.

Thus, I will spend the rest of this column exploring some of the data available which bear directly on the veracity of these statements.

Consider the first statement. There is a common belief that the NIH, or at least its study sections (the panels of consultants who evaluate and score applications), place tremendous emphasis on basic science and, as a corollary, tend not to fund clinical research. In fact, there probably was some truth to this belief in the past. In response to both internal and external concerns (continued on page 31)

901 North Washington Ave. Lansing, MI 48906-5137 (517) 485-5484 saem@saem.org www.saem.org

May/June 2002 Volume XIIII, Number 3

Annual Business Meeting During the Annual Business Meeting in St. Louis on May 20 Dr. Martin announced the results of the annual elections: President-Elect Donald M. Yealy, MD University of Pittsburgh Secretary/Treasurer Carey D. Chisholm, MD Indiana University Board of Directors James G. Adams, MD Northwestern University Katherine L. Heilpern, MD Emory University Donald J. Kosiak, Jr, MD Mayo Graduate School of Medicine Nominating Committee Jill Baren, MD University of Pennsylvania Constitution and Bylaws Committee Catherine Marco, MD St. Vincent Mercy Medical Center In addition, James Hoekstra, MD, was appointed to a one-year term on the Board of Directors to complete Dr. Chisholm’s unexpired term that resulted upon Dr. Chisholm’s election as Secretary-treasurer.

Dr. Martin announced that all proposed Constitution and Bylaws amendments had been overwhelmingly approved by the membership.

The Young Investigator Awards were presented to Eric Dickson, MD, University of Massachusetts, James Gordon, MD, Massachusetts General Hospital, and Daniel Morris, MD, Henry Ford Hospital. Awards were also presented to Jason Borton, MD, the 2002-2003 EMS Research Fellow, Robert Neumar, MD, University of Pennsylvania, recipient of the Institutional Research Training Grant; Samuel Yang, MD, Johns Hopkins University, recipient of the Resident Research Year Grant; Linda Papa, MD, University of Florida, recipient of the Scholarly Sabbatical Grant; Peter Panagos, MD, University of Cincinnati, recipient of the Neuroscience (continued on page 17)

Geriatric Grant Recipients Announced

Call for Advisors The inaugural year for the SAEM Virtual Advisor Program was a tremendous success. Almost 300 medical students were served. Most of them attended schools without an affiliated EM residency program. Their “virtual” advisors served as their only link to the specialty of Emergency Medicine.

Some students hoped to learn more about a specific geographic region, while others were anxious to contact an advisor whose special interest matched their own.

As the program increases in popularity, more advisors are needed. New students are applying daily, and over 100 remain unmatched! Please consider mentoring a future colleague by becoming a virtual advisor today. It is a brief time commitment – most communication takes place via e-mail at your convenience. Informative resources and articles that address topics of interest to your virtual advisees are available on the SAEM medical student website. You can complete the short application on-line at http://www.saem. org/advisor/index.htm. Please encourage your colleagues to join you today as a virtual advisor.

SAEM is pleased to announce the two recipients of the 2002 SAEM/ACEP Geriatric Emergency Medicine Resident/Fellow Research Grants. Paul-Andre Abboud, MD, from the Denver Health Medical Center Residency in Emergency Medicine will survey elder patients’ attitudes regarding participation in resuscitation research. Dr. Abboud’s sponsor is Kennon Heard, MD. James R. Davidson, MD, and co-investigator Stephanie J. Evers, MD, from the Indiana University School of Medicine Emergency Medicine Program will evaluate a technique for improving communication between nursing homes and the emergency department. Their sponsor is William H. Cordell, MD. Both projects will receive awards of $2500.

The SAEM/ACEP Geriatric Emergency Medicine Resident/Fellow Research Grants are sponsored by the John A. Hartford Foundation and the American Geriatric Society. The award is to support resident/fellow research related to the emergency care of the older person.

Investigations may focus on basic science research, clinical research, preventive medicine, epidemiology, or educational topics.

Recipients of Visual Diagnosis Contest Announced

CORD Meets in St. Louis

During the 2002 Annual Meeting in St. Louis a Visual Diagnosis Contest was open to all residents and medical students in attendance. The following winners are to be congratulated on their excellent diagnostic skills: Medical Student Winners: Cory J. Pitre, LSU/Charity Hospital and Wame Waggenspack, LSU/New Orleans Resident Winner: Chris Fee, MD, Highland Hospital The medical student winners will receive a free Annual Meeting registration to the 2003 Annual Meeting.

The resident winner will receive a textbook and a free Annual Meeting registration to the 2003 Annual Meeting.

The Council of Emergency Medicine Residency Directors (CORD) met in St. Louis on May 20. Louis S. Binder, MD, from MetroHealth Medical Center was elected to a threeyear position on the Board of Directors. The CORD Faculty Teaching Award was presented to Barry J. Knapp, MD, from Eastern Virginia Medical School. The CORD Resident Academic Achievement Award was presented to Debra Houry, MD, MPH, from Denver Health. The next CORD meeting will be held during the ACEP Scientific Assembly in Seattle on October 7.

AEM 2003 Consensus Conference: Disparities in ED Health Care Call for Papers – Deadline: March 1, 2003 The Editors of Academic Emergency Medicine announce the 2003 AEM Consensus Conference on "Disparities in Health Care" to be held on May 28, 2003 in Boston, the day before the SAEM Annual Meeting. Disparities in health care are likely to present both within the ED decision making process and in the larger healthcare system. The US emergency departments might be important sources of information about both facets. However, disparities need to be recognized in order to be addressed.

Do inequalities exist in our treatment of emergency patients? If so, under what circumstances, at what level and for what reason? In the larger healthcare system there is evidence that people of color and women do not always receive the same level of care. Are such disparities real?

When, why, how, do disparities occur? Who is at risk of receiving less than optimal care? What is the degree of disparity? How can disparity be eliminated? In a larger sense, what are the best ways to promote a highly reliable system of low variability? Do we teach our residents to deliver disparate care? How does the greater healthcare system contribute to real or perceived disparities in ED management? Are disparities sometimes due to systems incompetence? Is there a relationship between the degrees of inequality and degrees of system incompetence? How can we study these questions?

What measures can be used? Most emergency physicians assume that there should be no disparities in health care. If the

general public holds this believe as well, why has our society has not insisted upon the development of an equitable system of healthcare?

The goals of the conference will be to examine the presence, causes, and outcomes related to disparities of healthcare as they occur in emergency departments, and determine the degree to which forces from outside have an impact on our patients. The conference will aim to describe means of defining, assessing, measuring, and researching disparities that may occur in emergency care. The hope is to establish a research agenda for further assessment of these, and other related questions. The conference is a logical progression in the AEM consensus series, which has included "Errors in Emergency Medicine," "The Unraveling Safety Net, " and " Assuring Quality."

We therefore issue this Call for Papers related to the topic of Disparities in ED Health Care. Submitted manuscripts must be received at the AEM editorial office by March 1, 2003. Electronic submission to aem@saem.org of the original and a blinded copy is required. Also include a cover letter indicating that the submission is in response to this Call.

Accepted papers will be published in the late fall of 2003, along with Proceedings from the Consensus Conference. Questions can be directed to Michelle Biros (biros001@maroon .tc.umn.edu) or Jim Adams (jadams@nmh.org).

2

Everything I know I learned in…

St. Louis

Annual Meeting Presentation Awards Announced

Ellen Weber, MD Chair, SAEM Program Committee University of California, San Francisco

The SAEM Program Committee is pleased to announce the recipients of the Presentation Awards for the 2002 Annual Meeting. Recipients will be recognized during the Annual Business Meeting at the 2003 SAEM Annual Meeting in Boston. The awardees and their associated abstract citations (including title and co-authors) are listed below:

Wednesday, May 22, 2002. I’m sitting on the 17th Floor of the Adam’s Mark Hotel, sipping a Cosmopolitan (these are so good I may stay an extra week) and staring out over the top of my computer at the Jefferson Memorial Arch and the Mississippi River. My head is spinning–but not from the height.

In less than a week, my horizons have widened to include new possibilities for teaching, practice, publishing, training, and research. In these few days I’ve learned new ways to advocate for my patients, that getting an NIH grant is not only not impossible, but pretty darn feasible, that the NNT is just the reciprocal of the absolute risk reduction (okay I should have known that). I am now skeptical about my hospitals’ emphasis on throughput and the bottom line as it erodes the educational process, I understand what homoscedasticity is (or at least I did at the time), and that in fact, even a “senior” person like myself might be eligible for a training grant. I know how to norm the group when I lead my team, and what a posterior probability is. (Are you dizzy yet?)

I was impressed and inspired by the depth and breadth of our research presentations, and the sophistication of the work being done by our residents. The photo cases were tremendous—do you guys really see that stuff? And whether multimedia or simple teaching tools, the Innovations in Emergency Medicine Education Exhibits were impressive for their creativity and the time and energy they required.

The Annual Meeting continues to demonstrate what a creative and energetic group academic emergency physicians are, and the numerous ways we can use that energy to improve the lives of our patients and future physicians. Thanks to those of you who came to share your research, your knowledge, your insight, and to all of you who listened, asked the questions, and will take the messages home.

Faculty Clinical Science Presentation Debra Weiner, MD, PhD, Children's Hospital Debra L Weiner, Patricia L Hibberd, Peter Betit, and Carlo Brugnara : Effectiveness and Safety of Inhaled Nitric Oxide for the Treatment of Vasoocclusive Crisis in Sickle Cell Disease.

Acad Emerg Med 2002 9: 487-488.

Faculty Basic Science Presentation Richard Summers, MD, University of Mississippi Richard L Summers, Zizhuang Li, Domenic P Esposito, and Drew Hildebrandt: Effect of Delta Receptor Agonist on Duration of Survival During Hemorrhagic Shock. Acad Emerg Med 2002 9: 504-505.

Young Investigator Presentation Daniel Rusyniak, MD, Indiana University Daniel E Rusyniak, Mark A Kirk, Jason D May, Louise W Kao, Julie L Welch, Edward J Brizendine, and Robert J Alonso: Hyperbaric Oxygen Treatment in Acute Ischemic Cerebral Vascular Accidents: A Prospective, Double-Blind, PlaceboControlled Pilot Study. Acad Emerg Med 2002 9: 445-446.

Basic Science Fellow Presentation Mark Su, MD, New York University/Bellevue Hospital Center Mark Su, Jason Chu, Mary Ann Howland, Lewis S Nelson, and Robert S Hoffman: Amiodarone (Ami) Attenuates Fluorideinduced Hyperkalemia in Human Erthrocytes (RBCs). Acad Emerg Med 2002 9: 485.

Clinical Science Fellow Presentation Linda Papa, MD, CM, CCFP, University of Ottawa Linda Papa, Ian G Stiell, and George A Wells: Predicting Need for Intervention in Renal Colic Patients after ED Discharge.

Acad Emerg Med 2002 9: 361.

Clinical Science Resident Presentation Joe Suyama, MD, University of Cincinnati Joe Suyama, Edward J Otten, Matthew D Sztajnkrycer, Christopher Lindsell, Amy B Kressel, and Judith M Daniels: Surveillance of Infectious Disease Occurrences in the Community: An Analysis of Symptom Presentation in the ED. Acad Emerg Med 2002 9: 358-359.

Basic Science Resident Presentation Steven Bird, MD, University of Massachusetts Steven B Bird, Romolo J Gaspari, Won Jae Lee, and Eric W Dickson: Diphenhydramine as a Protective Agent in Severe Organophosphate Poisoning. Acad Emerg Med 2002 9: 357358.

Medical Student Presentation James Frederick, BA, University of Pennsylvania James R Frederick and Robert W Neumar: Delayed Inhibition of Calpain Activity after Global Brain Ischemia. Acad Emerg Med 2002 9: 443.

Best IEME Exhibit Winner Announced The SAEM Innovations in Emergency Medicine Education Exhibits are designed to highlight unique and innovative educational advances in the specialty. This year the Program Committee designed a separate “Call for IEME Exhibits” with a deadline significantly later than the abstract deadline. In response, SAEM members submitted over 60 proposed IEME Exhibits for consideration. A subcommittee of the Program Committee, chaired by Cathy Custalow, MD, PhD, reviewed the Exhibits and 39 were selected for presentation at the Annual Meeting in St. Louis. A score sheet was also developed and in St. Louis, the Program Committee subcommittee visited each IEME Exhibit and scored each Exhibit. The Program Committee is pleased to announce that Eric Savitsky from the University of California, Los Angeles, has been selected as this year’s Best IEME Exhibit Award recipient. His IEME Exhibit was entitled, “A Multimedia Web-based Trauma Tutorial and an Interactive Multimedia procedure tutorial.” The 39 IEME Exhibits presented in St. Louis will be published in an upcoming issue of Academic Emergency Medicine.

3

Semi-Final CPC Competition Results On May 18, fifty Emergency Medicine Residency Programs competed in the Twelfth Annual Semi-Final CPC Competition.

A resident from each participating program submitted a challenging unknown case for discussion by an attending from another residency program. The faculty discussant had 20 minutes to develop a differential diagnosis and explain the thought process leading to the final diagnosis.

Winning presenters and discussants were selected from each of five tracks and these individuals will represent those tracks at the national competition. The CPC finals will be held at the ACEP Scientific Assembly in Seattle on October 7. It is not necessary to register for the Scientific Assembly if you plan only to attend the CPC. The CPC Competition is sponsored by ACEP, CORD, EMRA, and SAEM.

Division B Best Presenter, Dylan Luyten, MD, Denver Health Medical Center Best Discussant, Eric Katz, MD, Washington University, St. Louis Division C Best Presenter, Donald Jeanmonod, MD, Baystate Medical Center Best Discussant, E. Parker Hays, MD, Carolinas Medical Center

Congratulations to the 2002 winners!

Division D Best Presenter, Doug Williamson, MD, University of California, Irvine Best Discussant, Eric Gross, MD, Maricopa Medical Center

Division A Best Presenter, Winny Hung, MD, Brown University Best Discussant, Peter Peacock, MD, State University of New York Downstate Brooklyn

Division E Best Presenter, Alec Walker, MD, Sinai-Grace Hospital/ Wayne State University Best Discussant, Robert Reiser, MD, University of Virginia

Emergency Medicine Activities at the AAMC Annual Meeting The Association of Academic Chairs of Emergency Medicine (AACEM) and SAEM have developed a presentation and panel discussion to be held on Sunday, November 10, 2002 during the AAMC Annual meeting. The sessions will be held at the San Francisco Hilton Hotel.

All emergency physicians are invited to attend any of the sessions at no charge. However, pre-registration for lunch is required. You can register for lunch via email at saem@saem.org. Contact the SAEM office with any questions.

The sessions begin at 8:00 am with a presentation entitled “ED Overcrowding: Threat to EM Residency Training”, sponsored by SAEM. At 9:45 am, John Moorhead, MD, will speak on “Workforce Issues in Emergency Medicine”. Dr. Moorhead is a past-President of ACEP and currently heads their Workforce Taskforce. At 10:45 am, AACEM will hold its Business meeting and from 11:30 am to 1:00 pm, lunch will be provided. Once again, all emergency medicine physicians are welcome to attend.

ABEM Call for Nominations As a sponsoring organization of the American Board of Emergency Medicine (ABEM), SAEM will develop a slate of nominees to submit to the ABEM Nominating Committee for consideration of the three or four seats that will be filled by election by the ABEM Board at its winter 2003 Board meeting. SAEM members wishing to be considered for the SAEM slate of nominees are invited to send a nomination to SAEM at saem@saem.org. The deadline is September 6, 2002.

Nominations should include a current copy of the nominee’s curriculum vita, as well as a cover letter outlining the nominee’s qualifications.

The SAEM Board of Directors will review all nominations and submit a slate of nominees to ABEM by December 1, 2002.

Successful candidates are expected to be members of SAEM with considerable experience in SAEM and academic EM, as well as experience in ABEM. The SAEM Board does not nominate current members of the SAEM Board for consideration. In addition, ABEM has established the following criteria for nominated physicians: ● Be a graduate of an ACGME-accredited EM residency program. ● Be an ABEM diplomate for a minimum of ten years. ● Have demonstrated extensive active involvement in organized EM. Ideally, this includes long-term experience as an ABEM item writer, oral examiner, or ABEM-appointed representative. ● Be actively involved in the clinical practice of EM. Physicians selected for the SAEM slate of nominees will be notified in October or November and will be required to submit the official ABEM nomination form, curriculum vita, and letter noting their willingness to serve if elected.

It is important to note that all organizations and individuals are invited to participate in the ABEM nomination process and further information can be obtained through the ABEM web site at www.abem.org. This Call for Nominations is published for the express purpose of developing the official SAEM slate of nominees.

4

Scholarly Sabbatical Award Recipient Update Daniel Davis, MD University of California, San Diego SAEM Scholarly Sabbatical Grant Recipient, 2001-2002 It is commonly said that the steepest to the extensive preliminary work that portion of the learning curve occurs durled to Dr. Patel’s NIH grant. Once Dr. ing medical school. As I near complePatel recognized my appetite for basic tion of my Scholarly Sabbatical Grant science research, however, he offered year, I now recognize that the most chalme the role as principal investigator on a lenging period of my education has just project using an innovative technique – begun. My original intent was to gain oligonucleotide microarray analysis – to exposure to basic science research investigate neuronal ischemic precondithrough a simple set of experiments that tioning, a phenomenon in which subwere part of a larger ongoing and more lethal ischemia confers temporary procomplex project in the field of brain tection against subsequent lethal ischemia – the research equivalent of a ischemic insults. This represented an “sampler platter”. Instead, the experiideal opportunity for a hungry young ence has awakened within me a thirst investigator with some time, energy, and for knowledge and discovery that only an aptitude for mathematics. The basic science research can quench. microarray chip allows the expression of While that might be a bit over drama8,800 genes to be measured simultanetized, I must admit that I did not anticiously, with multiple chips able to reprepate the immense satisfaction and fulfillsent an indefinite number of time points. ment that this experience has provided This powerful new tool represents an me. Once beyond the daunting task of important direction in the future of learning the “language” of the laboratogenetic research; however, the optimal ry, including such foreign terms as “polyapproach to analyzing the volumes of merase chain reaction” and “in-situ data generated has not yet been hybridization,” I found the experience defined. Thus, I had the unique opporanalogous to living in the Discovery tunity to “play” with the numbers and Channel, with a fascinating set of sciendevelop a unique but ultimately fruitful tific problems and their potential solustrategy for filtering data to identify reletions each week. Here I will attempt to vant genes and expression patterns. chronicle my experiences and, hopefulWe anticipate that this project will ultily, inspire other young investigators to mately lead to NIH grant funding, helpfollow a similar path. ing to ensure my future as a basic sciMy interest in brain injury led me outence researcher. side of our own department and to Dr. Working in the University of Piyush Patel, an established, NIH-fundCalifornia, San Diego (UCSD) ed researcher in the Department of Neuroanesthesia Laboratory with Dr. Anesthesia. Dr. Patel has extensive Patel allowed me to develop a close experience serving as a mentor and has working relationship with other investireceived the Anesthesiology gators under his tutelage. This not only Department’s teaching award multiple created a spirit of camaraderie but also times. His willingness to reach beyond led to collaboration on several related the boundaries of his own specialty to projects. Dr. Satoki Inoue, a young nurture my career and his generosity in anesthesiologist from Japan, came to making available to me any necessary UCSD to work with Dr. Patel on a project resources are debts I can never repay. that will define the role of c-fos, a tranThe experiments detailed in my grant scription factor that appears early folapplication were part of an ongoing projlowing an ischemic insult, in regulating ect to define the relative roles of necrothe gene transcription that ultimately sis and apoptosis in ischemic brain leads to ischemic tolerance. To assist injury and to test a strategy combining him in this endeavor, I learned to peranti-excitotoxic and anti-apoptotic theraform Western blots and immunohistopies to prevent neuronal damage in a chemistry. Ultimately, we intend to block rodent model of focal ischemia. ischemic tolerance using oligonuWhile these experiments were the cleotide antisense strands to c-fos and perfect introduction to animal-based identify changes in both gene expresresearch techniques, my creative input sion and the induction of ischemic tolerwas limited since the protocols had ance following sublethal ischemia. already been defined and the expected The background reading required for outcomes were virtually guaranteed due the above projects led me to an interest-

ing group of regulatory proteins known as decoy receptors, a term used to describe the mutant forms of several apoptosis-related receptors. Instead of being eliminated through evolutionary pressures, the decoy receptors have instead been retained as competitive inhibitors of the parent receptors to regulate apoptosis. Previously thought to be important only during development and with certain tumors, apoptosis has recently been implicated in the pathophysiology of neurologic diseases such as Alzheimer’s and stroke. After recognizing that the time course for neuronal ischemic preconditioning is similar to that for other receptor-mediated processes, I postulated that decoy receptors might play a role in mediating ischemic tolerance following sublethal ischemia. Dr. Patel was willing to support my diversions, leading to a series of pilot projects with promising – albeit very preliminary – results demonstrating an upregulation of decoy receptors following sublethal ischemia.

Although my main goal for the sabbatical year was to learn basic science techniques, I was able to pursue clinical research opportunities with some of the release time afforded by the grant. For the past three-and-a-half years, San Diego has been studying the effect of paramedic RSI on severe traumatic brain injury. I was first involved in this ambitious project as a junior resident, when I helped design a video to teach paramedics GCS scoring and a field neurologic exam. Dr. David Hoyt is a UCSD trauma surgeon and one of the principal investigators for this trial, and our relationship extends back to my medical school days. He has always been a staunch supporter of my career and offered me the role as lead author on a number of the papers being generated by this trial. The timing was perfect, as the main analyses were to be performed during my sabbatical period.

Thus, an added bonus of the grant was the opportunity to participate in this important clinical research project on traumatic brain injury that nicely complements my work in the lab.

It should now be apparent to anyone reading this far into the essay that a period of time dedicated to acquiring basic research skills can be incredibly productive and rewarding, even when (continued on page 8)

5

AEM Activities at the 2002 SAEM Annual Meeting Michelle H. Biros, MD, MS Hennepin County Medical Center Editor-in-Chief, Academic Emergency Medicine AEM Consensus Conference 2002 The 2002 AEM Consensus Conference was held on May 18, 2002 in St. Louis. This year’s topic was “Assuring Quality in Emergency Medicine.” This conference was the third Consensus Conference developed by AEM and co-sponsored by SAEM. The topic was a logical progression from the previous conferences on “Errors in Emergency Medicine” and “The Unraveling Safety Net”. It also dovetailed well with the Consensus Conference developed by CORD held in March on “ Best Practices / Core Competencies”.

The goals of the “Assuring Quality in Emergency Medicine” conference were to critically evaluate how the quality of emergency health care can be measured and quality care can be taught, to identify strategies most pertinent to studying and improving the quality of healthcare in emergency medicine, to discuss the importance of quality measures with key stakeholders both within and outside of our specialty, and to develop a health services research agenda for improving the quality of care in emergency medicine.

The conference was developed by Jim Adams, Michelle Biros, Dave Cone, Roger Lewis, and Bob Wears under the excellent leadership of Art Sanders.

Over 70 individuals attended the day long session. Ken Kizer, MD, MPH, the President and CEO of the National Quality Forum, delivered the Plenary Address regarding “What is Quality and Why are we Interested in it?” Helen Burstin, MD, MPH, of the Agency for Healthcare Research and Quality presented the Keynote Address on the topic, “Crossing the Quality Chasm.” A series of breakout sessions were held, including discussions on measuring and improving the quality of care, the researching of quality, quality and education, quality in clinical practice and

quality in education. The small groups were lead by prominent researchers, educators and clinicians, with recognized expertise in quality assurance and research. I gratefully acknowledge the hard work and contributions of Brent Asplin, Jim Augustine, Randall Case, Carey Chisholm, Pat Croskerry, Steve Davidson, Jo Anne Foody, Louis Graff, Robert Lowe, Dave Magid, Sue Nedza, Dan Spaite, Carl Stevens and John Vinen to the success of this meeting.

The proceedings of this conference, as well as a number of original papers related to quality care and its research, will be published in the November 2002 issue of AEM. This issue will also include the proceedings of the CORD Consensus Conference, and original contributions related to the teaching and evaluation of core competencies and best practices in emergency medicine.

Planning for the AEM Consensus Conference 2003 The AEM editors have chosen the topic of “Disparities in Emergency Health Care” for the 2003 Conference, to be held on May 28, 2003. Disparities in heath care are likely to be present within the ED decision making process and in the larger healthcare system. Our Consensus Conference will attempt to develop a research agenda on disparities in emergency healthcare, by determining how to define, measure, and teach about health care disparities within emergency medicine, how to research the occurrence of such disparities, and how to identify root causes.

Planning will occur over the summer.

We are soliciting nominations for leadership and other participation for this conference. Leaders will be expected to assist in the planning and development of the meeting, assist the editors in the selection and editing of original manuscripts received in response to a call for papers about disparities in emergency health care, and coordinate the develop-

ment of proceedings papers following the conference. The SAEM membership is invited to nominate qualified individuals, from both within or outside of our specialty, for this important task. Please send nominations to Michelle Biros or Jim Adams by August 15, 2002.

Nominations should be sent to the AEM office at aem@saem.org. We will also issue a call for papers on disparities in emergency health care, due March 1, 2003 (for more information, see the Call in this issue of the Newsletter). The selected original contributions and the proceedings of this conference will be published in the Consensus Conference Issue of AEM, in November 2003.

AEM Editorial Board Changes The following editors rotated off the AEM Editorial Board in May 2002: Chuck Cairns, Carlos Camargo, Steve Dronen, John Gallagher, Judd Hollander, Andy Jagoda, Joe LaMantia, Ed Panacek and Kathy Shaw. We are indebted to them for their years of outstanding service, which we firmly believe have enhanced the quality and energy of our journal, and we look forward to continued interactions with them in the future. We also welcome our new editors: Mike Blaivas, Rita Cydulka, Sue Fuchs, Gary Green, Bob O’Connor, Gene Pesola and Brian Zink.

Their contributions will continue to help the journal grow and we anticipate many fruitful collaborations with this stellar group.

AEM Reviewers’ Workshop The 2002 AEM Reviewers workshop was attended by 65 participants in St. Louis. The topic of presentations was “The Life and Death of Manuscripts; Reviewer’s Rules of the Road”, which was presented by Michelle Biros.

Suggestions for topics for next year’s workshop are now being solicited from our reviewers. Please send your suggestions to the AEM office at aem@saem.org by August 15, 2002.

EMF Directed Research Award in Acute Congestive Heart Failure Deadline: September 9, 2002 The Emergency Medicine Foundation is pleased to announce the Acute Congestive Heart Failure Award Program.

The Program awards up to two $25,000 awards for research projects to be conducted over a one-year funding period. The grants are awarded to experienced researchers in congestive

heart failure treatment. This program is funded in full by Scios, Inc. The deadline for receipt of applications is September 9, 2002. Notification of the award will be November 4 and the funding period will be January 1, 2003- December 31, 2003.

For more information contact EMF at www.acep.org.

6

SAEM Faculty Development Website <http://www.saem.org/facdev/index.htm> John Gallagher, MD Montefiore Medical Center Chair, Faculty Development Committee, 2000-2002 The development of a successful career in academic medicine is predicated upon the systematic accumulation of a body of scholarly work. Typically, this effort is concentrated in one of four overlapping scholarly domains: That of discovery, integration, application, or teaching. This classification of scholarship, originally proposed more than a decade ago by The Carnegie Foundation, and subsequently adopted by the Council of Academic Societies (CAS) of the Association of American Medical Colleges (AAMC), constitutes the primary organizational framework for the SAEM Faculty Development Website.

Scholarship The four types of scholarship can be defined briefly as follows: 1. The scholarship of discovery is that of original research. This is the predominant form of scholarship that has traditionally found greatest favor with medical institutions during the latter half of the 20th century.

2. The scholarship of integration is that of trans-disciplinary merger of information from disparate branches of science and medicine, with the goal of formulating creative and novel insights.

3. Closely allied to the scholarship of integration is the scholarship of application, which bridges the gap between theory and practice by bringing new information to bear on practical problem-solving, e.g., bench to bedside translocation of knowledge.

4. Finally, there is the scholarship of teaching, which requires intelligible communication of valid and reliable information, coupled with thoughtful and coherent reasoning from a knowledgeable source, to students, younger physicians, and other colleagues.

Thus, scholars discover new knowledge, synthesize new knowledge through integration of prior knowledge, apply new knowledge to the solution of old problems, and teach new knowledge to others.

As articulated clearly in the Societyâ&#x20AC;&#x2122;s mission statement, SAEM is dedicated to the advancement of all four domains of scholarship, each in the service of improving the care we provide to our patients.

The Website and the accompanying e-version of the Faculty Development Handbook are companion pieces, developed in parallel by the Faculty Development Committee at the request of the Board of Directors. Taken together, the Website and Handbook are intended to serve as a complementary and evolving repository of information for Emergency Medicine faculty seeking ideas and assistance in advancing their scholarly interests and academic careers.

Organization of the Website At the present time, the site contains the following components: 1. The Faculty Development Handbook, first edition, is a two-year work in progress nearing completion.

The 40-chapter Handbook is a joint project of the SAEM Faculty Development Committee and the Association of Academic Chairs of Emergency Medicine (AACEM). The focus of the Handbook is more circumscribed than the Academic Career Guide (see below), in the sense that the Handbook is aimed exclusively at full-time Emergency Medicine faculty. In contrast, the Academic Career Guide was targeted at a broader audience, including students and residents, in addition to faculty.

2. The Academic Career Guide, 2nd edition, which was cosponsored by SAEM and EMRA, and edited by Hobgood and Zink, contains 15 chapters fundamental to building an academic career. This 2000 edition is an excellent, thoughtfully-written, well-organized, lucid, and much-expanded version of the first edition of the Guide, originally published in 1992.

3. The webpage entitled Academic Promotion: The Clinical Track, focuses upon the scholarship of teaching. This page also provides a status report on the development of clinical tracks within U.S. medical schools, describes the content and construction of the educatorâ&#x20AC;&#x2122;s teaching portfolio, reviews the experiences of various medical institutions with the clinical track, and examines methods of measuring academic contributions of clinical faculty to the overall mission of medical schools and academic health centers.

4. The webpage entitled Academic Promotion: The Traditional Track, targets the clinician-scientist engaged in the scholarship of application, and to a lesser extent the scholarship of integration or discovery. This site provides a working definition of clinical investigation, contrasting it with the other major component of the Traditional track, i.e., that of basic scientific research and its scholarly domain of discovery. The site also reviews the severe shortage of clinical investigators in all disciplines and explores current impediments to the development of clinician-scientists, particularly in Emergency Medicine. The importance of obtaining specialized training in clinical investigation is emphasized, and various means of achieving this goal are presented.

Funding opportunities in both the public and private sector are described, with an emphasis on NIH funding mechanisms and grantsmanship. Finally, the status of tenure in the traditional track is examined. The Traditional Track website closes with three pieces on research as a career in Emergency Medicine, written by emergency physicians who have been, and continue to be, successful investigators.

5. Faculty development targeted at Minorities, particularly under-represented minorities, also has a major link from the Faculty Development homepage.

This section examines the difficulties under-represented minorities have faced, and continue to face, in obtaining guidance in academic career development. This is followed by links to such resources as The National Center on Minority Health and Health Disparities (NCMHD) loan-forgiveness program, the Minority Research Infrastructure Support Program (M-RISP), the K01 Mentored Minority Faculty Development Award, the Institute for Minority Faculty (funded through AHRQ), and the Minority Medical Faculty Development Program (MMFDP).

6. Similar to the above, there is a section of the website specifically pertinent to faculty development among women. The first series of links on this site are to selected portions of an excellent 150-page monograph from the AAMC that explores and summarizes (continued on page 30)

7

Ultrasound Image Bank Now Available Patrick Hunt, MD Richland Memorial Hospital SAEM Ultrasound Interest Group The SAEM Ultrasound Interest Group is pleased to announce the development of a web based teaching tool for ultrasound. The website allows members to view and download ultrasound images to use for non-profit teaching purposes. Members may also register on the site and will be able to submit images and case descriptions for posting. All images and case descriptions are peer reviewed prior to posting on the website to ensure the highest quality teaching tool possible. Editors will add comments to the cases as needed. The URL for the website is http://ultrasound.saem.org.

General Instructions for Use 1. You do not have to register to view the cases or to download images.

2. You are required to register to submit a case for posting to the website 3. Images downloaded from the site may only be used for non-profit teaching and/or personal use.

4. You may search for images by category or by keyword searches (e.g.

FAST, trauma, or aorta) 5. Images submitted to the site should be less than 100Kb each and should be in .jpeg format.

On your first visit to the website we encourage you to browse the site. You

will notice a navigation bar on the lefthand side of the site. Use these links to move around the site. The first three pages (Categories, Text Search and Contact Us) can be accessed without being a registered member. You can view all the cases in the database using these tabs, and download images by right clicking on an image. If you have any questions or suggestions you may submit them to the editor using the Contact Us link.

Once you have browsed the website and you are ready to upload a case you will need to register. Just click the register link and begin the registration process. Complete all the requested information and select a password, then submit the form. All information is kept private and is used only to identify users when they log in and to contact them if we have questions regarding submissions. After you have registered you will see a list of guidelines for case submission and a link to the case submission page. Clicking the case submission link will take you directly to the case submission form, however prior to opening this page you will be ask to enter the username and password you just registered.

Submitting a Case Once you have reached the case submission form, fill in all the requested

information and continue to the image selection page. Depending on the number of images you selected you will be ask to browse your hard drive for each image (.jpeg format.) Once all images have been located and selected you can continue to the case review page and if all the information is correct then you can upload the case. Once a case is uploaded the section editor will be notified and will review the case. If the case is accepted the section editor may make comments about the case in the description section. You will be notified by email once your case has been accepted. If your case is not accepted you will also be notified and suggestions for changes will be given. Please be patient, as section editors are all practicing clinicians volunteering their time to review cases.

Final Points If you log in on a public computer be sure to shut the machine down when you are finished to clear your login. If you have difficulty logging in try using a computer that is not behind a firewall. If you have any questions or suggestions please let us know as we want this to be the finest collection of images available online.

Scholarly Sabbatical Award

Medical Student Interest Group Grants

AACEM Elections Held

(Continued) working a half-time clinical load. I anticipate a dozen peer-reviewed manuscripts to be generated as a result of the sabbatical, with an even greater number of conference presentations and abstracts. More importantly, this year has opened the door to a future research career combining laboratory and clinical investigations and (hopefully!) sustainable grant funding. The year has been somewhat humbling as well, as the old axiom that “the more you learn, the less you know” proved itself as accurate as ever. And finally, the year has made me recognize how dependent we are upon those that have come before us, not only intellectually but spiritually as well. Thus, it is my sincere hope that future investigators at the beginning of their own research careers will approach me for guidance and inspiration.

Deadline: September 4, 2002 SAEM recognizes the valuable role of EM Medical Student Interest Groups to the specialty and has established grants of up to $500 each to help support these groups' educational activities.

Established or developing clubs, located at medical schools with or without EM residencies are eligible to apply. The deadline for this year's grants is September 4, 2002. Applications can be obtained at www.saem.org or from the SAEM office. Information on the grants approved for funding earlier this year can be found in the January/February 2002 issue of the SAEM Newsletter. In addition two articles in this issue of the Newsletter describe recipients’ use of their grant funds.

8

The Association of Academic Chairs of Emergency Medicine (AACEM) held its Annual Meeting and elections in St. Louis on May 18. During the meeting Frank Counselman, MD, Chair of the Department of Emergency Medicine at the Eastern Virginia University began his term as AACEM President, succeeding John Gallagher, MD, Chair of the Department of Emergency Medicine at the Montefiore Medical Center. Jerris Hedges, MD, MS, Chair of the Department of Emergency Medicine at Oregon Health and Science University was elected President Elect. Stephen Hargarten, MD, MPH, Chair of the Department of Emergency Medicine at the Medical College of Wisconsin was elected Secretary/Treasurer.

HP2010 EM Residency Lecture Developed Carlos Camargo, MD Massachusetts General Hospital Chair, SAEM Public Health Task Force The SAEM Public Health Task Force has developed a lecture titled "Healthy People 2010 - Emergency Medicine Module." It was developed to introduce emergency physicians to Healthy People 2010 (HP2010). HP2010 is the prevention agenda for the Nation, and SAEM provided input into the development of this important public health document. Indeed, many of the HP2010 objectives are directly related to EM. On behalf of the SAEM Board of

Directors, I am encouraging an interested resident or faculty member from every EM residency to give this lecture in the next few months. The presentation, and two accompanying questionnaires, are available for download on the HP2010 section of the SAEM website www.saem.org. Detailed lecture notes and internet links will help presenters to become familiar with the material. Also, members of the SAEM Public Health Task Force â&#x20AC;&#x201C; Dominic Borgiallo at bor-

giall@msu.edu and Carlos Camargo at ccamargo@partners.org â&#x20AC;&#x201C; are available for advice or assistance as needed.

Please encourage someone from your program to give this lecture in the near future. In four pilot presentations earlier this year, the majority of residents rated the information as "very useful." I personally believe that the information in this presentation is vital to the training of every EM resident.

Emergency Medicine Interest Group Grant Report Darrin B. Letsinger Louisiana State University, New Orleans On January of this year, SAEM awarded the LSU Medical School in New Orleans Emergency Medicine Interest Group (EMIG) chapter a grant of $500 to fund clinical skills workshops that our chapter conducts. The EMIG Clinical Skills Workshops were designed to give students practical experience suturing, IV/venipuncture, and splinting in a low pressure environment that would foster learning and understanding before being faced with an actual patient. Our workshops are designed around an instructional set of videos and checklists that dictate a standard by which all students are taught. The EM residency director reviewed all videos and approved their content, as well as the checklists and instructional handouts that are circulated before teaching sessions. After taking a pretest to assure students review required videos, we collect fees only adequate to cover the cost of the individualâ&#x20AC;&#x2122;s supplies. Students watch a video segment and are then paired with another student and a student-proctor.

Students taking the course interview the proctor as if they are a patient and perform the procedure on their fellow student taking the course. Proctors use the course checklist to ensure that the students perform to standard. After completing the workshop, students fill out a course evaluation that is kept confidential from the proctors.

Our largest expenditure ($1100) was creating instructional videos. These videos were instrumental in ensuring

that a standard satisfactory to the EM Residency Director could be maintained with student proctors/instructors. We have conducted few (two with six students each) suturing classes because of limited cadavers late in the academic year, splinting classes (forty students @ $10ea), and IV/venipuncture classes (36 students @ $7.50ea). Using the post-workshop evaluations as a gauge, success has been very encouraging.

Students rate their understanding of the skills taught and comfort level if having to perform these procedures on patients as excellent. They enjoy interacting with a proctor as a patient to learn pertinent patient skills. Students value our decision to use materials in the workshops that are identical to those used in the clinical setting. Participants unanimously praise the use of small groups (two students to one student-proctor) in lieu of large teaching groups.

In summary, our progress this year was slow at first secondary to the desire to produce a video that was of high quality to set the standard of care. Our number of participants completing these workshops may appear to be small, but we limit each workshop to no more that 16 students (to preserve a low student to proctor ratio). Often times, tests and clinical rotations limit enrollment to less than sixteen students per class, but we find that participants enjoy a small group workshop more and are more quickly interactive. The only criticisms that we have encountered are that students must pay to participate (but all who com9

mented said the experience was well worth the investment), the time of the course (2-3 hours; but the students again see value in the duration), and the pretest (we still see the utility of making sure material is reviewed before the workshop).

Next year we plan to hold suture workshops for the first half of the academic year (while cadavers are readily available) until all interested have had the opportunity to participate. After all interested in suture workshops have participated, we will offer splinting and IV/venipuncture workshops until demand has been met. We hope to expand the clinical skills workshops next year to include other skills such as Cspine immobilization. Since our videos have been produced and paid for with EMIG surplus and the SAEM Grant, we hope to be selected for a SAEM grant next academic year to purchase IV/ venipuncture arms so that students can practice their technique before performing the procedure on their peer.

Our thanks to SAEM for the grant award. As a student organization, funding for large projects such as production of an instructional video or instructional aids can cause the failure of worthwhile projects such as this one. After taking these workshops, many students have volunteered in the ED with the sole purpose of putting their skills to use. We are pleased that these workshops give students confidence and competence before being faced with initial patient encounters.

New England Regional Meeting Report Robert Dart, MD Boston Medical Center Chair, SAEM New England Regional Meeting This year’s 6th Annual New England Regional SAEM Meeting was held on April 3, 2002 in Shrewsbury, MA and was hosted by the Emergency Medicine Residency Program at Boston University School of Medicine. All eight Emergency Medicine Residency Programs from the six New England States participated in the conference.

Some residency programs cancelled their residency conference day to encourage residents to attend the meeting. A small number of abstracts from New York were also presented. It was our largest turnout yet with a total of 162 registered participants. A total of 81 abstracts were presented.

The conference began with opening remarks by Robert Dart, MD, Research Director for the host institution, followed by the keynote speaker, Ian Stiell MD, MSc, FRCPC, Chair of Emergency Medicine Research at the Ottawa Health Research Institute in Ottawa Canada. His interesting and entertaining presentation, “How to Succeed in Emergency Medicine Research” was very well received by the audience. The remainder of the morning session consisted of four oral presentations, followed by the first poster session.

A medical student luncheon titled, “Academic Emergency Medicine, Is It Right For You?” was given by Robert Dart, MD in an informal interactive format. The afternoon session began with the second poster session followed by the remaining oral presentations. The day concluded by an awards ceremony with closing remarks given by Dr. Stiell.

The following oral presenters received Excellence in Research Awards: Traci Thoureen, MD, Yale University School of Medicine. “Safety Equipment Use and Safety Counseling for Children Who Own Bicycles, Skateboards, In-line Skates and Scooters” Nathan Shapiro, MD, Harvard University School of Medicine/Beth Israel Hospital, “Mortality in Emergency Department Sepsis (MEDS): A Prospectively Derived and Validated Clinical Prediction Rule” Jill Ripper, MD, University of Connecticut School of Medicine/ Hartford Hospital, “Post-Sexual Assault Prophylaxis Study: A Nationwide Survey

of Emergency Physicians” Steve Bird, MD, University of Massachusetts Medical Center/ University of Massachusetts School of Medicine, “Diphenhydramine as a Protective Agent in Severe Organophosphate Poisoning” Christopher Bowe, MD, Maine Medical Center, “The Effect of Arm Traction on The Adequacy of Lateral Cervical Spine Radiographs” Rishi Sikka, MD, Boston Medical Center/Boston University School of Medicine, “A Pharmacy Claims Derived Measure of Short-Term Oral Steroid Use is Associated with Self-Reported Emergency Department Visits and Hospitalizations for Asthma” Tim Mader, MD, Baystate Medical Center, “Aminophylline in AtropineResistant Asystolic Out-Of-Hospital Cardiac Arrest” Selim Suner, MD, Brown University School of Medicine/Rhode Island Hospital, “Injuries Among Workers During the 2001 World Trade Center Rescue and Recovery Mission” The New England Regional Meeting continues to grow each year. Maine Medical Center eagerly looks forward to hosting next year’s conference. The conference will be coordinated by Dr. John Burton (burtoj@mail.mcc.org) and Tania Strout, RN (strout@mmc.org). With the continued support from all of the New England Residency Programs, we hope to foster the development and productivity of new researchers in emergency medicine.

Erratum In the March/April Newsletter it was announced that Howard A. Besson, MD, Harbor-UCLA had been elected to serve on ABEM. Dr. Besson’s name was spelled incorrectly. SAEM regrets the error.

Second New York State Regional Conference Held Rama Rao, MD New York University/Bellevue Hospital Center Chair, SAEM New York Regional Meeting The Emergency Medicine Residency Program at Bellevue Hospital Center/ New York University Medical Center is pleased to report the great success of the 2002 New York State Regional SAEM Conference. Seventeen different programs and/or hospital centers participated from New York, New Jersey, and Pennsylvania. The attendance included 210 residents and 52 faculty, for an overall attendance of 262 persons. Fortythree posters were presented, along with seven platform presentations. We presented a Wall of Academic Achievements in which each program listed the scholarly activities of current active residents. We are especially grateful to Dr. Susan Stern and Dr. Judd Hollander for excellent instructional and motivational presentations that were well received by both faculty and residents.

Given the unusual and difficult experiences of residents and faculty marked

by September 11, the afternoon was dedicated to how our roles as emergency physicians changed. To honor the efforts of our colleagues, and mark the terrible losses suffered by civilians, rescuers, and their survivors, each program was invited to prepare a Memorial Poster. (Six September 11 Memorial Posters were presented and subsequently displayed at the Annual Meeting in St. Louis). Susan F. Ely, MD, of the Office of Chief Medical Examiner of the City of New York, presented an overview of how her office continues to handle the World Trade Center tragedy. Joel Ackelsberg, MD, from the New York City Department of Health reviewed the challenges of bioterrorism and the events surrounding the anthrax investigation in autumn of 2001.

Given the large concentration of programs in the metropolitan area, and the simultaneous scheduling of Grand Rounds at most programs on Wednesday mornings, our region offers a unique opportunity to reach hundreds of emergency medicine physicians of all career and training levels. SAEM is an exceptional resource through which that education can occur annually. With the (continued on next page)

10

New York State Regional Conference (Continued) support of SAEM, we were able to sponsor a program highlighting the achievements of participating programs, provide didactic and informational sessions, as well as breakfast, for a nominal fee of $20 per person and $5 for lunch. We did not seek, nor need, any corporate sponsorship. Given the nominal expense, many programs funded their resident groups, facilitating registration and a high turn out. We express our gratitude for the support of the SAEM Board of Directors, including Dr. Stern, in the program development and assistance in making the regional conference a tremendous success. We are happy to report that the Emergency Medicine Residency at the Metropolitan Hospital Center has expressed an interest in hosting the 2003 regional meeting. We look forward to working with them for continued success of future programs.

Mid-Atlantic Regional Meeting Brian Burgess, MD Doctors for Emergency Service Chair, SAEM Mid-Atlantic Regional Meeting Planning Committee The 5th Annual SAEM Mid-Atlantic Regional Meeting was held on April 11 and 12, 2002 at the First USA Riverfront Arts Center located in Wilmington, Delaware.

Christiana Care Health System hosted this esteemed event and there were over 150 registrants, consisting of attendings, fellows, residents, nurses, paramedics and EMTs, traveling from as far as New York, Chicago and North Carolina. Attendees were able to learn about the latest exciting and educational research in emergency medicine from the high degree of diversified oral and poster presentations providing continuing education credits for the entire audience.

Highlights from the meeting included medical student presentations from Christiana Care residents: Dr. Munish Goyal, Dr. Angela-Siler Fisher, and Dr. Shkelzen Hoxhaj. Topics included: “Your EM Career”, “Successfully Becoming an Emergency Resident” and “Putting your Best Foot Forward”. Other highlights included guest speaker presentations

Western Regional Meeting Report Stephen R. Hayden, MD University of California, San Diego Chair, 2002 Western Regional Meeting Planning Committee The SAEM Western Regional Research Forum was held in San Diego this year on April 6-7 at a beautiful conference center right on San Diego Bay. The meeting was a huge success with over 150 registered participants. There were separate resident tracks, faculty tracks, and a special medical student forum on April 7. Highlights from the first day included a rousing keynote address from Peter Rosen in which he shared reflections on research and being an editor of a major emergency medicine journal for over fifteen years.

Peter provided a call to arms for the next generation of EM researchers.

Participants also learned from Carin Olson what to do if their manuscript is rejected, and Charles Cairns shared his vast experience and suggested how to get a research project funded. There were also several panel discussions including a hotly debated session on Resident Scholarly Activity (to do or not to do; that is the question), as well as Academic vs. Private Career Pathways.

A very innovative session was done this year, which allowed participants to bring their own research proposals to the experts. This involved some of the most experienced researchers in the western region who facilitated small group discussions with the participants and helped them modify their projects. One medical student had the opportunity to pick the brains of Jerris Hedges, Robert Lowe, Charles Cairns, and David Schriger all at one sitting; what an opportunity!

The second day of the conference saw several didactic sessions including a panel discussion coordinated by Deirdre Anglin on how to Successfully get your Project through the IRB, and the Medical Student Forum included presentations on EM career opportunities, what to do with your fourth year, and differences in EM program formats.

The medical student forum was incredibly successful with over 50 participants for this alone! The morning was capped off for the students in an informal session where they could meet representatives from many of the western region EM residencies.

The highlight of the entire meeting, however, was the research presentations. This year, using the SAEM elec-

(continued on next page) 11

tronic submission process, the western scientific review committee received over 110 abstracts (a record for the western forum!). Of these 90 were accepted for presentation at the meeting. Sixteen papers were presented during 3 oral sessions, and the remainder as poster presentations over the course of the 2-day meeting. Eleven of the oral presentations at the western forum were also accepted to the national SAEM Annual Meeting, and 27 of the poster presentations for a grand total of 38 of 90 (42%) of abstracts accepted to the regional forum were also accepted at the national meeting in St. Louis.

The meeting ended in the early afternoon of April 7 with a wonderfully funny medical version of The Weakest Link.

Colleen Campbell from the University of California, San Diego donned the black business suit and thin-rimmed black glasses that are the trademarks of the show and complete with flaming orange wig proceeded to terrorize the participants as they attempted to correctly answer the medical and research based questions. Only one participant, Chris Richards from the Oregon Health and Science University survived the onslaught of the other competitors (and host) to win.

Many thanks go to Dave Tanen, Bob Buckley, and Joel Roos (Naval Medical Center San Diego) for their tireless work on the scientific review committee, and Sean Deitch and Jill Vessey (both from UCSD) for helping coordinate the resident and medical student tracks.

All in all it was a very productive and successful meeting. As one participant put it, “I enjoy the regional meeting even more than the national meeting. It gives us the opportunity to share research ideas in a more relaxed setting. I feel almost schizophrenic at the national meeting and often miss out on this kind of intellectual dialogue with my colleagues from west coast programs.” The meeting next year will be hosted by Maricopa in Phoenix, AZ. I hope to see you all there!

Mid-Atlantic Regional Meeting (Continued) from visiting faculty involving “Gunshot Wounds in Four Assassinated Presidents” by Dr. Joe Lex, “Emergency Medicine Research: The Evangelical Approach” by Dr. Charles Pollack, and “Funding for Emergency Medicine Initiatives” by Dr. Marcus Martin. Twelve Oral Presentations and Seventy Five Poster Presentations were presented.

The meeting was very successful, stimulating productive discussion sessions. In addition, the research was informative, alerting the audience to new opportunities, techniques and approaches for the advancement of Emergency Medicine and Research. All research was professionally presented, cultivating fresh ideas which we will learn about at the 6th Annual SAEM Regional Meeting.

The SAEM regional planning committee included: Dr. Brian Burgess Course Director; Dr. Robert O’Connor Co-Chair; Patty McGraw Coordinator; Dr. Neil Jasani; Dr. Brian Levine, Dr. John Madden, Dr. Scott Krall, Dr. Craig Lauder, Dr. Dave Bailey, Dr. Paul Sierzenski, Dr. Robert Rosenbaum, Dr. Anita Hodson, Dr. Jerry Castellano, Dr. Brian Little, and Sherrill Mullenix.

Special thanks to our judges for the Oral and Poster Presentations: Dr. Brian Euerle, Dr. Robert O’Connor, Dr. Jeff Kline, Dr. Scott Krall, Dr. Brian Levine, Dr. Walt Schrading, Dr. Charles Reese IV, Dr. David Milzman, and Dr. Marc Pollack.

The Regional Planning Committee, consisting of Dr. Brian Euerle, Dr. Mark Pollack, Dr. Robert O’Connor, Dr. William Brady, Dr. David Milzman, and Dr. Jeff Kline, have selected George Washington University and Howard University as CoHosts on March 13-14, 2003 for the site of the 6th Annual SAEM Mid-Atlantic Regional Meeting. The 5th Annual MidAtlantic Planning Committee expresses best wishes to the next planning committee for a successful, exciting and educational meeting in 2003.

Award recipients for the Poster Presentations: 3rd place; Dr. Amanda Smith, SUNY, Brooklyn; “ARIMA Model of Atmosphere and ED Asthma: Conservative Model” 2nd place; Dr. Donald Alves, University of Maryland; “Ambulance Snatching: How Vulnerable Are We ?”

1st place; Dr. Douglas McGee, Albert Einstein Medical Center, Philadelphia; “A Brief Structured Intervention Did Not Improve Directly Observed Resident-Patient Interactions” Award recipients for the Oral Presentations: 3rd place; Dr. Marla Friedman, AI DuPont Hospital for Children, Wilmington; “Influenza in Young Children with Suspected RSV Infection” 2nd place; Dr. Michael Blaivas, North Shore University Hospital; “Elevated Intracranial Pressure Detected by Bedside Emergency Ultrasound of the Optic Nerve Sheath” 1st place; Dr. Jeffrey Kline, Carolinas Medical Center; “Predictors of Short Term Mortality in ED Patients with Pulmonary Embolism”

Southeastern Regional Meeting Update Andy Godwin, MD Shands Jacksonville Chair, 2002 Southeastern SAEM Regional Meeting David Caro, MD Orange Park Medical Center Co-chair, 2002 Southeastern SAEM Regional Meeting This year’s Southeastern SAEM conference was held April 12-14 at the Sea Turtle Inn on Jacksonville Beach, Florida. The meeting had 90 participants; the relaxed beach atmosphere and sunshine (which appeared late in the weekend) was enjoyed by all.

There were over 70 oral and poster presentations. The quality of the research was phenomenal. Research award winners included: Aisha Liferidge, MSIII (Emory) - Best Student Oral Presentation Lawrence DeLuca, MS III (Miami) - Best Student Poster Presentation Lisa Morrison, MD (UT Southwestern) - Best Resident Oral Presentation Ilene Brenner, MD & Nicole Jasper, MD (Emory) - Best Resident Poster Presentation Abhi Chandra, MD (Duke) - Innovations in Research James Moises, MD (LSU-Charity) - Best Overall Presentation

Multiple academic institutions participated in the conference activities, including Emory University, Louisiana State University, New Orleans; Louisiana State University Shreveport; Duke University, University of Florida; University of South Carolina, Columbia, University of Louisville, and University of Texas, Southwestern. Didactic sessions at the conference included an overview of bioterrorism preparedness

by Jay Schauben, PhD, (UF-Jacksonville), and the keynote address given by Bob Wears, MD, (UF-Jacksonville) entitled “Is This as Good as it Gets? Research into Remaking Healthcare in the 21st Century.” Other educational sessions included a hands-on ultrasonography workshop and state of the art medical simulation encounters. A research roundtable discussion paired medical students and residents with accomplished EM researchers over cold foamy beverages on a deck overlooking the surf. Next year’s conference will be held at the same location for more academics and fun at the beach!

12

2002-2003 EMF/SAEM Medical Student Grants SAEM and the Emergency Medicine Foundation (EMF) are pleased to announce the recipient of the 2002-2003 EMF/SAEM Medical Student Grants. Each of the recipients will receive $2,400.

Applicant: Institution: Preceptor: Project Title:

Brett Dee Nelson, William Spivey Award winner Johns Hopkins University Michael J. VanRooyen, MD, MPH Social Determinants of Emergency Medical Care Utilization in a Post-Conflict Setting

Applicant: Institution: Preceptor: Project Title:

Amy Schuster, William Spivey Award winner University of Maryland Robert Rosenthal, MD Molecular Mechanisms of Cerebral Ischemic Brain Injury

Applicant: Institution: Preceptor: Project Title:

Leo Hsu St. Louis University Albert K. Nakanishi, MD, MPH Primary Care intervention in the Urban ED: Does it Work for Asthma in Children?

Applicant: Institution: Preceptor: Project Title:

Timothy P. Korytko Akron General Medical Center John E. Duldner, Jr, MD Spontaneous Subarachnoid Hemorrhage- Compliance, Hyperacute Management, and Mortality After Published Guidelines

Applicant: Institution: Preceptor: Project Title:

Richard Turner Cox Institute James E. Olson, PhD Intracellular pH Dependence of Astroglial Volume Regulation

National Alcohol Screening Day Held on April 11, 2002 Karen Casper, MD Edward Bernstein, MD Boston University Medical Center There are approximately 100 million visits to the U.S. Emergency Departments (EDs) each year. As many as 10-30% of these ED patients present with alcohol related problems. Hospital EDs offer a focused opportunity not available elsewhere for alcohol screening, brief counseling, and referral. The ED is an ideal setting to meet people with harmful or hazardous drinking and take advantage of a “teachable moment.” This year National Alcohol Screening Day, (NASD) gave EDs across the country the opportunity to provide information to the community, to develop a referral network, and to help individuals with problem drinking identify their risk, and to enable them to take steps towards changing their behavior.

Last year a total of 296 patients at four sites (range 47-150) were screened using the ten question AUDIT (Alcohol Use Disorder Identification Test). The AUDIT, an internationally recognized screening test with a total possible score of 40, addresses quantity and frequency of use and alcohol problems. 78 or 28% screened positive (scores>8) for at risk drinking and 46 patients or 17% screened positive (scores>19) for dependent drinking. 48% agreed to a follow-up call at six months.

This year 449 people were screened at six ED sites (range 45-160) from California to New York This year’s AUDIT data is still being analyzed. Both Spanish and English versions of the AUDIT were available. Every site that participated was thrilled with the turn out. Dr. Maria O’Rourke, a graduating EM resident at Mount Sinai wrote that it gave her an opportunity “ to remind the department and staff about our referral list as well as to discuss the overall issues important to the ED- like screening and documentation.” At Mass General Hospital, they found that 20% participants without “obvious” alcohol problems were at risk for problem drinking. At Boston University Medical Center, the feedback from the participants was exciting. One gentleman, who heard about NASD on television came to assess his drinking. After completing the AUDIT and talking with the ED staff, he said that he realized that his drinking was preventing him from meeting his responsibilities and he wanted help. We were able to help him find an inpatient detox that day.

National Alcohol Screening Day provided an opportunity to raise public awareness surrounding alcohol’s effects on all aspects of life and encourage those with alcohol-related problems to obtain intervention and treatment. This year was the fourth annual NASD. Each year EDs across the nation have dedicated one day towards alcohol screening. This concentrated approach has helped communities and individuals to identify problem drinking. We are optimistic that next year even more sites will be able to participate. NASD, which is funded by NIAAA and SAMHSA and many organizations including SAEM (Board of Directors, Public Health Task Force, and Substance Abuse Interest Group) helped to advance HP 2010 Objective 26-22 which calls on EDs to identify and refer patients with alcohol problems to treatment. If you are interested in participating in NASD 2003 please send an email to ebernste@bu.edu 13

Two New Academic Departments Established

Report to SAEM Regarding EMIG Grant 2001-2002

Case Western Reserve University

Alison Sheets, MSII University of Colorado Health Sciences Center

The Case Western Reserve University (CWRU) Board of Trustees has established a Department of Emergency Medicine within the School of Medicine. Charles L. Emerman, MD, has been named the Chairman of the CWRU Department of Emergency Medicine at MetroHealth Medical Center. Dr. Emerman completed his residency training at Henry Ford Hospital and has been with Case Western Reserve University since 1982. Dr. Emerman was the recipient of the 1998 ACEP Research Leadership Award and is a Senior Examiner for the American Board of Emergency Medicine. His area of expertise is asthma research.

This represents the culmination of a great deal of work on the part of the emergency physicians at Case Western Reserve University and the MetroHealth Medical Center. The faculty of MetroHealth Medical Center includes a prior SAEM president, two prior members of the SAEM Board, a past president of Ohio ACEP, four examiners for the American Board of Emergency Medicine, and a current director of ABEM. The MetroHealth Medical Center is the county hospital for Cuyahoga County which includes Cleveland, Ohio.

MetroHealth, in conjunction with the Cleveland Clinic Foundation sponsors an Emergency Medicine Residency.

The Department has an active research program focusing on respiratory, cardiovascular, and geriatric emergencies.

On behalf of the University of Colorado Health Sciences Center Emergency Medicine Interest Group, I would like to thank SAEM for supporting us through the SAEM Medical Student Interest Group Grant. The radiology series proposed in our grant has proven to be quite successful and promises to continue in the future. We conducted a series of six presentations during the 2001-2002 school year.

The first was an extremities lecture to look at common injuries to the upper and lower extremities. Students were introduced to terminology and descriptions of abnormalities as well as a review of normal anatomy. This was given by Dr. Ray Kilcoyne from the Department of Radiology.

The second lecture topic was on the evaluation of the spine given by Dr. Pam Isaacs, also from the Department of Radiology. She gave a great overview of the difficult evaluation of spinal injuries with an emphasis on the most commonly occurring lesions. She also shared numerous pointers on how not to miss the easily overlooked abnormalities.

Our third presentation covered the chest x-ray. This vast subject was expertly handled by Dr. Deb Dyer from Radiology. This lecture discussed medical as well as traumatic abnormalities common to the Emergency Department setting.

The fourth and fifth presentations were both on the use of Ultrasound in the Emergency Department setting. Dr. Kristin Nordenholz from the Department of Emergency Medicine at University of Colorado Hospital gave a lunch hour overview of the indications for Ultrasound use. This lecture was followed by an intensive evening workshop given by Dr. John Kendall from Denver Health. This hands-on workshop was very well attended and allowed students to use the very latest Sonosite equipment in practice on one another. Additionally, Dr. Kendall discussed the current literature on efficacy and efficiency in the use of Ultrasound in the ED environment.

Our final lecture was given by Dr. Jean Abbott of the Department of Emergency Medicine. She presented “Orthopedic Masquerades,” a series of patient presentations suggesting minor orthopedic complaints that actually involved serious medical problems. A variety of interesting films were seen. This M&M type seminar was a new format for many of the first and second year students and provided a great interactive session.

Since receipt of the grant, the Emergency Medicine Interest group has been constructing an interactive course for our web site with the above topics to be presented. The extremities presentation being the first to go on line. An ultrasound tutorial on CD provided by Dr. Kendall, will also be available to the EMIG students for use in the library. This project will continue into next year for completion.

In summary the Radiology Series has been very popular and has been attended by students from all four medical school classes and from nursing, physician assistant and research programs. It has generated a lot of excitement for next year’s EMIG and has given the students who attended some very useful tools to take to the clinical years. As the on line program continues, all students will be able to review the valuable information in these presentations throughout their medical education.

University of California, Irvine The Academic Senate of the University of California, Irvine, (UCI) has unanimously voted to establish an academic Department of Emergency Medicine within the UCI College of Medicine, effective July 1, 2002. Mark Langdorf, MD, MHPE, has been appointed Chair-elect of the new department. Dr. A. Antoine Kazzi is the Vice Chair-elect for Academic Affairs.

The Department has 14 full-time faculty and operates the UCI Medical Center Emergency Department, a 47,000 visit, Level I Trauma and ACS verified Burn Center. There are sections of toxicology, emergency ultrasound, research, pediatric emergency medicine, international EM, disaster/EMS, and public policy. Eight of the faculty have fellowship training or advanced degrees. Dr. Kazzi serves as Vice President of the American Academy of Emergency Medicine.

In coordination with other UC faculty and leaders, the department publishes the California Journal of Emergency Medicine, and co-sponsors a Disaster EMS Fellowship with Harbor UCLA. A fellowship in emergency ultrasound is approved for 2003.

This transition follows 15 years as a division of internal medicine, during which time many people worked very hard to fulfill the academic mission of EM. We would like to thank Dr. Kym Salness, the founding Division Chief, who guided us through our formative years, and Dr. Gregg Pane, the founding Residency Director. This is the first academic departmentalization of EM at the University of California and therefore a landmark step for the specialty of EM.

14

Academic Announcements SAEM members are encouraged to submit Academic Announcements on promotions, research funding, and other items of interest to the SAEM membership. Submissions should be sent to saem@saem.org by July 30 for the July/August issue of the Newsletter.

Richard M. Cantor, MD, will receive the ACEP Outstanding Contribution in Education Award during the ACEP Scientific Assembly. Dr. Cantor is being recognized for his exceptional service as an ACEP fauclty member for various programs and meetings.

Edward A. Panacek, MD, MPH, will receive the ACEP Outstanding Contribution in Research Award. Dr. Panacek is being recognized for his research work and his service as director of the ACEP Emergency Medicine Basic Research Skills course.

Michelle Biros, MS, MD, has been promoted to Professor of Emergency Medicine (tenured) at the University of Minnesota. Dr. Biros is also Editor-inChief of Academic Emergency Medicine.

John Mahoney, MD, has been named Assistant Dean for Medical Education at the University of Pittsburgh School of Medicine. Dr. Mahoney is an Assistant Professor in the Department of Emergency Medicine.

Joseph F. Waeckerle, MD, will receive the ACEP Outstanding Contribution to Emergency Medicine Award during the ACEP Scientific Assembly in Seattle.

Dr. Waeckerle is being recognized for his 13 years of service as Editor-inChief of Annals of Emergency Medicine.

Michael D. Bishop, MD, will receive the ACEP John G. Wiegenstein Leadership Award during the ACEP Scientific Assembly in Seattle. Dr. Bishop is being recognized for his work in government affairs and reimbursement issues on behalf of ACEP.

Ricardo Martinez, MD, will receive the ACEP Outstanding Contribution in EMS Award during the ACEP Scientific Assembly. Dr. Martinez is being recognized for his long time advocacy for EMS and emergency medicine and is a former administrator of the National Highway Traffic Safety Administration.

Leslie Zun, MD, has been promoted to Professor of Emergency Medicine at Finch University/The Chicago Medical School. Dr. Zun has been the Chairman of the Department of Emergency Medicine since 1999.

News from the Emergency Medicine Foundation Robert Neumar, MD University of Pennsylvania Donald M. Yealy, MD University of Pittsburgh SAEM Representatives to EMF The Emergency Medicine Foundation (EMF) Board of Trustees met in Dallas on March 10, 2002. Dr. Robert Schaefermeyer currently serves as Chair of the Foundation, with Michael L. Carius serving as Chair-Elect. The three main outcomes of the meeting were to allocate funding for the 2002/2003 EMF grant proposals, restructure grant categories for 20032004, and propose new initiatives to enhance fundraising.

Evaluation and Funding of 2002-2003 Grants The review and decision process for funding EMF Grant proposals was significantly modified for the 2002-2003 cycle. As part of an ongoing commitment to provide the highest quality peer review of EMF applications, the review process was modified this year to model that of the NIH. The ACEP Scientific Review Committee (SRC) adopted a study section format to evaluate, discuss and score grant proposals. The SRC was divided into clinical and laboratory investigation study groups. Each study group met in Dallas on March 8 and 9 where all 2002-2003 proposals were reviewed at once. A one to five

point scoring system similar to that of the NIH was utilized and overall percentile rankings were generated. Based on the resulting scores and rankings, representatives of the SRC made funding recommendations the following day at the EMF Board Meeting. A total of $453,677 was allocated to fund 16 projects out of the 89 that were submitted.

The feedback from those involved was overwhelming positive, and the plan is to continue this format for future cycles.

Revisions of Grant Categories for 2003-2004 In an effort to optimize distribution of EMF funds in a way that best fosters research in emergency medicine, the SRC made a number of recommendations to modify the grant categories for future cycles. The goals of each category were re-evaluated and the number and quality of applications received in each category considered. Based on this review, the Creativity and Innovation, Innovation in Medicine Education, and Established Investigator award categories will not be offered for the 2003-2004 funding cycle. Proposals are being developed to best serve 15

investigators who would have applied for funding in these categories.

Furthermore, the goals and objectives of EMF/ENAF team grant will be re-evaluated possibly resulting in a modification of the application criteria. Finally, the EMF/SAEM medical student grants will be awarded to an institution rather than an individual student in order to facilitate recruiting of medical student researchers.

Fundraising Initiatives With the assistance of a fundraising consultant, EMF plans to both expand traditional avenues of fundraising and explore innovative fund raising techniques. In addition, a motion was adopted to request that the ACEP dues check-off amount be raised to $50. This request will be submitted to the ACEP Board of Directors for approval.

The EMF remains committed to funding academic emergency physicians and related health care providers.

SAEM offers support through joint sponsorship of the Medical Student Grants, representation on the EMF Board, and participation of many SAEM members on the ACEP Scientific Review Committee.

2002 SAEM Medical Student Excellence Award Winners Listed below are the recipients of the 2002 SAEM Medical Student Excellence in Emergency Medicine Award. This award is offered to each medical school in the United States to honor an outstanding senior medical student. This is the ninth year this award has been made available. Recipients receive a certificate and one-year membership to SAEM, including subscriptions to the SAEM Newsletter and Academic Emergency Medicine. Information about next year's Excellence in Emergency Medicine Award will be sent to all medical school dean's offices in February 2003.

Albert Einstein College of Medicine John Timothy Fisher

Medical College of Georgia Gearge E. Malcom

Arizona College of Osteopathic Medicine Katharine A. Mitzel

Medical College of Ohio Daniel Jeffrey Rashid

Baylor University Joel Edward Buzy

Medical College of Wisconsin Maxwell B. Davis

Brown University Dan Avstreih

Meharry Medical College Lynn Tuggle

Chicago College of Osteopathic Medicine Mark Ogden

Memorial University of Newfoundland Pei Shih Theng

Cornell University Monique Iris Sellas

Michigan State University Simon A. Mahler

Des Moines University Elizabeth Ann Williamson

Morehouse School of Medicine Shelise Michele Henry

Duke University Carlos David Sanchez

New York Medical College Eric J. Loeliger

East Carolina University Dawn Elaine Boudrow

New York University Patrick Simon Reinfried

Eastern Tennessee State University Candie Michelle Templeton

Northeastern Ohio Universities Brian Barhorst

Eastern Virginia Medical School Rebecca Lipscomb Georgetown University Anthony Napoli Harvard Medical School Mark Christopher Bisamzo Howard University Neha Parikh Indiana University Jayne MacLaughlin Johns Hopkins University Eveline Antoine Hitti Kansas University Richard Prudencio Kirksville College of Osteopathic Medicine Scott Balonier Lake Erie College of Osteopathic Medicine Steven J. Verbridge Loma Linda University Debbie Washke Louisiana State University, New Orleans Thomas Chad VanDerHeyden Louisiana State University, Shreveport Robert Pringle Jr. Loyola University Karice M. Bezdicek MCP Hahnemann Abbe Pitera Marshall University Christopher S. Goode Mayo Medical School Kyle R. Martin

Uniformed Services University of the Health Sciences Joshua D. Hartzell

University of New England College of Osteopathic Medicine Scott M. Russo

UMDNJ - New Jersey Medical School Jennifer Hannum

University of North Carolina, Chapel Hill Kevin J. Biese

UMDNJ - Robert Wood Johnson Medical School Mark Saks

University of North Dakota Michael L. Moen

University of Alabama at Birmingham Frederic M. Jones

University of North Texas, Fort Worth Mark A. Gamber

University of Alberta Randy Naiker

University of Oklahoma Matthew R. Bonner

University of Arizona Mark Eric Zeitzer

University of Pennsylvania Jessica Diane Hill

University of Buffalo Paul Hinchey

University of Pittsburgh James Quan-Yu Hwang

University of California, Davis Abram Levin

University of Rochester Timothy Lum

University of California, Irvine Donald Janes

University of South Alabama Joshua Thomas Kotouc

University of California, Los Angeles Heather Conrad

University of South Carolina Adrian Doran Langley

Nova Southwestern University College of Osteopathic Medicine Gary Lai

University of California, San Diego Thomas Hemingway

University of South Florida Brandi L. McClain-Carter

Oregon Health & Science University Lalena Yarris

University of Connecticut Alec Belman

University of Southern California Connie Teng

Penn State Darren A. Boyack

University of Florida Robyn Hoelle

University of Texas, Galveston Eugene Kangethe Gicheru

Philadelphia College of Osteopathic Medicine Ali S. Price

University of Hawaii Jason K. Fleming

University of Texas, Houston Joseph Robson

Ponce School of Medicine Jenny Lu

University of Health Sciences, Kansas City Eric T. Harrington

University of Texas, San Antonio Adam R. Krommenhoek

Queen's University Paul Cleve

University of Kentucky Michael Presley

University of Texas Southwestern, Dallas Kelley R. Jacqmin

Rush Medical College Eric S. Brittain

University of Louisville Laurie Bay

University of Vermont Mariah McNamara

Saint Louis University Duane H. Moore

University of Manitoba Christian LaRiviere

University of Wisconsin Sharon A. Swencki

St. George's University Herald Ostovar

University of Massachusetts Troilus Plante

Vanderbilt University Tricia Scholes Rotter

State University of New York, Stony Brook Joshua Simon Ardise

University of Miami Mark Frisch

Virginia Commonwealth Holley Cousins Meers

State University of New York, Downstate Elzbieta Pilat

University of Michigan Carl Dahlberg

Wake Forest University Vernon Smith

State University of New York, Syracuse Karl Svoboda

University of Mississippi Russell A. Knight

Washington University Jennifer Stuart Lee

Temple University Jennifer Clark

University of Missouri, Columbia Mark Christopher Moylan

West Virginia School of Osteopathic Medicine Billie J. Hall

Thomas Jefferson University Allyson Kreshak

University of Missouri, Kansas City Meredith A. Leach

West Virginia University Jeremy Leslie

Tufts University Martine Sargent

University of Nebraska Stefanie Huff

Wright State University Carrie Strauss-Dunn

Tulane University Justin Barrett Williams

University of Nevada Vanessa R. Branstetter

Yale University Jeanne K. Tyan

16

Board of Directors Update The SAEM Board of Directors meets each month, usually by conference call.

This article will highlight the Board’s activities during the Board’s long range planning session held during the CORD Navigating the Academic Waters and Core Competencies Conferences, as well as the conference call in April and the two meetings held during the Annual Meeting in St. Louis.

During the long range planning session the Board discussed a wide-range of potential activities and objectives in the categories of: membership, governance, finances/research fund/investments, communication and public relations, meetings, and office/staff issues.

A host of potential objectives were discussed including: amending the active membership requirements to include an attestation that an applicant is active in academic emergency medicine or has a faculty appointment, rather than requiring a letter verifying a faculty appointment, conducting a membership drive by writing to all chairs of academic departments, highlighting “to become a member” on the SAEM web site, adding data regarding research coordinators to the Residency Catalog, promoting the resident discount program to osteopathic and allopathic residency programs, sponsoring an SAEM booth at national medical student organization conferences, begin charging annual dues for emeritus membership, investigate ways to better navigate the SAEM web site, develop mechanisms to provide information to the membership about the Society’s activities, develop a database of Annual Meeting didactic sessions presented in the past five years, and amend the Interest Group Orientation Guidelines regarding dissolution.

The Board met with Ms. Anne Watkins, an expert on issues related to fund raising and development officers, to discuss the development of the SAEM Research Fund. The Board agreed that the fund must be developed to fund the existing grants, and expanded to fund additional grants. The Board agreed that the fund must be publicized and promoted to attain a level of awareness and importance in SAEM, as well as outside of SAEM. The Board agreed that by 2010 the Research Fund should be the largest and most influential source of research training grants in Emergency Medicine.

Also, during the long range planning session the Board reviewed all current

committees and task forces and began discussion of objectives for 2002-2003.

The Board agreed that committees were intended to be permanent within SAEM, while task forces were developed to complete specific tasks. The Board agreed to develop a Task Force on Federal Funding of Emergency Medicine and Disaster Medicine Research. The Board also agreed to develop an Annual Meeting Task Force to centralize process and administration in the SAEM office, while providing more opportunity for the Program Committee to focus on content and creativity in the Annual Meeting planning. It was noted that with the expansion of the Annual Meeting it would be important to disperse deadlines throughout the year and meet deadlines.

The Board adopted a position statement on the Patient Privacy Rule. The position statement will be published in the SAEM Newsletter and posted on the SAEM web site, along with a letter SAEM sent to Secretary Tommy Thompson outlining the Society’s concerns regarding the Patient Privacy Rule.

The Board approved the Faculty Development Handbook developed by the Faculty Development Committee.

The Board noted that AACEM may propose in the future that the Handbook be published as a joint project by AACEM and SAEM. The Board approved the Ultrasound Image Bank developed by the Ultrasound Interest Group. The Board requested a Newsletter announcement when the Interest Group completed the work to post the Image Bank on the web site.

The Board agreed to participate in the next Model of Emergency Medicine/Core Content Task Force as invited by ABEM. Dr. Chisholm and Dr. Hoekstra will represent SAEM. The Board reviewed the National Hospital Ambulatory Medical Care Survey and agreed to provide written input regarding the Survey.

The Board agreed to participate in the ABEM request to submit references for the ABEM Lifelong learning and SelfAssessment Program. It was agreed that Dr. Adams and Dr. Chisholm would serve as the SAEM Board representatives and would collate references selected by SAEM members.

The Board agreed to not consider a “member only” section of the web site at 17

this time. The Board agreed that because of the Society’s mission and academic focus, information on the web site should be made available to all.

The Board agreed to send a letter of support to AHRQ, upon development by the Public Health Task Force.

The Board agreed with Dr. Martin’s recommendation to accept the invitation from the ACEP Academic Affairs Committee to meet with SAEM and CORD during the Annual Meeting. Dr. Chisholm and Dr. Hamilton agreed to serve as the SAEM Board representatives.

The Board will meet monthly via conference call and the next face-to-face meeting will be held during the ACEP Scientific Assembly in Seattle on October 7. All SAEM members are invited to attend the SAEM Board meetings.

Annual Business Meeting (Continued) Research Fellowship; and the recipients of the Best Oral and Poster Awards from the 2001 Annual Meeting.

Marcus Martin, MD, presented his Presidential Address (published in this Newsletter) and introduced incoming president Roger Lewis, MD, PhD.

Keep Your Membership Mailings Coming!

Be sure to keep the SAEM office informed of changes in your address, phone or fax numbers, and especially your e-mail address.

SAEM sends infrequent e-mails to SAEM members, but only regarding SAEM issues or activities.

SAEM does not sell or release its mailing list or e-mail addresses to outside organizations. Send updated information to saem@saem.org

SAEM Responds to Patient Privacy Rule On May 9, 2002 SAEM sent the following letter to Tommy G. Thompson, the Secretary of the US Department of Health and Human Services. The letter was developed by the National Affairs Committee, chaired by James Hoekstra, MD. The Society for Academic Emergency Medicine (SAEM) welcomes the opportunity to comment on the Secretary’s March 27, 2002 proposal to modify the federal medical privacy rule. SAEM represents over 5000 emergency physicians practicing in academic medical centers and teaching hospitals.

SAEM members are active in clinical research involving human subjects as it relates to the provision of emergency care. We submit this formal comment letter in accordance with the requirements of the Notice of Proposed Rulemaking (NPRM).

SAEM appreciates and commends the Secretary’s willingness to increase the rule’s “workability” by reducing the significant obstacles that the rule erects to the conduct of essential biomedical, epidemiological, and health services research and the provision of healthcare. SAEM offers our endorsement of the NPRM while identifying some remaining concerns about the rule and its application. We remain concerned that the modified rule would still impose unwarranted liability and unnecessary procedural burdens upon covered entities who use and disclose health information in federally-regulated research.

SAEM believes that the undeniably strong public interest in furthering epidemiological, public health, and health services research can only be served by a separate, more reasonable standard for the de-identification of protected health information for research purposes.

Covered entities should be permitted to release information that has been de-identified under this research standard if the recipient researcher agrees in writing not to attempt to re-identify or contact the subjects of the information, and not to further disclose the information except as required by law.

The NPRM acknowledges that the research community perceives a pressing need for an alternative de-identification standard, yet the Secretary has not formally proposed to create one. This issue is critical, and SAEM’s view on this issue is as follows: 1. Aggregated data, even identifiable data, exists in modern electronic systems in hospitals, pharmacies, insurance agencies, federal agencies, etc. Such data provide the opportunity for ongoing health care research with great potential societal benefit. The existence of such data poses the risk, not the fact, of a moral hazard. These databases must be recognized, handled, and guarded as potentially hazardous to society and to individuals.

Adverse effects from unauthorized use of such confidential data can range from personal embarrassment to loss of current and future livelihood. Hence, the use of such data for other than the customary business for which the data were acquired should only be undertaken when there is significant societal benefit to the use of such data and appropriate safeguards are taken to protect the individuals appearing within such databases.

2. Strict limits on the use of identified, aggregated data must be established. Prohibited uses should include marketing and tracking of any individual outside of the customary business for which the data were acquired. Contact with individuals for non-research purposes must be prohibited.

3. Use of data for potential financial profit is prohibited. Intent to gain information about any individual is not allowable.

Use of identified, aggregated data for health care research should be encouraged as long as the research plan has been reviewed by a federally recognized institutional review board that ensures that the research has the potential to provide societal benefit and provides appropriate data security. All aggregated data used for research purposes should be destroyed within three years of study completion, provided the expansion of the aggregated data for further approved research is not underway.

This issue is of critical importance; SAEM believes that the “workability” of the rule for research hinges upon adoption of a modified de-identification standard for research uses and disclosures. In agreement with AAMC, we urge the Secretary to adopt the following modification to §164.514: §164.514(a)(i) Standard: de-identification of protected health information. Health information that does not identify an individual and with respect to which there is no reasonable basis to believe that the information can be used to identify an individual is not individually identifiable health information. (ii) Exception for information disclosed for research purposes. Information that does not directly identify an individual and that conforms to the requirements of §164.514(b)(3) is not individually identifiable health information when disclosed to a researcher or researchers pursuant to each researcher’s written agreement that: (A) The information will be used only for research purposes and will not be further disclosed except as required by law; and (B) The researcher will not attempt to re-identify or contact individuals who are the subjects of the information. *** §164.514(b)(3). Implementation specifications: requirements for de-identification of protected health information disclosed for research purposes. A covered entity may determine that health information disclosed pursuant to a data use agreement is not individually identifiable health information if: (i) Under the procedures described in §164.514(b)(1), the covered entity has determined that the risk is very small that the information could be used, alone or in combination with other reasonably available information, by the recipient researcher to identify an individual who is the subject of the information; or (ii) The following identifiers of the individual or of relatives, employers, or household members of the individual, are removed: (A) Names; (B) Street address; (C) Telephone numbers (D) Fax numbers; (E) Electronic mail addresses (F) Social security numbers (G) Vehicle identifiers and serial numbers (H) Photographic images depicting the full face or full profile; and (iii) The covered entity does not have actual knowledge that the information could be readily used alone or in (continued on next page) 18

Patient Privacy Rule (Continued) combination with other reasonably available information to identify an individual who is the subject of the information.

In the preamble to the proposed rule the Secretary describes a possible set of “direct” identifiers that might be removed to create a modified de-identification standard for research. The Secretary’s list comprises the elements listed above, with the addition of URLs and IP addresses. We recognize the need to add URLs and IP addresses to the list of direct identifiers and urge that with the addition of these two elements our proposal for a research de-identification standard should be adopted in the final rule.

We note, however, that the preamble discussion of de-identification lists examples of “identifiable information” (e.g., admission dates and five digit zip codes) that a covered entity might be permitted to include in a “limited dataset” to be used

or disclosed for research purposes. We assume that the Secretary did not intend that this “limited dataset” be restricted to those data fields described in the NPRM. SAEM believes that a covered entity should be permitted to include any information in the research or “limited” dataset that is not a direct identifier, as described above, and regarding which the entity does not have actual knowledge that the information could be readily used, alone or in combination with other reasonably available information, to identify an individual who is the subject of the information.

Thank you for the opportunity to express our strong support for the important modifications proposed thus far. We emphasize, however, that with respect to the provisions that we identify in this letter, further modifications are necessary if the privacy rule is to become a truly workable standard that does not unduly impede patient care and research.

Report of the Frontlines of Medicine Project Consensus Conference Hernan F. Gomez, MD University of Michigan SAEM Representative to Frontlines Conference It was my pleasure and honor to have served as the SAEM representative for the Frontlines of Medicine consensus conference. The meeting was filled with many fine and nationally prominent speakers from within emergency medicine, and key individuals from high profile federal agencies such as the CDC. The Honorable Tom Sawyer, Member of Congress (14th District, Ohio) eloquently discussed issues involving legislation, healthcare, and preparedness, including the need for high speed internet access to all hospitals for effective communication and data collection. As may be discerned by the title of the program – representation in this conference was clearly in our area of interest.

The Frontlines of Medicine Project (http://www.frontlinesmed.org/) is a newly inaugurated effort to develop a nonproprietary, and standardized “open systems” approach for collecting and reporting emergency department data for the purposes of biological and chemical surveillance. The aim of this form of surveillance is to capture in real-time data from emergency departments from around the country for the early diagnosis and treatment of disease. By pooling multiple key forms of data from multiple sites and sources within the emergency medicine domain, disease may be recognized early and thus optimize the opportunity to save lives. There are similar initiatives being planned within various agencies, and the proactive Frontlines planning from emergency

medicine leadership is good news to emergency medicine as a whole. The framework constructed by the Frontlines leadership will allow emergency medicine clinicians to determine the nature of information technology (IT) design of ED-based surveillance infrastructure which may then promote communication (vertical and horizontal) with local and federal public health agencies.

The emergency department is such a key area of data collection that it would be reasonable to assume that the emergency medicine world would likely find themselves incorporated into other surveillance systems if we were to simply play the role of passive observers. The Frontlines Project allows emergency medicine clinicians to play an active role in design elements in a surveillance program aimed to link individual (and very busy) departments with public health and other vital decision making agencies.

This project is a collaborative effort of emergency medicine (including emergency medical services and clinical toxicology), public health, emergency government, law enforcement, and informatics. Recent national events including the disaster of September 11, 2001 and subsequent anthrax distribution by mail have intensified efforts to improve surveillance for chemical and biological terrorism. The leadership of the Frontlines Project have proactively organized this effort with the recognition that emergency departments are uniquely positioned as surveillance sites because

they universally contain the following ideal characteristics: a) they are open 24 hours each day, b) are ubiquitous in distribution c) continuously treat large numbers of patients of all ages d) direct out-of-hospital emergency medical services e) have been heavily involved in nuclear, biological, and chemical preparedness issues for a number of years prior to September 11. The leadership of this effort are to be congratulated for taking the initiative of placing emergency medicine in a central role in determining how surveillance and data sharing, and ultimately (vertical and horizontal) communication should be planned in the emergency medicine domain.

A proposed system that would be seamless and shared between emergency medicine and public health would be a step in the right direction for improving historical problems with collaboration between emergency medicine and public health. Impedances to effective collaboration are detailed in a recent review (Pollock et al. Emergency medicine and public health: new steps in old directions. Ann Emerg Med 2001; 38:675-683). The benefits of sharing health care data among emergency departments and with public health agencies are being investigated by several agencies. Examples include: Indianapolis Network for Patient Care, which includes an automated transfer of data from hospitals to public health authorities. Sandia National laboratories have shown feasibility of collecting (continued on page 24)

19

2002-2003 SAEM Committee/Task Forces Annual Meeting/Program Committee Task Force Co-Chair: Susan S. Fish, PharmD MPH, Boston University, sfish@bu.edu Co-Chair/Board Liaison: Susan A. Stern, MD, University of Michigan, suestern@umich.edu David A. Guss, MD, University of California, San Diego Jerris R. Hedges, MD MS, Oregon Health and Science University Judd E. Hollander, MD, University of Pennsylvania Arthur B. Sanders, MD, University of Arizona.

Ellen J. Weber, MD, University of California, San Francisco Donald M. Yealy, MD, University of Pittsburgh Ethics Committee Chair: Catherine A. Marco, MD, St. Vincent Mercy, cmarco2@aol.com Jean T. Abbott, MD, University of Colorado Susan S. Fish, PharmD MPH, Boston University Joel M. Geiderman, MD, Cedars-Sinai Medical Center Herbert Hern, MD, Highland Hospital Gregory Luke Larkin, MD MS MSPH, University of Texas Southwestern Benjamin S. Lerman, MD, Alameda County Mary Patricia McKay, MD, Allegheny General Hospital Tammie E. Quest, MD, Emory University Raquel Marie Schears, MD, MPH, St. Mary's Hospital Robert C. Solomon, MD, West Virginia School of Osteopathic Medicine Board Liaison: James Adams, MD, Northwestern University, jadams@nmh.org Faculty Development Committee Chair: J. Lee Garvey, MD, Carolinas Medical Center, lgarvey@carolinas.org William G. Barsan, MD, University of Michigan Theodore A. Christopher, MD, Thomas Jefferson University Gregory P. Conners, MD, MPH, University of Rochester Deborah B. Diercks, MD, University of California, Davis David Esses, MD, Montefiore Medical Center Jennifer Krawczyk, MD, University of California, Irvine Gloria Kuhn, DO, PhD, Wayne State University O. John Ma, MD, Truman Medical Center Robert L. Muelleman, MD, University of Nebraska Debra G. Perina, MD, University of Virginia S. Scott Polsky, MD, Summa Health System Latha Ganti Stead, MD, Mayo Clinic Board Liaison: Marcus Martin, MD, University of Virginia, mlm8n@virginia.edu Financial Development Committee Chair: Brian J. Zink, MD, University of Michigan, bzink@umich.edu Francis L. Counselman, MD, Eastern Virginia Kerry Forrestal, MD, BS, Thomas Jefferson University Mark Hauswald, MD, University of New Mexico Judd E. Hollander, MD, University of Pennsylvania Joseph A. Salomone, III MD, Truman Medical Center Jill D. Teplensky, MD, PhD, Thomas Jefferson University Frank L. Zwemer, Jr MD, MBA, University of Rochester Board Liaison: Roger Lewis, MD PhD, Harbor, UCLA, roger@emedharbor.edu Graduate Medical Education Committee Chair: Michael S. Beeson, MD, Akron City Hospital, beesonm@summa-health.org Mike Burg, MD, University Medical Center, Fresno Meta Carroll, MD, Children's Memorial Hospital Mark W. Fourre, MD, Maine Medical Center Sheryl L. Heron, MD MPH, Emory University Michael Hochberg, MD, Albert Einstein

David S. Howes, MD, University of Chicago Shar Jwayyed, MD, Summa Health System Eric Legome, MD, NYU/Bellevue Hospital Usamah Mossallam, MD, Henry Ford Hospital Peter Shearer, MD, Boston Medical Center Patricia Dighton Short, MD Board Liaison: Carey Chisholm, MD, Indiana University, cchisholm@clarian.org Grants Committee Chair: Adam J. Singer, MD, State University of New York, Stony Brook, asinger@notes.cc.sunysb.edu Evaline A. Alessandrini, MD, Children's Hospital, Philadelphia Joel A. Fein, MD, Children's Hospital, Philadelphia Lowell W. Gerson, PhD, NEOUCOM Jason Scott Haukoos, MD, Harbor-UCLA Dexter L. (Tony) Morris, PhD MD, Cogent Neuroscience Robert E. O'Connor, MD MPH, Christiana Care Brian J. O'Neil, MD, Detroit Receiving Hospital Marc S. Rosenthal, PhD, DO, Saginaw Cooperative Hospitals, Inc. Robert A. Swor, DO, William Beaumont Hospital Kelly D. Young, MD, Harbor-UCLA John G. Younger, MS MD, University of Michigan Board Liaison: Donald Yealy, MD, University of Pittsburgh, yealydm@msx.upmc.edu National Affairs Committee Chair/Board Liaison: James W. Hoekstra, MD, Ohio State University, hoekstra.1@osu.edu Brent R. Asplin, MD, Regions Hospital David F.M. Brown, MD, University of Chicago Jill Grant, MS, MD, University of Virginia J. Brian Hancock, MD, Timberline Emergency Physicians, P.C. Stephen Hargarten, MD MPH, Medical College of Wisconsin David Harter, MD, Cook County Hospital Mark C. Henry, MD, State University of New York, Stony Brook Kenneth V. Iserson, MD MBA, University of Arizona Antoine Kazzi, MD, University of California, Irvine John A. Marx, MD, Carolinas Medical Center William Frank Peacock, IV MD, Cleveland Clinic Lynne D. Richardson, MD, Mt. Sinai Medical Center Robert W. Schafermeyer, MD, Carolinas Medical Center David P. Sklar, MD, University of New Mexico Patient Safety Task Force Chair: Robert L. Wears, MD MS, University of Florida, wears@ufl.edu David Barlas, MD, North Shore University Hospital Christopher Beach, MD, Northwestern University Kenneth E. Bizovi, MD, Oregon Health and Science University Karen Cosby, MD, Cook County Hospital/Rush Patrick G Croskerry, MD PhD, Dartmouth General Hospital Gregory D. Jay, MD PhD, Rhode Island Hospital Shawna Perry, MD, University of Florida Stewart Reingold, MD, Advocate Christ Hospital Stephen Schenkel, MD, University of Michigan Marc J. Shapiro, MD, Rhode Island Hospital John Dennis Vinen, MD, Royal North Shore Hospital Michele B. Wagner, MD, Beth Israel Deaconness Board Liaison: James Adams, MD, Northwestern University, jadams@nmh.org Program Committee Chair: Ellen J. Weber, MD, University of California, San Francisco, weber@medicine.ucsf.edu Chris Barton, MD, University of California, San Francisco Dane M. Chapman, MD PhD, Washington University David C. Cone, MD, Yale University 20

Kevin M. Curtis, MD, University of Pennsylvania Cathy Custalow, MD PhD, University of Virginia M. Christopher Decker, MD, Medical College of Wisconsin Brian Euerle, MD, University of Maryland Hospital Leonard R. Friedland, MD, Temple University Diane Gorgas, MD, Ohio State University David A. Guss, MD, University of California, San Diego Alan Heins, MD, University of Maryland Sean O. Henderson, MD, LAC + USC Medical Center Debra Houry, MD MPH, Denver Health Medical Center John J. Kelly, DO, FACEP, Albert Einstein Medical Center David C. Lee, MD, North Shore University Hospital Lewis Nelson, MD, New York University/Bellevue Hospital Diana M. Pancu, MD, New York University/Bellevue Hospital Susan B. Promes, MD, Duke University Richard D. Shih, MD, Morristown Memorial Hospital Terry L. Vanden Hoek, MD, University of Chicago Gary M. Vilke, MD, University of California, San Diego Mary Jo Wagner, MD, Saginaw Cooperative Hospitals, Inc. Stewart W. Wright, MD, University of Cincinnati Board Liaison: Sue Stern, MD, University of Michigan, suestern@umich.edu

Adrienne Birnbaum, MD, Jacobi Medical Center Kerry B. Broderick, MD, Denver Health Michael Canter, MD, Jacobi Hospital Norman C. Christopher, MD, Children's Hospital/Akron Jamie Collings, MD, Northwestern Memorial Hospital Adam D. Corrado, Chicago Medical School Susan E. Farrell, MD, Beth Israel Deaconess Cherri Hobgood, MD, University of North Carolina, Chapel Hill Tamara Howard, MD, Howard University Michelle Lin, MD, San Francisco General Hospital David Edwin Manthey, MD, Wake Forest University, Baptist Steven A. McLaughlin, MD, University of New Mexico Terry J. Mengert, MD, University of Washington Charissa B. Pacella, MD, University of Pittsburgh Tamas R. Peredy, MD, Maine Medical Center Cory J. Pitre, MD, Indiana University David A. Wald, DO, Temple University Lori A. Weichenthal, MD, University Medical Center, Fresno Board Liaison: Kate Heilpern, MD, Emory University, kheilpe@emory.edu Undergraduate Question Bank Task Force Chair: Stephen H. Thomas, MD, Massachusetts General Hospital, thomas.stephen@mgh.harvard.edu Michael Filbin, MD, Brigham and Women's/Massachusetts General Hospital Jonathan Fisher, MD, Brigham and Women's/Massachusetts General Hospital Jennifer L. Isenhour, MD, Vanderbilt University Annie Tewel Sadosty, MD, Mayo Clinic Emily Senecal, Stanford University Board Liaison: Kate Heilpern, MD, Emory University, kheilpe@emory.edu

Public Health Task Force Chair: Carlos A. Camargo, Jr MD DrPH, Massachusetts General Hospital, ccamargo@partners.org Edward Bernstein, MD, Boston University Dominic A. Borgialli, DO, MPH, Michigan State University, Lansing Gail D'onofrio, MD, Yale-New Haven Hospital Linda C. Degutis, DrPH, Yale University Dave A. Holson, MD, Harlem Hospital Charlene Babcock Irvin, MD, St. John Hospital Terry Kowalenko, MD, University of Michigan Robert Lowe, MD MPH, Oregon Health and Science University Daniel A. Pollock, MD, National Center for Injury Prevention and Control Jason Shapiro, MD, Mount Sinai Federico E. Vaca, MD, University of California, Irvine Board Liaison: Glenn Hamilton, MD, Wright State University, glenn.hamilton@wright.edu Research Committee Chair: Mark G. Angelos, MD, Ohio State University, angelos.1@osu.edu Robert N. Bilkovski, MD, Christ Hospital Clifton Callaway, MD PhD, University of Pittsburgh D. Mark Courtney, MD, Northwestern Memorial Hospital Gary B. Green, MD MPH, Johns Hopkins University Alan E. Jones, MD, Carolinas Medical Center David J. Karras, MD, Temple University Jeffrey A. Kline, MD, Carolinas Medical Center Lawrence A. Melniker, MD, New York Methodist Hospital Roland Clayton Merchant, MD, Rhode Island Hospital Craig D. Newgard, MD, Harbor-UCLA James E. Olson, PhD, Wright State University Niels K. Rathlev, MD, Carney Hospital Junaid Razzak, MD, Yale University Michael Roshon, MD, Carolinas Medical Center Richard Eric Rothman, MD PhD, Johns Hopkins Hospital Jan M. Shoenberger, MD, Los Angeles County/USC Medical Center Harold K. Simon, MD, Egleston Children's Hospital Jill D. Teplensky, MD, PhD, Thomas Jefferson University Robert O. Wright, MD, MPH, Children's Hospital, Boston Board Liaison: Judd Hollander, MD, University of Pennsylvania, jholland@mail.med.upenn.edu Undergraduate Committee Chair: Wendy C. Coates, MD, Harbor-UCLA, coates@emedharbor.edu

Under-Represented Member Research Mentoring Task Force Chair/Board Liaison: Glenn C. Hamilton, MD, Wright State University, glenn.hamilton@wright.edu Kumar Alagappan, MD, Long Island Jewish Medical Center Louis S. Binder, MD, MetroHealth Medical Center Rita K. Cydulka, MD, MetroHealth Medical Center Michelle Grant Ervin, MD MHPE, Howard University Hospital Miguel C. Fernandez, MD, University of Texas Juan A. Gonzalez-Sanchez, MD, Hospital De La Universidad De Puerto Rico Fred P. Harchelroad, Jr MD, Allegheny General Hospital Thea James, MD, Boston Medical Center Norm Kalbfleisch, MD, Oregon Health and Science University Varnada Karriem-Norwood, MD, Emory University Marcus L. Martin, MD, University of Virginia James Thomas Niemann, MD, Harbor-UCLA Manish M. Patel, MD, Emory University Shawna Perry, MD, University of Florida Lynne D. Richardson, MD, Mt. Sinai David P. Sklar, MD, University of New Mexico Task Force on Federal Funding of Emergency Medicine & Disaster Medicine Research Chair: Michelle H. Biros, MS, MD, Hennepin County, biros001@maroon.tc.umn.edu Frederick M. Burkle, Jr MD, John Hopkins University Clifton Callaway, MD PhD, University of Pittsburgh E. John Gallagher, MD, Montifore Medical Center Mark C. Henry, MD, State University of New York, Stony Brook Kristi L. Koenig, MD, VA Medical Center Robert W. Neumar, MD PhD, University of Pennsylvania Arthur B. Sanders, MD, University of Arizona Carl H. Schultz, MD, University of California, Irvine Board Liaison: Roger Lewis, MD PhD, Harbor-UCLA, roger@emedharbor.edu

21

Annual Meeting Highlights

2002-2003 SAEM Board of Directors: (Front L-R) Sue Stern, MD, Judd Hollander, MD, Kate Heilpern, MD, Roger Lewis, MD, PhD, Carey Chisholm, MD. (Back L-R) James Hoekstra, MD, James Adams, MD, Glenn Hamilton, MD, Donald Kosiak, MD, Donald Yealy, MD, and Marcus Martin, MD.

Ellen Weber, MD, Annual Meeting Program Committee Chair and Dane Chapman, MD, are pictured with Keynote Speaker, Kenneth Ludmerer, MD, who spoke on “The Coming of the Second Revolution in Medical Education.” (L-R) Dr. Weber, Dr. Ludmerer, and Dr. Chapman.

2002-2003 CORD Board of Directors: (Front L-R) Pam Dyne, MD, Mary Jo Wagner, MD, and Debra Perina, MD. (Back L-R) Steve Hayden, MD, Sam Keim, MD, Susan Dufel, MD, and Louis Binder, MD.

Dr. Marcus Martin (L) introduced Dr. David Sklar, the recipient of the 2002 Leadership Award, who received his award during the Annual Meeting Banquet. Dr. Sklar’s talk will be published in a future issue of AEM.

2002 CPC Semi-Final Competition winners: (Front L-R) Doug Williamson, MD, Eric Gross, MD, Winny Hung, MD, Robert Reiser, MD, Donald Jeanmonod, MD. (Back L-R) Alec Walker, MD, Dylan Luyten, MD, Eric Katz, MD, Peter Peacock, MD, and E. Parker Hays, MD. They will compete in the CPC Finals that will be held on October 7 during the ACEP Scientific Assembly in Seattle.

22

Dr. Ed Panacek, CORD Board 1999-2002, completed his term on the Board of Directors and was thanked for his service to CORD.

Dr. Martin is pictured with (L-R) Robert Neumar, MD, University of Pennsylvania, recipient of the Institutional Research Training Grant, Linda Papa, MD, University of Florida, recipient of the Scholarly Sabbatical Grant, and Jason Borton, MD, State University of New York, Buffalo, recipient of the 2002-2003 EMS Fellowship Grant.

Dr. Marcus Martin is pictured with (L-R) Catherine Marco, MD, elected to the Constitution and Bylaws Committee, James Hoekstra, MD, appointed to the Board, Carey Chisholm, MD, elected Secretary/Treasurer, Dr. Martin, Katherine Heilpern, MD, elected to the Board, Donald Kosiak, MD, elected Resident Member of the Board, Jill Baren, MD, elected to the Nominating Committee, and Donald Yealy, MD, elected as the President-elect.

Frank Counselman, MD, (R) congratulates Dr. Barry Knapp, Eastern Virginia Medical School, the recipient of the CORD Faculty Teaching Award.

Debra Houry, MD, MPH, Denver Health Medical Center, recipient of the CORD Resident Academic Achievement Award, is congratulated

by Lee Shockley, MD.

2002-2003 AACEM Executive Committee: (L-R) Jerris Hedges, MD, John Gallagher, MD, Frank Counselman, MD, and Steve Hargarten, MD.

23

Dr. Martin is pictured with the 2002 Young Investigator Award recipients: (L-R) James Gordon, MD, Daniel Morris, MD, Dr. Martin, and Eric Dickson, MD.

Frontlines of Medicine Project (Continued) emergency encounter data to detect 6 primary syndromes that might be consistent with bioterrorism (Zelicoff A et al.

The Rapid Syndrome Validation Project (RSVP) a technical paper. Sandia National Laboratories. Available at: http://www.cmc.sandia.gov/bio/rsvp/pub .html).

Dr. Dan Pollock and Lawrence P. Hanrahan described an overview of CDC activities such as the National Electronic Disease Surveillance system (NEDSS) project, and the Health Alert Network (HAN). It was clear from this overview that the Frontlines Project may be designed to fully integrate with these systems. NEDSS is a public health initiative which provides a standardsbased, integrated approach to disease surveillance and connects public health to the rather unwieldy clinical information systems infrastructure. HAN is a HERSA component for hospital pre-

paredness and is in part dedicated to effective interfacing with NEDSS and area hospitals.

The ultimate objectives (largely met in the conference) were to: 1) introduce and establish the Frontlines project as a networking resource for healthcare providers, public health authorities, health information systems experts, government officials and agencies, and professional associations interested in the application of syndromic surveillance in emergency medicine and related fields 2) introduce a defining approach to the application of syndromic surveillance data collection from multiple frontlines sites (emergency medicine departments, clinics, physician offices, veterinarians, schools or worksite absenteeism, etc. 3) establish an initial version of XML-based messages to be utilized in pilot projects for sending surveillance data from emer-

Conference Participants Edward Barthell, MD, Executive vice President Infinity HealthCare, Inc., Craig Feied, MD, Director of Informatics, National Center for Emergency Medicine Informatics, Dennis G. Cochrane, MD, Emergency Medicine Associates, Morristown Memorial Hospital Residency in EM, William H. Cordell, MD, Director, Division of Research, Indiana University School of Medicine, John C. Moorhead, MD, MS, Professor, EM and Public Health & Preventive Medicine, Oregon Health and Science University, Dept of EM, Mark Smith, MD, Chairman, Dept of EM, Washington Hospital Center, Charles Sneiderman, MD, PhD, Research Medical Officer, Office of High Performance Computing and Communications, National Library of Medicine, Christopher W. Felton, MD, President, EMSystem, Infinity HealthCare, Inc., Michael Collins, BS, Senior Software Engineer, Infinity HealthCare, Inc., Mohammad N. Akhter, MD, MPH, Executive Director, APHA, Brent R. Asplin, MD, MPH, Health Partners Research Foundation, Erik Auf der Heide, MD, MPH, Disaster Planning and Training Specialist, Agency for Toxic Substances and Disease Registry, Carlos Camargo, MD, DrPH, Director, EMNet Coordinating Center, Dept. of EM, Stephen K Epstein, MD, MPP, FACEP, Clinical Operations Director, Dept of EM, Beth Israel Deaconess Medical Center, Virginia Foster, PhD, MPH, Epidemiologist, Department of Defense-Global Emerging Infections Surveillance and Response system (DoD-GEIS), Capt. Arthur J. French, MD, US Coast Guard EMS Physician Liaison, National Highway Traffic Safety Administration, Michael Gillam, MD, Director EM Informatics, Evanston Hospital, Chair ACEP Informatics Section, Hernan F. Gomez, MD, Medical Toxicology, Univ of Michigan, Dept of EM, Jonathan A. Handler, MD, Director of Emergency Medicine Informatics, Division of EM, Northwestern University, Lawrence P. Hanrahan, PhD, MS, Chief Section of Epidemiology and Toxicology, Bureau of Environmental Health, Brian F. Keaton, MD, Board of Directors, ACEP, EM Informatics Director, Dept of EM, Summa Health System, Linda Lawrence, MD, Chief, Emergency Medicine, Andrews AFB, Scott Lilibridge, Special Assistant to the Secretary for national Security and Emergency Management, Dept of HHS, Dan Pollock, MD, Medical Epidemiologist, National Center for Injury Prevention and Control, CDC, Helga E. Rippen, MD, PhD, MPH, Director, Science & Technology Policy Institute, RAND, Mhomas O. Stair, MD, Research Director Emergency Department, Brigham and Womenâ&#x20AC;&#x2122;s Hospital , Joseph F. Waeckerle, MD, Editor in Chief, Annals of Emergency Medicine, C. Peter Waegemann, Chairman Centre for the Advancement of Electronic Health Records. In addition, the Honorable Tom Sawyer, Member of Congress, US House of Representatives (14th District, Ohio) was present during key portions of the conference.

24

gency departments to regional surveillance entities and finally 4) facilitate future activities for ongoing communication of related activities among stakeholders and possible funding of pilot projects to validate initial recommendations.

The effort may be summarized as the beginning of a proactive effort on the part of the emergency medicine leadership to control the design and IT infrastructure that will one day be the part of day-to-day preparedness operations in the modern 21st century emergency department. We can passively let other organizations do this for us, or we can design it to maximally fit our needs and integrate a Frontlines system that would maximally fit the needs of emergency medicine and ultimately minimize morbidity and mortality in the face of the unthinkable.

Newsletter Advertising The SAEM Newsletter is mailed every other month to the 5,500 members of SAEM. Advertising is limited to fellowship and academic faculty positions. All ads are posted on the SAEM web site at no additional charge.

Deadline for receipt: July 30 (JulyAug issue), September 1 (Sept/Oct issue), October 15 (Nov/Dec issue), March 1 (March/April) and June 1 (May/June). Ads received after the deadline can often be inserted on a space available basis.

Advertising Rates: Classified Ad (100 words or less) Contact in ad is SAEM member........$100 Contact in ad non-SAEM member ....$125 1/4 - Page Ad (camera ready) 3.5" wide x 4.75" high......................$300 To place an advertisement, e-mail, fax or mail the ad, along with contact person for future correspondence, telephone and fax numbers, billing address, ad size, and Newsletter issues in which the ad is to appear to: Jennifer Mastrovito at jmastrovito@saem.org, via fax at (517) 485-0801 or mail to 901 N. Washington Avenue, Lansing, MI 48906. For more information or questions, call (517) 4855484 or jmastrovito@saem.org.

All ads posted on the SAEM web site at no additional charge.

Scholarly Activity and Promotion in University and Community Settings Gloria Kuhn, DO, Wayne State University Scott Polsky, MD, Summa Health System Latha Stead, MD, Mayo Clinic Sean Henderson, MD, LAC+USC Medical Center Debra Perina, MD, University of Virginia SAEM Faculty Development Committee There is increasing pressure for change in the criteria used for promotion of faculty in the traditional, tenured system embraced by the academic medical community. Increased emphasis on delivery of patient care to finance the cost of educating medical students and residents in academic health centers has necessitated recruiting physicians whose primary interests and responsibilities are in the areas of patient care and teaching rather than research.1, 2 Many physicians have practices based in the community hospital and teach as “voluntary faculty.” Promotion/tenure (PT) committees are under pressure to reassess promotion guidelines and some institutions have questioned the need for tenured positions.

However, in other academic centers, there is general recognition that achievement of both promotion and tenure (PT) is still valuable within the academic community. Promotion and tenure not only garners additional salary and a measure of job security, but provides an increase in standing or power within the institution along with other less tangible benefits. In many academic centers, tenure often “legitimizes” individuals; their opinions may now be freely voiced and senior faculty from other specialties now recognize them as equals and colleagues. This tenured position allows the emergency medicine physician to be fully integrated within the entire academic community as “equals at the table”. Such faculty have found themselves more accepted, more productive, and with a greater ability to effect change and have a positive impact on patient care within their institutions.

These two views of the value of tenure are at the heart of an ongoing debate in the academic world over what constitutes productivity and scholarly activity and how faculty should be rewarded in terms of promotion and money. There are now a multitude of classifications of faculty within the academic medical community. The traditional model of the physicianresearcher, whose primary focus was clinical or bench research has been joined by the clinical-educator who performs relatively little research when compared to colleagues who have risen through the traditional tenure system.3 Many clinicians engaged in teaching medical students and residents practice in community settings rather than in university-based practices. Academic emergency physicians are particularly affected by debate over PT criteria. The practice of emergency medicine as a medical specialty began at community hospitals and many training programs are based in community hospitals with university affiliations. In general, the majority of emergency medicine faculty fit the model of the clinician-educator rather than the clinician-researcher.

Many faculty members remain convinced that promotion is reserved for those engaged in research or do not know how to manage their academic career so that they are successful when seeking promotion.4-6 The purpose of this article is to discuss 1) activities that medical schools value when considering faculty for promotion, 2) the community academic environment as compared to the university and, 3) methods to perform a literature review to learn more about promotion, tenure and scholarly activity.

Scholarship Traditionally, knowledge of discovery, which is the finding of new information, is the area that has been rewarded in academic settings. This is best illustrated by original research which is supported by grants and publishing of results in peer reviewed journals. Boyer, while recognizing the importance of original research, argued that new knowledge has little value unless it can be 1) integrated into an existing body of knowledge, 2) applied to problem-solving and the expansion of other scholars’ efforts, and 3) taught to others so they can have the benefit of discovered knowledge and use it to advance their own work. Thus, scholarly activity was any activity that contributed to advancement of any of the four areas of knowledge.7 It is in the areas of integration, application, and teaching that clinician-educators spend most of their time and efforts.

Using the Boyer model of scholarship, those working in these areas make valuable contributions to the advancement of knowledge and these are worthy of reward by the academic community. This expanded view of scholarship has opened the way for a variety of activities and resulting products to be viewed as valuable endeavors which advance the mission of the academic institution and which may result in both promotion and tenure.5, 8 Many activities and products produced by clinician-educators are now examined by PT committees when considering faculty for promotion. (Table 1) Quality and Presentation of Scholarly Activities This expanded view of scholarship in no way diminishes the requirement for publication/presentation by educators, as this is the most common, and perhaps only, method for scholars to view, judge, and expand upon each others work. Many academicians do not regard teaching excellence and innovation as actual scholarship until they are made public through publishing or presentations so that other scholars and educators have access to them and can learn from the efforts expended. 9 In some settings, the number of publications needed for promotion is as stringent for the clinician-educator as it is for the basic scientist. It is only the focus of the work that has shifted from bench research or clinical trials to educational curriculum design, testing of educational modalities, or creation of new educational techniques. Recognition of this shift of focus is critical to those who are primarily interested in teaching and patient care as opposed to bench or clinical research. One of the most important concepts for an individual who is seeking promotion and tenure under the clinician-educator track to understand is that one must develop a “focus area” in an educationally related issue(s). It is necessary to resist the natural urge to accept every possible academic opportunity and thus become too diffuse in academic endeavors.

One must also be able to demonstrate peer evaluation and recognition of scholarship through documentation of one’s academic efforts. Evaluations from national lectures, letters from colleagues requesting copies of educational items developed, or testimonials from others who have found presentations useful can be used. In general, P&T Committees award promotion (continued on next page) 25

and/or tenure if the applicant has demonstrated excellence in two of the three traditional areas of research, teaching, and service. Table 1 lists these areas, as well as providing examples of items that are considered scholarly activities in these areas. Fortunately, it is now recognized that research can be performed in any of these areas and adds value to the academic community. Additionally, the mix of required productivity in each of the areas of research, teaching, and service is dependent upon the track or classification in which the physician seeks promotion and whether tenure is sought.

The Academic Setting in the Community Hospital While classical academic promotion is the domain of the medical school, residency training in emergency medicine is often accomplished in programs based in community hospitals with quite varied medical school relationships. Promotion in a community hospital setting, as opposed to the university, may be at the discretion of the group with the emergency department contract and/or hospital administration. Clinical performance, administrative involvement, and commitment to the community may be as important for promotion as teaching credentials; research experience may be seen as less valuable.

The primary problems that community hospital emergency medicine residency programs face regarding scholarship fall into three groups: financing of protected time; training and evaluation issues; and mentoring.

Money and Time The amount of funding actually passed on to faculty varies greatly in community hospitals. Funding of protected time is quite variable. Many clinical faculty members receive no funding for teaching or protected time for scholarly/administrative activities. Their salaries are dependent upon generated patient revenues. It is common for the clinical faculty in a community hospital program to work four clinical shifts (32-36 hours) per week. This leaves little time for faculty/teaching activities outside of clinical supervision.

Training and Evaluation Programs are often faced with difficulty in defining those specific skills that their faculty will need. There are few sources of information specific to the needs of residency directors and department chairs of emergency medicine struggling to implement effective faculty development programs at community hospital teaching sites. Resources which may be helpful include bibliographies on faculty development.10, 11 The SAEM, through its web site (http://www.saem.org/), publications, and meetings has served as a resource to disseminate information on faculty development. Literature searches using “emergency medicine” as one of the key words will be helpful.

The ACGME at its web site (http://www.acgme.org/) also provides access to tools that can be used for residency assessment. (Table 2) Lack of training for the academic chair in a community hospital in how to evaluate faculty may be a significant issue.

Many chairs in community hospitals have never received any training in university methods for evaluating academic faculty and have no experience in university settings. These chairs have developed their own methods for faculty development and evaluation with little published material validating these methods. We need to be able to define the relative values of standard academic activities such as research and publication, clinical teaching, didactic teaching, and the less academic pursuits such as political activity in the health system, hospital and house of medicine, and social contributions. There is further difficulty in defining appropriate levels of participation for core versus clinical faculty. These problems are present in

both the community and university but even more of a challenge for community department chairs when evaluating faculty.

Lack of available time for faculty development is another problem shared by community and university institutions.

Sheffield found that the average work-week for clinician educators at the University of Washington was over 58 hours with only 7.6 hours devoted to scholarship. 12 Establishing a relationship with a mentor has been found to be of great value for junior faculty interested in academics.13 Finding mentors for educational activities may be particularly difficult in the community hospital and may necessitate going outside of one’s home institution.

Searching the Literature on Faculty Development With the advent of the internet, a wealth of information is available on any topic, including faculty development. The challenge is finding the relevant information, and then staying current with it. Detailed in Table 2 are strategies that yielded a useful search.

There are a multitude of resources available to both beginning and established faculty. The hardest part of availing oneself of these opportunities is perhaps the lack of knowledge or the lack of time to locate them. To facilitate searching, the faculty development committee of SAEM has built a web-site, (www.saem.org//facdev/FD_Manual_2001/stead3.htm), that catalogs published media with an annotated bibliography for each of the following categories: Faculty Development, Clinical Teaching, Women in Medicine, Promotion and Tenure, and Minorities in Medicine. In addition, the web-site also details lists of awards for emergency medicine faculty as well as funding sources for research and educational projects.

Summary Clinician–educators can be successful when seeking promotion. There are a multitude of scholarly activities which are now recognized by P&T committees when evaluating faculty for promotion. Promotion tracks have been created so that both university and community based faculty, who devote the majority of their time and efforts to teaching and patient care, can receive recognition and reward for the important work they do. These activities are now recognized as fundamental to the strength of the academic health center, fostering the creation of new knowledge, and aiding in the teaching of new generations of physicians. Yet, both problems and opportunities exist for faculty in both community and university settings as they plan and implement academic careers.

References 1. Barchi, R.L. and B.J. Lowery, Scholarship in the medical faculty from the university perspective: retaining academic values. Acad Med, 2000. 75(9): p. 899-905.

2. Kevorkian, C.G., D.H. Rintala, and K.A. Hart, Evaluation and promotion of the clinician-educator: the faculty viewpoint. Am J Phys Med Rehabil, 2001. 80(1): p. 47-55.

3. Bickel, J., The changing faces of promotion and tenure at U.S. medical schools. Acad Med, 1991. 66(5): p. 249-56.

4. Batshaw, M.L., L.P. Plotnick, B.G. Petty, et al., Academic promotion at a medical school. Experience at Johns Hopkins University School of Medicine. N Engl J Med, 1988. 318(12): p. 741-7.

5. Nora, L.M., C. Pomeroy, T.E. Curry, Jr., et al., Revising appointment, promotion, and tenure procedures to incorporate an expanded definition of scholarship: the University of Kentucky College of Medicine experience.

Acad Med, 2000. 75(9): p. 913-24. (continued on next page) 26

6. Simpson, D.E., K.W. Marcdante, E.H. Duthie, Jr., et al., Valuing educational scholarship at the Medical College of Wisconsin. Acad Med, 2000. 75(9): p. 930-4.

7. Boyer, E., Scholarship Reconsidered: Priorities of the Professoriate. 1990, Princeton, NY: carnegie Foundation for the Advancement of Teaching.

8. Lovejoy, F.H., Jr. and M.B. Clark, A promotion ladder for teachers at Harvard Medical School: experience and challenges. Acad Med, 1995. 70(12): p. 1079-86.

9. Nieman, L.Z., G.D. Donoghue, L.L. Ross, et al., Implementing a comprehensive approach to managing faculty roles, rewards, and development in an era of change. Acad Med, 1997. 72(6): p. 496-504.

10. Hamilton, G.C., A library to assist in the development of academic faculty in emergency medicine. J Emerg Med, 1988. 6(6): p. 551-3.

11. Westberg, J. and N. Whitman, Resource materials for faculty development. Fam Med, 1997. 29(4): p. 275-9.

12. Hewson, M.G., A theory-based faculty development program for clinician-educators. Acad Med, 2000. 75(5): p.

498-501.

13. Palepu, A., R.H. Friedman, R.C. Barnett, et al., Junior faculty members’ mentoring relationships and their professional development in U.S. medical schools. Acad Med, 1998. 73(3): p. 318-23.

Table 1: Examples of activities tangible to P&T committees for Clinician-Educators SCHOLARLY ACTIVITY Invited lectureships Development of curriculum materials Book chapters Comprehensive case reviews Reviewer for specialty journal Editor of journal or textbook Development of educational software or web based learning programs Development of regional or national educational conferences Scientific poster presentations Peer-review abstracts and journal articles Speaker at national or regional CME courses EDUCATIONAL ADMINISTRATIVE ACTIVITY Service on hospital committees Service on departmental committees Service in local society organizations Service in national society organizations Medical student clerkship director Residency director (or associate, assistant) Course director for medical students Rotational/site Director for resident rotations PATIENT CARE Excellence as measured by: Patient satisfaction scores Productivity standards PATIENT CARE ADMINISTRATIVE ACTIVITY Development of clinical care guidelines/protocols Development of a new patient care product line

Table 2: Search Strategies 1.

2.

3.

Use both medical and “layperson” search engines.

• Our favorites: www.google.com and www.nlm.nih.gov (medline) Useful search terms: • Faculty development • Medical school faculty • Academic medicine • Promotion and tenure • Women faculty • Minority faculty • Teaching portfolio Keeping current: • Subscribe to e-TOC (electronic table of contents e-mailed to you each month) for the following journals: • Academic medicine (www.academicmedicine.org) ➔ has the highest yield • JAMA (www.jama.ama-assn.org) • Periodically visit the AAMC web-site at www.aamc.org

27

Marcus L. Martin, MD University of Virginia SAEM Past-President President’s Address given May 20, 2002 at the SAEM Annual Meeting in St. Louis, Missouri.

As I stated in my Inaugural President’s Message in Atlanta, in May 2001, SAEM’s main goal for 2001-2002 was to “March to the Arch” in St. Louis and we have successfully done so and in fine fashion. I would like to thank the Emergency Medicine Residents’ Association (EMRA) for their development of the PDA guide for the Annual Meeting in St. Louis. The state of the Society is excellent, mainly due to the dedication (commitment to a certain mission, course of action) and loyalty, (fidelity, allegiance, and faithfulness) of the “SAEM family”. The dedication, loyalty and scholarly activity of the membership, committees, task forces, interest groups, staff, Board, AEM Editorial Board and leadership has positioned SAEM to be in an excellent state.

According to Glassick1, scholarly activity of all forms can be assessed in six categories (objectives, preparation, appropriate methods, significant results, effective presentation and reflective critique). I believe the SAEM family has produced much scholarly activity and deserves check marks of approval in all six of these categories. I will not reiterate all the objectives set forth for the 2001-2002 committees and task forces.

However, the leadership and members of these committees and task forces are commended for the outstanding work that they have done. (see table 1) In addition, I commend the strong efforts of the Editor-in-Chief of Academic Emergency Medicine, Michelle Biros, and senior associate editors, James Adams and David Cone.

The SAEM Board was tasked with the initiative of projecting SAEM in 2010 and developing the SAEM research fund strategic plan. The SAEM Board is also to be commended.

The SAEM membership is growing and our finances are stable. In 1989, the SAEM membership was 1,495 and in 1999 the membership was 4,837. In year 2002, the SAEM membership is approximately 6,000. In 1989, the amount of SAEM operating revenue was approximately $350,000, and in 1999 the operating revenue was $1.4 million.

In year 2002 the operating revenue is

Dedication and Loyalty

expected to be $1.5 million and operating expenses are expected to be $1.2 million. In 1989, total SAEM research funding was $9,000, and $140,000 in 1999 and will dramatically increase to $300,000 in 2002.

The SAEM reserve/endowment is $3 million. Even with the past year’s poor stock market performance, the state of our Society is solid financially. Continued growth of the SAEM research fund will be very dependent upon the benevolence and charity of our growing and maturing membership.

In projecting SAEM in 2010, the Board surveyed the Council of Academic Societies (CAS). The 100 CAS organizations have academic and medical education orientation. The collective membership includes the majority of faculty members of American medical schools and teaching hospitals. I will share with you some of the results of the survey: sixty percent of the organizations are greater than 30 years old; 10 percent are 20-30 years old; twenty percent are 10-20 years old and 10 percent are 5-10 years old. Looking at SAEM’s history places us in the 20% group (1020 years old). However, if you include the UAEM history, we are in the 20-30 year old group. The average number of members in CAS organizations is 7,400 and the range is 100-93,000. The operating expenses average $7,750,000 and the range is $45,000 to $76,000,000.

The average annual dues for CAS members is $440 with a range of $80 to $5,000. Recently, the SAEM dues were raised to $365. The SAEM dues appear to be a real bargain. Forty percent of the CAS organizations have a foundation or an endowment fund. SAEM is included in that group. The average amount of the endowment funds for CAS organizations is $2.4 million with a range of $62,000 -$5,000,000. Some of the CAS organizations did not report the amount of their endowments.

In the CAS survey, top challenges faced by academic organizations include the following: Membership – aging/retention/attrition, quality benefits, interest in academics, international influx; travel demands and time demands.

Revenues – successful annual meetings, journals, endowment, outside funding and research/education fund-

ing.

The SAEM family objectives were established during my president-elect year. Preparation for the past year was done in timely fashion by individual and group efforts. Appropriate methods were utilized by the SAEM family members and carried out in multiple effective ways. We have an extensive list of accomplishments which I consider significant results. We have had a successful inaugural year of the virtual advisor program which provided mentorship to 300 medical students. The majority of these medical students are located at medical schools with no affiliated EM residency. The faculty development handbook has been completed and is a section of the website. There were successful constitution and bylaw changes and a successful election process. A subgroup of the Board, along with Board input developed the SAEM research fund strategic plan, which is a document in evolution. Through the Board initiative of projecting SAEM 2010, some very important long-range goals were developed and will serve as a resource for the next set of 5-year goals. A series of outstanding Newsletter articles have been written and shared with the membership on research, national affairs, ethics, resident information, NIH information, EM researcher profiles and grant programs.

Revisions of the Emergency Care Center Categorization application were made and one new application was submitted this year. The development of the emergency medicine training, competency and professional practice principals position statement was done in conjunction with and endorsed by AAEM, ACEP, AACEM, CORD and EMRA. Grant applications were reviewed and awards were made. A successful combined conference was held with the academic chairs at the annual fall AAMC meeting. We monitored and responded to national affairs issues such as HCFA (CMS) regulations and others throughout the year. Several consultations were completed. Several teaching modules were either developed or are in the process of development such as ethics, patient safety, healthy people 2010 and academic careers in emergency medicine. The resident’s section of the website was updated. This was also the inaugural (continued on next page)

28

Dedication and Loyalty (Continued) year for the institution training grant.

There were many important contributions made by interest groups and for the first year we created leadership updates provided to task force and committee chairs and others in leadership.

Timely responses were published to certain training practice issues such as the ECG interpretation statement by the American Heart Association and the American College of Cardiology. The salary survey was completed. We reformatted the medical student education section of the SAEM website. An assessment of the Emergency Medicine shelf exam for students was done and a decision was made to initiate a question and answer bank for students. The research mentoring of minority residents and students through the development of a cultural competency case teaching module and the initiation of minority student focus groups related to careers in emergency medicine got off to a successful start. Information retrieved through the CAS survey was presented at the AAMC Spring CAS meeting which provided for emergency medicine visibility at that forum. The AEM consensus conference on “Quality In Emergency Medicine” was a successful conference held at this Annual Meeting in St. Louis. A new AEM database and a new funded staff position for AEM was created this year. There were 6 successful SAEM regional meetings held this year with record attendance.

There were also some records broken at the 2002 Annual Meeting in St. Louis including IEME exhibits, abstracts accepted and the total number of workshops and affiliated meetings. There were record size SAEM newsletters and onsite program brochure this year. I quote our executive director, Mary Ann Schropp “I am going to remember you for the year when everything SAEM printed was the biggest ever.”

Effective presentation of the results has occurred through journal and newsletter publication, regional meetings, leadership updates website posting, selective mass emails and at this annual meeting. Reflective Critique has occurred through president’s messages, board updates and feedback from the membership through meeting evaluations.

Reflections Mid way through my term as SAEM president, our country was affected by the tragedies of 9/11 and ongoing acts of bio-terrorism. It was a trying time for

Americans as we experienced terrible acts upon citizens of our country. Our sense of security was disrupted like no time before. Like many of you, I developed a renewed sense of purpose in life and a deeper appreciation of my family, country and fellow Americans. The news coverage of events of 9/11 are indelibly imprinted in our minds. After making sure my department was poised to help victims of the Pentagon attack (the Department of Emergency Medicine at the University of Virginia is located within 2 hours of Washington, DC), I then held the prescheduled SAEM Board teleconference that day.

The Board’s resolve was to help in anyway we could, beginning with the message to support our fellow EMS providers in New York, DC and Pennsylvania. There was not a lot most of us could do. Deep concern was felt and expressed to the victims and their families and emotional support given to all healthcare workers that diligently worked the frontlines to provide care.

This week (May 19-25, 2002) we recognize national EMS week. On that day, 9/11 and every day of the year, America’s EMS providers show immense dedication and loyalty.

It has been my privilege to work with loyal and dedicated past presidents, 11 of them, during my years on the Board.

I have learned a lot from them and appreciate their dedication. These past president include Art Sanders, MD, John Marx, MD, Bill Barsan, MD, Steve Dronen, MD, Louis Binder, MD, Scott Syverud, MD, Louis Ling, MD, David Sklar, MD, Sandy Schneider, MD, Lewis Goldfrank, MD and Brian Zink, MD. I had the great pleasure of beginning my presidency, delivering the Keynote Address at the 13th annual Emergency Medicine Research Day and 25th Anniversary of Emergency Medicine Program at Indiana. They guarded me very closely and made sure I performed the traditional presidential duties removing the garbage following the program luncheon. I did so with a smile and while singing a song. I also had the opportunity the last several years to travel to various other emergency medicine programs in nearly 15 different states.

Loyalty and dedication in our organization extend throughout. A very big thank you is in order for the SAEM staff including Jennifer, Karyn, Sonya, Sylvia, Frank, Patty and Mary Ann. Mary Ann, the Society for Academic Emergency Medicine recognizes your loyalty and 29

dedication for your work in the administrative/executive director capacity for UAEM/SAEM for the past 25 years.

The Society’s mission is to improve patient care by advancing research and education in emergency medicine. The mission and accomplishments of the Society are direct results of Mary Ann’s labor. We are deeply indebted.

During my year as SAEM President, I wrote some tales. Abraham Lincoln had the popular reputation of being a storyteller.2 It was not the story itself, but the purpose or effect that interested Lincoln. To avoid long and useless discussions by others or luxurious explanations, Lincoln often used a short story to illustrate his point. Lincoln felt that the sharpness of a refusal or the edge of a rebuke could be blunted by an appropriate story so as to save wounded feeling and yet serve the purpose. Lincoln was not simply a storyteller but storytelling as an emollient saved him friction and distress.

The following is a tale on leadership I heard in church one Sunday morning: My minister was preaching a sermon on the family. His sermon discussed the father as the head/leader; submission by wives to husbands; father’s not exasperating children and children staying out of trouble and doing good. The minister told a story about the wife who was making her husband’s favorite salad.

She worked hours, putting in all the ingredients. Their 7-year old son ran into the kitchen and knocked over the bowl. The salad spread to the floor everywhere. The mother, now irate, ran after the boy through the house. The boy ran under the house. The mother stated “I am not coming under there after you.” Your father will take care of you when he gets home. The father came home and saw the salad all over the floor. The mother said “look what your son has done!” I want you to go down under the house and punish him.

The father said “I just came from work”.

“I don’t want to get in the middle of this”.

The mother replied, “go punish him I said”. In submission, the father said “I will.” The father went under the house, sat down beside his son. The little boy saw his father “exasperated”, said “Dad what’s the matter, she after you too?”

Sometimes leaders are led, sometimes leaders submit and sometimes leaders can become exasperated. Good leaders are good listeners. I hope that I have been a good leader for SAEM and it is my goal, even after presidency, to (continued on next page)

Dedication and Loyalty (Continued) maintain the highest level of dedication and loyalty to the organization.

On the home front, my loyal dog and good buddy “Peanut” does an amazing job guarding my household, particularly my office door. Sometimes he gets me in trouble at home when he growls as my wife passes the hallway by my office door. I have to watch Peanut’s behavior so that we both are not thrown out of the house. I am grateful for my family. Two sons and two daughters who have been dedicated to completion of degrees of higher education. Three of whom have completed college and one with 2 years remaining. One son just completed college at UVA, and had his commencement exercise was yesterday. I had to

leave shortly after he received his diploma and missed the family gathering afterwards. However, my wife called and left a voice mail message that in today’s Charlottesville, Virginia paper appeared a picture of my son hugging my wife at the graduation. This was an Associated Press picture that appeared in multiple papers around the state. This was great news and very uplifting for me to hear that this occurred.

Dedication and loyalty require commitment and passion. There are many personal examples that I can give of my family’s dedication and loyalty. My oldest son, a body builder day in and day out without exception, goes to the gym to exercise and has committed himself

to specific dietary habits that the average person could not maintain. I admire him for doing something I have difficulty accomplishing. Most importantly, my wife and children have been dedicated and loyal to me throughout the many years of my SAEM membership and board activities.

Thanks to the entire SAEM family for your trust, support, dedication and loyalty. It has been an outstanding year for SAEM and I could not have performed my duties as President of the organization without your support. Continued dedication and loyalty of the SAEM membership is extremely important to continue the evolution of SAEM into a superior academic organization.

References 1. Glassick E, Huber Mt, Maeroff GI. Scholarship Assessed: Evaluation of the Professoriate. San Francisco, CA: Jossey-Bass, 1997 2. Phillips DT. Lincoln on Leadership –Executive Strategies for Tough Times. Warner Books Inc., NY, NY, 1992.

Table 1: Committees and Task Forces (2001-02)

Chair(s)

Constitution and Bylaws Committee Consultation Service Task Force Emergency Center for Categorization Committee Ethics Committee Faculty Development Committee Financial Development Committee Graduate Medical Education Committee Grants Committee Chair National Affairs Committee Nominating Committee Patient Safety Task Force Program Committee Public Health Task Force Public Relations Committee Research Committee Salary Survey Task Force Undergraduate Committee Under Represented Member Research Mentoring Task Force

Kate Heilpern, MD Louis Binder, MD & Linda Spillane, MD Andrew Sama, MD Catherine Marco, MD John Gallagher, MD Scott Syverud, MD Michael Beeson, MD James Quinn, MD James Hoekstra, MD Roger Lewis, MD, PhD Robert Wears, MD Ellen Weber, MD Carlos Carmargo, MD Marcus Martin, MD Mark Angelos, MD Steve Kristal, MD Wendy Coates, MD & Stephen Thomas, MD Glenn Hamilton, MD

SAEM Faculty Development Website (Continued) the most current data on women in U.S. academic medicine.

Other links are to the Women in Medicine (WIM) program and its listserv, which facilitates networking and electronic discussions. Additional areas explored through this site include gender-specific role models, women in leadership positions in academic medicine, gender equity in salary and academic rank (the “glass ceiling, sticky floor” phenomenon), family and parenting issues, and women’s health in medical education.

7. The section entitled “Sabbaticals, Conferences, Seminars, and Distance Learning” offers a wide variety of links targeted at multiple facets of academic career development.

8. Finally, the website closes with an extensive and diverse

annotated electronic bibliography pertinent to academic career development.

In summary, faculty development in Emergency Medicine, much like this website, is a continually evolving work in progress. Optimally, faculty development begins in the earliest possible stages of a career and continues throughout the remainder of one’s academic life. The SAEM Faculty Development Committee hopes the information provided on this website will be of some help in furthering the broad range of career goals and eclectic interests of academic emergency physicians.

30

S A E M

Call For Nominations Young Investigator Award Deadline: December 13, 2002

In May 2003, SAEM will recognize a few young investigators who have demonstrated promise and distinction in their emergency medicine research careers. The purpose of the award is to recognize and encourage emergency physicians/scientists of junior academic rank who have a demonstrated commitment to research as evidenced by academic achievement and qualifications. The criteria for the award includes: 1. Specialty training and certification in emergency medicine or pediatric emergency medicine.

2. Evidence of significant research collaboration with a senior clinical investigator/scientist. This may be in the setting of a collaborative research effort or a formal mentor-trainee relationship.

3. Academic accomplishments which may include: a. postgraduate training/education: research fellowship, master’s program, doctoral program, etc. b. publications: abstracts, papers, review articles, chapters, case reports, etc. c. research grant awards d. presentations at national research meetings e. research awards/recognition The deadline for the submission of nominations is December 13, 2002, and nominations should be submitted electronically to saem@saem.org. Nominations should include the candidate’s CV and a cover letter summarizing why the candidate merits consideration for this award. Candidates can nominate themselves or any SAEM member can nominate a deserving young investigator. Candidates may not be senior faculty (associate or full professor) and must not have graduated from their residency program prior to June 30, 1996.

The core mission of SAEM is to advance teaching and research in our specialty. This recognition may assist the career advancement of the successful nominees. We also hope the successful candidates will serve as role models and inspirations to us all. Your efforts to identify and nominate deserving candidates will help advance the mission of our Society.

The Top 5 Most-Frequently-Read Contents of AEM During the Month of May 2002 Most-read rankings are recalculated at the beginning of the month. Rankings are based on hits received by articles archived on AEMJ.org.

1 2 3 4

The ACLS Thirty-minute Stop Guideline: Consequences of Noncompliance James T Niemann, Samuel J Stratton, Nisha Chandra-Strobos Acad Emerg Med May 01, 2002 9: 459-459. (In "CPR")

5

Antomicrobial-impregnated Endotracheal Tubes for the Prevention of Ventilator-associated Pneumonia Victor Pacheco-Fowler, Trupti Gaonkar, Lester Sampath, Peter Wyer, Modak Shanta Acad Emerg Med May 01, 2002 9: 368-368. (In "Infectious Disease")

A Randomized Clinical Trial of Analgesia in Children with Acute Abdominal Pain Michael K. Kim, Richard T. Strait, Thomas T. Sato, Halim M. Hennes Acad Emerg Med Apr 01, 2002 9: 281-287. (In "CLINICAL INVESTIGATIONS") The Prevalence of Sexually Transmitted Disease in Women Suspected of Urinary Tract Infection Tara Shapiro, Mark Dalton, John Hammock, Jeff Lebowitz, Robert F Lavery, John Matjucha, David Salo Acad Emerg Med May 01, 2002 9: 369-369. (In "Infectious Disease") Topical Local Anesthetic Application to Wounds in Children: Does Application at the Time of Triage Decrease the Overall Treatment Time in the Emergency Department?

Stephen Priestley, Anne-Maree Kelly, Linda Chow, Colin V E Powell, Anne Williams Acad Emerg Med May 01, 2002 9: 449-450. (In "Wound Care")

President’s Message (Continued) regarding the evaluation and funding of clinical research proposals, an NIH panel met from early 1995 until late 1996 with the charge “…to review the status of clinical research in the United States and to make recommendations to the advisory committee to the Director, NIH about how to ensure its effective continuance.”1 This panel concluded, among other things, that it was important to include experienced clinical investigators on grant review panels

and, moreover, to ensure that clinical research proposals were only reviewed by panels whose workload included a substantial number of clinical research proposals. The panel’s report also emphasized the importance of substantive research training for clinical investigators, concluding that “The NIH should improve the quality of training for clinical researchers by requiring grantee organizations to provide formal training experiences in clinical research and careful 31

mentoring by experienced clinical investigators.”

While the NIH has publicly stated that it values clinical research and will strive to ensure that such research is evaluated fairly and funded appropriately, the question remains whether there are data available which address NIH’s success in meeting his goal. The most direct evidence is probably the funding rate (the fraction of submitted proposals (continued on next page)

President’s Message (Continued) which are funded) for career development grants in the K series. These career development grants are intended to foster the development of young faculty members during the critical transitional period after fellowship or postdoctoral training but before the investigator has a sufficient research track record and experience to compete for traditional investigator-initiated funding.

For the purposes of this discussion, we will consider two flavors of the K awards, the K08 awards which support the career development of investigators conducting basic or laboratory research, and the K23 awards, which are available to investigators pursuing careers in patient oriented research.

Figure 1 (adapted from the NIH website2) shows the funding success rate for a variety of K awards. The K08 program has been in existence since before 1990, and currently has a funding rate of 49%. The K23, patient oriented research career development program, has only been in existence since 1999 but its funding rate is 46%—virtually identical to that of the K08 basic science program. Thus, at least as measured by funding success rates, the NIH appears to value clinical and basic research equally. Additional data from the NIH shows that the success rate for K23 applications is similar across all of the NIH institutes that use this funding mechanism. As an aside, while one might question the validity of using data only from career development grants to measure NIH’s general commitment towards clinical research. I believe it is exactly these grants that are most relevant to the field of emergency medicine.

As a specialty, we are still working to develop clinical research expertise— thus, these grants have tremendous potential impact on our specialty.

If there is no evidence that NIH systematically discriminates against clinical research, perhaps emergency medicine investigators are frustrated by a systematic bias against investigators with primary medical training (MD degrees), as opposed to graduate training (PhD degrees).

The available data do not support the contention that this bias exists either, however. Figure 2 shows both the number of applications Figure 1.

submitted by investigators whose primary training is medical (e.g., MDs, MD/MPH, and MD/PhD) and those with only PhD degrees, and the associated success rates. While the vast majority of applications are submitted by investigators with only PhD degrees, the success rate for applications, shown on the left-hand vertical axis, is virtually identical for the MD-degree and PhD-degree applicants. The funding rate does fluctuate from year to year, primarily based on the availability of funds appropriated

by Congress. Regardless, there is no evidence of any bias in funding decisions based on the primary degree of the investigator.

Even if the available evidence suggests that the NIH is actively funding clinical research, and does not discriminate based on the primary degree of the investigator, it is still possible that there is a systematic bias against applications submitted by emergency physicians. This is a difficult question to address directly, Figure 2. because the NIH system for categorizing the specialty of the investigator does not include a category for emergency medicine. Thus, many of the applications submitted by emergency physicians are categorized

as coming from departments of medicine, surgery, or even other fields. I have been told that the system for categorizing the specialty of the investigator is based on categories used in a survey administered by the AAMC, and that there has been some resistance to including emergency medicine as a separate category on this survey, as this would make it difficult to compare current data with data from years past.

There is indirect evidence, however, that federal funding agencies recognize the importance of emergency medicine research and fund a substantial number of emergency-medicine related projects. For example, a current search of

the CRISP database, which lists funded applications from NIH Institutes and the Agency for Healthcare Research and Quality (AHRQ), using the key word “emergency” yields 204 new grants beginning in the years 2000-2002. A substantial fraction of these projects are being conducted by investigators who would describe themselves as emergency physicians. In addition, the NIH website includes a page which specifically lists funded projects in emergency medicine for the year 2001.4 The development of this page is somewhat of a curiosity, as it is attributed to a single university source, and apparently was not developed internally (continued on next page)

32

President’s Message (Continued) within the NIH. I believe the posting of this page shows that, even within the NIH, there is a recognition that they have a difficulty in identifying the emergency medicine projects that are either submitted or funded.

The best data regarding the success of emergency physicians securing federal funding for their research is probably that published by Camargo et al as an abstract.5 Dr. Camargo’s group identified emergency medicine investigators serving as principal investigators on federal grants from 1986 to 1999, using an extensive search of the CRISP database and a variety of other methods.

They identified 45 such investigators and, of these investigators, 56% had an MD degree and 36% had an MD plus another degree. These 45 researchers received a total of 77 grants during 1986-1999 but, ironically, emergency medicine was listed as the investigator’s department for only 14% of the grants.

This illustrates the magnitude of the problem associated with identifying federally funded research in emergency medicine—namely that most emergency physicians are not identified with their specialty. In 25% of cases, the department was identified as medicine and in 6% as surgery.

The 77 grants were distributed across a wide range of scientific areas, including 29% in toxicology, 12% in ischemia-reperfusion injury, 10% in resuscitation, and 10% in EMS. Seventy-five percent of grants were awarded by NIH Institutes, 21% by AHRQ, 3% by HRSA, and 1% by the CDC. The most noteworthy finding is not the number or distribution of grants, however, but the number of grants received as a function of time. Figure 3 shows the number of new federal grants received during each two-year block of time. There has been a marked increase in the rate at which emergency physicians are receiving federal funding and, moreover, the total number of grants is now equal to or larger than the number of major grants given by the traditional emergency medicine-directed sources (e.g., the Emergency Medicine Foundation and SAEM).

In other words, federal funding Figure 3.

agencies are now a major, and possibly the major, source of funding for investigator-initiated research in emergency medicine.

Based both on the data summarized above, and my own experience as a guest reviewer on a number of study sections, I believe it is clear that study section members do not consider the clinical specialty of the investigator.

What is important to those reviewing grant applications is the match between the proposed work and goals of the funding program, the quality of the proposal itself, the investigator’s track record and the preliminary data included in the application, and the institutional research environment. It is also clear that NIH personnel are aware of the difficulties surrounding the tracking of applications and funded proposals in emergency medicine, and are actively working to ensure that extramural research in emergency medicine is reviewed and handled appropriately.

This year, SAEM has created a task force, chaired by Michelle Biros, the Editor-in-Chief of Academic Emergency Medicine, whose goal is to examine a number of issues surrounding the federal funding of emergency medicine and disaster medicine related research.

While the precise objectives for the task force can be found on the SAEM website,6 they center around ensuring that we have accurate data on the current funding of emergency medicine and disaster medicine research by federal agencies, evaluating the current structure of federal funding data to ensure that accurate and complete information is available in the future, and evaluating the current potential for the creation of federal funding programs specifically targeting emergency medicine and disaster medicine research. This last

objective requires some further explanation, however. The term “program” can mean many things. A federal funding program may consist simply of the explicit listing of emergency medicine and disaster medicine as falling within the scope of currently-existing funding opportunities, it could consist of specific set-aside funds within current grant programs, or it could consist of specific requests for applications (RFAs) targeting emergency medicine and/or disaster medicine. Clearly a large number of disaster medicine research programs will be created after the recent terrorist and bioterrorism attacks, based on newly appropriated funding.

In summary, I believe there is no evidence to support many common myths regarding the federal funding of emergency medicine research. Our colleagues are often successful, and increasingly so, in obtaining federal funds for emergency medicine research. This success includes both bench and clinical research. The shortterm challenge for our specialty is to obtain accurate and complete information on the federal funding of emergency medicine research, and to use this information to dispel some of the myths which, paradoxically, discourage many investigators from pursuing such funding even though the success rates for certain federal grant programs are higher than the corresponding rates for emergency medicine-targeted foundations. The long-term challenge, however, is to make sure there is an increasing number of well-trained investigators who have adequate protected time to pursue their research endeavors, so that we can build on our accomplishments so far.

This article was adapted from Dr. Lewis’ remarks at the SAEM Annual Meeting Banquet on May 20, 2002 in St. Louis.

References 1.http://www.nih.gov/news/crp/97report/exe csum.htm 2.http://grants1.nih.gov/training/data/K_FY2 001/sld012.htm 3.http://silk.nih.gov/public/cbz2zoz.@www. mdsphds.pdf 4.http://grants1.nih.gov/grants/award/trends/ emermed01.htm 5. Camargo CA Jr., Kim SH. Federal funding of emergency medicine investigators.

Ann Emerg Med 2000;36:S10.

6. http://www.saem.org/inform/02tfobj.htm

33

FACULTY POSITIONS ALBANY MEDICAL CENTER – RESIDENCY DIRECTOR. We have a fully accredited PG 1-3 residency in Emergency Medicine and accept 10 residents per year. We are the oldest academic department of emergency medicine in NYS. Applicants should be board certified in emergency medicine and have previous experience in and a strong commitment to resident education and research. Send a letter and CV to Mara McErlean, MD, Interim Chair, Albany Medical Center, Department of Emergency Medicine MC 139, 43 New Scotland Ave., Albany, New York 12208 or contact either Mara McErlean, MD or Joel Bartfield, MD at the Adams Mark.

E MERGENCY M EDICINE RESEARCHER The Department of Emergency Medicine (EM) seeks a FT academic emergency physician with expertise in EM research. The position will include substantial protected time as well as administrative support. Boston Medical Center (BMC) is a Level 1 Trauma Center with 95,000 visits annually. The Department of EM is separate within BMC and also serves as an academic department within Boston University School of Medicine. The emergency department has a well established residency program & expertise in the following areas of research: cardiology, asthma, gynecology, EMS, infectious disease, substance abuse and domestic violence.

ANN ARBOR, MI – FACULTY ACADEMIC/CLINICAL STAFF POSITION: Seeking BC/BP EM physician to join St. Joseph Mercy Hospital. Level II Trauma Center with on-site Medflight air ambulance service that sees 92,000 patients annually between the ED, adult and pediatric ambulatory care centers, and chest pain observation unit. Approved EM Residency program sponsored by hospital and U of M Medical Center. Employed positions offer excellent remuneration plus faculty stipend, productivity bonus, paid malpractice, relocation allowance, cafeteria-style benefits, 401(k), long-term disability, flexible scheduling, and more. Contact Nancy Ely @ 800-466-3764, ext.337; nely@epmgpc.com; or visit us @ EPMGPC.com.

Research staff currently includes a FT Nurse Coordinator–FT PhD Epidemiologist–PT Research Nurse–PT secretary. Candidates must be ABEM board certified or eligible and demonstrate a commitment to emergency medicine research. Must possess formal training or an established track record in Emergency Medicine Research. Competitive salary with excellent benefit package.

COLUMBIA UNIVERSITY: Attending Emergency Physicians – Harlem Hospital Center Emergency Services affiliated with Columbia University, seeks residency-trained or ABEM-certified Emergency Physicians who have excellent clinical skills, a strong interest in teaching and a commitment to public medicine. We are a 290-bed, Level 1 trauma center, regional burn center, EMS-based station with over 75,000 annual visits. An appointment to the faculty of the Columbia University College of Physicians and Surgeons is anticipated at the Instructor or Assistant Clinical Professor level, commensurate with experience. Competitive salary and benefits package provided. Submit CV to: Reynold Trowers, MD, Director of Emergency Services, Harlem Hospital Center, 506 Lenox Avenue, New York, NY 10037 or call him at (212) 939-2253. Columbia University takes affirmative action to ensure equal opportunity.

Further Information Contact…Robert Dart MD/Research Director–Department of Emergency Medicine–Boston Medical Center–1 BMC Place–Boston, MA 02118-2393 TEL: 617-414-4849–FAX: 617-414-5975–Email: rdart@bu.edu

MOUNT SINAI SCHOOL OF MEDICINE: The Department of Emergency Medicine is recruiting board certified or eligible emergency physicians for its Mount Sinai, Elmhurst and Jersey City sites. We are an academic department with a fully accredited emergency medicine residency. Our supportive leadership is looking for individuals interested in pursuing a multidimensional academic career. Many opportunities for research, teaching and participation in the life of medical school are available. We are committed to faculty career development and job satisfaction. Prospective applicants can contact Sheldon Jacobson MD, Chair Emergency Medicine via email @ sheldon.jacobson@mssm.edu, fax (212) 426-1946, phone (212) 659-1660.

NEW YORK – Albany Medical Center

OHIO, Columbus: Academic Chair/Director of Emergency Medicine partnership opportunity at Doctors Hospital. Modern, two-campus facility hosts 32 residents in an AOA-approved emergency medicine residency program and is pursuing dual accreditation with ACGME. Emergency Medicine Physicians is a highly regarded regional group of emergency medicine residency trained physicians offering equal equity ownership in a dynamic, democratic organization with guaranteed due process. The Directors will work 80-120 clinical hours/month plus protected administrative/academic time with stipend.

Outstanding compensation package includes partnership/profit sharing, fully funded pension ($24,000/yr.), business expense account ($15,000/yr.), family health/dental/prescription plan, life/disability insurance, flex saving, 401(k), malpractice, and more. For more information contact Kevin M. Klauer, DO, FACEP or Dominic J. Bagnoli, Jr., MD, FACEP at Emergency Medicine Physicians, Ltd., 4535 Dressler Road NW, Canton, OH 44718, 800-8280898, e-mail (careers@emp.com), or FAX CV to 330-493-8677.

is seeking applications for the position of Residency Director. We have a fully accredited PG 1-3 residency in Emergency medicine and accept 10 residents per year.

First established in 1988, our emergency department is the oldest academic department of emergency medicine in the state of New York. Albany Medical Center is a Level I Trauma center. Our emergency department has an annual census of 65,000 of which 16,000 are pediatric patients.

Applicants should be board certified in emergency medicine and have previous experience in and a strong commitment to resident education and research. Academic rank and salary commensurate with previous experience and accomplishments. Qualified applicants should send a cover letter and CV to Mara McErlean, MD, Interim Chair, Albany Medical Center, Department of Emergency Medicine MC 139, 43 New Scotland Ave., Albany, New York 12208.

OHIO STATE UNIVERSITY: Assistant/Associate or Full Professor. Established residency training program. Level 1 Trauma center. Nationally recognized research program. Clinical opportunities at OSU Medical Center and affiliated hospitals. Send curriculum vitae to: Douglas A. Rund, MD, Professor and Chairman, Department of Emergency Medicine, The Ohio State University, 016 health Sciences Library, 376 W. 10th Avenue, Columbus, OH 43210 or call (614) 293-8176. Affirmative Action/Equal Opportunity Employer.

UNIVERSITY OF CALIFORNIA, IRVINE: The Division of Emergency Medicine is recruiting an experienced EM researcher to join our 14 full-time faculty. Appointment at the Associate or Professor level in the Clinical Scholar series anticipated. Substantial protected time available. UCI Medical Center is a 472-bed tertiary care hospital with a full range of residencies. The ED is a progressive 33-bed Level 1 Trauma Center with 45,000 patients, in urban Orange County. Collegial relationships with all services. Board certification required. MPH, PhD or research fellowship/training strongly desired.

Excellent salary and benefits with clinical and academic productivity incentive plan. Inquiries held in strict confidence. Send CV to Mark I.

34

Langdorf, MD, MHPE, FACEP, FAAEM, UCI Medical Center, Route 128. 101 City Drive, Orange, CA 92868 or email to milangdo@uci.edu. University of California is an equal opportunity employer committed to excellence through diversity.

Associate Residency Director/Director of US. Newark Beth Israel Medical Center, Newark, New Jersey/St. Barnabas Health Care System (18 miles from NYC). Academic affiliation/appointment Mt. Sinai School of Medicine, New York, New York. ED volume 77,000 visits in 2001: approx 2/3 adults, 1/3 children. Pediatric ED administratively part of Department of EM, staffing with EM and peds EM BC/BP physicians. Fully ACGME-accredited EM residency with 30 residents in a PGY 1,2,3 format. Highly supportive and collegial team of 20 EM faculty with diverse interests and talents, all BC/BP EM or peds EM. Research Division headed by VC for Academic Affairs and Research Director. Fully implemented US program with 2 sonosite machines, US credentialling and CQI by Department of EM. Highly competitive compensation package and non-clinical time for academic and administrative responsibilities. We are seeking an experienced teacher/academician for Associate Residency Director at the Assistant, or, preferably, the Associate Professor level. I am particularly interested in exploring the possibility of creating a position of Director, US/ Associate Director, EM Residency for an individual with ultrasonography experience/credentials.

Please contact: Marc Borenstein, MD Chair and Residency Director Department of EM Newark Beth Israel Medical Center 973-926-7562 phone 973-926-1894 fax e-mail: mborenstein@sbhcs.com

UNIVERSITY OF CALIFORNIA, IRVINE: The Division of Emergency Medicine is recruiting a 15th full-time faculty member. Appointment anticipated at the Assistant or Associate Clinical Professor level, or in the Clinical Scholar series with demonstrated academic achievement. UCI Medical Center is a 472-bed tertiary care hospital with a full range of residencies. The ED is a progressive 33-bed Level 1 Trauma Center with 45,000 patients, in urban Orange County. Collegial relationships with all services. Board certification required. Fellowship or advanced degree strongly desired. Excellent salary and benefits with incentive plan. Send CV and three letters of reference to Mark I. Langdorf, MD, MHPE, FACEP, FAAEM, UCI Medical Center, Route 128. 101 City Drive, Orange, CA 92868. University of California is an equal opportunity employer committed to excellence through diversity.

UNIVERSITY OF MISSOURI-KANSAS CITY: Academic physician group practice, Hospital Hill Health Services Corporation, is seeking an Emergency Medicine physician to fill a newly-created full-time appointment at the Assistant or Associate Professor level for the University of Missouri-Kansas City School of Medicine and Truman Medical Center beginning August 1, 2002. Candidates must be residency-trained and BC/BE in EM. Clinical or academic track available, with preference given to those with an established track record in research or interest in ultrasonography, substance abuse/toxicology, or injury prevention. Contact Robert A. Schwab, M.D., Chair, Department of Emergency Medicine, 2310 Holmes Street, Kansas City, MO 64108. (816) 556-3250. Robert.Schwab@tmcmed.org. EOE VANDERBILT UNIVERSITY: The Department of Emergency Medicine has an unexpected opening for a clinician-educator at a level commensurate with qualifications. Please consider joining our successful Department. We have 1st and 4th year medical student rotations, a Level I Trauma Center, contiguous Pediatric and Adult EDâ&#x20AC;&#x2122;s, a superb residency and all the other components of a well established program. We provide great benefits and Nashville is a great city. Please reply to Corey M. Slovis, M.D., Chairman, Department of Emergency Medicine, Vanderbilt University, 703 Oxford House, Nashville, TN. 37232-4700.

Email: corey.slovis@mcmail.vanderbilt.edu. Vanderbilt is an equal opportunity employer.

I may also be reached at the Adams Mark Hotel during the SAEM Meeting

Faculty Position

Cook County Hospital Department of Emergency Medicine

Molecular Brain Resuscitation Fellowship The Molecular Brain Resuscitation Laboratory at the University of Pennsylvania is offering a two-year research fellowship to Emergency Medicine Residency graduates interested in studying the molecular mechanism of acute neuronal injury caused by stroke, cardiac arrest and head trauma. This training program is part of a multidisciplinary collaboration between NIH-funded laboratories in the Departments of Emergency Medicine, Neurosurgery, Neurology and Pharmacology.

The fellowship is supported by an Institutional Training Grant from the Society for Academic Emergency Medicine. Fellows will be enrolled in the Neuroscience Graduate Program enabling them to pursue a PhD in Neuroscience. Clinical duties are limited to 4 ED shifts/month. Salary ~95K. Start date July of 2003.

This is an extremely attractive position with one of the largest residencies in the country. We have a very active research division and are moving into a new hospital in August 2002. Competitive salary and time for faculty development. To apply send C.V. to:

Send letter of interest and curriculum vitae to:

Robert R. Simon, M.D. Professor and Chairman Department of Emergency Medicine 1900 W. Polk Street, Room 1035 Chicago, IL 60612

Robert W. Neumar, MD, PhD Hospital of the University of Pennsylvania Department of Emergency Medicine 3400 Spruce Street Philadelphia, PA 19087 Voice: (215) 898-4960 Fax: (215) 573-5140 Email: rneumar@mail.med.upenn.edu Website: http://www.uphs.upenn.edu/em/brain/

35

International Emergency Medicine Fellowship The College of Medicine at the University of Florida Gainesville Campus is recruiting for the position of Clinical Assistant Professor/Clinical Associate Professor in the Department of Emergency Medicine. This teaching hospital emphasizes active involvement with Emergency Medicine residents and medical students. The position could advance to tenure accruing depending upon qualifications and level of experience. The ideal applicant will be residency and board certified in Emergency Medicine, mature with an academic track record, and significant teaching experience. Faculty will provide clinical guidance and supervision of treatment delivered in the ED. A progressive, democratic, superb, 10-person faculty group of team players with emphasis on quality emergency care with dedicated customer service. Shands at UF is the hub of a multi-hospital network. Emergency Medicine medically directs county EMS and hospital transport including the ShandsCare helicopter. Shands Hospital at the University of Florida offers a competitive salary and benefits package including relocation incentives. Great compensations, Great benefits package, Great City!

International Emergency Medicine Fellowship involves: • Two-year track combining clinical emergency medicine, international fieldwork and a project • Academic classes leading to a Master’s degree at the Harvard School of Public Health • Academic appointment at Harvard Medical School • Clinical emergency medicine at affiliated teaching hospitals • Participation in training of medical students and residents • Competitive salary, benefits, CME, international travel funds, and training course expenses • Opportunity to tailor experience to meet interests in disaster response, medical neutrality, human rights, health emergencies in large populations, international public health, and refugee relief

Requires: • Completion of an Emergency Medicine residency program • Completion of application process, interview, and selection Inquiries should be sent to: Daniel Gurr, MD, Fellowship Director Department of Emergency Medicine Brigham and Women’s Hospital 75 Francis Street, Room PBB-100 (617) 732-5813 Boston, MA 02115 or by e-mail dgurr@partners.org

Application deadline: September 30, 2002. Anticipated start date: November 1, 2002. Please send CV to David C. Seaberg, MD, F.A.C.E.P. Associate Professor and Associate Chairman, Department of Emergency Medicine, University of Florida, 1600 SW Archer Road, PO Box 100186, Gainesville, FL 32610-0392. Women and minorities are encouraged to apply. University of Florida is an Affirmative Action Equal Opportunity Employer.

Residency Director

Department of Emergency Medicine Brigham and Women’s Hospital

Cook County Hospital Chicago, Illinois

A Teaching Affiliate of Harvard Medical School

Fellowship Director, Institute for International Emergency Medicine and Health

The Department of Emergency Medicine at Cook County Hospital is seeking candidates for Residency Director.

Applicants must be residency trained and board certified in Emergency Medicine and active at the national level with resident education and training. Applicants should be energetic, motivated and possess outstanding teaching and leadership skills. The Department of Emergency Medicine at Cook County Hospital has 54 residents in a PGY II-IV format and 26 full time faculty. The Emergency Departments care for 115,000 adult, 30,000 pediatric and 5,000 Level I trauma patients each year. A new 463 bed Cook County Hospital will be completed in the fall of 2002 with a new state of the art ED electronic information system. The Residency Director is in charge of the Education Division within the department supervising all educational activities and provides leadership and mentoring for the Associate and Assistant Residency Directors. The department offers a very competitive benefit package and protected time to pursue educational, administrative and research projects. Faculty appointments are at our medical school affiliate, Rush Medical College.

• Full-time position in the Institute for International Emergency Medicine and Health (IEMH), a rapidly growing division within Brigham and Women’s Hospital Department of Emergency Medicine dedicated to improving emergency medical care throughout the world.

• Oversight of two-year fellowship program in international emergency medicine and health, combining clinical emergency medicine, fieldwork, and a Master’s degree from the Harvard School of Public Health.

• Involvement in IEMH’s large-scale emergency medicine systemsbuilding and train-the-trainers programs.

• Appointment to the Clinician Scholar or Clinical Investigator track with Harvard Medical School faculty appointment.

• Base hospital for the four-year Harvard Affiliated Emergency Medicine Residency (HAEMR) training program.

• Competitive salary, outstanding comprehensive benefit package.

Requirements: • ABEM board eligibility or certification and completion of a PGY14 or PGY 2-4 Emergency Medicine Residency Program.

• Established track record in and demonstrated commitment to International emergency medicine and health.

Interested candidates should contact: Jeff Schaider, MD, FACEP, Associate Chairman Department of Emergency Medicine Cook County Hospital 1900 West Polk Street 10th floor Chicago, IL 60612 Telephone - 312 633 5451 jschaider@ccbh.org

Please send your letter of interest with curriculum vitae to: Mark A. Davis, M.D., M.S., Director Institute for International Emergency Medicine and Health (IEMH) Department of Emergency Medicine Brigham and Women’s Hospital 75 Francis Street, Room PBB-100 Boston, MA 02115 Email: madavis@partners.org

36

SAEM Membership Application Please complete and send to SAEM with appropriate dues, $25 initiation fee, and supporting materials.

SAEM • 901 N. Washington Ave. • Lansing, MI 48906 • 517-485-5484 • Fax: 517-485-0801 • www.saem@saem.org Name ______________________________________________________________________ Title: MD DO PhD Other _________ Home Address _______________________________________________________________ Birthdate_________________ Sex: M F ___________________________________________________________________________________________________________ Business Address ______________________________________________________________________________________________ ___________________________________________________________________________________________________________ Preferred Mailing Address (please circle): Home Business Telephone: Home ( ______ ) ______________________________ Business ( ______ ) ______________________________ FAX: ( ______ ) _____________________________________ E-mail: ____________________________________________________ Medical School or University Faculty Appointment and Institution (if applicable): _________________________________________________ Membership benefits include: • subscription to SAEM’s monthly, peer-reviewed journal, Academic Emergency Medicine • subscription to the bimonthly SAEM Newsletter • reduced registration fee to attend the SAEM Annual Meeting Check membership category:

❒ Active

❒ Associate

❒ Resident

❒ Fellow

❒ Medical Student

Active: individuals with an advanced degree (MD, DO, PhD, PharmD, DSc or equivalent) who hold a university appointment or are actively involved in Emergency Medicine teaching or research. Annual dues are $365 plus a $25 initiation fee payable when the application is submitted. The application must be accompanied by a CV. I attest that I hold a university appointment or am actively involved in Emergency Medicine teaching or research: ❒ Yes ❒ No Associate: health professionals, educators, government officials, members of lay or civic groups, or members of the public who have an interest in Emergency Medicine. Annual dues are $350 plus a $25 initiation fee payable when the application is submitted. The application must be accompanied by a CV. Resident: residents interested in Emergency Medicine. Annual dues are $90 plus a $25 initiation fee payable when the application is submitted. My anticipated date (month and year) of residency graduation is_________. (A group discount resident member rate is available.

Contact SAEM for details.)

Fellow: fellows interested in Emergency Medicine. Annual dues are $90 plus a $25 initiation fee payable when the application is submitted.

My anticipated date (month and year) to complete my fellowship is_________.

Medical Student: medical students interested in Emergency Medicine. Annual dues are $75 (includes journal subscription) or $50 (excludes journal subscription), plus a $25 initiation fee payable when the application is submitted. The application must be accompanied by a letter verifying that the applicant is a medical student and the anticipated graduation date.

Interest Groups: SAEM members are invited to join interest groups. Include $25 annual dues for each interest group: ❒ trauma ❒ neurologic emergencies ❒ evidence-based medicine ❒ airway ❒ ultrasound ❒ pain management ❒ geriatrics ❒ CPR/ischemia/reperfusion ❒ pediatric emergency medicine ❒ web-educators ❒ health services & outcomes ❒ clinical directors ❒ youth violence prevention ❒ research directors research ❒ diversity ❒ simulation ❒ injury prevention ❒ domestic violence ❒ substance abuse ❒ international ❒ EMS ❒ toxicology ❒ medical student educators ❒ ethics

My signature certifies that the information contained in this application is correct and is an indication of my desire to become an SAEM member.

Signature of applicant _______________________________________________________________________ Date ________________

37

S A E M

S A E M Call for Abstracts 2003 Annual Meeting

Call for Didactic Proposals 2003 Annual Meeting

May 29-June 1 Boston, Massachusetts

May 29-June 1, 2003 Boston, Massachusetts

Deadline: January 7, 2003 The Program Committee is accepting abstracts for review for oral and poster presentation at the 2003 SAEM Annual Meeting. Authors are invited to submit original research in all aspects of Emergency Medicine including, but not limited to: abdominal/gastrointestinal/genitourinary pathology, administrative/health care policy, airway/anesthesia/analgesia, CPR, cardiovascular (non-CPR), clinical decision guidelines, computer technologies, diagnostic technologies/radiology, disease/ injury prevention, education/professional development, EMS/out-of-hospital, ethics, geriatrics, infectious disease, IEME exhibit, ischemia/reperfusion, neurology, obstetrics/gynecology, pediatrics, psychiatry/social issues, research design/methodology/statistics, respiratory/ENT disorders, shock/ critical care, toxicology/environmental injury, trauma, and wounds/burns/orthopedics.

Deadline: September 9, 2002 The Program Committee is soliciting proposals for didactic sessions for the 2003 Annual Meeting. Didactic sessions should emphasize issues of research, education, clinical advances in Emergency Medicine, and faculty development. Didactics may be aimed at medical students, residents, junior faculty and/or senior faculty. The format may be a lecture, panel discussion, or workshop. The Program Committee will also review proposals for pre- or post-day workshops, or multiple sessions during the Annual Meeting aimed at indepth instruction in a specific discipline.

Didactic proposals should support the mission of SAEM and should fall into one of the following categories:

The deadline for submission of abstracts is Tuesday, January 7, 2003 at 3:00 pm Eastern Time and will be strictly enforced. Only electronic submissions via the SAEM online abstract submission form will be accepted. The abstract submission form and instructions will be available on the SAEM web site at www.saem.org in November. For further information or questions, contact SAEM at saem@saem.org or 517-4855484 or via fax at 517-485-0801.

• Education (education methodology, improving the quality of education, enhancing teaching skills) • Research (research methodology, improving the quality of research) • Career Development • State-of-the-Art (presentation of cutting-edge basic science or clinical research that has important implications for further investigation or the future practice of emergency medicine) • Health Care Policy and National Affairs

Only reports of original research may be submitted. The data must not have been published in manuscript or abstract form or presented at a national medical scientific meeting prior to the 2003 SAEM Annual Meeting. Original abstracts presented at national meetings in April or May 2003 will be considered.

Note that State-of-the-Art sessions are not a review of the literature of a summary of clinical practice. All submitters are asked to briefly explain how the session meets the SAEM mission.

Abstracts accepted for presentation will be published in the May issue of Academic Emergency Medicine, the official journal of the Society for Academic Emergency Medicine. SAEM strongly encourages authors to submit their manuscripts to AEM. AEM will notify authors of a decision regarding publication within 60 days of receipt of a manuscript.

The deadline for submission is Monday, September 9, 2002 at 5:00 pm Eastern Time.

Only on-line submissions will be accepted. To submit a proposal, complete the on-line Didactic Submission Form at www.saem.org.

For additional questions or information, contact SAEM at saem@saem.org or 517-485-5484 or via fax at 517-485-0801 38

S A E M

SAEM 2003 Research Grants Emergency Medicine Medical Student Interest Group Grants These grants provide funding of $500 each to help support the educational or research activities of emergency medicine medical student organizations at U.S. medical schools. Established or developing interest groups, clubs, or other medical student organizations are eligible to apply. It is not necessary for the medical school to have an emergency medicine training program for the student group to apply. Deadline: September 4, 2002.

Research Training Grant This grant provides financial support of $75,000 per year for two years of formal, full-time research training for emergency medicine fellows, resident physicians, or junior faculty. The trainee must have a concentrated, mentored program in specific research methods and concepts, and complete a research project. Deadline: November 1, 2002.

Institutional Research Training Grant This grant provides financial support of $75,000 per year for two years for an academic emergency medicine program to train a research fellow. The sponsoring program must demonstrate an excellent research training environment with a qualified mentor and specific area of research emphasis. The training for the fellow may include a formal research education program or advanced degree. It is expected that the fellow who is selected by the applying program will dedicate full time effort to research, and will complete a research project. The goal of this grant is to help establish a departmental culture in emergency medicine programs that will continue to support advanced research training for emergency medicine residency graduates. Deadline for applications is November 1, 2002.

Scholarly Sabbatical Grant This grant provides funding of $10,000 per month for a maximum of six months to help emergency medicine faculty at the level of assistant professor or higher obtain release time to develop skills that will advance their academic careers. The goal of the grant is to increase the number of independent career researchers who may further advance research and education in emergency medicine. The grant may be used to learn unique research or educational methods or procedures which require day-to-day, in-depth training under the direct supervision of a knowledgeable mentor, or to develop a knowledge base that can be shared with the faculty memberâ&#x20AC;&#x2122;s department to further research and education. Deadline: November 1, 2002.

Emergency Medical Services Research Fellowship This grant is sponsored by Medtronic Physio-Control. It provides $50,000 for a one year EMS fellowship for emergency medicine residency graduates at an SAEM approved fellowship training site. The fellow must have an in-depth training experience in EMS with an emphasis on research concepts and methods. The grant process involves a review and approval of emergency medicine training sites as well as individual applications from potential fellows. Deadline: November 1, 2002.

Neuroscience Research Fellowship This grant is sponsored by AstraZeneca. It provides one year of funding at $50,000 for an emergency medicine resident, graduate, or junior faculty member to obtain a mentored research training experience in cerebrovascular emergencies. The research training may be in basic science research, clinical research, or a combination of both, and the mentor need not be an emergency medicine faculty member. Completion of a research project is required, but the emphasis of the fellowship is on the acquisition of research skills. Deadline: November 1, 2002.

EMF/SAEM Medical Student Research Grants This grant is co-sponsored by the Emergency Medicine Foundation and SAEM. It provides up to $2400 over 3 months for a medical student to encourage research in emergency medicine. More than one grant is awarded each year. The trainee must have a qualified research mentor and a specific research project proposal. Deadline: February 3, 2003.

Geriatric Emergency Medicine Resident/Fellow Grant This grant is made possible by the John A. Hartford Foundation and the American Geriatric Society. It provides up to $5,000 to support resident/fellow research related to the emergency care of the older person. Investigations may focus on basic science research, clinical research, preventive medicine, epidemiology, or educational topics. Deadline: March 3, 2003.

Further information and application materials can be obtained via the SAEM website at www.saem.org.

39

S A E M

NEWSLETTER

Society for Academic Emergency Medicine 901 N. Washington Avenue Lansing, MI 48906-5137

Presorted Standard U.S. Postage PAID Lansing, MI Permit No. 485

Newsletter of the Society for Academic Emergency Medicine Board of Directors Roger Lewis, MD, PhD President Donald Yealy, MD President-Elect Carey Chisholm, MD Secretary-Treasurer Marcus Martin, MD Past President James Adams, MD Glenn Hamilton, MD Katherine Heilpern, MD James Hoekstra, MD Judd Hollander, MD Donald J. Kosiak, Jr., MD

Editor David Cone, MD David.Cone@yale.edu Executive Director/Managing Editor Mary Ann Schropp mschropp@saem.org Advertising Coordinator Jennifer Mastrovito Jennifer@saem.org

“to improve patient care by advancing research and education in emergency medicine”

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.

S A E M

Call for Abstracts 12th Annual Midwestern Regional SAEM Meeting September 13, 2002 Toledo, OH

The Program Committee is now accepting abstracts for oral and poster presentations. Abstracts must be submitted electronically via the SAEM web site at www.saem.org. Deadline is 3 pm eastern standard time, Friday, August 2, 2002.

Location: The Toledo Museum of Art, 2445 Monroe St, Toledo, OH, 8:00 am – 4:00 pm.

Registration fees: Faculty - $70; Residents, nurses - $30; Students, paramedics, EMTs – Free. Make checks payable to: St. Vincent Mercy Medical Center and send to St. Vincent Mercy Medical Center, Emergency Medicine Residency, 2213 Cherry Street, Toledo, OH 43608.

Hotel: Reservations can be made at the Wyndham Hotel Toledo, Two SeaGate/Summit St, 1-800-473-7829, for $75 per night plus $15 valet service.

Keynote Speaker: Brian J. Zink, MD, Past President of SAEM, Associate Professor, Department of Emergency Medicine, Assistant Dean for Medical Student Career Development, University of Michigan Medical School, will speak on the topic: “Faculty Development in Emergency Medicine - Finding Your Mission and Your Niche.”

For information contact: Michael C. Plewa, MD, St. Vincent Mercy Medical Center Emergency Medicine Residency, phone: 419-251-4723, fax: 419-251-4211, e-mail: Michael_Plewa@mhsnr.org