May-June 2003

S A E M

NEWSLETTER

Newsletter of the Society for Academic Emergency Medicine

PRESIDENT’S MESSAGE

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

May/June 2003 Volume XV, Number 3

SAEM Web Editor-in-Chief Sought

Educational Research: Time to Reach the Bar, Not Lower It I believe emergency physicians are among the best clinical educators in academic medicine and a tradition of outstanding clinical education is one of the defining Roger J. Lewis, MD, PhD characteristics of our field. Being a great educator, of course, requires knowing not only what to teach, but how to teach. When accepted educational methods are systematically studied, however, we sometimes find they are either less effective than we believed, or that alternative methods are more effective. For example, it is now well documented that the traditional didactic lecture on a clinical topic is ineffective for changing post-residency physicians’ clinical behavior.1,2 Defining the most effective methods for teaching resident physicians is increasingly important, as we attempt to fit a larger and larger quantity of medical, scientific, social, and administrative content into residency training. Moreover, the definition of six areas of competency to be achieved by residency graduates in all fields by graduation, does little to define practical and effective methods for teaching this material, or measuring success.3,4 Our tradition of clinical and educational excellence notwithstanding, the field of emergency medicine is still striving to define and distinguish itself in the realm of research.

While tremendous gains have been made in this area, and I have summarized some of them in my discussion of federal funding of emergency medicine research previously (http://www.saem.org/newsltr/2002/may-jun/mayjun.pdf), there is still much to be done if we are to gain an equal footing with the traditional core disciplines within academic medicine. Regardless of the quality of our clinical activities, the currency within academic medical centers that most reliably garners respect is research productivity measured by extramural funding. This is unlikely to change in the foreseeable future.

These two factors, our tradition of excellence in clinical education and our need, as a field, to increase the quality and impact of our research activities, result in a key opportunity for our field. Emergency medicine is poised to be the academic specialty at the cutting edge of research into educational methodology—to determine the best methods for training physicians to be effective healthcare providers in the (continued on page 31)

The SAEM Board of Directors is initiating a search for an SAEM member to serve as an Editor-in-Chief for the SAEM web site (www.saem.org). The web site is an increasingly important source of information on all aspects of academic emergency medicine for emergency physicians, residents, and medical students. The web site complements SAEM's other media resources, the SAEM Newsletter and our peerreviewed journal, Academic Emergency Medicine.

The Web Editor-in-Chief will be responsible for editorial and content decisions, revision of the organization of the site, improving the presentation of materials, and suggesting changes that will augment end-user functionality. Technical support, script programming, and the actual uploading of content will continue to be handled by the SAEM staff and by paid consultants to SAEM. The Web Editor-in-Chief will report directly to the SAEM Board of Directors. It is anticipated that initial appointments will be for two years, subject to renewal. This position represents an excellent opportunity for an SAEM member with technical vision and excellent organizational skills who wishes to increase their involvement in the Society. The position will require frequent interactions with the Board of Directors, Committee and Task Force Chairs, and other members.

Interested members should send a letter of interest which includes: (1) a description of relevant experience and activities; (2) a brief description of the applicant's vision for the SAEM web site; and (3) URLs for any web site(s) the applicant has developed. Letters of interest should be addressed to Roger J. Lewis. The deadline for receipt is May 16, 2003.

One or more members of the Board will interview applicants during the upcoming Annual Meeting in Boston.

CAS/AAMC Spring Meeting David P. Sklar, MD University of New Mexico SAEM Representative to the CAS/AAMC The Council of Academic Societies (CAS) of the Association of American Medical Societies (AAMC) met in Tampa, Florida on March 13-16. This group, which includes representatives from all academic specialty societies in medicine, convenes in the spring to address issues of common concern or interest. Since the group includes basic scientists as well as clinicians, topics for discussion are generally broad and relevant to most specialty areas. At this year’s meeting the science and art of teaching and learning served as focal points. Because much of medical education (continued on page 8)

SAEM 2003 Research Grant Recipients Announced Adam Singer, MD Stony Brook University Hospital Chair, SAEM Grants Committee The mission of SAEM is to improve patient care by advancing research and education in emergency medicine. This mission is supported by the development of excellent basic and clinical investigators in the field of emergency medicine. One of the best ways to increase the productivity and quality of EM researchers is by supplying them with adequate funding to develop their careers.

The mission of the SAEM Research Fund overlaps with that of the Society to improve the care of emergency patients through medical research and scientific discovery. To accomplish this, the fund desires to enhance research capability within emergency medicine by helping investigators develop their skills. In order to maximize the use of funds, SAEM assumes all administrative costs associated with the Research Fund so that one hundred percent of all donations are used to fund the grants program. Currently SAEM funds the following grants: Institutional Training, Research Training, Scholarly Sabbatical, EMS Research Fellowship, Neuroscience Research Fellowship, Medical Student Research, Medical Student Interest Group, and Geriatric Resident/Fellow. Unlike many other funding programs where funding is driven by the specific project proposed, the SAEM research fund is primarily intended to assist investigators in the development of basic skills required to become future successful and productive researchers. Thus great emphasis is placed on the presence of a strong mentor and supportive institutional setting conducive to the development of these skills.

SAEM was privileged to receive many excellent grant applications, evidence of the continued development of academic emergency medicine. The review of applications was a significant time commitment for the Grants Committee and the decisions were difficult.

It is my pleasure to present the recipients of the 2003 SAEM research grants in the following categories: Institutional Training, Research Training, Scholarly Sabbatical, EMS Research Fellowship, and Neuroscience Research Fellowship.

The SAEM Research Training 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 James Holmes, MD faculty.

This year’s recipient is Dr. James Holmes and the title of his proposal is: “Development of a clinical decision instrument for definitive abdominal evaluation in blunt trauma patients.” Dr. Holmes completed his residency in Emergency Medicine at the University of California at Davis in 1997 after serving as the Chief Resident. He is currently an Attending Physician and an Assistant Professor in the Division of Emergency Medicine at UC Davis. Dr. Holmes will complete a two-year formal training in epidemiology, biostatistics, injury prevention, and cost-effective analysis. On completion of the course work Dr. Holmes will obtain an MPH from UC Berkeley. Additional didactic training will include an instructional course in recursive partitioning, a grantwriting course, and a course on management of networks. Dr. Holmes research goal is the development of a simple decision instrument based on defined clinical criteria that can identify blunt trauma victims who are at risk for having intra-abdominal injuries requiring therapy and require no further diagnostic evaluation for abdominal trauma beyond physical examination. It is hoped that implementation of this instrument will reduce abdominal CT imaging without missing significant injuries.

The SAEM Institutional Research Training Grant provides financial support of $75,000 per year for two years for an academic emergency medicine proMark Angelos, MD gram to train a 2

research fellow. The sponsoring program must demonstrate an excellent research-training environment with a qualified mentor and specific area of research emphasis. This year’s award goes to Dr. Mark G. Angelos, from Ohio State University. The title of the grant is: “Studies in reactive oxygen species and heart reperfusion.” The proposed program is a two-year training program incorporating a PhD program in biophysics and a research plan in an established laboratory. In addition to being prepared for a PhD, the fellow at Ohio State will learn techniques of measuring reactive oxygen species in the perfused heart, a model with which Dr. Angelos is well experienced and published.

The SAEM Scholarly Sabbatical Grant provides funding of $10,000 per month for six months to help emergency medicine Daniel Morris, MD faculty at the level of assistant professor or higher obtain release time to develop skills that will advance their academic careers. This year’s recipient is Dr. Daniel Morris and the title of his proposal is: “Isolation and genetic expression of migrating neuroblasts after cerebral ischemia.” Dr. Morris has a master’s degree in biochemistry and completed his EM residency at the University of Cincinnati in 1991. After his residency, Dr. Morris completed a Shock and Resuscitation Research Fellowship at Henry Ford. He is currently senior staff and Clinical Instructor at the EM Department at Henry Ford Hospital. Dr. Morris received the SAEM Young Investigator Award in 2002. His area of research has focused on neuronal injury. During his scholarly sabbatical Dr. Morris will work in his mentor’s lab developing techniques for measuring cerebral perfusion in experimental stroke using RNA isolation, real time PCR, and laser scanning confocal microscopy. Dr. Morris will use these techniques to isolate migrating neuroblasts in a rat model of embolic stroke. (continued on page 3)

2003 Research Grant Recipients Announced (Continued) The Emergency Medical Services Research Fellowship is sponsored by Medtronic Physio-Control. It provides $60,000 for a one-year fellowship for emergency medicine residency graduates at an S A E M approved fellowship-training site. This year’s recipient is Dr. Carin Van Gelder.

Dr. VanGelder completed three Carin Van Gelder, MD years of a general surgical residency at the Lahey Clinic in Burlington MA, and is currently the Chief Resident in the EM department at the Yale-New Haven Hospital. She has had significant

Geriatric Emergency Medicine Grant Recipient Announced Lowell Gerson, PhD Northeastern Ohio Universities College of Medicine SAEM Grants Committee We are pleased to announce that Kevin Gibson, MD, Division of Emergency Medicine, Washington University, is the recipient of the 2003 SAEM/ACEP Geriatric Emergency Medicine Resident/Fellow Research Grant.

Dr. Gibson’s project is “Verification of an Abdominal Pain Evaluation Tool: A Pilot Study”. He and his sponsor Lawrence M. Lewis, MD, plan to evaluate the usefulness of a data collection device (APET) for determining which components of the history, physical examination, laboratory testing, and radiographic imaging are most important in clinical decision making regarding the ED evaluation and treatment of undifferentiated abdominal pain in seniors.

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.

involvement in EMS since 1989 when starting as an EMT. She has continued to be a volunteer EMT since then and also has taught ATLS. Her research proposal focuses on hemodymanic monitoring and measuring of physiological stress on firefighters in a controlled burn environment.

The Neuroscience Research Fellowship 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. This year’s recipient is Dr. Selim Suner and the title of his proposal is: “Response of neuronal activity to injury of nearby cells in non-human primate motor cortex.” Dr. Suner has a Master’s Degree in Engineering from Brown University and

completed his Residency in Emergency Medicine at Brown in 1996.

He is currently an Attending Physician and an Assistant Professor at Brown.

Dr. Suner will Selim Suner, MD develop a primate model to test and guide treatment of cerebral damage in the immediate as well as chronic setting. Dr. Suner will also determine the effects of stroke on neurons controlling the upper extremity that surround a focal area of injury in the motor cortex.

EMF/SAEM Medical Student Grant Recipients Announced The Emergency Medicine Foundation (EMF) and SAEM have for many years cosponsored the Medical Student Grant program. Each grant receives $2,400 in funding, half from EMF and half from SAEM. Recently the EMF Board of Trustees and the SAEM Board of Directors approved the recipients of the 2003-2004 Medical Student Grants: Applicant: Andrew Wong, University of Michigan Project: The Effect of Acetylcholine on Alveolar Macrophage Response to P. Aeruginosa Applicant: Rhonda Forest and Kyle Shaver, Hospital of the University of Pennsylvania Project: Risk Stratification of Patients with Acute Coronary Syndromes

Applicant: Tiencia DePass, University of North Carolina Project: What Really Happens When Patients Leave the ED? Self-reported Discharge Instruction Adherence Among Different Racial Groups Seen in the ED Applicant: Jonathan Leake, Emory University Project: Screening Female patients for Depression, PTSD, Suicidality, and Domestic Violence in the ED Applicant: Dan Telem, Thomas Jefferson University Project: The Evaluation of Arginase Activity during Acute Vasoocclusive Sickle Cell Crisis

Newsletter Submissions Welcomed SAEM invites submissions to the Newsletter pertaining to academic emergency medicine in the following areas: 1) clinical practice; 2) education of EM residents, off-service residents, medical students, and fellows; 3) faculty development; 4) politics and economics as they pertain to the academic environment; 5) general announcements and notices; and 6) other pertinent topics. Materials should be submitted by e-mail to saem@saem.org. Be sure to include the names and affiliations of authors and a means of contact. All submissions are subject to review and editing. Queries can be sent to the SAEM office or directly to the Editor at david.cone@yale.edu.

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SAEM Academic Excellence Award

Judd Hollander

Cocaine associated chest pain, acute coronary syndromes, wound care, the Academic Associate Program, development of clinical outcome measures are just a few of the fields in which Dr. Judd Hollander has made outstanding contributions.

Dr. Hollander received his undergraduate degree from the University of Pennsylvania and graduated from the New York University Medical School in 1986. After completing an Internal Medicine Residency at Barnes Hospital in St. Louis, Dr. Hollander did an emergency medicine residency at Jacobi Hospital in Bronx, New York. In 1992 Dr. Hollander created the research program at the State University of New York at Stony Brook where he served as the Director of Clinical Research for five years.

Currently, Dr. Hollander is a Clinical Professor of Emergency Medicine at the University of Pennsylvania where he serves as the Director of Clinical Research.

Dr. Hollander has had an illustrious career as a physician, teacher, and researcher. He has received multiple awards including faculty awards for excellence in teaching, awards for outstanding reviews and consulting for Annals of Emergency Medicine and Academic Emergency Medicine, the George W Householder, III Memorial Prize for Meritorious Cardiovascular Research, and more recently the American College of Emergency

Physicians Outstanding Contribution in Research award.

While at Stony Brook, Dr. Hollander created the first Academic Associate program in which undergraduate students receive training in research methods and help enroll patients in clinical studies in the emergency department.

Dr. Hollander then created a similar program at the University of Pennsylvania, which has served as a model for many other emergency departments throughout the country.

Recognizing the importance of methodology in research, Dr Hollander was instrumental in the development of multiple clinical outcome measures. While at Stony Brook, Dr. Hollander developed the first clinically relevant scale that measures cosmetic outcome after laceration repair. This scale has since been used by multiple authors and investigators throughout the world and is the preferred cosmetic scale recommended by the Food and Drug Administration. Dr. Hollander has also been instrumental in the development of the POGO scale that measures the degree of glottic opening during laryngoscopy.

Dr. Hollander is probably best known for his research in acute coronary syndromes especially those associated with cocaine use. While a resident, Dr. Hollander set up a multicenter study group that conducted many monumental studies on cocaine associated chest pain. His efforts with regards to cocaine associated chest pain have resulted in multiple publications including a review article in the New England Journal of Medicine. Most recently an article on a protocol for evaluating patients with cocaine associated chest pain was published this year in the New England Journal of Medicine in which Dr. Hollander was the senior author.

Dr. Hollander is also well recognized for his research on wound care.

In addition to devising an outcome measure for the cosmetic appearance for scars, Dr. Hollander has been involved in many research proj-

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ects including the introduction of cyanoacrylate tissue adhesives to the United States. He also was a coauthor on another review article in New England Journal of Medicine on laceration repair.

During his career, Dr. Hollander has had over a hundred original peerreviewed manuscripts and he has presented over a 160 abstracts at various national and international meetings. Dr. Hollander has also published multiple editorials and book chapters and is a co-editor of a book on wound repair. Dr. Hollander has served on many national emergency medicine committees. He is currently completing a three-year term as a member of the SAEM Board of Directors and was the past chair of the SAEM Scientific Subcommittee of the Program Committee and also chaired the ACEP Scientific Review Committee.

Next year he will chair the SAEM Progress Committee.

Dr. Hollander has also distinguished himself as a teacher and mentor. He has mentored multiple undergraduate students, medical students, residents and faculty in emergency medicine. His students have won multiple national awards for research and have been first authors on a large number of peer-reviewed publications. Many of Dr. Hollander’s prior students have also developed illustrious academic careers and his teachings and spirit are well represented across the nation. Those of us who have had the privilege of working with and under Judd know him as a kind, generous and witty individual who has always been available and approachable for his students. No matter how busy he is Judd always has time to listen to his colleagues and students both personally and professionally. It is my distinct pleasure to congratulate Dr. Judd Hollander for this well-deserved honor as the 2003 SAEM Academic Excellence Award recipient.

Adam J Singer, MD Stony Brook University

SAEM Leadership Award “The purest treasure mortal times afford, is spotless reputation” Richard II, Act 1, Scene 1, William Shakespeare.

E. John Gallagher, MD

Leadership remains a complex mosaic; easy to recognize, but impossible to describe. Many of us trust our instincts to recognize those around us whose judgment we should follow. Those of us who have been afforded the chance to have personal or professional interaction with Dr. John Gallagher recognized immediately his gift of leadership as a physician, a teacher, and a human.

His work and his actions will prove his contributions as a vanguard to our specialty for years to come. Please consider the evidence: John’s academic career began in earnest in 1964 (the year of the birth of this reporter) when he received a full scholarship to Franklin and Marshall College. His career thereafter has been propelled by energy, unflagging attention to detail, and respectful competence. Attempts to describe the man by simple recapitulation of his curriculum vita would fail to describe John’s impact on those around him. However, the sheer volume and depth of his contributions provide preliminary insight. At present, he holds dual Professorships at the Albert Einstein College of Medicine in the Department of Medicine and the Department of Epidemiology. Additionally, John is the unified Chair of the Department at Albert Einstein College of Medicine.

He is a member of the senior leadership at his medical school, including his contribution as a faculty senator, a member of the Committee of Professors, a member of the Senate Counsel, a multiple-time Search

Committee Chair; a member of countless advisory boards, and a member of the Medical Students Admissions Committee. If all politics are local, these accomplishments should authorize John as a consummate politician. However, his accomplishments extend across the U.S. and across academic disciplines.

Within SAEM, John has served on the Program Committee, and was the Chair of the Faculty Development Committee for 2 years and the Chair of the National Task Force for Emergency Medicine Training. He has an abstract reviewer since 1994 and a moderator numerous times. He has been a consultant to five medical schools that successfully implemented residencies in emergency medicine.

Over the past 20 years, John has served as an omnifarious member of the American Board of Emergency Medicine. He is an oral examiner, a review panel member, a member of the Academic Affairs Committee, a chief examiner, and the editor of the in-training examination for the past 5 years.

For the American College of Emergency Physicians, he has been a chair or co-chair of four committees, and has functioned as a consultant for the development of over 10 practice parameter guidelines. To prevent the weight and volume of this Newsletter from doubling, these efforts are not described in detail.

With regards to strict academic contributions, John has done it all, serving as an editorial board member to four journals, and having received federal, private, and public foundation extramural funding. He has published 100 original peer-reviewed articles, most as first author, and many others as an invited commentator.

He has published 22 book chapters, many as first author.

As a leader, many of us have witnessed first hand John’s resolute dedication to helping young investigators.

He gives completely unselfishly of his time in his editorial and review processes in the functions. For those who have dealt with John’s reviews, it is well known that 5

the volume and length and detail of his manuscript and grant reviews often exceed the volume and length of the work that he is reviewing. It remains difficult to comprehend how he can make so many contributions within the confines of the same amount of time allotted to all of us.

The only explanation is raw dedication and skill.

Those who know John also will recognize him as a humanitarian. He maintains strong belief in protection of rights of the underprivileged population that we serve in emergency medicine. He has leveraged his tremendous intellect not to acquire wealth or political strength, but to educate, and to provide better medical care for the disenfranchised members of our society. As an individual, he remains warm, humble and approachable.

Most importantly, John conveys a clear message, “If you win, I win.”

With any discussion that John undertakes, he imparts an intelligence and enthusiasm that reminds one of the boundless motivation that the prospect of acquiring and using knowledge for the good of society can instill. Do you remember the time when as a medical student, every learning experience was a galvanizing experience? John helps those around him to feel the excitement of learning. (If you have a chance to discuss a topic relevant to our practice with John, expect your heart rate to achieve at least 85% maximum predicted value…out of pure intellectual energy transfer.) Thus, John’s enormous contributions as can be documented within a curriculum vita –though monolithic in aggregate— were small in comparison to the way that he functions as a mentor and role model within our specialty. And SAEM is not alone in this viewpoint, considering that the Institute of Medicine recently inducted him into its membership. I hope that the membership will share my joy in conferring the 2003 SAEM Leadership Award to Dr. John Gallagher.

Jeffrey A. Kline, MD Carolinas Medical Center

2003 Young Investigator Award Recipients

Daniel Davis, MD, completed his undergraduate training at UCLA, where he was a National Merit, Regents, and Alumni Scholar, and a member of the 1987 NCAA National Championship Volleyball Team. He attended the University of California, San Diego (UCSD) School of Medicine, where he remained for his residency in emergency medicine. As a third year resident, he was the “UCSD Medical Center House Officer of the Year.” During his senior year, he served as Chief Resident and was named “Outstanding Emergency Medicine Resident.”

As a resident, Dr. Davis developed research interests in brain injury and resuscitation and was recognized as the 1999 recipient of the “CORD Academic Achievement Award.” This research interest has been cultivated as a faculty member, and he took a principal role in the San Diego Paramedic RSI Trial under the guidance of Dr. David Hoyt in the Division of Trauma. This resulted in several manuscripts that should illuminate the safety and effectiveness of rapid sequence intubation by paramedics in the pre-hospital arena. In 2001, Dr. Davis was the recipient of the SAEM Scholarly Sabbatical Grant and this year is the recipient of the UCSD Rosen Faculty Research Development Grant. These grants have afforded him the opportunity to work with an established investigator in brain injury at UCSD, Dr. Piyush Patel. Dr. Davis was involved in a series of investigations exploring the relative roles of excitotoxicity and apoptosis in ischemic brain injury. He took a lead role on a project using microarray analysis to identify gene candidates that mediate neuronal ischemic preconditioning.

Within his department, Dr. Davis served as Medical Student Director and has recently accepted the positions of Medical Director for a regional AeroMedical service and the UCSD Base Hospital. Dr. Davis initiated the UCSD

Edward Jauch, MD, MS earned a BS in Mechanical Engineering from the University of Dayton, then a Master of Science in Mechanical Engineering and Theoretical Mechanics from Cornell University. He performed additional postgraduate studies in Mechanical Engineering at the University of Kansas and research in the Department of Orthopedic Surgery at the University of Cincinnati. He received his Doctor of Medicine and completed an EM residency from the University of Cincinnati.

Dr. Jauch’s primary area of research interest has been the development and identification of neuronal markers for neurological emergencies. He has performed much of the preliminary work involving neuronal markers in acute ischemic stroke and traumatic brain injury in the ultra early phases in the ED. These efforts have led to numerous publications and abstracts, as well as forming the core of ongoing research projects at the University of Cincinnati and Children’s Hospital Medical Center. He has capitalized upon the advancing technology of expression proteomics to identify plasma proteins associated with intracerebral hemorrhage following the administration of fibrinolytics in the acute ischemic stroke model. He is performing similar proteomics efforts investigating perihematomal edema formation and blood-brain dysfunction in intracerebral hemorrhage. The goal is to develop plasma assays to improve patient identification and selection of acute therapies in both forms of stroke. Additionally, these projects will help identify new proteins associated with ischemic stroke leading to improved diagnostic assays with increased sensitivity, specificity, and accuracy for cerebral ischemia. His efforts have now been rewarded with a 1.3 million dollar NIH/NINDS grant.

Dr. Jauch’s efforts in stroke research have led him to be involved in shaping stroke care and stroke care public policy.

He chairs the SAEM Neurologic 6

Paul F. Klawitter, MD, PhD, received his medical degree from the State University of New York (SUNY) Health Science Center in Syracuse, New York in May 1993, followed by his residency in Emergency Medicine at SUNY Health Science Center, Syracuse graduating in June 1996. Following a year and a half of clinical practice, Dr. Klawitter made the decision to return to academics.

Rather than accepting an academic appointment at a teaching institution, he decided to fully embrace academia by returning for additional training and research experience through a PhD program.

In January of 1998, Dr. Klawitter joined the Department of Emergency Medicine at the Ohio State University in Columbus Ohio and subsequently enrolled in the Biophysics Graduate Program. Over the next four years, he successfully completed graduate course work, worked as an attending in the Emergency Department and developed his research projects in the laboratory.

In March 2002, Dr. Klawitter successfully defended his dissertation, which was entitled “The Role of Antioxidants in Cardiac and Skeletal Muscle during Conditions of Energy Deficit” and received his PhD in Biophysics. During this four-year period, Dr. Klawitter added greatly to our research program working in our laboratory studying cardiac muscle and in the neighboring laboratory of Tom Clanton, PhD who served as Dr. Klawitter’s PhD advisor.

Dr. Klawitter was the recipient of a three-year NIH National Research Service Award. He was the recipient of the Ohio State University Woody Hayes Award for Outstanding Contribution to the Department of Emergency Medicine in 2000. He made numerous abstract presentations at national meetings and has subsequently published the major findings of his dissertation in highly respected research journals including (continued on page 7)

Young Investigator Award (Continued) Emergency Medicine Research Associate Program, with over 50 undergraduates from two institutions assisting in clinical departmental research and serves as an executive committee member of the UCSD School of Medicine Admissions and Recruitment Committee. Dr. Davis has published 65 journal articles, abstracts and book chapters and will be editor of the “Difficult Airways” section of the Journal of Emergency Medicine effective July 2003.

We are most pleased to have someone of Dr. Davis’ talents and accomplishments affiliated with the Department of Emergency Medicine at UCSD and are honored to have him join the ranks of the distinguished recipients of the Young Investigator Award.

Emergencies Interest Group and is the ACEP representative to the Ohio Department of Health Council on Stroke Education and Prevention. He is a fellow of the American Heart Association national Stroke Council and is active in educational material development.

He is an enormously productive investigator. He is one of those rare young investigators who have demonstrated promise and distinction in their emergency medicine research careers.

In addition, he is the medical director for a medical mission to Haiti each year and a board member of the Regional Autism Advisory Council. We congratulate him on this well-deserved honor.

Journal of Applied Physiology and American Journal of Physiology. Dr. Klawitter is currently an Assistant Professor at SUNY Health Science Center in Syracuse where he is building his own research program and laboratory. It was my great pleasure to work with Dr. Klawitter for 4 years during his tenure at Ohio State University. I anticipate his academic career will continue to flourish at SUNY Health Science Center. We congratulate him on this well-deserved honor as recipient of the Young Investigator Award.

Mark Angelos, MD Ohio State University

W. Brian Gibler, MD University of Cincinnati

David Guss, MD University of California, San Diego

SAEM to Participate in AAAEM/EuSEM Conference Judd E. Hollander, MD University of Pennsylvania SAEM Board of Directors SAEM will organize a “Research Education Track” as part of the American Academy of Emergency Medicine/European Society of Emergency Medicine Conference September 14-17, 2003 outside of Barcelona, Spain. AAEM and EuSEM have asked SAEM to help plan a halfday track focusing on methodological aspects of clinical research that can assist researchers in the international community. Sessions will discuss issues ranging from research training through data collection and dissemination of your research results, as well as ethical issues in informed consent and how to deal with authorship disputes.

The planned sessions for the SAEM portion of the Research Education track and the speakers are listed below: “Formal Research Training as a Pathway to Successful Career Development” will be given by Robert Neumar. Dr. Neumar is Chair of the ACEP/EMF Scientific Review Committee

“Optimizing Your Chances to Publish Your Research: How to Write an Abstract” by Judd Hollander. Dr. Hollander will be the Chair of the SAEM Program Committee for the upcoming year.

“Optimizing Your Chances to Publish Your Research: Manuscript Preparation” by Michelle Biros. Dr. Biros is the Editor in Chief of Academic Emergency Medicine.

“Designing Prospective Research in Your ED: How to Have Valid Data and a Happy ED Staff by Adam Singer. Dr. Singer is the Chair of the SAEM Grants Committee and a member of the AEM Editorial Board “Obtaining Funding Early in Your Career: Emphasis on EM Organizations and Industry” by James Adams. Dr. Adams is a member of the SAEM Board of Directors and a Senior Associate Editor of AEM “Ethics and Human Subject Issues in Research: Informed Consent and International Guidelines” by Jill Baren.

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Dr. Baren is on the SAEM Nominating Committee “Ethics and Human Subject Issues in Research: Data Safety and Monitoring in Clinical Studies” by Roger Lewis. Dr. Lewis is the President of SAEM and Senior Statistical Editor for AEM. The European Society of Emergency Medicine has also been invited to develop sessions to be presented within the Research Education Track. Other sessions at this meeting include tracks in trauma management, pediatric emergency medicine, disaster medicine, resuscitation, and prehospital care tracks. Hands-on procedure tracks include ultrasound, airway management, and noninvasive ventilation.

Additional sessions feature descriptions of emergency medicine around the world and international journals of emergency medicine. SAEM is excited about the opportunity to participate in our area of expertise and looks forward to this collaborative international meeting.

SAEM Position on Optimizing Care of the Stroke Patient The SAEM Board of Directors developed and approved this position statement on February 7, 2003.

Improving treatment of the stroke patient must be a priority for emergency physicians and the healthcare system.

Important research needs exist in both basic and clinical science. Further, health services research is needed to identify the optimal delivery mechanisms, accounting for both benefits and burdens, when considering new therapies for stroke treatment.

Since delays in accessing medical care is one of the largest barrier to improving stroke care, research and policy directed at the education and behavior change of all citizens regarding stroke signs, symptoms and need for rapid medical attention is the first priority. Other aspects in need of attention include optimizing initial diagnostic and therapeutic strategies for care.

Importantly, availability of emergency department, radiology, and neurology resources cannot be assumed.

Overcrowding, lack of timely access to expert interpretation of imaging studies, and other barriers exist. Also of high priority is to optimize preventive strategies.

Effort to minimize the risk of sustaining stroke should be similarly emphasized and investigated.

Ongoing controversies surround the use of thrombolytic therapy for acute stroke. Although evidence demonstrates the therapeutic benefit for an important minority of patients, substantial increased risk of intracranial hemorrhage exists. The narrow therapeutic window and strict protocol demands make this intervention far different from other therapeutic interventions. There is little available information surrounding subgroups of patients most likely to benefit and also most likely to be harmed.

Many important questions remain.

It is not yet clear whether the treatment risk is outweighed by the likely therapeutic benefit. Minimizing the complication rate must remain an important priority. The Society for Academic Emergency Medicine endorses the creation of a national research initiatives, including a registry to gather outcomes data for stroke victims, whether or not thrombolytic therapy is administered.

Data should include details of the care process, including timeliness and quality of the clinical interventions and adequacy of important support systems. At this time, decisions regarding thrombolytic therapy must be individualized, based on specific clinical and operational circumstances. Currently insufficient data exist to mandate thrombolytic therapy as the standard of care for acute ischemic stroke for all patients across all medical treatment settings.

Although advocacy of stroke centers is well-intended, it is premature to stratify acute care hospitals. Such hierarchical stratification should await outcomes data demonstrating the overall systems benefit of such centers.

The Society for Academic Emergency Medicine enthusiastically endorses efforts to optimize stroke care and prevention through ongoing scientific investigation, assessment of outcomes data, and improved education of health care providers and the lay public.

CAS/AAMC Spring Meeting (Continued) seems driven by exams with a new clinical skills exam about to be added, it was refreshing to hear speakers address the importance of curiosity, creativity, and synthesis in the teaching process.

Acknowledged teaching experts Faith Fitzgerald from the University of California, Davis, Daniel Federman from Harvard, (who will be a speaker at the Annual Meeting in Boston) and Aviad Haramati from Georgetown University School of Medicine described the excitement and joy of connecting with a group of students and what education could be with the right focus and the needed time and attitude. The educational process rather than the facts seemed to be most important, and the attitude of the teacher meant more than the teacher’s knowledge base. Evidence based methodologies with use of databases and literature could augment bedside teaching.

The next day there was a discussion of the new AAMC definition for underrepresented minority, which now includes all ethnic and racial groups whose presence in the medical profession is proportionately lower than their presence in the population.

There was also a discussion about the affirmative action lawsuits at the University of Michigan and the position of AAMC in providing an amicus brief.

Experts then addressed the contributions of cognitive psychology, learning theory and humanism to medical education and the opportunities to use these areas of knowledge to inform and enrich medical education.

The AAMC also provides advocacy for academic medicine concerning budgetary support for research, and medical education. A review of the potential opportunities to successfully lobby members of the Congress occurred, as well as predictions of possible upcoming problems.

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Dr. Jordan Cohen, President of AAMC and Dr. Richard Knapp, Executive Vice President of AAMC addressed the initiatives of AAMC concerning the development and support of academic chairs, resident work hours, reassessment of medical education, financial and budgetary issues, and legal challenges concerning the match. As many of us in emergency medicine know from the Daniel’s suit, litigation based upon theories of anti-trust and conspiracy can be disruptive, expensive, and time consuming. The AAMC is attempting to get the support of all medical schools and academic societies to defer the cost of the litigation, which if the plaintiffs prevailed would eliminate the resident match system.

Overall, the meeting was a useful opportunity to build relationships with other academic societies in areas of mutual concern and demonstrate the important place of emergency medicine

Evidence-Based Medicine Interest Group Meeting Michael Brown, MD Spectrum Health-Butterworth Chair, SAEM Evidence-Based Medicine Interest Group A recent survey by Gloria Kuhn, and other interest group members, found that only 22% of residency programs provided more than five hours of EBM teaching per year.1 The two greatest perceived barriers to integrating EBM into teaching and patient care were lack of trained faculty and lack of time.

Following this survey, a poll of interest group members demonstrated the diversity of EBM training needs among programs. Some residency programs desired a 1-2 day program similar to previous SAEM workshops. Other programs had more advanced needs such as assistance with the development of systematic reviews, teaching EBM at the undergraduate level, and developing methods for incorporating EBM into

Health Services and Outcomes Interest Group Meeting Donald B. Chalfin, MD, MS Albert Einstein/Beth Israel Medical Center Chair, SAEM Health Services and Outcomes Interest Group The Health Services and Outcomes Research (HSOR) Interest Group will meet on Friday, May 30 from 9:00-10:00 am in the Falmouth Room. As in years past, this meeting will address issues related to new advances and emerging trends in health services and outcomes research in emergency medicine and related disciplines. In addition, this year’s meeting will explore ways to promote and enhance collaboration between group members and the institutions and departments that they represent. Another topic for discussion will be HSOR sponsored proposals and proposed didactic sessions at the 2004 Annual Meeting of the SAEM. All interested individuals are invited to attend.

For further information, please contact Donald B. Chalfin, MD, MS, Director, Division of Research, Maimonides Medical Center, Brooklyn, New York via telephone at 718-283-6052 or via email at dchalfin@maimonidesmed.org or dchalfin@applied-decision.com.

daily practice. This reinforced the range and variety of EBM penetration into various EM residency programs and the need for continued development of both basic and advanced SAEM courses in the future.

All programs are now required to assess competency in practice-based learning; EBM concepts have been incorporated into this ACGME definition.

In order to assist residency programs in addressing this competency, interest group members organized and participated in a panel discussion which highlighted various models for implementation of EBM into the curricula of residency programs (2003 “Best Practices” conference sponsored by CORD with slides, handouts posted at www.cor-

dem.org). Future initiatives include the development of an online EBM course and the development of a teaching module focused on EBM undergraduate medical education. This year, Barney Eskin has organized an innovative EBM workshop with a ‘hands on’ computer lab. This basic course will take place on the last day (June 1) of the SAEM Annual Meeting in Boston.

Reference 1. Kuhn GG, Wyer PC, Rowe BH, Cordell WH: A Survey to Determine the Prevalence and Characteristics of Training in Evidence-based Medicine in Emergency Medicine Residency Programs (Abstract 322). Acad Emerg Med 2002:9:477-478.

Toxicology Interest Group Meeting The Toxicology Interest Group will be meeting at noon on Friday, May 30, 2003 at the Annual Meeting. Topics to be covered will include a review of our

interest group objectives and elections.

Please contact kennon.heard@ushsc.edu to add a topic to the agenda.

Medical Student Educators Interest Group Meeting Douglas Ander Emory University Chair, SAEM Medical Student Educator Interest Group Emergency medicine (EM) has a greater than ever prominence in undergraduate education. An increasing number of medical schools have electives and mandatory clerkships in EM. As EM faculty interact with more students the chances of being faced with a difficult student increases. In addition, all faculty who teach medical students are typically required to evaluate and more importantly provide the student feedback.

Many EM faculty and medical student educators lack a formal education in feedback and the challenges of a difficult student. The Medical Student Educators Interest Group for several years has been providing the medical educator at the SAEM Annual Meeting with educational sessions ranging from item writing to the logistics of constructing an EM clerkship. In Boston we are 9

planning an educational session whose objectives are to teach the EM faculty how to give effective feedback and deal with the difficult student. The session will consist of short presentations, case scenarios, and use of standardized students for demonstration of these important skills. The session will be led by Dr. Lori Weichenthal, Assistant Clinical Professor of Medicine, UCSF School of Medicine and Director, Medical Student Sub-internship and Dr. Todd Berger, Assistant Professor of Emergency Medicine, Emory University School of Medicine and Assistant Director of Undergraduate Education.

The annual business meeting of the Medical Student Educators Interest Group will be held immediately following the educational session. I invite all mem(continued on page 29)

Resuscitative Hypothermia Academic Industry Roundtable

First Working Session on Emergent Genomics

Recent trials and evolving new technologies have generated renewed enthusiasm for research into the role of induced hypothermia in the resuscitation of patients with several different pathologies. These data also suggest the critical importance of very early initiation of hypothermia in the Emergency Department. Hypothermia research in the past has been primarily organized by specialists from several different disciplines that often had limited contact with each other. Academic emergency medicine is uniquely positioned to facilitate interdisciplinary research efforts and communication in hypothermia research.

RHAIR will bring researchers in emergency medicine with an interest in hypothermia together with hypothermia researchers from neurology, cardiology, neurosurgery, and anesthesiology, as well as with representatives of the relevant industries and governmental funding and regulatory agencies.

The participants will discuss specific topics related to the general theme; “How to Build Interdisciplinary Research in Hypothermic Resuscitation”. A proceeding of the meeting will be produced for peer-reviewed publication.

This meeting will be a four-hour interactive gathering on May 31 from 6:00-10:00 pm during the SAEM Annual Meeting in Boston.

John Younger, MS, MD University of Michigan There is a revolution underway in the field of medical genomics; genetic variants associated with illness are being identified at a rapid and still accelerating pace. Underlying genetic variation no doubt affects the nature and severity of disease among patients cared for in the ED. It remains unclear, however, what role if any increased understanding of these unalterable patient characteristics might play in the actual delivery of emergent medical care. Fundamental hurdles abound, such as upon which diseases and genes focus should be placed and whether genetic information can ever realistically become available in clinically meaningful ‘real time.’

The University of Michigan and Carolinas Medical Center are excited to sponsor the First Working Session on Emergent Genomics during the SAEM Annual Meeting on May 30, 7:009:00 pm in Boston. This session will provide a forum for investigators to briefly present ideas, strategies, and preliminary data and to troubleshoot every aspect of this very challenging new endeavor. This will not be a didactic session! Rather, it will be an informal opportunity* for investigators and potential investigators to discuss their work, no matter how preliminary, in this area. We therefore extend an open invitation to anyone currently working in the area with experience in any of the following: • Identifying which diseases warrant study • Selecting candidate genes • Choosing a detection technique (PCR, real-time PCR with fluorescent probes, gene sequencing, etc.)

• Reliably collecting blood leukocyte, buccal scrape, or other tissue in the ED for DNA isolation • Using point-of-care DNA extraction systems and thermocyclers (including hand-held PCR devices) • Addressing consent and regulatory hurdles related to emergent collection of genetic material, including HIPPA. To sign up for a presentation or for more information contact: jyounger@umich.edu. The time available for individual presentations will be inversely proportional to the number of interested participants. Wine and beer will be provided.

Rural Emergency Medicine Summit Janet Williams, MD West Virginia University SAEM Representative to the ACEP Rural Workforce Task Force The Rural Emergency Medicine Summit was held March 29-30 in Albuquerque, New Mexico. Conference attendees included representatives from SAEM, ACEP, EMRA, ABEM, CORD, RRC-EM, American Academy of Family Physicians, Society for Emergency Medicine Physician Assistants, Federal Office of Rural Health Policy, and the National Rural Health Resource Center. Several physicians actively engaged in the practice of emergency medicine in rural and frontier areas participated as well.

The primary goal of the Summit was to develop strategies to improve quality of emergency medical care in rural America.

Key topics of discussion included:

Currently Scheduled Participants “Use of rapid screening methods to detect thrombophilic gene mutations as an adjunct to pretest probability assessment and risk stratification in venous thromboembolic disease in the ED setting,” Jeff Kline, MD, Carolinas Medical Center

• Overview of the rural healthcare environment • Workforce issues, particularly maldistribution of emergency physicians • Scope of clinical practice unique to rural emergency medicine • Legislative initiatives • Medical student and residency training issues • Research priorities for rural emergency medicine

“Mannose binding lectin polymorphisms: a potential target for infectious and inflammatory disease characterization in the ED?,” John Younger, MS, MD, University of Michigan “Acute molecular triage for infectious disease in the ED,” Richard Rothman, MD, PhD, and Samuel Yang, MD, Johns Hopkins University

Data presented regarding the current status of emergency medical care in America indicates that the majority of rural emergency physicians are neither residency trained nor boarded in emergency medicine. The majority of the rural emergency medicine workforce is comprised of non-specialists, largely primary care physicians. Our specialty continues to churn out residency trained emergency physicians with an ultimate goal of staffing all emergency departments with board (continued on page 29)

“Microarray technology as a screening tool for gene expression changes in neuroinjury,” David W. Wright, MD, Emory University “Identifying Genetic Risk Factors in the Conversion of Traumatic Synovitis to Osteoarthritis,” Gregory Jay, MD, PhD, Brown University 10

Geriatric Interest Group Meeting Lowell W. Gerson, PhD Northeastern Ohio Universities College of Medicine Chair, SAEM Geriatric Interest Group Hilary Siebens, MD, will talk about assessing seniors quickly in emergency departments and streamlining communication among emergency physicians, primary care physicians and other providers. Dr. Siebens, an internist/geriatrician/physiatrist, has experienced the provider-side challenges of managing complicated primary care seniors and their frequent needs for emergency care. These patients use hospitals, nursing homes, and home health services without any one physician aware of all key issues. ED visits can be difficult and exhausting for patients and providers alike. Standard organization of information for these patients, applied in all care settings, efficiently communicates the context of patients’ problems

and simplifies collection of core information.

Dr. Siebens will describe the Domain Management Model that she developed.

The model categorizes patient issues into four easily remembered domains: I. Medical/Surgical Issues, II. Mental Status/Emotions/Coping, III. Physical Function, and IV. Living Environment (physical, social, financial). This model is especially helpful for patients presenting with functional decline and falls along with acute illness. It facilitates efficient case discussion within and across ED programs. This new “mental model”, in use already by some geriatricians and physiatrists, can be used for teaching and for streamlining communication among ambulance personnel, ED staff,

PCPs and other healthcare settings.

Hilary Siebens, MD, is currently the Medical Director, Center for Seniors and Younger Persons with Disability, at the University of California, Irvine, Medical Center. After receiving board-certification in internal medicine, geriatrics, and physical medicine and rehabilitation, she has focused on geriatric rehabilitation, has written numerous review chapters, and has pursued research in quality improvement and exercise in hospitalized seniors.

The Geriatric Interest Group will meet at 12:00-1:30 pm on Saturday, May 31. All SAEM members are invited to attend.

New Interest Group: Mentoring Women A new SAEM Interest Group has recently been formed entitled Mentoring Women. The objectives of this Interest Group are two-fold 1) to increase opportunities for women in emergency medicine through formal and informal mentorship and 2) to look for opportunities to improve women in academic emer-

gency medicine. The group will hold its first organizational meeting at the upcoming SAEM Annual Meeting in Boston. The meeting will take place on May 29 from 4:00-5:30 p.m. This formative meeting is open to all SAEM members – men and women alike. We will be discussing our objectives and brain-

storming ways to accomplish them in the coming year, as well as electing a chairperson for the group. If you will not be able to attend the meeting but would like to be part of this new interest group, please contact Dr. Susan Promes at prome001@mc.duke.edu

Diversity Interest Group At the 2002 Annual Meeting members of the Diversity Interest Group (DIG) presented to the AACEM meeting regarding diversification of Academic Emergency Departements. This program was quite well received and follow up discusions amongst the chairs and DIG have proved even more fruitful.

Many of the chairs related their difficulties in attracting under-represented minority emergency physicians (URMEP’s) to their institutions.

After discussion, one of several potential proposed solutions is assistance through the current SAEM Consulting Service in the area of Diversity promotion and recruitment.

Such a service might provide site visits and specific enumeration of issues,

strengths, and weaknesses to a requesting site. This year the Under Represented Member Task Force will complete it’s multi-site focus group study on the opinions of URM medical student regarding EM as a potential future career choice. This will be new information and a natural starting point for the DIG to begin discussions about assistance services in the broad area of Diversity. These services could support medical student and faculty recruitment and advance faculty development in diversity issues. The potential for data gathering and research on this important topic are wide open. As we are still in the brain-storming stages it would be very valuable to have as much input from interested individuals as possible 11

early in our discussions. Any proposal must be submitted to and reviewed by the Board, but now is the time to begin.

There are many other opportunities to consider, eg, how can we promote academic EM to resident URM’s with recognized abilities in this area? There is much to do and the DIG meeting is Boston is a great place to continue good work.

The DIG would like to invite all interested members, especially residents, to attend the DIG meeting at the SAEM Annual Meeting on May 31 from 12:001:30 pm, or send your input to our Chair, Kevin L Ferguson at University of Florida Department of EM, 1329 SW 16th St. room 2204 or email klferg@emergency.ufl.edu

2003-2004 SAEM Committee/Task Force Objectives Listed below are the 2003-04 committee and task force objectives (SAEM’s year runs from May to May to coincide with the Annual Meeting). While SAEM’s mission “to improve patient care by advancing research and education in emergency medicine” gives direction to SAEM’s activities, and the Five-Year goals and objectives (http://www.saem.org/newsltr/hd5yrpla.htm) lay the foundation, it is the extensive and detailed work of each committee and task force towards the fulfillment of their specific goals and objectives, which really advance the academic specialty.

Although the committee and task force objectives are developed and approved by the Board of Directors, they are based on SAEM’s Five Year Goals and Objectives and on the suggestions of prior committee and task force chairs and members, and from individual SAEM members. The Board strives to ensure that he objectives assigned to each committee and task force are welldefined, achievable, and directly related to SAEM’s core mission. The Board appreciates feedback regarding these objectives from the membership, and most importantly, invites suggestions for future objectives.

Constitution and Bylaws Committee - Linda Spillane, MD, Chair 1. Review the Constitution and Bylaws to ensure accuracy relative to the Society’s activities and internal functions.

Propose needed amendments to the Board by December 1, 2004 for approval.

2. Review and propose Constitution and Bylaw changes to the Board by December 1, 2004 be offered to membership for 2004 Annual Meeting based on recommendations from the Leadership Development Task Force.

al(s) and submit to the Program Committee for consideration of presentation at the 2004 Annual Meeting.

Specifically, individual career and portfolio development sessions for medical school and organization advancement for junior and senior members should be developed, addressing advancement in academic rank and local/national leadership positions (e.g. Department Chair, Dean’s office, and SAEM/other organization leadership positions). This should be done in conjunction with Leadership Development Task Force.

2. Evaluate Faculty Development Web site, and offer assessment and suggestions for enhancement to Board

by November 1, 2003.

3. Complete development of a list of full professors in emergency medicine. Make this list available, with appropriate permissions, on the SAEM Web Site, and submit a written plan to Board on mechanism to update yearly by February 1, 2004.

4. Submit two articles for publication in the SAEM Newsletter (for later posting on Web site) to address focused issues in faculty development.

CORD/SAEM Diversity Training Task Force - Marcus Martin, MD and Antoine Kazzi, MD, Co-Chairs 1. Develop curriculum (using previously developed guides

by SAEM Graduate Medical Education Committee) to incorporate diversity awareness and skills to residency training programs. This will be done jointly with the Council of Emergency Medicine Residency Directors.

Report to SAEM Board on progress by December 1, 2003.

2. Create Web site product based on objective #1 to be submitted to SAEM Board by May 1, 2004.

Fellowship Training Task Force - Robert Neumar, MD, Chair 1. Develop and apply a tool to identify all current fellowship programs (accredited and non-accredited, EM and nonEM based) available to EM residency graduates.

Accompany this with at least one article on choosing fellowships (including certification, funding, and site differentiation issues) for publication in the SAEM Newsletter and web site. Report to Board by March 1, 2004 with results.

2. Develop SAEM Newsletter and Web site product that conveys information from objective # 1, targeting both fellow candidates and program directors (as influentials).

3. Together with GME Committee, by September 10, 2003, develop a “Choosing a Fellowship” session proposal for consideration by Program Committee for 2004 Annual meeting.

Education Research Task Force - Gloria Kuhn, DO, Chair 1. By September 10, 2003, develop Annual Meeting session(s) proposal in conjunction with Research and Undergraduate Educators Committees for consideration by the Program Committee to identify methods, barriers, and success in educational research.

2. Create Web site resource and/or SAEM Newsletter article related to objective #1 (together with partners) by May 1, 2004.

Ethics Committee - Terri Schmidt, MD, Chair 1. Identify list of current ethics topics important to SAEM members, and submit to Board by November 1, 2003; following this, create a position paper draft on the topic selected by Board.

2. Develop position paper on “Teaching on the Newly Dead” and submit to Board by December 1, 2003.

3. Write two articles on ethics-related subjects for the SAEM Newsletter.

4. By September 10, 2003, propose educational sessions on ethics related subjects for SAEM meetings for consideration of presentation at the Annual Meeting and regional meetings.

5. Promote and continue the Ethics Consultation Service, and identify reasons for use/disuse, reporting to Board

by February 1, 2004 with assessment and plan.

Financial Development Committee - Brian Zink, MD, Chair 1. Submit a written proposal to Board by October 1, 2003 identifying a structure for financial management of all SAEM non-operating funds. The structure should include a written description of how investment and research funds are managed (including evaluation of potential fund management professional relationships), how fund management decisions are made, creation of an advisory body, and how the any working group/advisory body reports to the larger committee, SAEM headquarters, and the Board of Directors and Secretary-Treasurer.

2. Provide oversight for the activities of the development

Faculty Development Committee - Frank Counselman, MD, Chair 1. By September 10, 2003, Develop educational propos-

(continued on page 13) 12

SAEM Committees/Task Force Objectives (Continued) consultant. This includes providing guidance on development initiatives, helping to develop materials that can be used in development efforts, and evaluating the work of the development consultant.

3. Coordinate and evaluate the 2003-2004 SAEM annual appeal to members for the Research Fund. Offer report to Board by May 1, 2004 on effectiveness and strategies for improvement.

should submit a written report to Board detailing specific activities each group and the Task Force will accomplish to achieve MOU goals by September 1, 2003.

2. Prepare written report on the Task Force/MOU progress for the Board by March 1, 2004.

3. By September 10, 2003, submit at least one Annual Meeting proposal from each working group regarding Task Force/MOU activities for consideration of presentation by the Program Committee.

4. Inform SAEM members of Healthy People 2010 issues of interest to the membership through publication of at least two articles in the SAEM Newsletter.

Graduate Medical Education Committee - Michael Beeson, MD, Chair 1. Coordinate the Resident Section of the SAEM Newsletter, including the solicitation, selection, and editing of articles, with strict attention to focus, quality, and timely completion to meet publication deadlines. Ensure at least one submission per issue from Committee or others devoted to resident issues/concerns.

2. Maintain and update the Resident Section of the web site, and send written report to Board outlining suggested enhancements by November 1, 2004.

3. Integrate ‘Fellowship Catalog’ being developed by Fellowship Task Force into current GME venues including Web site.

4. Develop resources (implementation guides and assessment tools) for the “Systems-Based Practice Core Competency” and the “Academic EM Elective,” and post on Web site by February 1, 2004.

5. Submit article for publication in the SAEM Newsletter regarding new ACGME resident training hours regulations by January 1, 2004.

Leadership Development Task Force - John Marx, MD, Chair 1. Evaluate current mechanisms for identifying and assisting SAEM members who desire elected and other leadership positions within the organization. The current Constitution and Bylaws and nominating processes should be reviewed and changes suggested if seen potentially helpful. Offer a report to the Board by November 1, 2004.

2. By September 10, 2003, develop a proposal for a “Leadership Series” together with Faculty Development Committee aimed at senior faculty/members to be submitted to Program Committee for consideration for 2004 Annual Meeting.

National Affairs Committee - Robert Schaefermeyer, MD, Chair 1. Develop a draft program for the AAMC meeting by respective deadline by March 1, 2004. Submit reports on interactions for publication in the January/February and May/June issues of the SAEM Newsletter.

2. Develop an advocacy network plan for SAEM members and options for implementation, including how to work with other organizations rapidly “breaking” issues of widespread concern, and identify/plan a template for establishing and maintaining linkage with collaborators.

This plan should be delivered to the Board by January 1, 2004.

3. Monitor legislative and regulatory issues pertinent to academic emergency medicine. Develop Newsletter articles to educate the SAEM membership regarding these issues. Write position statements as needed on these issues for consideration and action by the Board.

4. Develop a position paper on “Financing of Emergency Medicine GME Programs in the Era of Declining Medicare Reimbursement/Support” and submit to Board

by February 1, 2004.

Grants Committee - Clifton Callaway, MD, Chair 1. Coordinate the grant application reviews (working with expert reviewers from committees, task forces and interest groups) and recommend recipients to the Board for the following grants: Research Training Institutional Research Training Scholarly Sabbatical Medical Student Interest Group EMS Research Fellowship Neuroscience Fellowship EMF/SAEM Medical Student 2. Explore the possibility of offering a one-year medical student research training fellowship and prepare a report to the Board by January 1, 2004.

3. Review all grant applications for clarity and consistency, offer a report summarizing any changes to Board by September 1, 2003, and incorporate any proposed changes before next grant cycle. Specifically evaluate and offer advice on electronic-only (Web-based) applications and creation of common on-line form mirroring NIH format for all submissions.

Nominating Committee - President-elect will chair 1. Develop a slate of nominees for the elected positions on the Board of Directors, Nominating Committee, and Constitution and Bylaws Committee and submit to the Board for approval by February 1, 2004.

2. Solicit and review nominations for the Young Investigator Award and recommend recipients to the Board by January 1, 2004.

3. Solicit and review nominations for the Academic Excellence and Leadership Awards and recommend recipients to the Board by January 1, 2004.

Healthy People 2010 Task Force - Carlos Camargo, MD, Chair 1. Implement activities as defined in the SAEM/DHHS Memorandum of Understanding (MOU), which includes work in four areas: 1) Access to Quality Health Services, 2) Injury and Violence Prevention, 3) Respiratory Diseases, and 4) Substance Abuse. Each working group

(continued on page 14) 13

SAEM Committees/Task Force Objectives (Continued) 4. Review announcements for all awards to ensure consistency and clarity of qualifications and criteria by August 1, 2003.

5. Review scoring templates for all awards and offer draft of changes (if deemed helpful) to Board by November 1, 2004.

4. Evaluate the program instituted this year to provide mentorship and feedback to young investigators with unsuccessful grant applications. Suggest modifications, continuation, or termination of this program to the Board by January 1, 2004.

Undergraduate Education Committee - Wendy Coates, MD, Chair 1. Evaluate the Medical Student Web site and Virtual Advisor Program ongoing operations, and submit written reports outlining successes and potential enhancements to Board by December 1, 2003.

2. Create mentorship educational product(s) aimed at faculty in the role of medical student education director, and

by September, 10, 2003 submit proposal to Program Committee for consideration of presentation at the 2004 Annual Meeting. In conjunction with this, submit at least one Newsletter and post on Web site to accompany this work.

3. By September 10, 2003, together with Research Committee, develop an educational program that addresses the fundamentals of research as applied to the evaluation of educational interventions for consideration by Program Committee at the 2004 Annual Meeting.

4. Complete the “How-To Run a Medical Student Clerkship� guide for Web site posting by November 1, 2003.

5. Develop a module for medical student educators that introduces the concept of professionalism (as outlined by the ACGME) in EM to medical students. Disseminate through an article for the SAEM Newsletter and Web site that introduces students to the importance of professionalism in their careers.

6. Assess current needs of medical student clerkship directors and offer written report to Board on these and potential organizational approaches by March 1, 2004.

Program Committee - Judd Hollander, MD, Chair 1. Plan 2004 Annual Meeting, and deliver quarterly reports to Board on progress, successes, limits and opportunities.

2. Create and implement new mechanisms to assist committees, task forces and Interest Groups with the development of session submissions to Program Committee for consideration at 2004 Annual meeting.

3. Continue tracking/database development of didactic sessions offered in Annual Meeting in past 5 years.

4. Evaluate success and offer suggestions to enhance participation/attendance at SAEM meetings by non-members, particularly other academic physicians. Submit a report to Board by December 1, 2003.

Research Committee - Mark Angelos, MD, Chair 1. By September, 10, 2003, develop research-related didactic proposals and submit to the Program Committee for consideration of presentation at the 2004 Annual Meeting. These should include educationalresearch strategies (latter should be done in conjunction with Undergraduate Education Committee and Education Research Task Force). At least one should deal with HIPAA and its effect on clinical research and coping strategies, and be accompanied by a SAEM Newsletter submission by March 1, 2004.

2. Identify and highlight emergency medicine researchers who attain new federal grant funding or large scale industry funding, and any new or under-recognized funding sources, and develop at least two articles for publication in the SAEM Newsletter.

3. Evaluate need, current status, and future direction of any tracking tool of EM investigators, and submit a written report of options and recommendations to Board by February 1, 2004.

Undergraduate Question Bank Task Force - Stephen Thomas, MD, Chair 1. Finish development of a question/answer bank that could be used by educators in the evaluation of medical students in EM, and prepare for Web site posting by

Simulation Interest Group Meeting William Bond, MD Lehigh Valley Hospital Chair, SAEM Simulation Interest Group The SAEM Simulation Interest Group will be holding its second annual meeting on May 31 at 12:00 noon - 2:00 pm. The interest group has grown rapidly from 30 members last year to 50 members this year. This growth reflects the enthusiasm of the membership for this exciting new educational modality.

This meeting will see the official introduction of our website and discussion

about its future uses. The meeting will contain an update on efforts to convert Anesthesia Crisis Resource Management principles into Emergency Medicine Crisis Resource Management.

We will discuss our relationship with other simulation societies, both nationally and internationally. We welcome potential new members who are working in the field of simulation, or planning 14

to work on simulation, to drop by the meeting. Also please consider signing up for the simulation workshop/ panel discussion that will be held at the Harvard Simulation Center on the afternoon of June 1 (for details see the Annual Meeting brochure on the SAEM web site).

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 June 3, 2003 to be included in the July/August issue.

Marco Coppola, DO, has been promoted to Professor of Emergency Medicine at Texas A&M University System Health Science Center College of Medicine.

He is the first Professor of Emergency Medicine in the history of Texas A&M. Lieutenant Colonel Coppola, Texas Army National Guard, has also received the U.S. Army Surgeon General’s “A” proficiency designation.

Robert L. Galli, MD, was one of nine new members appointed by HHS Secretary Tommy G. Thompson to the Advisory Committee to the Director of the CDC on February 20. The Advisory Committee advises the CDC director on policy issues and broad strategies for promoting health and quality of life by preventing and controlling disease, injury, and disability. Dr. Galli is professor and chair of the Department of Emergency Medicine at the University of Mississippi.

Roger Lewis, MD, PhD, has been promoted to Professor in the Department of Medicine, Division of Emergency Medicine at the University of California, Los Angeles.

John Lumpkin, MD, has been named the senior vice president and director of the health care group at the Robert Wood Johnson Foundation.

Dr. Lumpkin, the former director of the

Illinois Department of Public Health, is a member of the Institute of Medicine’s Committee on Minority Health Statistics and chair of the National Committee on Vital Health Statistics.

John B. McCabe, MD, has been elected as an at-large member of the Executive Committee of the American Board of Medical Specialties, representing emergency medicine through the American Board of Emergency Medicine. Dr. McCabe is Professor of Emergency Medicine at State University of New York Health Science Center at Syracuse.

The Great Cincinnati/Northern Kentucky Stroke Team received one of the first Specialized Programs of Translational Research in Acute Stroke (SPOTRIAS) from the National Institute of Neurological Disorders and Stroke (NINDS). This grant provides one million dollars per year for the next 5 years for research performed by the stroke team. The funding will support stroke team infrastructure and three primary research projects; two of which have emergency physicians as principal investigators. Arthur Pancioloi, MD, Associate Profressor of Emergency Medicine with Tenure and ViceChairman, Universtiy of Cincinnati is the principal investigator for, “The Combination Approach to Lysis Utlizing Eptifibated and rt-PA.. This project will study the combination of IV eptifibatide and IV low-dose rt-PA in acute ischemic stroke patients within 3 hours of stroke onset.

Edward Jauch, MD, MS, Assistant Professor Emergency Medicine is the principal investigator for,

“Biomarkers in Acute Ischemic Stroke.”

Dr. Jauch will study known serum proteins that are markers of neurologic injury and will also utilize proteomic techniques in an exploratory format to identify, characterize and quantify serum proteins that may serve as markers of neuronal injury and potentially predictors of response to the intervention.

George Shaw, MD, PhD, Assistant Profressor of Emergency Medicine has received a Whitaker Biomedical Engineering Research grant in the amount of $225,000 to study ultrasonographic augmentation of thrombolysis at the microscopic level. He has also received a grant from the Neuroscience Institute in the amount of $25,000 to fund a pilot study of the effects of human clot age on the efficacy of ultrasound-enhanced thrombolysis in an invitro model.

Harvey W. Meislin, MD, has been elected president-elect of the American Board of Medical Specialties, representing the emergency medicine through the American Board of Emergency Medicine. Dr. Meislin is professor and chair of the Department of Emergency Medicine of the University of Arizona.

Kimberlydawn Wisdom, MD, MS, director of the Institute of Multicultural Health at Henry Ford System, has been appointed Michigan’s first Surgeon General by Governor Jennifer Granholm. Dr. Wisdom is a board-certified emergency physician at Henry Ford and an assistant professor in the Department of Medical Education at the University of Michigan.

American Geriatrics Society Awards Announced The American Geriatrics Society (AGS) has announced that two emergency physicians were recipients of Dennis W. Jahnigen Career Development Scholars Awards. These highly competitive two-year faculty development awards of $200,000 each provide a foundation on which individuals can initiate and sustain a career in geriatrics-oriented research and education. The awards, funded by grants from the John A. Hartford Foundation and the Atlantic Philanthropies, are available to young faculty in the ten specialties represented on the AGS Council of the Section For Surgical and Related Medical Specialties. The emergency medicine winners are: Manish N. Shah, MD Assistant Professor University of Rochester Medical Center Specialty Mentor: Sandra M. Schneider, MD Geriatrics Mentor: Robert M. McCann, MD “Prehospital Screening to Prevent Injuries and Illness” Scott T. Wilber, MD Assistant Professor of Emergency Medicine

Summa Health System/Northeastern Ohio Universities College of Medicine Specialty Mentors: Lowell W. Gerson, PhD and Michelle Blanda MD Geriatrics Mentor: Kyle R. Allen, DO “Prediction of Short-term Functional Decline and Service Needs in Older ED Patients”

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Advocacy, Involvement and You Robert W. Schafermeyer, MD Carolinas Medical Center Chair, SAEM National Affairs Committee Life, a professional career, passes by. You work hard and long hours, teach your residents and medical students, complete research, treat patients, deal with administrative burdens and, in a sense, feel successful. You follow the rules. The rules change. You follow the new rules. Your reimbursement is flat or diminished. The rules change. You work harder. The rules change some more.

Sound familiar? Academic careers can be like this. Just when you think you have figured it out, they—the government, the hospital CEO, the dean— change the rules. Many of us complain, yet, for the most part, do not get involved in trying to solve the problems.

Many of us are too busy, too humble, or too tired to take action, or believe that we cannot change the minds of politicians and bureaucrats. After all, its not about truth and beauty, it’s about power and money.

The complexity of health policy and reimbursement issues may make you reticent to get involved. Yet who knows more about what is needed to provide quality health care, solve health policy issues, preserve the health care safety net, and care for the patient? Of course, we have no time to spare: meetings, patients, and papers fill the hours. Can I spare one hour a week? Are you kidding? Every moment is filled with something. So we follow the rules. The rules change. The alphabet soup speaks.

Pronouncements come from CMS, GAO, OIG, DHHS, PPAC, RUC, CPJ, and Congress.

Can I make a difference? Will my voice be heard? Should I even care?

After all, “they” will look out for me and make sure that I have the resources needed for my patients, for my medical center, for my career. I wish it were so. I hate to burst your bubble, but if you are not politically involved, you cannot be your patients’ best advocate or a champion on behalf of your emergency physician partners or our specialty.

To advocate means to speak for, on behalf of, to plead the case of another (from the Latin ad + vocare). Physicians have been filling this role for hundreds of years and will do so in the future. We need every emergency physician to spend some time as a physician advocate, even if it is only an hour a week. It can be related to what you do on a daily basis or another issue such as the uninsured, educational reform, etc.

Advocacy is the lifeblood of change, of patient protection, of looking out for the interests of your medical center, your specialty, your partners, your residents and your family.

You say it’s too hard, you’re not sure where to start, how to be heard. Well, it’s easier and takes less time than you think. There are multiple ways to be involved and, hopefully, effect change.

Everyone is a constituent of a Senator, a Representative, and state legislators.

Calling or e-mailing your opinion is easy and inexpensive, and if you get your colleagues to also call or send an e-mail, you increase the odds of being heard, being effective.

You and a couple of colleagues can also visit your representative or senator at their district or state office when they are home. Call and set up an appoint-

ment, discuss the problems, give your key message and an example. Finish with what you believe is the best solution to the problem.

You can also invite them for a visit to the emergency department where they can see the problems firsthand, and you can help them understand why they need to act. It could also be “good politics” for your hospital.

You can get the needed guidance for these advocacy efforts from county or state medical association leadership— AMA, ACEP, AAMC, SAEM. Many of these professional societies have developed legislative and regulatory agendas and key messages, and have “schools of advocacy” where you can enhance your skills. As mentioned last September in the SAEM Newsletter, if you belong to one of these organizations, join their advocacy networks.

ACEP’s 911 program wants and needs you, and signing up is easy. The AMA’s leadership and legislative meeting is usually in March. State society meetings occur at a variety of times. ACEP has a Legislative leadership meeting in Washington, DC where you can learn how to be an effective advocate and you can sign up for it on their website. A similar course is held in the fall at Scientific Assembly.

So what are you waiting for? All of us, as faculty, can lead by example and become vocal advocates and also get our residents to get involved. Sign up, become informed, and let’s strengthen our advocacy efforts on behalf of our patients, our colleagues, and our specialty.

A Compendium of Web-Based Research Funding And Information Sources James Olson, PhD Wright State University SAEM Research Committee During the past eighteen months the Research Committee of SAEM has published newsletter articles which describe potential sources of funding for prospective researchers and information on the grant writing and grant review process. We have focused on providing web-based resources for all this information. In this article I summarize all the sources that have been reviewed since September 2001. While not complete, this list represents a great number of agencies and associations that have been or can be sources of research funding for the Emergency Medicine researcher.

Grant Writing Information Description of NIH IRGs and Study Sections www.csr.nih.gov/review/IRGDESC.asp

Private Foundations Resource Guide fdncenter.org/learn/shortcourse/prop1.html NIH Tips on Grant Writing www.ninds.nih.gov/funding/grantwriting.htm (continued on page 17)

American Heart Association Peer Review Guidelines www.americanheart.org/presenter.jhtml?identifier=410 16

Web-Based Research Funding and Information Sources (Continued) Bioterrorism Funding State Sources of Bioterrorism Funding www.hhs.gov/ophp/funding

U.S. Air Force Office of Scientific Research www.afosr.af.mil U.S. Air Force Research Laboratory/Human Effectiveness Directorate www.he.afrl.af.mil

Biodefense Research Training and Career Development Opportunities www.niaid.nih.gov/dmid/bioterrorism/biodtraining020529.htm

U.S. Navy Office of Naval Research www.onr.navy.mil

Mechanisms of Immunomodulation grants.nih.gov/grant/guide/rfa-files/RFA-AI-02-003.html

U.S. Navy Health Research Center www.nhrc.navy.mil

Combating Terrorism Technology Support Office www.bids.tswg.gov/tswg/bids.nsf/Main?OpenFrameset&57YJ2V

Defense Advanced Projects Research Agency www.darpa.mil

Informatics for Disaster Management grants1.nih.gov/grants/guide/pa-files/PAR-02-137.html

Emergency Medicine and Private Funding Organizations Emergency Medicine Foundation www.acep.org/2,1628,0.html

Diagnosis of Biological Threats www.acq.osd.mil/sadbu/sbir/solicitations/sbir022/army022.htm Federal Agency Web Sites NIH Home Page www.nih.gov

SAEM Research Awards www.saem.org/awards/grants.htm Robert Wood Johnson Foundation www.rwjf.org/index.jsp

NIH Guide for Grants and Contracts grants.nih.gov/grants/guide

Centralized Grant Information Proposal (SiteCENTRAL) pc.ecgint.com

NIH Web Site Navigation www.grantsnet.org

Johnson & Johnson www.jnj.com

NIH Application Forms grants.nih.gov/grants/forms.htm

The David and Lucile Packard Foundation www.packard.org

NIH Requests for Applications (RFA) grants.nih.gov/grants/guide/rfa-files Specific Requests for Applications

The Foundation Center www.fdncenter.org

Pharmacotherapy for Alcoholism grants.nih.gov/grants/guide/rfa-files/RFA-AA-02-004.html

The Pew Charitable Trusts www.pewtrusts.com

Improving Outcomes Following Resuscitation from Cardiopulmonary Arrest grants.nih.gov/grants/guide/rfa-files/RFA-HL-02-003.html

Community of Science www.cos.com

National Highway Traffic Safety Administration www.nhtsa.dot.gov/nhtsa/whatsup/tea21/index.html

Pediatric Emergency Medicine Society for Pediatric Research www.aps-spr.org

National EMS Research Agenda www.nhtsa.dot.gov

American Academy of Pediatrics www.aap.org/section/PEM.default.HTM

Department of Defense Web Sites Agency for Health Care Research and Quality Training Programs www.ahra.gov/fund/training/t32.htm

Maternal and Child Health Bureau mchb.hrsa.gov/grants National EMSC (EMS for Children) Data Analysis Resource Center www.nedarc.org

U.S. Army Combat Casualty Care Research Program www.usaccc.org

Emergency Medical Services for Children www.ems-c.org

U.S. Army-Telemedicine and Advanced Technology Research Center www.tatrc.org

Ambulatory Pediatric Association www.ambpeds.org 17

ACADEMIC RESIDENT News and Information for Residents Interested in Academic Emergency Medicine Edited by the SAEM GME Committee

Hospital Credentialing- What EM Residents Should Know Sharhabeel Jwayyed, MD Summa Health Systems SAEM GME Committee The credentialing process is something most residents give little thought to during residency. This is understandable given the hectic nature of residency. The need to meet dayto-day residency requirements supercedes concerns about credentialing which to most residents is a distant matter to be addressed some time in the future. The fact is time moves quickly and the future is often here sooner than expected.

Unfortunately, most residents focus on credentialing at the end of their residency. They typically scramble to gather information and the documents needed for the credentialing process while at the same time trying to pack, move, and find new housing, not to mention complete last minute residency requirements. This often results in failure to comply with all credentialing requirements and delays the process of obtaining hospital privileges that are needed to begin work at your new institution. Understanding the process will afford you the opportunity to prepare for credentialing during the course of your residency and allow you to gather needed information in a careful, organized manner. By doing so, many potential mishaps and associated frustrations can be avoided.

The purpose of the credentialing process is to assure that you meet the medical staff requirements of the institution where you will be practicing. These requirements vary from institution to institution but generally include an application to practice medicine at that institution, professional references, a current state medical license and DEA certificate, residency certificate, board certification status and medical liability insurance.

The credentialing application requires generic information such as name, phone numbers, business, home and email address. The name and address of all undergraduate, medical school and other professional institutions attended is also requested. Information about all internships and residency programs and the names and contact information of the program directors is needed. Residents who completed an internship at a different institution than their residency should contact that program to update the contact information for the program director. The credentialing application may also have a disclosure section that asks questions about remediation, reprimands, denial or suspension of medical staff privileges, criminal convictions, substance abuse and personal health issues that could affect your ability to perform your duties as a physician.

Three reference letters are typically requested. These letters must be from individuals in your general field of practice who have worked extensively with you over the last three years or who has been responsible for professional observation of your work. Some institutions will accept one letter from a current partner or associate. Reference letters from relatives are not acceptable. Issues related to reference letters are one of the major stumbling blocks in the credentialing 18

process. One of the main problems is that reference letters are either late or never received by the requesting institution.

There are many potential reasons for this particular problem.

Beyond simply being busy (and forgetful), residents don’t realize how many letters a given faculty member is asked to write each graduation cycle. Further, residents apply for privileges at many different institutions and not uncommonly change their mind about where (or to whom) they want their reference letter sent. This can make tracking which requests have been honored difficult. Residents should identify and approach potential authors of their reference letters early in their senior year and provide those individuals two to three months to complete and submit the letters. Friendly reminders to authors to complete the letters are usually welcome. It is appropriate to ask to be notified when the letters are submitted. Contact the institution to assure the letters have been received and properly handled.

It is generally understood that an active state medical license is a requirement of the credentialing process. Keep in mind the state license application process can take three to six months to complete. Since requirements vary from state to state, contact the state medical board in those states you are considering working in for an application and review it for any unique requirements. An individual DEA license is also required and may take just as long to obtain, so apply for one as soon as possible.

Completion of a residency program in your field of practice and board certification are required at most institutions. Be prepared to provide copies of your residency certificate and information regarding your time frame for obtaining board certification. Many institutions will grant provisional hospital privileges to board eligible physicians. Most institutions require full board certification within three to five years of being granted medical staff privileges.

All hospitals will ask for procedure credentialing that you are requesting. You may need to demonstrate actual procedure numbers for some specific procedures. Most recently, hospitals are increasingly asking for procedural competency attestations and actual numbers for conscious sedation, ultrasound, and central venous line placement. Although it may have seemed to be a mundane requirement to document your procedures, you will find that it helps tremendously during the credentialing process.

Information regarding medical malpractice claims, suits, judgments and settlements is mandatory. The nature of the claim and the outcome are the key elements sought. This information can be obtained from your hospital risk management department. Information about medical malpractice insurance coverage during your employment at the new institution is also required and can be obtained from the group you are joining or directly from their insurance carrier.

The credentialing process is an unavoidable hurdle for graduating residents.

Ultimately, it is your responsibility to make sure all requested information has been submitted. Apply early and provide accurate information. Follow-up with individuals and departments to make sure they have provided the information requested. Understanding the process will enable you to meet the requirements in a timely fashion and hopefully remove one obstacle from the road to becoming an attending physician.

Checklist 1. Send for a hospital application 3-4 month prior to start date 2. Provide accurate contact information for all institutions and individuals 3. Contact authors of professional references 2-3 months prior to start date 4. Apply for State Medical License 3-6 month prior to start date 5. Apply for DEA license 3-6 months prior to start date 6. Contact hospital credentialing department 1 month prior to graduation to check on the status

CPC Cases Selected The CORD CPC Committee, chaired by Douglas McGee, DO, is pleased to announce the selection of the 50 cases that will be presented during the CPC Competition on May 28, 2003 in Boston. Each emergency medicine residency program was invited to submit a case for consideration and 81 cases were submitted. Each case was reviewed and scored by eight reviewers and the following programs were selected to present their cases: Albany Medical Center Albert Einstein College of Medicine at Beth Israel Medical Center Allegheny General Hospital Beth Israel Deaconess Harvard Boston Medical Center Carolinas Medical Center Christ Hospital and Medical Center Duke University Eastern Virginia Medical School George Washington University Grand Rapids MERC/Michigan State University Henry Ford Indiana University Jacobi/Montefiore Lehigh Valley Hospital-Muhlenberg Osteopathic Lincoln Medical and Mental Health Center Long Island Jewish Medical Center Maimonides Medical Center Maine Medical Center Martin Luther King/Charles Drew University Medical College of Virginia Medical College of Wisconsin MetroHealth Medical Center Morristown Memorial Hospital Naval Medical Center-San Diego

Naval Medical Center-Portsmouth New York Medical College New York Methodist Hospital New York University/Bellevue Hospital Center Ohio University College of Medicine/Doctors Hospital Saginaw Cooperative Hospitals, Inc. San Antonio Uniformed Services Health Education Consortium Stanford/Kaiser Temple University Hospital Texas Tech University UMDNJ-Robert Wood Johnson University of California, Davis University of California, Irvine University of California, San Diego University of Connecticut University of Illinois University of Massachusetts University of Pennsylvania University of Pittsburgh University of Rochester University of Texas Southwestern Wake Forest University Baptist Medical Center Washington University/Barnes Hospital William Beaumont Hospital Yale New Haven Hospital

There is no registration fee to attend this day-long event and all emergency physicians are invited to attend. Five semi-final “Best Faculty Discussants” and five “Best Resident Presenters” will be selected and announced during the CPC Reception that will be held on the evening of May 28. The semi-finalists will compete in the CPC Finals that will be held during the ACEP Scientific Assembly in October in Boston. Contract cord@cordem.org for further information.

AAMC and Sallie Mae offer new MEDLOANS Consolidation Loan The AAMC and Sallie Mae, a federally guaranteed student loan provider, have introduced “MEDLOANS Consolidation Loan,” a federal consolidation loan program. The new product allows eligible borrowers to lower their monthly student loan payments by up to

50 percent or more, lock in historically low interest rates, and potentially save thousands of dollars in interest expenses by taking advantage of special borrower benefits.

MEDLOANS Consolidation Loan allows borrowers to roll all eligible student loans into a new 19

loan with one monthly payment. The loan may be repaid with terms up to 30 years, based on their total education loan indebtedness.

For more information, contact: http://www.aamc.org/medloans

The 2003 NRMP Match in Emergency Medicine Louis Binder, MD MetroHealth Medical Center/Cleveland Clinic/Case Western Reserve University The results of the 2003 NRMP Match became final on March 21, 2003. Emergency Medicine residency programs offered a total of 1251 entry level positions (5.4% of total positions in all specialties). The following numbers (taken from the 2003 NRMP Data Book) include information from all programs that entered the 2003 Match:

EM positions/total NRMP positions

2001 22,828 11% 120 (106 PG1, 14 PG2) 1148 (1001 PG1, 147 PG2) 5.0%

2002 22,916 10% 125 (112 PG1, 13 PG2) 1211 (1073 PG1, 138 PG2) 5.3%

2003 23,365 9% 125 (112 PG1, 13 PG2) 1251 (1114 PG1, 137 PG2) 5.4%

# EM programs with PG1 vacancies # unmatched EM PG1 positions

3/106 (3%) 6/1001 (0.6%)

9/1148 (8%) 20/1073 (2%)

17/112 (15%) 41/1114 (3.7%)

# EM programs with PG2 vacancies # unmatched EM PG2 positions

1/14 (7%) 3/147 (2%)

2/13 (15%) 5/138 (4%)

Total # EM programs with vacancies Total # unmatched EM positions

4/120 (3%) 9/1148 (0.8%)

11/125 (9%) 25/1211 (2%)

21/125 (17%) 48/1251 (3.8%)

2002 858 276 1134

2003 856 300 1136

1126 438 1564

1062 433 1495

56/858 (6.5%)

36/820 (4.2%)

Total # of NRMP positions Overall % of positions unfilled Number of EM programs listed Total PG1/PG2 entry positions

4/13 (31%) 7/137 (5%)

Applicant Pool Data Applicants who ranked only EM programs: US graduates Independent applicants Total applicants

2001 825 279 1104

Applicants who ranked at least one EM program: US graduates 1092 Independent applicants 430 Total applicants 1522 US seniors applying only to EM Programs who went unmatched 54/825 (6.8%) Independent applicants applying only to EM programs who went unmatched

190/279 (68%)

145/276 (53%)

114/300 (38%)

Percent of matched US seniors who matched in EM residencies

825/12,365 (6.7%)

858/11,915 (7.2%)

856/12,037 (7.1%)

Breakdown of filled EM positions by type of applicant: 2001 PG1 EM positions 1001 Filled by US graduates 825 (82%) Filled by independent applicants 170 (17%) Total filled 995 (99.4%)

2002 1073 866 (81%) 186 (17%) 1052 (98%)

2003 1114 859 (77%) 214 (19%) 1073 (96%)

PG2 EM positions Filled by US graduates Filled by independent applicants Total filled

138 113 (82%) 21 (15%) 134 (97%)

137 97 (71%) 33 (24%) 130 (95%)

147 114 (78%) 30 (20%) 144 (98%) 20

(continued on page 21)

2003 NRMP Match (Continued) Total EM positions Filled by US graduates Filled by independent applicants Total filled

1148 939 (82%) 200 (17%) 1139 (99.2%)

1211 979 (81%) 207 (17%) 1186 (98%)

1251 956 (76%) 247 (20%) 1203 (96%)

** For PG1 filled entry positions (1073), 859 were filled by US seniors, 67 were filled by US physicians, 86 by osteopathic physicians, 40 by US international medical graduates, 13 by international medical graduates, 4 by Canadian physicians, and 4 by Fifth Pathway graduates.

From these data, several conclusions can be drawn: 1.

Emergency Medicine experienced an increase of 40 entry level positions in the 2003 Match over 2002 Match numbers (a 3.3% increase), occurring almost exclusively from quota increases occurring in EM 1-3 and 1-4 programs. Emergency Medicine now comprises 5.4 percent of the total NRMP positions (all time high) and 7.1% of matched US seniors (7.2 last year). The number and mix of EM programs in the 2003 Match was otherwise unchanged from 2002.

2.

The overall “hard” demand for EM entry level positions (applicants who ranked only EM programs) remained level for US seniors in 2003, after having grown modestly in 2002, and after having no growth in 2000 and 2001. “Hard” demand by Independent Applicants (mostly US graduates and osteopaths) showed a modest increase of 24 positions (8.7 increase for this small pool). The major decline in demand for EM positions in 2003 was in “soft” demand among US seniors (US seniors who ranked at least 1 EM position, but also ranked other specialties), which decreased by 64 positions (5.7%) from 2002. “Soft” demand by Independent Applicants in 2003 remained level from 2002 data. The excess applicant demand over and above the size of the training base is 131 to 244 applicants (10% to 20% surplus), depending on how the parameters of the applicant pool are determined. Last year, the excess applicant demand data were 215 to 353 applicants (18 to 29% surplus).

3.

A increase of 40 in the supply of EM entry level positions in 2003, coupled with a leveling of “hard” demand and contraction of “soft” demand by US seniors, resulted in a decrease in the fill rate for EM programs in 2003 (96.2%), compared with 98% in 2003. The growth of supply over demand was also manifested by an increased number of unfilled EM positions in the Match (48 in 2003, compared with 25 in 2002 and 9 in 2001).

4.

The proportions of EM positions filled by US seniors versus Independent Applicants (US graduates, Osteopaths, and International Medical Graduates) shifted slightly in 2003 compared with 2002. In 2003, 76% of EM entry positions were filled with US graduates, compared with 81-82% over the last 3 years; and 20% of EM entry level positions were filled by Independent Applicants, versus 16-17% over the last 3 years. These data are consistent with the contraction of “soft” US senior demand and increase in “hard” Independent Applicant demand in the 2003 EM applicant pool.

5.

Overall, the growth in supply in EM entry level positions (40 spots in 2003), coupled with a leveling of “hard” demand and a contraction of “soft” demand by US seniors, resulted in an increasing number of unmatched positions, a doubling of the number of programs with unmatched positions, and a decrease in the number of unmatched applicants (6.5% in 2002, versus 4.2% in 2003), creating more of a “buyer’s market” for EM positions than at any time since 1996. The unmatched rate of 4.2% for US seniors going into EM and 38% for Independent Applicants going into EM support the notion that most US seniors and Independent Applicants who apply will match into an EM residency.

6.

A three year trend is now evident of increasing growth in EM positions (increases of 30, 63, and 40 positions in the last 3 years), coupled with a leveling and/or decline of applicant data (1112, 1104, 1134, and 1136 “hard” applicants in 2000-2003, and 1528, 1542, 1564, and 1495 “soft” applicants), with a particular decline in the “soft” US senior population. EM supply has increased linearly across the past 15 years, except for 1998, when GME contraction initiatives were encouraged; barring such an external factor adversely impacting supply, it seems unlikely that institutions sponsoring EM residency programs will voluntarily downsize. It remains to be seen if the leveling of demand for EM positions is a transient versus permanent phenomenon (there have been 1-2 year level offs in demand previously, with subsequent resumption of applicant growth).

7.

The implications of these trends are that EM programs may need to look to “non-traditional” applicants more so than in the past; and collective faculty efforts to communicate the desirability of EM careers to students (raising EM applicant demand) will be helpful to all programs.

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Constitution and Bylaws Amendments to be Considered by the Membership The Constitution and Bylaws Committee and the Board of Directors have developed a number of proposed amendments to the Constitution and Bylaws for consideration by the membership. A ballot has been mailed to all active members of SAEM. The results of the ballot will be presented during the Annual Business Meeting, which will be held on May 31 in Boston. The proposed amendments are published below, and the entire document may be viewed on the SAEM web site at www.saem.org.

In the amendments below, strike-outs note the old language, while new proposed language is provided in boldface.

1. Deleting the Membership Committee: The Board of Directors and Constitution and Bylaws Committee agree that references to the Membership Committee should be deleted, since the Board does not review individual membership applications. It was agreed that language regarding the Membership Committee was not useful. The proposed amendments are: Constitution: Article III – Membership, Section 2: (5) Candidates for emeritus membership shall be (a) active members who seek such status and who have given 15 continuous years of active service to the Society and have attained the age of 65 years or (b) other active members who under special circumstances are invited for such emeritus status by the Membership Committee Board of Directors.

Constitution: Article V- Committees: The standing committees shall be the: (1) Nominating Committee, (2) Membership Committee, and (3) Constitution and Bylaws Committee.

Bylaws: Article II – Board of Directors: The Secretary-Treasurer shall chair the Membership Committee.

Bylaws: Article VI – Committees and Liaisons: Section 4: Membership Committee. The Board of Directors shall constitute the Membership Committee.

The Secretary-Treasurer shall serve as chair of the Membership Committee.

The Membership Committee has the responsibility for establishing the qualifications for each membership classification. Applicants reviewed by the

Executive Director and SecretaryTreasurer not meeting the qualifications for election to a requested classification of membership shall require presentation to and approval by the majority of the Membership Committee, before membership in that classification can be granted.

2. Defining Board Membership on Committees and Task Forces: The Board of Directors agreed that given the current hierarchy within SAEM, Board members should not serve on committees and task forces. The proposed amendment is: Bylaws: Article II – Board of Directors, Section 2, Responsibilities: Members of the Board may not serve on as chairs or members of committees, or task forces, or interest groups of the Society.

No Board member may serve as chair of the Constitution and Bylaws Committee. with the following exceptions: The President-elect serves as chair of the Nominating Committee and the Board elects one member of the Board to serve a one-year term on the Nominating Committee. Members of the Board may serve as members of interest groups. Members of the Board may serve on subcommittees or working groups of the Board. The Board has oversight responsibility for all publications of the Society. the Secretary-Treasurer serves as chair of the Membership Committee. The entire Board serves as the Membership Committee. Members of the Board may be appointed to serve as chairs of ad hoc committees and task forces.

3. Clarifying Committee and Task Force Appointments: The Board of Directors and Constitution and Bylaws Committee agreed to clarify the role and tenure of committees and task forces. The proposed amendment is: Constitution: Article V – Committees: Additional committees and task forces may be created by the Board of Directors and President to aid in the Society’s efforts to achieve and further its goals. All appointments to committees and task forces are for one year. The Board of Directors and president-elect will evaluate each committee and task force annually to ascertain whether the committee or task force will be continued, restruc22

tured, or dissolved. Task Forces may be reappointed for one additional year, for a maximum of two years.

4. Clarifying the Assessment of Dues: It was noted that the Board of Directors has authority to assess all SAEM dues and that specifying the various membership categories was not necessary. In addition, it was noted that in the future it may be necessary to assess dues for emeritus members as that classification of membership increases. The proposed amendment is: Bylaws: Article I – Membership, Section 2: Dues: Annual dues for active, associate, resident/fellow, and medical student members will be established by the Board of Directors. Honorary and emeritus members are exempt from dues.

Membership in the Society may be terminated for nonpayment of dues.

5. Clarifying Financial Reports to the Board: The Constitution and Bylaws Committee recommended an amendment that clarified the financial reports that are presented to the Board. The proposed amendment is: Bylaws: Article II – Board of Directors, Section 11: The A financial record report will be presented to the membership biannually. Detailed financial reports are provided to the Board of Directors, and at such times as requested by the President of the Society. The financial records of the Society shall be reviewed annually by the Board of Directors. upon request of the Secretary-Treasurer for consideration during Board meetings. The Board of Directors may retain a certified accountant or financial consultant to review the financial records of the Society.

6. Clarifying Board Meetings: The Constitution and Bylaws Committee recommended an amendment that clarified the meetings of the Board.

The proposed amendment is: Bylaws: Article II – Board of Directors, Section 8: Regularly scheduled Mmeetings of the Board of Directors are open to all members of the Society and to the public. However, Cclosed meetings of the Board and Executive Committee and Executive Director may be convened by order of the President.

Board of Directors Update This article includes the highlights of the February 22 Board of Directors meeting held in conjunction with the CORD Navigating the Academic Waters Conference, and Board actions in March, 2003.

During the February meeting, the Board interviewed potential financial development companies and reviewed financial development proposals for the Research Fund. The Board approved a budget to develop a feasibility study.

The Board reviewed and further developed the draft 2003-2004 committee and task force objectives. The objectives have been finalized and are published in this issue of the Newsletter.

The Board reviewed the amendments to the Constitution and Bylaws proposed by the Constitution and Bylaws Committee, and in addition, developed and approved additional amendments. The complete list of Constitution and Bylaws amendments is published in this issue of the Newsletter.

A ballot to approve or disapprove the proposed amendments has been sent to all active members of SAEM. The results of the ballot will be announced during the Annual Business meeting on May 31 in Boston and will be published in the July/August issue of the Newsletter.

The Board reviewed and approved the slate of nominees submitted by the Nominating Committee for the positions that will be filled by election. These positions include: president-elect, members of the Board of Directors, the resident member of the Board, two members of the Nominating Committee, and a member of the Constitution and Bylaws Committee. The slate of nominees is published in this issue of the Newsletter. A ballot to elect the members to fill the open positions has been sent via mail to all active members of SAEM. A separate ballot for the election of the resident member of the Board has also been sent to all resident members of SAEM. The results of the elections will be announced during the Annual Business Meeting on May 31 in Boston and will be published in the July/August issue of the Newsletter.

The Board approved the Nominating Committee’s recommendation that Dr.

Judd Hollander receive the 2003 Academic Excellence Award and that Dr. John Gallagher receive the 2003 Leadership Award. Additional information regarding the recipients is published in this issue of the Newsletter. Dr. Hollander and Dr. Gallagher will receive their awards, and briefly address the membership, during the Annual Business Meeting on May 31 in Boston.

The Board approved the Nominating Committee’s recommendation that Dr. Daniel Davis, Dr. Edward Jauch, and Dr. Paul Klawitter receive the 2003 Young Investigator Award. Additional information on the recipients is published in this issue of the Newsletter. The recipients will be presented to the membership during the May 31 Annual Business Meeting.

The Board agreed to publish a “call for nominations” for the position of SAEM Web Editor. The call for nominations was published in the Newsletter, and it is anticipated that an Editor will be selected in the Summer of 2003.

The Board approved a manuscript developed by Dr. Marcus Martin in regards to last year’s objective comparing SAEM to other academic medical societies. The Board also approved two manuscripts submitted by the Undergraduate Committee. All three manuscripts will be submitted for consideration of publication in the peerreview literature.

The Board also reviewed a commentary that Dr. Martin has submitted for consideration of publication in the November 2003 issue of Academic Emergency Medicine.

The Board did not approve two applications, and one proposed application, for satellite symposia at the Annual Meeting in Boston, because they had been submitted after the February 15 deadline.

The Board approved two sessions proposed by SAEM members to be held during the Annual Meeting. The first session, the First Working Session on Emergent Genomics, developed by Dr. John Younger, will be held on May 30 at 7:00-9:00 pm. The second session, the Resuscitative Hypothermia Academic Industry Roundtable, developed by Dr. Robert Silbergleit, will be held on May

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31 at 6:00-10:00 pm. The Board also approved several interest group meeting agendas and Newsletter articles developed by the interest groups. The articles are published in this issue of the Newsletter.

The Board selected Dr. Douglas Lowery to serve as the SAEM representative to attend the conference, “Terrorism Preparedness and Response: CDC and the Acute Care Community.” Dr. Lowery will develop a report for publication in the July/August issue of the Newsletter.

The Ambulatory Pediatric Association invited SAEM to participate in a multi-organization project to develop a consensus document on developing a policy on parental/caretaker presence during CPR and other procedures.

The Board selected Dr. Norm Christopher as the SAEM representative to participate in this project.

The Board reviewed the Medical Response to Terrorism course developed by the American Public Health Association, the National Association of EMS Physicians and the National Association of State EMS Directors.

SAEM will provide a link to the course on the SAEM web site.

The Board approved a grant developed by the Program Committee and submitted to the Association of American Medical Colleges. The grant proposes the development of a pre-day conference on the topic of “A Course in Responsible Research”, which if approved, will be presented in conjunction with the 2004 Annual Meeting in Orlando.

The Board approved the proposed recipients of the EMF/SAEM Medical Student Research Grants. An article announcing the recipients is published in this issue of the Newsletter.

The SAEM Board of Directors meets every month, usually via conference call. The Board will meet on the evening of May 28 and the evening of May 30 during the Annual Meeting in Boston, in order not to conflict with the educational sessions of the Annual Meeting. All SAEM members are invited to attend the Board meetings.

2003 Slate of Nominees The Board of Directors has approved the slate of nominees developed and proposed by the Nominating Committee. A ballot has been mailed to all eligible SAEM members. Results of the election by ballot will be compiled at the SAEM office and announced during the SAEM Annual Business Meeting on May 31 at 11:00 am - 12:00 pm. All members are urged to participate in the election and attend the Annual Business Meeting. The slate of nominees is as follows:

President-elect Candidate

Carey Chisholm, MD

Brief CV: I am a Clinical Professor of EM at Indiana University and have served as a residency director since 1985. I attended the Medical College of Virginia (1976-1980) and served my scholarship obligation to the US Army by doing my EM training at Madigan Army Medical Center in Tacoma Washington (1980-1983).

SAEM Related Activities: My first “SAEM” meeting (then UAEM) was in 1983. I have served in a number of capacities within SAEM, most recently (1998-current) on the SAEM Board of Directors and as an Associate Editor for Academic Emergency Medicine. Other venues include the Newsletter Editor, Residency Aid (1990-92, chair 1992-95), Nominating (1995-97), and Program (1991-94) Committees, and the Consulting Service (1990-present). Past involvement in EM organizations includes the CORD Board of Directors (President 1995-97), ABEM (In-training Examination Item Writer, Oral Examiner) and the ACGME (Special Site Surveyor).

Perspective on SAEM Issues: The specialty of EM grows and develops in our nation’s academic centers. With looming Federal and state budget deficits, the academic health system and research funding will be stretched further than it ever has been before. SAEM must advocate our mission to assure that our ability to develop and deliver high quality care is not jeopardized. As we have matured as a specialty, our organization must assist in asking not only “can” we do this, but “should” we do this as well. With the “information explosion”, SAEM should not only in assist our members in their mission, but also assist the providers of care to better understand how these advances will impact their practice.

This assures that “evidence” is included in setting a standard of care rather than relying on the legal or biomedical industry to set our specialty’s practice standards.

Personal Commentary/Summary: I would be honored to serve as the President of our organization.

Board of Directors Candidates

Leon Haley, MD

Brief CV: Vice-Chair for Clinical Operations, Grady Campus for the Department of Emergency Medicine at Emory University. I am also the Deputy Senior Vice-President of Medical Affairs and Chief of Emergency Medicine for the Grady Health System. I completed medical school at the University of Pittsburgh, Emergency Medicine at Henry Ford Hospital and a Masters degree in health administration from the University of Michigan.

SAEM Related Activities: I have been a member of SAEM for 13 years and I am currently a member of the Nominating Committee, having served since 2001. I am the Chair of the Clinical Directors Interest Group having served since 1999 and a member of the Diversity Interest Group. I have directed or participated in several didactic presentations for both groups.

Perspectives on SAEM Issues: I would like to bring focus on: 1) ED Operational Challenges as a barrier to research activity and quality education for residents and students; 2) Health Disparities including serving as a facilitator at this year’s session; 3) Diversity in Health Care Leadership; 4) ED Financial Challenges as it relates to quality patient care but also academic success; 5) Further integration of nursing and other health care professionals into the academic ED practice; and 6) Increasing the link between community service and emergency medicine.

Personal Commentary/Summary: Serving in the combined capacities of health system administrator, chief of a large public hospital emergency department and academic faculty member, I believe that I am well positioned to help the SAEM Board establish key strategies for the future agenda of emergency medicine.

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I am honored to be nominated as a candidate for SAEM’s Board of Directors. I have served on several SAEM committees and task forces over the past 12 years and currently serve on SAEM’s National Affairs Committee and the Public Health Task Force.

I currently serve as Chair of Emergency Medicine at the Medical College of Wisconsin (MCW) and direct the Injury Research Center at MCW. I have been active in academic emergency medicine since joining the MCW faculty in 1989. I have practiced emergency medicine for over 25 years both in private/community and academic settings.

I can bring to the Board of Directors experience and leadership that I believe can contribute to SAEM’s growth and development. I would be honored to serve.

Stephen Hargarten, MD

James Hoekstra, MD

Catherine Marco, MD

Brief CV: I graduated from the University of Michigan Medical School and the University of Cincinnati Emergency Medicine Residency. I served as faculty at Ohio State University from 1988-2003, and was promoted to Professor of EM and Associate Dean for Clinical Education. I am presently Chairman of the Department of EM at Wake Forest University. My areas of expertise include cardiovascular emergencies and acute coronary syndromes. My clinical research has included serum markers of MI, shortstay protocols for the diagnosis of ACS, and the ED use of antithrombin and antiplatelet therapies.

SAEM Related Activities: I have been a member of the SAEM Pharmaceutical and Biotechnology Liaison Committee and the Undergraduate Education Committee, and have chaired the National Affairs Committee. In addition, I am the SAEM representative to the Council of Academic Societies of the AAMC. For the past year, I have served on the SAEM Board of Directors.

Perspective on SAEM Issues: Through my Board membership, I have learned a great deal about the mission and direction of SAEM. I believe we are poised on the brink of expansion from a faculty development and research-fostering organization to the visible and recognizable voice of academic emergency medicine. This transformation involves opening our doors to the NIH, CDC, AHRQ, foundations, and industry to increase our research endowment and partner in national research initiatives. It also includes increasing our activity in national affairs to foster the development and strength of academic emergency medicine programs.

Personal Commentary/Summary: I welcome the opportunity to participate in this development as a member of the Board of Directors.

Brief CV: After graduating from Brigham Young University, I completed medical school at The Johns Hopkins School of Medicine in 1986, and completed a residency in Emergency Medicine at Johns Hopkins in 1990. I am currently on the faculty at St. Vincent Mercy Medical Center in Toledo, Ohio, and an Associate Professor at the Medical College of Ohio. I have numerous publications in scientific journals and textbooks, and have presented numerous lectures at national, state, and local meetings. I have received numerous research grants and awards, and have mentored many students and residents in research. I was honored to receive the Distinguished Alumni Award from the Johns Hopkins Department of Emergency Medicine in 2001.

SAEM Related Activities: I currently serve as an Associate Editor of Academic Emergency Medicine.

I served as Chair of the SAEM Ethics Committee from 2001 to present, and on the SAEM Ethics Committee since 1997. I served on the Constitution and Bylaws Committee from 2002 to present. I have served as an SAEM abstract reviewer, and have presented numerous research abstracts and didactic sessions at SAEM Meetings.

Perspectives on SAEM Issues: SAEM faces many challenges in the upcoming years, including challenges in graduate medical education, evaluation of residents and training programs, and compliance with educational mandates. SAEM will be integral to promoting the advancement of research and teaching in Emergency Medicine, and serving the needs of the SAEM membership.

Personal Commentary/Summary: I have enjoyed my service with SAEM, and look forward to continuing to serve the SAEM membership in the future!

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Susan Stern, MD

Brief CV: Associate Professor, University of Michigan, Department of Emergency Medicine (19932003). BS 1983 Tufts University; MD 1987 Case Western Reserve University; Residency Emergency Medicine (1987-1991), Research Fellowship (1991-1993) University of Cincinnati. Resuscitation Research funded through Department of Defense. Reviewer: Academic Emergency Medicine, Annals of Emergency Medicine, and Resuscitation. Education Coordinator, University of Michigan, Emergency Medicine Residency (1995-2001). Admissions Committee and Faculty Career Advisor, University of Michigan Medical School. ABEM Item Writer (2001-present).

SAEM Related Activities: Education Committee (1994-1995), Program Committee (PC) (1995-present), Chair- PC (1998-2000), Member, Board of Directors (2000-present).

Perspectives on SAEM Issues: Through the Annual Meeting, the journal (AEM), the committees and task forces, and the developing Research Fund, SAEM has been very effective in fostering EM research, addressing vital educational and public health care issues, and cultivating the careers of academic emergency physicians. These efforts have contributed to the recent unprecedented advancement of academic EM. Despite our successes, many challenges remain. We must protect and advance our academic mission within medical centers at a time when funding and resources are becoming increasingly scarce. SAEM must play a leading role in the further development of EM leadership on a national level, and the provision of support and programming to assist medical educators and researchers on a local level. SAEM has been crucial in the development of my academic career; it has been a privilege to serve the Society thus far.

Personal Commentary/Summary: As a Board Member, I will continue to work diligently to advance our mission, and ensure that the next generation of academic emergency physicians are afforded even greater opportunities to develop their careers and our specialty.

Resident Member of the Board Candidates

Valerie De Maio, MD

Michael Hochberg, MD

Brief CV: My interest in Emergency Medicine predated medical school, in the field, as an EMS provider.

In 1994, I joined the OPALS Study and completed my MSc (Epidemiology) at the University of Ottawa with Dr. Ian Stiell. This work has led to the opportunity to publish over 60 abstracts and 10 peerreviewed papers. I continue to be actively involved in clinical research endeavors in my second year as an Emergency Medicine resident at the University of North Carolina.

SAEM Related Activities: For the past seven years, I have given oral presentations at the SAEM Annual Meeting. I was honored to present in the plenary session on two occasions during medical school (1999, 2001). In addition, I have twice received the best medical student presentation at SAEM (1999, 2001).

Perspective on SAEM Issues: Increasing the stature of Emergency Medicine in the academic mainstream is a readily attainable goal and begins with the resident EM physician. We need to increase the number of residents choosing academic positions by fostering interest, opportunities, education and mentorship at the resident level, dispelling the misconceptions of the academic career, and improving resident research curricula by developing creative and dynamic project and funding initiatives between SAEM and the residency programs.

Personal Commentary/Summary: My objective is to further the development of programs and relationships that increase the involvement of the residents in the academic pursuits of SAEM. With your assistance, I would like to reinforce the existing SAEM agenda and explore new programs that combine academic development, mentorship, project support and recognition of the resident academician.

A graduate of SUNY Buffalo Medical School and an EM-2 at Jacobi/Montefiore Medical Center.

Currently, I serve on SAEM’s Graduate Medical Education Committee. My article “A Resident’s Perspective on Fellowships” is pending publication in the SAEM Newsletter. Previously, I served one year on ACEP’s Bylaws Committee, where I completed a review of Connecticut’s State ACEP Bylaws.

In addition to my national responsibilities, I was named to a Jacobi/Montefiore ED Task Force which examined the dynamic relationship between physicians and nurses. While on this Task Force, I designed a series of lectures for the nurses to be given by the residents in the hope that this would foster a growing trust between the active care-givers in the ED. Prior to my ED training, I spent my surgical intern year at Mt.Sinai Medical Center in New York where I assisted in pancreatic cancer gene therapy research. This research is still ongoing and awaiting publication. As a resident, it is sometimes easy to become distracted by the daily grind of work. However, this distraction should not lead to blindness.

The current leaders of Emergency Medicine have done our field proud, and I only wish to expand on their work; to become ever progressive in the medical world around us. For example, through the expansion and standardization of fellowships; through connecting the concepts of preventive medicine with emergency medicine. I hope to assist the SAEM Board in planning our march into the future.

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Benjamin Sun, MD

Brief CV: Harvard University: BA 1995; MD, MPP 2000. Harvard Affiliated Emergency Medicine Residency: 20002004. EMF/SAEM Medical Student Grants 1999, 2000. Harvard Risk Management Foundation Grant 2000.Wuerz Scholarship for Emergency Medicine Research 2002. EMF Resident Grant 2003.

Sun B, Burstin H, Brennan TA. Predictors and Outcomes of Frequent Emergency Department Users.

Academic Emergency Medicine. 2003;10(4).

Sun B, Adams J, Burstin H. Validating a model of patient satisfaction with emergency care. Annals of Emergency Medicine 2001;38:527-32.

Sun B, Adams J, Orav EJ, et.al. Determinants of patient satisfaction and willingness-to-return with emergency care. Annals of Emergency Medicine 2000;35:426-434.

SAEM Related Activities: SAEM-funded research 1999-2001.

Presentations at National and Regional Meetings 1999, 2002.

Perspective on SAEM Issues: Residents compose half the membership of SAEM – their involvement both now and post-graduation is critical to SAEM’s success. My central priority is to expand SAEM’s educational resources for residents interested in academic careers. Specific proposals: Reorganizing SAEM resident section to have formal administrative structure and goals; formalizing a liaison system with resident membership of SAEM and AAEM, and EMRA to provide a representative and clear resident perspective on SAEM Board; Introducing seminars specific to resident academic development at SAEM Annual Meeting and soliciting resident development articles in SAEM Newsletter.

Personal Commentary/Summary: Academic development requires early guidance and mentorship. I am planning a career in emergency medicine research, and I will devote my elective time and experiences as a fourth year EM resident to improving SAEM’s relevance to its resident members. Thank you for your consideration and support!

Nominating Committee Candidates

Cathy Custalow, MD

Adam Singer, MD

Brief CV: Assistant Professor of emergency medicine at the University of Virginia in Charlottesville, Virginia. I received a PhD degree in Anatomy in 1990 and MD degree in 1994 from the Medical College of Virginia. I completed residency training at the Denver Health Medical Center Residency in Emergency Medicine in 1998 and research fellowship training at Carolinas Medical Center in 1999. I was the inaugural recipient of the SAEM Resident Research Award in 1999. Currently my research and educational work is focused on improving emergency medicine procedural training and skill maintenance for medical students, residents and faculty in emergency medicine. I am an associate editor for the 4th Edition of the Roberts and Hedges textbook, Clinical Procedures in Emergency Medicine and am currently writing a new Color Atlas of Emergency Department Procedures. I am a reviewer for Annals of Emergency Medicine and Prehospital Emergency Care.

SAEM Related Activities: I have served as a reviewer for the SAEM Research Training Grant. I have been on the Program Committee at SAEM since 1999, currently serving as the Didactic Subcommittee Chair. I recently chaired a task force to revise the Innovations in Emergency Medicine Education Exhibits, resulting in a record 40 new educational exhibits at the Annual Meeting in St. Louis and the institution of a new award for the best exhibit in this category.

Perspectives on SAEM Issues: One of my goals for SAEM is to improve educational research and to assist SAEM and its members in obtaining funding in this area.

Brief CV: I received my medical training at the Ben-Gurion University in 1986. I then served as a Medical officer for 5 years. After completing a surgical internship at the Yale New Haven Hospital I transferred to an emergency medicine training program at the State University of New York at Stony Brook where I also served as a Chief Resident. At the end of my residency I joined the faculty at Stony Brook where I served as the Director of Residency Research and am now the Director of Clinical Research and Associate Residency Director. My main focus of research has been cutaneous injuries and wound healing. I have been involved with both basic and clinical research and have over 100 peer reviewed original publications, as well as several books and multiple book chapters.

SAEM Related Activities: I have been an active member of SAEM for nearly 10 years. I have served as a Program Committee Member and as the Chair of the Scientific Subcommittee. I am currently the Chair of the Grants Committee. I have also been active on the Academic Emergency Medicine Editorial Board and have been an Associate Editor of AEM for the last 5 years.

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Personal Commentary and Summary: I am an academic emergency physician who has supported SAEM and its related organizations for the last decade, serving in a number of functions. My work with SAEM has been an honor and a pleasure and I look forward to continuing to serve the Society and its members as a member of the Nominating Committee.

Constitution and Bylaws Committee Candidates

Craig Newgard, MD

Stephen Thomas, MD

Brief CV: Assistant Professor, Oregon Health & Science University; Departments of Emergency Medicine and Public Health and Preventative Medicine Fellow, Oregon Health Policy Institute. BS, Nutrition Science, UC Davis (1992); MD, Loyola University, Chicago (1997); MPH, Epidemiology, UCLA (2001); Residency - Emergency Medicine, Harbor-UCLA (1997-2000); Research Fellowship, Emergency Medicine, Harbor-UCLA (2000-2002); Board Certified Diplomat - ABEM (2001).

SAEM Related Activities: SAEM Research Committee (1999-present); Didactic Proposals Subcommittee Chair (2001-2003); Pharmaceutical Steering Committee (1999-2000); SAEM Task Force on Resident Indebtedness (1999); SAEM Resident Research Award (2000-2001); Consulting Reviewer, Academic Emergency Medicine (2002-present).

Perspective on SAEM Activities: The Constitution and Bylaws must serve the functions of the Society at the present time and be adaptable to the constantly changing environment around us. We need the foresight and vision to periodically reformat the template on which our Society functions to best facilitate our mission and objectives. Whether the topic is research, education, committees, the Annual Meeting, the journal, or otherwise, the Constitution and Bylaws should reflect our current goals and should be amended as appropriate to better help us attain these goals and to move forward as a Society.

Personal Commentary/Summary: Having served on the SAEM Research Committee, several subcommittees, and a SAEM Task Force over the last 4 years, I have gained a great deal of experience with SAEM committee work and the internal workings of the Society. Being a young, enthusiastic member of SAEM with a vision for the future and the energy to get the job done, I welcome the opportunity to serve as a member of the Constitution and Bylaws Committee.

Brief CV: Reared in Louisiana and graduating LSU’s six-year MD program in 1990, I trained in EM and as Air Medical Fellow at University Medical Center of Eastern Carolina (ECU). I’m now at Boston MedFlight and Massachusetts General Hospital, where I direct the EM clerkship and chair the committee overseeing EM education at six Harvard-affiliated hospitals. As Harvard EM residency faculty, I’ve witnessed nascence and maturation of a new program, which I serve as a research advisor (having done graduate work in Quantitative Methods at Harvard’s Public Health School). Based upon authorship of approximately 100 peer-reviewed articles and chapters, I hold the Harvard rank Assistant Professor of Surgery.

SAEM Related Activities: I’ve served on the EMS Committee and PhysioControl Task Force (199596), and also the Undergraduate Medical Education Committee (1997-2000, co-chair 2001-02).

Currently, I chair a Task Force developing a question bank for medical student educators.

Perspectives on SAEM Issues: Frankly, when the Nominating Committee contacted me to request that I stand for this position, some investigation was in order – despite years as an SAEM loyal I could claim significant interactions with neither the Constitution nor the Bylaws. After reviewing the C&B and seeing the work that has gone into their development and maintenance, I realize that in order for these documents to appropriately reflect the organization’s changing needs, ongoing oversight by dedicated parties is a necessary and serious business.

Personal Commentary/Summary: I sincerely appreciate being requested to stand, and if elected look forward to the challenge of working with the Committee to serve SAEM.

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Call for Didactic Proposals 2004 Annual Meeting May 16-19, 2004 Orlando, Florida The Program Committee is inviting proposals for didactic sessions for the 2004 Annual Meeting. This year the Program Committee would like to emphasize proposals on educational research methodology and leadership development (including advancement within academic departments, medical schools and national organizations). Didactic proposals 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 consider proposals for pre- or post-day workshops or multiple sessions during the Annual Meeting aimed at in-depth instruction in a specific discipline.

Didactic proposals must support the mission of SAEM (to improve patient care by advancing research and education in emergency medicine) and should fall into one of the following categories: • • • • •

Education (educational research methodology, 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, not a review of the literature or a summary of clinical practice) Health Care Policy and National Affairs

The deadline for submission is Wednesday, September 10, 2003 at 5:00 pm Eastern Daylight Time. Only online submissions will be accepted. To submit a proposal, complete the online Didactic Submission Form at www.saem.org.

For additional questions or information, contact SAEM at saem@saem.org or call 517-485-5484 or send a fax to 517-4850801.

Medical Student Educators Interest Group Annual Meeting (Continued) bers of the interest group, all EM clerkship or elective directors and medical educators to participate in the educational session and the business meeting. Topics of discussion at the business meeting will include the direction of the interest group, organization of medical student educators, and future educational initiatives. The interest group will be held on May

31 from 9:00-11:00 am in the Provincetown/Orleans Rooms of the Marriott Copley Place Hotel.

Another important session for the medical student educator is a lunch session on May 31 from 12:00-1:30 pm in Suffolk Suite. The session is entitled, “Competency in Medical Student Education”. Pre-registration and a $35 fee is required.

Rural Emergency Medicine Summit (Continued) certified emergency physicians.

However, there are significant barriers to this becoming a reality in rural areas due to many factors including recruitment and retention difficulties, clinical practice differences, as well as economic factors faced by rural hospitals. It is likely that primary care physicians will continue to provide a significant amount of emergency care in rural areas for years to come.

Summit attendees discussed potential strategies for emergency medicine organizations and academic departments of emergency medicine to positively impact emergency care in rural areas. A series of recommendations were developed that focused on the following two goals: • Enhance migration of emergency medical trained and boarded physi-

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cians to rural areas • Improve the quality of emergency medical care provided by non-specialists in rural areas.

The recommendations are forthcoming and will be shared with participating organizations for comments and feedback. The Summit proceedings will be published as a series of articles in Annals of Emergency Medicine.

The 5 Most-Frequently-Read Contents of AEM – March 2003 Most-read rankings are recalculated at the beginning of the month. Rankings are based on hits received by articles archived on AEMJ.org.

1

GR Pesola The Use of B-type Natriuretic Peptide (BNP) to Distinguish Heart Failure from Lung Disease in Patients Presenting with Dyspnea to the Emergency Department Acad Emerg Med Mar 01, 2003 10: 275-277. (In “COMMENTARIES”)

2

PA McCullough, JE Hollander, RM Nowak, AB Storrow, P Duc, T Omland, J McCord, HC Herrmann, PG Steg, A Westheim, CW Knudsen, WT Abraham, S Lamba, AHB Wu, A Perez, P Clopton, P Krishnaswamy, R Kazanegra, AS Maisel Uncovering Heart Failure in Patients with a History of Pulmonary Disease: Rationale for the Early Use of B-type Natriuretic Peptide in the Emergency Department Acad Emerg Med Mar 01, 2003 10: 198-204. (In “CLINICAL INVESTIGATION”)

3

TJ Mader, HA Smithline, L Durkin, G Scriver A Randomized Controlled Trial of Intravenous Aminophylline for Atropine-resistant Out-of-hospital Asystolic Cardiac Arrest Acad Emerg Med Mar 01, 2003 10: 192-197. (In “CLINICAL INVESTIGATION”)

4 5

AL Blomkalns, CJ Lindsell, A Chandra, ME Osterlund, WB Gibler, CV Pollack, BR Tiffany, JE Hollander, JW Hoekstra Can Electrocardiographic Criteria Predict Adverse Cardiac Events and Positive Cardiac Markers?

Acad Emerg Med Mar 01, 2003 10: 205-210. (In “CLINICAL INVESTIGATION”) JM Bartfield, RD Flint, M McErlean, J Broderick Nebulized Fentanyl for Relief of Abdominal Pain Acad Emerg Med Mar 01, 2003 10: 215-218. (In “CLINICAL INVESTIGATION”)

Log onto www.aemj.org and start taking advantage today!

Call for Advisors

Advertising Positions Available at Annual Meeting

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 web site. 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 again offering an opportunity to advertise in the on-site program. The Annual Meeting will be held May 29-June 1 in Boston and will attract approximately 1,800 academic emergency physicians.

A limited amount of space is being set aside for the position available section and only academic positions available will be accepted. The deadline for receipt of ads at the SAEM office is May 1.

The following ad requirements and prices are available for the on-site program: Classified line ads (100 words maximum): $100 (contact SAEM member) or $125 (non-SAEM member) Quarter page ads: 31⁄2” wide x 43⁄4” deep Half page ads: 71⁄2” wide x 43⁄4” deep or 31⁄2” wide x 93⁄4” deep Full page ads: 71⁄2” wide x 93⁄4” deep

$300 $350 $450

A typesetting fee ($25-$50) will be charged if the quarter, half, or full page ads are not camera-ready.

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President’s Message (Continued) 21st century. While we may be poised, are we ready to take the lead?

Performing high-quality educational research is hard. The basic rules of educational research are no different than for clinical research—one must have a clearly-defined and important hypothesis to be tested, which is answerable using reliable and valid measures on a suitable population to which you have access. Care must be taken to ensure that the study design minimizes bias and, when bias is unavoidable, one must include provisions to estimate its direction and magnitude. Following these rules while conducting clinical research is difficult, while performing educational research it is often much harder. Moreover, establishing a career based on achievements in educational research requires not one or two studies, but a pattern of investigation that demonstrates a growth in the sophistication of the hypotheses being tested and of the investigator.

Establishing such a pattern requires long-term commitment, both by the investigator and on the part of their department and institution.

Consider, for example, the problem of defining the study population in educational research. There are really two populations, the students or residents being taught, and the faculty or other personnel doing the teaching. In order to obtain results which are reliable and externally valid, it is important that both of these populations be large enough and representative of residents and educators at many different institutions.

It is virtually impossible to obtain large and diverse enough samples at a single institution. An emergency medicine residency training program may have 2040 residents and 10-30 faculty. These numbers are really too small to form the basis for a clinical trial. Thus, high-quality educational research must virtually always be multi-institutional.

It is often difficult to define the outcome of interest in an educational study.

Many of the skills we are trying to teach are complex, multidimensional, and involve the ability of the resident to apply knowledge to a varied and diverse set of patient care problems. Once the skill or knowledge to be taught is defined, there still remains the task of developing measures of the outcome, and demonstrating the reliability and validity of those measures. Ironically, much of the educational research currently published, across many fields, is

based on outcome measures that would never be deemed reliable or valid enough to be used in an educational testing setting. Consider, in contrast, the extraordinary effort which is devoted to ensuring the reliability and validity of ABEM examinations.5,6 Given the obvious importance of obtaining reliable answers to fundamental questions regarding best methods of teaching emergency medicine to our residency trainees, how can we overcome the challenges associated with performing high-quality educational research? First, we must acknowledge that research examining educational methodologies is an important, fundamental, and necessary part of the career of emergency medicine educators. Any commitment to educational research must be backed up, however, with protected time above and beyond that required to simply administer educational and residency programs, to allow the medical educator the time to acquire research skills, set up multiinstitutional collaborations, complete the research, and publish their findings.

Second, we must raise our expectations regarding the domain expertise of our medical educators. While I believe emergency medicine sets, in general, very high standards regarding clinical knowledge and general teaching skills, we must also expect our educators to have an understanding of modern educational principles and educational research methodology, including principles of psychometric measurement (questionnaire and test development, measuring internal validity, etc.). Third, we must ensure that those devoting the time and effort necessary to produce high-quality educational research receive the professional status and recognition they deserve. Specifically, educational research must be viewed as equally valuable as basic scientific and clinical research in the eyes of academic promotions committees, chairs, and deans. It would be short sighted to acknowledge the contributions of those who generate the basic scientific and clinical results which form the basis of emergency medical care, while devaluing the contributions of those who ensure these advances are incorporated into the practice armamentarium of the next generation of physicians.

Lastly, and perhaps most controversially, we should gradually reduce and eventually eliminate the publication in peer-reviewed journals of educational 31

research studies that fail to meet the quality standards required of clinical research studies. Examples of such publications include small, single-center studies in which the numbers of educators is so small so that the results are not generalizable to any other setting.

[Consider the generalizability of a study in which all instruction is provided by two or three people.] Similarly, educational concept papers published in the peer-review literature should be required to include data that demonstrate the effectiveness of the educational techniques being discussed. In the basic science and clinical sciences, opinion and concept pieces are usually written by authors with long investigative careers who include summaries of results from multiple primary studies to support their analysis or insights Currently, many educational concept papers are not required to meet this standard for supporting evidence.

While I understand this last recommendation will be offensive to some, I believe respect for educational research will only be ensured by raising the bar to a level equivalent of that for other types of research, hence the title of this editorial.

There are great opportunities in educational research. There are opportunities to improve the effectiveness of resident and medical student education, both within emergency medicine and across all clinical disciplines; opportunities to improve the quality of clinical practice of the next generation of emergency physicians; and opportunities to set the standard for investigations into a fundamental part of what we do as academic emergency physicians—teach. It is time to reach the bar.

References 1. Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA 1995;274:700705.

2. Davis D, O’Brien MAT, Freemantle N, Wolf FM, Mazmanian P, TaylorVaisey A. Impact of formal continuing education. Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes?

JAMA 1999;282:867-874.

3. Jouriles NJ, Emerman CL, Cydulka RK. Direct observation for assessing (continued on page 32)

President’s Message (Continued) emergency medicine core competencies: interpersonal skills. Academic Emergency Medicine 2002:9:1338-1341.

4. Legome E, Pancu D, Nadel E, Manko J. A novel approach to resident evaluation and the core competencies. Academic Emergency Medicine 2003;10:97.

5. American Educational Research Association.

Standards for Educational and Psychological Testing 1999 (Standards for Educational and Psychological Testing, 1999).

American Educational Research Association, February 2000.

6. Bianchi LC, Gallagher EJ, Korte RC, Ham HP. Interexaminer Agreement on the American Board of Emergency Medicine Oral Certification Examination.

Annals of Emergency Medicine. In Press.

Residency Vacancy Service The SAEM Residency Vacancy Service was established more than ten years ago to assist residency programs and prospective emergency medicine residents. The Residency Vacancy Service is posted on the SAEM web site at www.saem.org. Residency programs are invited to list their unexpected vacancies or additional openings by contacting SAEM. SAEM monitors and updates the listings. Prospective emergency medicine residents are invited to review these listings and contact the residency programs to obtain further information. Listings are deleted only when the residency program informs SAEM that the position(s) are filled.

Solicitation of Reading for ABEM Future Lifelong Learning and Self-Assessment Tests A cornerstone of ABEM’s new EMCC program is the concept of Lifelong Learning and Self-Assessment (LLSA). The primary goal of LLSA is to promote continuous learning on the part of ABEM diplomates. ABEM will facilitate this learning within the context of LLSA by identifying an annual set of readings to guide diplomates in self-study of recent Emergency Medicine (EM) literature.

ABEM has sought to involve the EM community-at-large in the LLSA process by inviting EM organizations and ABEM diplomates to make suggestions for readings to the ABEM Board of Directors. For the 2004 LLSA test currently under development, the Board received over 100 suggestions collectively from the ACEP, SAEM, CORD, AAEM and a number of individual ABEM diplomates.

System Disorders and Toxicologic Disorders. ABEM will select 50% of the readings for the 2005 LLSA test from these two designated areas, while the remaining 50% of test content will be drawn from the remaining content areas of the EM Model “Listing of Conditions.”

How to Submit Recommendations for LLSA Readings For each reference submitted, ABEM must receive the following two items: 1. Complete an LLSA Form for each reference that you recommend to the Board. Be sure to provide all requested information for each reference, including the article title completely written out, the journal name, etc. Do not use abbreviations. Do not alter the form in any way, except to add the requested information in the space provided. The LLSA Reference Form is available from ABEM and may also be downloaded as an MS Word document from the ABEM website. The form can be computer-printed or typewritten.

Submission Criteria for LLSA Readings The Board has determined that readings used for the LLSA tests should meet the following criteria: 1. Focus on recent advances or current clinical knowledge in Emergency Medicine; 2. Be clinically oriented in content; 3. Be drawn from peer-reviewed EM journals, peer-reviewed journals from related primary specialty fields, textbook chapters, or updated practice guidelines; 4. Be published in printed or electronic form within the immediate five years preceding the LLSA test in which it will be used; 5. Relate to either the designated content areas for a given year (50%), or to the remaining content areas (50%) of the EM Model “Listing of Conditions.”

2. Provide one paper copy of the article, chapter or other text for which you have submitted a reference must be mailed or faxed to ABEM in order to be considered for inclusion.

Electronic copies of references cannot be accepted due to copyright restrictions.

References received by June 1, 2003, will be considered for inclusion in the 2005 LLSA module. Materials submitted after that date may be considered for future LLSA tests.

Recommendations may be submitted via fax to (517) 3323943 or mail to LLSA References, American Board of Emergency Medicine, 3000 Coolidge Road, East Lansing, MI 48823.

If you have specific questions or comments contact Timothy J. Dalton, Examination and Evaluation Project Specialist, at (517) 332-4800.

Content of LLSA Test in 2005 Although readings for the first LLSA test in 2004 have already been selected, the Board welcomes reference suggestions for future LLSA tests from the larger EM community on an ongoing basis.

Currently, ABEM is soliciting readings for the 2005 LLSA test, for which the designated content areas will be Nervous 32

FACULTY POSITIONS HIGHLAND GENERAL HOSPITAL Department of Emergency Medicine is seeking committed emergency medicine physicians with an interest in teaching housestaff and students. The ED treats over 65,000 patients annually, serves as a trauma center and is the base station for Alameda County. Qualified candidates must have completed an approved Emergency Medicine Residency Training Program with ABEM board eligibility or certification. The position includes 25% academic / administrative protected time, a competitive salary and benefit package in addition to a unique and stimulating environment making this an attractive opportunity in academic emergency medicine. Direct inquiries to: Barry Simon, MD, Chairman, bsimon@acmedctr.org, 510-4374564.

Fellowship Opportunity

Emergency Medicine/Neurology The Department of Emergency Medicine and the Department of Neurology Stroke Program at The University of Texas-Houston Medical School are jointly offering a two-year fellowship to Emergency Medicine Residency graduates.

This is part of an NIH-funded fellowship training program to develop clinicianscientists who are expert in the acute care of stroke patents. During the twoyear training period, the trainee will work as part of a multidisciplinary Stroke Team in evaluating and treating acute stroke patients at four regional Emergency Centers, and will participate in ongoing clinical activities that include prehospital care, emergency treatment, acute brain imaging, neurosonology, endovascular therapy, neuro-critical care and outcomes assessment.

Participation in ongoing clinical research protocols is and important part of the program, and the development of new research initiatives by the trainee will be encouraged through enrollment in a specialized program in clinical research training. Clinical duties will also include a limited number of ED shifts each month. Positions are available starting either July 1st, 2003 or July 1st, 2004.

IOWA: BC/BE Emergency Medicine or Family Physician needed to join group covering 285 bed regional referral and teaching center. Community of 40,000 people located between Minneapolis, Minnesota and Des Moines, Iowa.

Thirteen 12-hour shifts per month. Twenty-five visits annually. Comprehensive benefits and competitive compensation. Contact Jerry Hess, Mercy Medical Center-North Iowa, 1000 4th Street SW, Mason City, Iowa 50401, phone - (888) 877-5551; fax - (641) 422-6495 or email hessj@mercyhealth.com.

KENTUCKY: The Department of Emergency Medicine at the University of Kentucky is recruiting full-time faculty members at the assistant or associate professor level. The desired individual must be BE/BC in emergency medicine.

Academic tenure track and non-tenure track positions available. The EM residency has full accreditation. The Emergency Department at UK Hospital is a Level I trauma center, regional referral center, with 40,000 annual visits. The department has nine full-time faculty and provides medical direction to Air Medical and Hyperbaric Oxygen Programs. Contact: Roger Humphries, MD, Acting Interim Chair, Department of Emergency Medicine, University of Kentucky Medical Center, 800 Rose St., Room M-53, Lexington, KY 405360298: phone 859-323-5908; fax 859-323-8056; or E-mail rlhump0@uky.edu We are an EOAAE.

Send a letter of interest, curriculum vitae, and three letters of reference to: David J. Robinson, MD, MS, FACEP, University of Houston Health Science Center at Houston, Department of Emergency Medicine, 6431 Fannin, Suite JJL 433, Houston, TX 77030. Office: (713) 500-7875, Fax: (713) 500-7884, Email: David.J.Robinson@uth.tmc.edu.

NEW JERSEY, UMDNJ (Newark) - Come in on the ground floor at a major medical school and university hospital. We're planning to start an EM residency and have faculty opportunities for Emergency Physicians at ALL LEVELS, including RESIDENCY DIRECTOR, EMS director and Director of Clinical Operations. The ED has an annual volume of 72,000, including 2,700 level I trauma patients.

Competitive compensation and benefits package including on-site fitness and child care centers. For information please contact Ronald Low, MD, MS, at 973972-7882. UMDNJ-University Hospital is an AA/EOE, M/F/D/V. Visit us on the web at www.TheUniversityHospital.com.

The University of Texas is an Equal Opportunity, Affirmative Action Employer.

Minorities and women are strongly encouraged to apply. This is a security-sensitive position and thereby subject to Texas Education code ยง51.215.

PHOENIX, ARIZONA: Maricopa Medical Center is seeking a full-time faculty member. We have an accredited 3-year Residency training program at a Level I Trauma and regional Burn Center with an ED census of 44,000 adult patients per year. The department also sponsors the Good Samaritan Toxicology Fellowship program. We are seeking a Board Certified/Prepared candidate in Emergency Medicine who is committed to academic Emergency Medicine. Experience and credentialing in ultrasonography, supervising residents and medical students, as well as clinical research experience are preferred. Competitive salary with an excellent benefits package is available. Interested applicants should contact Norberto Adame, Jr., MD, FACEP, Interim Chairman, Department of Emergency Medicine, 2601 E. Roosevelt, Phoenix, Arizona, 85008. Phone 602-344-5418 or e-mail at nadamejr@cox.net. We are an EOAAE.

Faculty Opportunity

Department of Emergency Medicine The University of Texas Houston Health Science Center is seeking candidates for a full-time faculty position immediately available in the Department of Emergency Medicine. The department has responsibility for two emergency centers. Memorial Hermann Hospital is located within the Texas Medical Center. This emergency department has an annual census of 55,000 patient visits and is one of only two Level I trauma centers in Houston.

Additionally, Memorial Hermann is a regional burn center, a nationally recognized stroke center, and a comprehensive cardiac care center. The Lyndon Banes Johnson Hospital has an annual census of 85,000 visits and is a Level III trauma center. Qualified applicants will be board certified/prepared in EM and possess interest/expertise in the clinical teaching of emergency medicine.

Excellent salary and comprehensive benefits package, including relocation assistance.

THE 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, 169 Means Hall, 1654 Upham Drive, Columbus, OH 43210, email Conway.70@osu.edu, or call (614) 293-8176. Affirmative Action/Equal Opportunity Employer.

UNIVERSITY OF KENTUCKY: The Department of Emergency Medicine at the University of Kentucky is recruiting full-time faculty members at the assistant or associate professor level. The desired individual must be BP/BC in emergency medicine. Academic tenure track and clinical non-tenure track positions available. The EM residency has full accreditation. The Emergency Department at the UK Hospital is a level I trauma center with 40,000 annual visits. The department has nine full-time faculty. Contact: J. Stephan Stapczynski, MD, Department of Emergency Medicine, UKMC, 800 Rose Street, Room M-53, Lexington, KY 40536-0298, Phone: (859) 323-5908, Fax: (859) 323-8056, or Email: jsstap01@uky.edu. We are an EOAAE.

Please forward your CV to: Dr. Brent R. King University of Houston Health Science Center at Houston Department of Emergency Medicine P.O. Box 20708 Houston, TX 77030

WASHINGTON HOSPITAL CENTER and GEORGETOWN UNIVERSITY HOSPITAL in Washington, D.C., and Franklin Square Hospital and Union Memorial Hospital in Baltimore, MD are seeking physicians board certified or residency trained in emergency medicine to join their faculty. Our department is both traditional and cutting edge: traditional in that we believe that the provision of medical care is a sacred trust; cutting edge in that we are committed to using the most advanced information technology to improve clinical care.

Contact Mark Smith, MD, FACEP, Chairman, at (202) 877-0808, fax (202) 8772468 or write to him at Washington Hospital Center, Department of Emergency Medicine, 110 Irving Street, NW, Washington, D.C. 20010-2975.

The University of Texas is an Equal Opportunity, Affirmative Action Employer.

Minorities and women are strongly encouraged to apply. This is a security-sensitive position and thereby subject to Texas Education code ยง51.215.

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The SAEM Newsletter is mailed every other month to the 5,500 members of SAEM. Advertising is limited to fellowship and academic faculty positions.

ATLANTA, GA

Deadline for receipt: June 1 (July/August), August 1 (September/October), October 1 (November/December), December 1 (January/February), February 1 (March/ April), and April 1 (May/June). Ads received after the deadline can often be inserted on a space available basis.

DEPARTMENT OF EMERGENCY MEDICINE Due to continued growth, we anticipate openings for full-time academic emergency physicians in both research and clinician-educator tracks. Emory offers a dynamic and professional environment with special strengths in patient care, teaching, community service, EMS, toxicology, clinical and laboratory research, and public health. Excellent salary and benefits. Applicants must be residency trained and/or board certified in EM. Emory is an equal opportunity/affirmative action employer. Women and minorities are encouraged to apply. For further information visit our web site at http://www.emory.edu/em or contact:

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 or fax 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: Carrie Barber at carrie@saem.org, via fax at (517) 485-0801. For more information or questions, call (517) 485-5484.

Arthur Kellermann, MD, MPH, Professor and Chair Department of Emergency Medicine 1365 Clifton Rd., Suite B-6200 Atlanta, GA 30322 Phone: (404)778-2600 Fax: (404)778-2630 Email: Paula Bokros - pbokros@emory.edu

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

Emory is an equal opportunity/affirmative action employer.

UNIVERSITY OF FLORIDA Jacksonville and Gainesville

Call for Abstracts 13th Annual Midwest Regional SAEM Meeting

The University of Florida is seeking qualified candidates for two (2) positions as Co-Directors of Research in the Department of Emergency Medicine (one in Jacksonville and one in Gainesville). Candidates must be BC/BE in Emergency Medicine. The Directors will conduct and oversee research projects, mentor junior faculty and residents research activities, and provide support for clinical trials. Proven experience in securing extramural grants and contracts is mandatory. Faculty appointments are available at the rank commensurate with experience and productivity. Both departments are in urban hospitals with a combined annual patient volume of 140,000+. Excellent benefits package which includes health, life, and disability insurance, vacation & sick leave, 403B retirement plan with immediate vesting, and sovereign immunity on medical liability coverage. Mail letter of interest and CV (or fax 904/244-5666) to Dr. David Vukich, Professor & Chairman, Dept. of Emergency Medicine, University of Florida/HSC, 655 W. 8th Street, Jacksonville, Florida 32209. Will begin reviewing applications on 4/1/03. Anticipated start date 8/1/03 or sooner. EOE/AA employer.

September 19, 2003 Saginaw Cooperative Hospitals, Inc. Saginaw, MI The Program Committee is now accepting abstracts for review for oral and interactive poster presentations. The meeting will take place September 19, 2003, 8:00 am – 5:00 pm, at Curtis Hall on the campus of Saginaw Valley State University, Saginaw, Michigan.

The deadline for abstract submission is Monday, July 14, 2003, by 3:00 p.m. EDT. Only electronic submissions via the SAEM online abstract submission form at www.saem.org will be accepted. Acceptance notifications will be sent in late July.

Registration forms are available from Melinda Wardin, Department of Emergency Medicine, Saginaw Cooperative Hospitals, Inc., 1000 Houghton Avenue, Saginaw, MI 48602. E-mail contact is mwardin@schi.org Registration Fees: Faculty--$75; Residents/Nurses--$30; EMTs/Students—No Charge. Late fee after September 12, 2003: add $25.

Visit our website for updated information: www.schi.org

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AEM 2003 Consensus Conference: Disparities in ED Health Care May 28, 2003 All SAEM members are invited to attend and participate in the AEM Consensus Conference. The cost is only $50 and includes the lunch session. Use the SAEM online Annual Meeting registration form at www.saem.org to register for the Consensus Conference.

8:00 am

Introduction: Goals and Objectives Lewis Goldfrank, MD, Bellevue Hospital Center

8:30 am

Keynote Address: General Overview of Health Care Disparities Jordan Cohen, MD, President, Association of American Medical Colleges

9:30 am

Health Care Disparities in Emergency Medicine Moderator: Robert A. Lowe, MD, MPH, Oregon Health and Sciences University ● Summary of clinical studies to date (related to Emergency Medicine) ● Summary of socio-economic/behavioral studies to date (Emergency Medicine) ● Where are we research rich/research lacking? ● Investigating root causes of emergency health care disparities ● Racism, Sexism, Money ● What is known; what needs to be done

10:30 am

Researching Disparities in Health Care Moderator: Robin Weinick, PhD, Agency for Healthcare Research and Quality ● Summary of the unique aspects of researching disparities ● Current markers/measures/methods ● What works and what does not ● Special confounder issues

11:30 am

Lunch Plenary Session: Healthy People 2010: Setting Research Priorities for Emergency Medicine Nicole Lurie, MD, Rand

1:00-3:00 pm

Consensus Groups 1) Researching Emergency Medicine Health Care Disparities Facilitator: Robert A. Lowe MD, MPH, Oregon Health and Sciences University ● Where are we research rich/ research poor? ● Where are our methodologic strengths and weaknesses? ● How can we study disparities? ● What are our best measures, our outcome parameters?

2) Emergency Medicine Education and Health Care Disparities Facilitator: Glenn Hamilton, MD, Wright State University ● Do we teach our residents to deliver disparate care? ● Does our educational milieu set up biases? ● How have curriculum in Emergency Medicine incorporated HCD issues? ● What are the best educational practices on this, and assessment?

3) Clinical aspects and implications of Emergency Medicine Health Care Disparities Moderator: TBA ● What inequalities exist in Emergency health care? ● Under what circumstances do these inequalities arise? ● What are the clinical obstacles to fulfilling our moral imperatives? ● What are the public health advantages of eliminating disparities?

4) Systems and Administration Moderator: Leon Haley, MD, Emory University ● Are all disparities bad? ● Are only the vulnerable served inadequately by our current health care system? ● Are what appear to be inequities really systems incompetence? ● We assume there should be no inequality in health care: does society also assume this? ● What would be the systems cost of equality in health care?

3:00-4:00 pm

Summary Presentation and Consensus Groups Findings Moderator: Lewis Goldfrank, MD, Bellevue Hospital Center 35

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 Susan Stern, MD

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

SAEM Interest Group Meetings All SAEM interest groups will meet during the SAEM Annual Meeting. All members are invited to attend. Members may join SAEM interest groups at a cost of $25 per year per interest group. Resident members may join one interest group at no charge. Contact SAEM at saem@saem.org.

THURSDAY, MAY 29, 2003 12:00-1:00 pm Patient Safety; Robert Wears, MD: wears@ufl.edu 12:45-1:30 pm Public Health; Contact Carlos Camargo, MD: ccamargo@partners.org 12:00-1:30 pm Injury Prevention; Contact Linda Degutis, MD: linda.degutis@yale.edu 1:00-4:00 pm Ultrasound; Contact Paul Sierzenski, MD, RDMS: peski@comcast.net 1:30-3:30 pm Web Educators; Contact John Vozenilek, MD: vozonline@ameritech.net 2:30-4:00 pm Pediatric; Contact Norm Christopher, MD: nchristopher@chmca.org 3:00-4:00 pm Evidence-Based Medicine; Contact Michael Brown, MD: brownm@msu.edu 4:00-5:30 pm Mentoring Women; Contact Susan Promes, MD: prome001@mc.duke.edu 4:30-5:30 pm Disaster Medicine; Contact John Wightman, MD, MA: jwightman@cdham.org FRIDAY, MAY 30, 2003 9:00-10:00 am Health Services and Outcomes Research; Contact Donald Chalfin, MD, MS: dchalfin@applied-decision.com 9:30-10:30 am Traige; Drew Richardson, MD: drew.richardson@act.gov.au 11:00-12:00 am CPR/Ischemia/Reperfusion; Contact Norm Paradis, MD: norman.paradis@uchsc.edu 12:00-1:00 pm Neurologic Emergencies; Contact Edward Jauch, MD: edward.jauch@uc.edu 12:00-1:00 pm Toxicology; Contact Kennon Heard, MD: kennon.heard@ucjsc.edu 12:30-1:30 pm EMS; Contact Jonathan Rubin, MD: jrubin@mcw.org 1:30-2:30 pm Domestic Violence; Contact Debra Houry, MD: dhoury@emory.edu 4:00-5:30 pm International; Contact Jeffrey Smith, MD: jpsemerg@aol.com 4:00-6:00 pm Research Directors; Michelle Blanda, MD: blandam@summa-health.org 4:30-5:30 pm Substance Abuse; Contact Robert Woolard, MD: rwoolard@lifespan.org SATURDAY, MAY 31, 2003 9:00-11:00 am Medical Student Educators; Contact Doug Ander, MD: dander@emory.edu 11:00-12:00 noon Clinical Directors; Contact Leon Haley Jr., MD, MHSA: lhaley@emory.edu 12:00-1:30 pm Geriatric; Contact Lowell Gerson, PhD: lgerson@neoucom.edu 12:00-1:30 pm Diversity; Contact Kevin Ferguson, MD: klferg@emergency.ufl.edu 12:00-2:00 pm Simulation; Contact William Bond, MD: wfbond@rcn.com 2:30-3:30 pm Airway Interest Group; Contact Carlos Camargo, MD: ccamargo@partners.org