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MAY/JUNE 2011
ARTHUR KELLERMANN, MD, MPH
SAEM Annual Meeting Keynote Speaker
VOLUME XXVI NUMBER 3
SAEM ANNUAL MEETING
BOSTON, JUNE 1-5, 2011
AN ACADEMIC CAREER: Planning for an EM Residency and Beyond
SAEM AWARD WINNERS 2011
SAEM has
Gone GREEN!
SAEM M em bership
SAEM STAFF Executive Director James R. Tarrant, CAE Ext. 212, jtarrant@saem.org Executive Director – CORD Barbara A. Mulder bmulder@saem.org Executive Assistant Sandy Rummel Ext. 213, srummel@saem.org Bookkeeper Janet Bentley Ext. 202, jbentley@saem.org Customer Service Coordinator Michelle Iniguez Ext. 201, miniguez@saem.org Education Coordinator Kirsten Nadler Ext. 207, knadler@saem.org Grants Coordinator Melissa McMillian Ext. 207, mmcmillian@saem.org Help Desk Specialist Neal Hardin Ext. 204, nhardin@saem.org IT/Communications David Kretz Ext. 205, dkretz@saem.org
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President’s Message
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Saem Member Highlight
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Ethics of ScarceResource Allocation
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SAEM Has Gone Green! We have heard the request for SAEM to go “green” and we are listening. As of January 2011, SAEM has taken a step forward in the green movement by delivering the SAEM Newsletter electronically to your email. The electronic newsletter can be downloaded from our website to your laptop, net book, or iPad to be read wherever you are. Whether on an airplane or sitting at the kitchen counter, members will still have easy access to the newsletter. Also, if you have missed an issue, don’t forget all newsletters are archived on our website at www.saem.org under Publications. The newsletter contains valuable information and we don’t want you to be left out! Make sure you review your profile to ensure SAEM has your email on file.
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SAEM Annual Meeting Resident Survival Guide
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SAEM Award Winners 2011
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Calls And Meeting Announcements
President’s M essage SOCIETY FOR ACADEMIC EMERGENCY MEDICINE Jeffrey A. Kline, MD
Failing with Success Notice: The following contains satire. Reader discretion is advised. No homeless persons were offended in producing this essay. A homeless man limped in on his closed distal fibular fracture and sat on a stretcher in the hallway. His foot, ankle and lower left leg were encased in a 1/2-inch layer of malodorous, fraying, soggy, browntinged duct tape. Some unseen force of nature, possibly volatile organic molecules comprising odeur sans-abri, physically Jeffrey A. Kline, MD blocked adherence of the tape to his skin. The result was the world’s grungiest walking cast. “Pretty fancy splint you have there,” said the doc. “The one they put on here got wet. So I made this one,” he said. The radiograph showed nice callus formation. Add “cast material” to the long list of uses for duct tape. He left the ED with a new walking boot and a full stomach. Over the past year, I have chosen this forum to address the readers of this Newsletter as individuals, as opposed to addressing the SAEM membership as a whole. If I have offended anyone in the process, I must confide that the problem stems from the fact that I was born in 1964, so according to sociologists, I am both a Boomer and a Generation X-er. Thus, I can take absolutely no responsibility for my actions. After all, I have been diagnosed with regular guy syndrome (RGS). Blame it on RGS. Besides, I prevailed over my opposition in a grueling election to become President so that I could get to say what I want. Well, actually I ran unopposed, but that is not the point. The point is that I wanted this to be a fun read, reflecting the strategic plan to make SAEM relevant to young members. In this, my last message, I want to reiterate that resilience is the key to academic success, and you have to rely on a community of smart friends when the going gets tough. If this message provides even a small boost to the resilience of a young faculty member, struggling to make his or her mark, then my effort was worthwhile. This is a true statement. The past 5 days offered me rejections on two manuscripts that I really care about, and my K12 grant was triaged, and in my role as interim chair of our department, this week has brought acute exacerbations of chronic, insoluble problems with patient satisfaction, ED operations and faculty scheduling. For those who are all-in for a career in academe, not-gettingwhat-you-want is part of your incentive compensation. I have true expertise in being knocked down and getting up again. I am an elite rejection athlete. Should the Olympic committee add this as a new event, I will try out for it. And like a Greek mythical creature, academic rejection and failure can take many forms. But for this discussion, I will focus on rejection that comes from peer review. Allow me to offer three steps to help with recovery. First, you must negotiate the stages of dealing with rejection, which are analogous to the Kubler-Ross stages of dealing with grief from a loss. Stage I of dealing with rejection is anger. Anger is understandable, because your work represents, well, you to some extent, and a rejection of your work feels like a rejection of you. Like Pluto. One day you feel part of the team, and the next day, as a result of an arbitrary action of peer review, you get the boot. Kicked out of the solar system, gone. Floating in the dark, only
to be occasionally taunted by Uranus. Stages II and III are pretty much all anger as well. High-performing, competitive people do not take rejection with alacrity. The anger stages are often times spiced up with a patient or nursing complaint or two, a moving traffic violation, and a random “good news, my paper got accepted” from whomever occupies the role of Uranus to your Pluto. Stage III actually merges into Stage IV, which is the Desire for Revenge stage. In the era of real paper reviews (pre year 2000 or so), the Desire for Revenge stage incorporated pathetic attempts at Crime Scene Investigation such as recognizing typewriting, the type of paper used, or maybe an imprinted signature from a superimposed document that might give away the identity of the reviewer. Now, the Desire for Revenge stage has diminished to the act of recognizing the writing style or references used by reviewers, all of whom have the highest AAS scores possible, often times citing themselves.1 In any event, the Desire for Revenge stage always fades into the penultimate Stage V Bargaining phase, also known as the “Long Conversations with Colleagues on a Cell Phone with Bad Reception” phase. This is where your SAEM membership is particularly helpful because if you get rejected as often as I do, you need a lot of friends. Finally, you reach the most important, but inevitable Stage VI, the stage of Apathy. There you go, now you’re on the road to getting healthy again. Second, keep in mind that much of peer review is just plain opinion. Not necessarily factual, and often times the content is neither right nor wrong. Some of peer review is an abject joke, so don’t take it too seriously. The news of rejection causes a psychic spike that you feel in your back. It hurts you. Accordingly, your next best action is to immediately do nothing. When you see the “we regret we cannot publish/fund/promote you,” just stop. Put it down. Don’t try to take it all in because you’ll choke on it. Let it set for a week. Third, look at what they say as potential advice: some of their reasons are right, and others are not. Your job is now to get up, lick your wounds, and decide how the rejection can make you and your work better. Don’t be like Pluto, circling around in the dark, feeling sorry for yourself. No formula works well here, but use what you have to help you cope. Your friends, your colleagues, your family, and duct tape if need be. You may never develop thick skin, but you have to develop a high pain tolerance, and a good mentor is the person who can help you take the pain. A true mentor believes in you even when you do not. The human aspect provides resilience in the setting of failure. And along these lines, we should all rejoice in the fact that NHLBI may provide over $20 million dollars for emergency care research training in the K12 program. This includes me, one whose application was triaged. I know the funded sites will deserve the money. Funding will be based upon the quality of the environment, the course work, the opportunity for patient-oriented research and the track record of the mentors judging from their biosketches. But I know that biosketches do not tell the story of how mentors go out for beers and stay on the phone and are simply, unconditionally, always there for their trainees. That thought is all I need to get over that small rejection. One more thing will help. That’s your job. Go to work, and help out a man who has to make a cast out of duct tape. That will put it all into the right perspective. Thanks for allowing me the chance to share some thoughts, and, I hope, some humor with you. Best of luck in your successes, and your failures. Kline JA. Expertise, part III. SAEM Newsletter, issue # 1, 2011.
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Executive director’s M essage SAEM Academies Grow If you are not a member of an academy, you may have seen references to them on the website or newsletter. What are SAEM academies and how can you participate? The Board of Directors (BOD) listened to member ideas to expand involvement and address the diverse interests of the membership. The Board worked with the Clerkship Directors to develop a template establishing a new component, called academies, to broaden academic emergency medicine involvement. In March James Tarrant, CAE 2011, the Board of Directors approved two new academies, Global Emergency Medicine Academy and Academy of Emergency Ultrasound, increasing the number of SAEM academies to seven. To learn more about each academy’s activities, visit Academies at www. saem.org. Academies are member-driven. When a critical mass of 100 members with a common interest and objective is achieved, the group may consider developing an academy. Most are formed from an existing Interest Group that has projects and activities that are beyond the scope of an interest group. CDEM has published the 2nd edition of Medical Student Educators’ Handbook; the Simulation Academy is guiding Simulation Consultations; and AWAEM has a Survival Guide for career advancement. Academies have expanded meeting time at the Annual Meeting, and all SAEM members are welcome to attend and learn more about any of the academies. As developed by CDEM, the inaugural academy, the “Academy” structure provides a venue for SAEM members with a special interest or expertise to join together to promote a forum for the exchange of information among members, in line with SAEM’s mission to advance education and research in Emergency Medicine (EM). The Academy structure also provides the SAEM Board of Directors with the ability to utilize the expertise of an identifiable group, to provide a forum for members to speak as a unified voice within our specialty as well as to other national organizations, to provide a forum for members to network, collaborate on educational initiatives, develop policy, and perform research, and to promote faculty development. The Academy Guidelines are available to all members on the SAEM Website to assist in determining if an academy fits a group’s needs. From the Guidelines: An Academy is considered a subcategory of national SAEM membership. As such, all academies are part of national SAEM and do not have separate bylaws or formal incorporation documents. Academies may however establish operational guidelines that delineate the policies and procedures that will govern the operation of the academy as long as they are not in conflict with the operational guidelines, policies, procedures, or mission of SAEM, as determined by the SAEM BOD. An Academy provides a venue for SAEM members with a special interest or expertise to join together in order to: 1. Promote a forum for the exchange of information between members in line with SAEM’s mission to advance education and research in Emergency Medicine. 2. Provide the SAEM Board of Directors (BOD) with the ability to utilize the expertise of an identifiable group on specific issues. 3. Provide a forum for members to speak as a unified voice to the SAEM BOD as well as other national organizations within their scope of special interest or expertise.
4. Provide a forum for members to network, collaborate on educational initiatives, develop policy, perform research, and provide faculty development pertaining to their area of special interest or expertise. An established group can consider formation of an Academy if it has a well defined agenda and mission statement and a track record of accomplishments and leadership, such that a higher level of administrative support from SAEM will allow the Academy to function somewhat independently of the SAEM BOD for purpose of interaction with outside organizations. The seven academies are: • AAAEM - Academy of Administrators in Academic Emergency Medicine AAAEM is envisioned as a professional association that will provide a forum for administrative leaders to collaborate with colleagues and interact with chairs of departments of emergency medicine at America’s leading academic medical centers to promote the specialty of emergency medicine and professional career growth. • AGEM - Academy of Geriatric Emergency Medicine AGEM provides a forum for the collaborative exchange of ideas among emergency medicine researchers, educators, trainees and clinicians. Its mission is to improve the quality of emergency care received by older patients through advancing research, education and faculty development. • AWAEM - Academy for Women in Academic Emergency Medicine AWAEM promotes the recruitment, retention, advancement and leadership of women in academic emergency medicine throughout their careers. • CDEM - Clerkship Directors in Emergency Medicine CDEM was the first “Academy” within the membership of SAEM. CDEM is comprised of medical student educators who are committed to enhancing medical student education within our specialty. CDEM provides an opportunity for EM clerkship directors and medical student educators to join forces, collaborate, and become a unified voice at the national level. • Simulation Academy Simulation Academy is an educational organization comprised of emergency medicine physicians who are committed to enhancing education, research, and patient safety through the use of simulation. • GEMA - Global Emergency Medicine Academy GEMA improves the global delivery of emergency care through research, education, and mentorship and enhances SAEM’s role as the international emergency medicine organization that augments, supports, and shares advances in global research, education, and mentorship. • AEUS - Academy of Emergency Ultrasound AEUS advances education and research in ultrasound for the bedside evaluation of emergency medical conditions, resuscitation of the acutely ill, critically ill or injured, guidance of invasive procedures, monitoring of certain pathologic states, and as an adjunct to therapy. The Academy serves as a platform for discussion on subjects that are of concern to emergency medicine physicians practicing clinical sonography. Congratulations to the two new academies! For more information on any of the academy meetings scheduled at the SAEM Annual meeting or to join, visit the Academies page on the SAEM website.
SAEM M em ber highlight Arthur Kellermann, MD, MPH Arthur Kellermann, MD, MPH, is Vice President and Director of RAND Health and the Paul O’Neill-Alcoa Professor in Policy Analysis at the RAND Corporation in Santa Monica, California. RAND is a global organization dedicated to improving policy and decision making through research and analysis. Before joining RAND, Dr. Kellermann was Professor of Emergency Medicine and Associate Dean for Health Policy at the Emory School of Medicine in Atlanta. He founded the Department of Emergency Medicine at Emory University and served as its first chair. He also established the Emory Center for Injury Control, a WHO collaborating center for injury control and emergency health services. He has published more than 200 scientific papers on a wide range of topics, including emergency cardiac care, health policy, and injury control. A member of the Institute of Medicine of the National Academies, he is a past recipient of SAEM’s Leadership and Hal Jayne Academic Excellence Awards, and ACEP’s John G. Wiegenstein Award. Don’t miss out on the opportunity to hear Dr. Kellermann speak as the Keynote Speaker in Boston, MA, at the 2011 SAEM Annual Meeting, June 4, 2011. He will be speaking on the topic of “Emergency Medicine – Yesterday, Today, and Tomorrow”; this event will take place at 2:00pm in Salon G at the Boston Marriott Copley Place.
June 3, 2011 in Boston, MA The 2011 SAEM Foundation Luncheon featured speaker is Michael S. Sparer, PhD, JD, Professor and Chair of the Department of Health Policy and Management at the Mailman School of Public Health at Columbia University. He will be speaking on the recent health care legislation, obstacles to its enactment, and its anticipated effects on academic emergency medicine. Dr. Sparer is a well-published and nationally recognized expert in health policy, and an outstanding speaker. This should be an incredible opportunity for membership, and worth the price of admission.
Michael S. Sparer, PhD, JD
Luncheon Cost: $70.00 Register online ~ www.saem.org * Fax ~ 847-813-5450 Mail ~ SAEM, 2340 S. River Road, Suite 200, Des Plaines, IL 60018 Attention Department Chairs: Also a great opportunity to sponsor a resident to attend this one-ofa-kind educational event. Call SAEM for details 847-813-9823. The SAEM Foundation Luncheon is open to Foundation donors only!
Ethics in Action ETHICS OF SCARCE-RESOURCE ALLOCATION Kenneth V. Iserson, MD, MBA, FACEP, FAAEM, FIFEM Department of Emergency Medicine, The University of Arizona On what ethical basis do you allot resources when faced with insufficient medical equipment, supplies and staff for the patients you feel obligated to treat? The Problem. Healthcare resources must be rationed in many situations: acutely after natural and man-made disasters and multiple-casualty incidents, subacutely during epidemics, and chronically in resource-poor regions or countries. Nearly every discussion of disaster plans calls for resources to be allocated on an ethical basis and, invariably, suggests using the theory of utilitarianism. Utilitarianism is often simplistically described as favoring acts that produce the greatest good for the greatest number of people, and is a form of “consequentialism,” a type of ethical theory that says that an action’s outcome determines its moral worth. Aside from some ethical discussions of patient triage, few specific suggestions have emerged about how to ethically prepare for or implement the allocation of scarce resources. In resource-poor situations, those responsible for distributing the scarce resources face difficult decisions about who will receive treatment and live and who will not and thus either die or face increased suffering. This holds true whether the decision makers are administrators managing the “big picture” on a regional or national level, or triage officers making life-by-life choices for individual patients. When no resources exist, the situation is tragic, but no allocation decision needs to be made. This may be the experience in a leastdeveloped country when a child arrives with a hemoglobin of 1.1 gm/dl (malaria) and no blood can be obtained quickly—the child dies. Or it may be that the inability to perform cardiac surgery in a developing country condemns a young man with severe mitral stenosis to death. But these types of cases occur less often than those where some, but insufficient, resources exist. The Ethics. What we need is an ethical theory on which to base allocation decisions; utilitarianism seems the right choice. We also need professionals who are not only trained in the practical clinical application of that theory but, equally important, are trained and experienced in allocating resources and are given authority to act commensurate with their responsibilities. These professionals also need to be virtuous—acting in ways that are consistent with moral principles. In these terribly difficult situations, they would serve as society’s “moral agents,” and make agonizing decisions fairly. In this context, fairly means equitably: the few available resources would go to those who need and can most benefit from them. This can only be accomplished if those responsible distribute the resources without bias and without amassing personal benefit. Being able to recognize the ethical basis for difficult triage decisions underlies many of these qualities. If triage officers do not understand the ethical basis for their decisions, they may be indecisive. Failing to act due to moral uncertainty is unacceptable, however, since inaction is often the worst of the available options. The practical applications of utilitarianism to scarce resource allocation include: 1. Use available resource-to-patient ratios, rather than the size of the incident, to determine whether resources must be rationed. If sufficient resources exist for those who need them, no rationing is needed. 2. Resources should be distributed on an equitable (not equal) basis. That means that patients get only what they need, not necessarily what they demand.
3. Prioritize patients based on fairness and on how much good they can receive from the resources provided. 4. Give treatment priority to those patients who, if they can quickly return to their jobs, can most help others, and also to those who can get the greatest medical benefit in the shortest amount of time from the fewest resources. This is the “multiplier effect.” (1,2) Preparation. It is much better to learn resource allocation principles and educate physicians to make these hard decisions before, rather than during, disasters. Patient prioritization, which is often called “triage,” should follow a predetermined plan. In disaster settings, this process is often much more difficult and may more frequently include the “expectant” category than in the normal emergency department or EMS situation. Few individuals have experience allocating scarce resources on a large-scale basis. Governments often use broad budget mechanisms rather than equitable distribution methods to allocate healthcare resources. A rare example of equitable government allocation was the scheme mandated by Oregon’s Basic Health Services Act of 1989.(3) So, how should regional administrators prepare to divide up an insufficient pie for a needy populace? Some available preparation methods include: 1. Doing resource allocation. Those who do a task repeatedly become good at it. Emergency physicians and EMS personnel, especially those who receive multi-casualty incidents with some regularity, feel comfortable assuming this clinical responsibility for small numbers of patients. However, they usually have little or no experience with regional allocation. 2. Doing tabletop exercises and disaster drills. Tabletop exercises may be one of the few ways to prepare to allocate scarce resources for large areas or populations. 3. Read and discuss articles that describe an ethical basis for allocating scarce resources.(1, 2, 4, 5) 4. Developing institutional and regional scarce-resourcedistribution policies as part of a disaster plan. Prepare these plans in consultation with local bioethics committees or consultants. The process itself helps to clarify and educate participants in the practical clinical application of utilitarian principles in times of scarcity. 5. Preparing a document describing any planned scarcedistribution policy. Publicizing the plan not only will enhance transparency and public trust, but also provide public feedback that will help officials better understand what stakeholders think constitutes fair allocation. Appropriate distribution of scarce healthcare resources requires an understanding of what needs to done (equitable distribution), how to do it (without bias or personal gain), and the ethical basis for these actions (Utilitarianism). Advance preparation is necessary to have professionals capable of performing this difficult task. 1. Moskop JC, Iserson KV: Triage in Medicine—Part II: Underlying Values and Principles. Annals of Emergency Medicine 2007;49(3):282-7. 2. Pesik N, Keim ME, Iserson KV: Terrorism and the ethics of emergency medical care. Annals of Emergency Medicine 2001;37(6):642-646. 3. Dixon J. Priority setting: lessons from Oregon. The Lancet. 1991;337(8746):891-894. 4. Iserson KV, Moskop JC: Triage in Medicine—Part I: Concept, History, and Types. Annals of Emergency Medicine 2007;49(3):275-81. 5. Iserson KV: The Most Difficult Healthcare Decisions, at www.crestaznm.org. (videos).
GROWING UP Emergency Medicine: From grass roots to health sector leadership Anoop Kumar, MD Albert Einstein Medical Center, Philadelphia, PA The improvement of medicine will eventually prolong human life, but the improvement of social conditions can achieve this result more rapidly and more successfully.1 These are the words of Rudolf Virchow, father of modern pathology and proponent of the theory of the social determinants of health. It is a message that resonates loudly today in a political climate that stresses the importance of prevention and primary care in health. Dr. Virchow’s message is relevant to all fields of medicine, but no specialty has a greater ability to lead this effort than emergency medicine (EM). This ability is rooted in two factors – our specialized leadership and management skills, and our unique perspective on medicosocial problems. Both are inextricably linked to the history of EM. In the late 19th and early 20th century, medical care was still commonly provided by doctors who forged lasting relationships with their patients.4 This strong doctor-patient relationship suffered from the industrialization of society. Waning need for rural jobs due to technological advancements in farming and the appeal of economic prosperity in bigger cities contributed to an urban population shift that began in the 19th century and continued through the 20th century.3 Adding to this picture was the trend of general practitioners moving toward specialty practice and making fewer house calls.4 As a result, emergency room (ER) visits to U.S. hospitals increased from 9.4 million in 1954 to 27.7 million in 1965 to 42.7 million in 1970. 4 The increasing visits put a spotlight on the substandard care provided by ERs, most of which were staffed by interns or rotating physicians who did not want to be there.4 In 1961, a group of pioneers responded to this by planning the first group of full-time emergency physicians (EPs) dedicated to the emergency department (ED). Full-time employment in the ED marked the beginning of a specialty that was formed as a service to an unmet social need. EPs address every type of medicosocial emergency. Some are primarily medical – the 45-year-old man who regularly visits his family physician, exercises, and takes his anti-hypertensives now comes to the ED with symptoms of a heart attack. Others are more rooted in social factors – the 60-year-old woman without adequate health insurance who is unable to afford her necessary daily medications now comes to the ED with her third heart failure exacerbation this month. From the perspective of the ED, the distribution of emergencies is depicted below.
Social
Medical
This diagram suggests that all emergencies presenting to the ED can be classified as primarily medical, primarily social, or a combination of both. An EP can address the medical component
of an emergency in the ED, but is extremely limited in being able to address the social component. Yet, no specialty understands the social component better than EM. Daily, EPs address issues related to primary care shortage, insurance problems, overcrowding, inadequate prenatal care, alcoholism, drug abuse, psychiatric care, homelessness, violence, and neglect, all while providing specialized care for medical and surgical emergencies. Indeed, the majority of what succeeds and fails in healthcare and public policy directly affects the clientele who present to EDs daily nationwide. The ED is, as such, a microcosm of society. This affords EPs a unique, powerful perspective that no other group can contribute – a perspective that is among the most relevant in the health sector. Thus, the vision of the EP is broader that the ED can actualize. Although, the ED is a modern, high-tech unit managed by specialists that define the standard for emergent care, its influence largely stops at the front door. Rudolf Virchow suggested a different perspective – a broader perspective. Diagrammed below, his assertion that illness is the result of social factors was a direct threat to a sitting political administration nursing a stagnant social policy.5 Social Medical
Times have changed since Dr. Virchow made his assertion. Social conditions have indeed improved on many fronts, but his perspective still holds great relevance to EM. His interpretation that all health issues can be traced to social phenomena is one that matches the day-to-day experience of EPs. Indeed, it enables EPs by engaging an actionable perspective that applies both within and beyond the ED. It allows us to answer bigger questions. The healthcare legislation passed less than a year ago acknowledges this perspective and financially backs the growing focus on population health and efficient use of resources. On another front, the corporate world is actively proliferating disruptive solutions such as telemedicine and healthcare specialty shops that redefine healthcare delivery. Where does emergency medicine fit in? Again, the history of EM provides the backdrop against which the unique opportunity we have to lead in this time of change becomes clear. After the first EPs began practicing full time in the ED in 1961, the focus in EM shifted to achieving primary board status.4 At issue was whether or not EM was a specialty. Other specialties questioned whether EPs offered a truly unique skill set.4 The “jack of all trades” description of EPs suggested that our skill set is
merely a collection of those of several different specialties. EM residency programs necessarily reflect this by placing residents on rotations within virtually every department in the hospital to gain vital experience in a full range of emergent care. But does this capture the essence of our specialty? I argue that it does not. The skill to intubate, float a pacer, and deliver a baby does not by itself an emergency physician make. It is the ability to lead a team successfully through these varied and simultaneous emergencies while managing both the medical and administrative activities of the ED as a whole that defines the consummate EP. While leadership and management are helpful in every career, and certainly in all medical specialties, they are indispensable in EM. No other specialty contends with the volume, range, and acuity of social and medical issues at one time that EPs do. In the language of the corporate world, leadership and management define the core of our specialty. We have not declared this before because medical specialties are traditionally defined by rigid anatomical or demographic characteristics – the ophthalmologist specializes in the eye, the neonatologist in neonates, the cardiologist in the heart, etc. The EP assimilates all these into practice, yet specializes in managing them simultaneously without missing a beat. This ability to lead and manage teams, reconcile the big picture with the minutiae, and consistently deliver results puts EM in the ideal position to make a difference beyond the confines of the ED. Today, the political and corporate worlds are converging at the health sector to develop innovative solutions to decades-old problems. This movement was reflected in the 2010 Adelaide Statement on Health in All Policies, a World Health Organization (WHO) publication designed to engage leaders and policymakers to consider “health and well-being as a key component of policy development”:6 To advance Health in All Policies the health sector must learn to work in partnership with other sectors. Jointly exploring policy innovation, novel mechanisms and instruments, as well as better regulatory frameworks will be imperative. This requires a health sector that is outward oriented, open to others, and equipped with the necessary knowledge, skills and mandate. This also means improving coordination and supporting champions within the health sector itself.6 The specialized leadership and management skills and unique medicosocial perspective that EPs bring to the table make us prime candidates to be the champions that WHO describes. The potential field for EM runs the gamut from public policy to the details of emergent medical management. Addressing the former end of this spectrum is key to improving outcomes on the latter end. To do so, we must take two important steps. First, we must formally recognize and develop leadership and management as the core of our specialty. Leadership and management, as we use the phrase here, is not restricted to boardroom discussions on strategic planning and change management, but rather embraces the broader notion that empowerment and involvement are keys to success. Currently, EPs undergo pseudo-management training during residency by virtue of working in the ED – on-the-job training. Thus, all competent EPs today are at least adequate managers. But as a specialty, we must raise the bar from adequacy to specialization by focusing the provision of emergent care through the lens of leadership and management. There is an abundance of research today from
the world’s top business schools on this topic. Leadership and management have been researched extensively and applied in highly competitive businesses and service industries to maximize efficiency. This repository of theoretical and practical knowledge must be assimilated into EM, a field where it stands to be most relevant. Interns should learn from day one that they are not only physicians, but also stewards of societal resources. The goals of management should be made clear, and proven pearls and pitfalls of management styles from various industries must be explored. Medical decisions must be assessed in the context of outcomes and efficiency. As they mature through training, residents’ views of management should be broadened to understand the role of leadership and how it adds to management. They should be exposed to the idea that the social problems they are privy to through their patients’ lives can be addressed in novel ways. These edifying processes can occur in collaboration with local business schools. Thus, we must deliberately emphasize and develop the core skills of our specialty. Secondly, a wider range of educational options should be made available to enable EPs to develop innovative solutions to today’s problems. Some programs already offer combined EM-Master’s degree opportunities. We should expand on this to include a combined EM-MBA (Master’s in Business Administration) to promote leadership in the corporate sector and a combined EMMPA/MPP (Master’s in Public Administration/Master’s in Public Policy) to promote political leadership. Many students are choosing combined MD-MBA programs today to gain an understanding of clinical medicine to inform their business decisions. However, their ability to stay relevant and maintain an edge is compromised by a lack of residency training and clinical contact. A combined EM-MBA or EM-MPA program offers these aspirants a unique opportunity to practice as a specialist in a popular field while moving forward with a trans-sectoral agenda. Taken together, the steps of formally developing leadership and management and promoting new educational options encouraging EM leadership in society will not only fortify the position of EM as a most relevant specialty, it will attract highly motivated and capable talent to our ranks. Fully matured, EM will be a specialty representing highly trained, transformative clinicianleaders dedicated to a healthy society through the advancement of healthcare on all fronts. By working toward this goal, the modern EP stays true to the spirit of service in which EM was founded and guides the trajectory of our specialty toward health sector leadership. References 1. Virchow R. Gesammelte Abhandlungen aus dem Gebiet der Öffentlichen Medicin und der Seuchenlehre. Vol 1. Berlin (DE): Hirschwald; 1879. 2. “The 1920s: Medicine and Health: Overview.” American Decades. 2001. Encyclopedia.com. http://www.encyclopedia.com/doc/1G2-3468300943.html 3. “Twentieth-Century American Population Growth.” Richard A. Easterlin. Cambridge University Press. 2008. 4. “Anyone, Anything, Anytime: A History of Emergency Medicine.” Zink, Brian J. 2006 5. “Rudolf Virchow: The Physician as Politician.” Eisenberg, Leon. Medicine and War, Vol. 2, 243-250 (1986) 6. Adelaide Statement on Health in All Policies. World Health Organization, 2010. http://www.who.int/social_determinants/hiap_statement_who_sa_final.pdf
Academ ic Announcements Dr. Haru Okuda was recently named national medical
director for the Department of Veterans Affairs Simulation Learning Education and Research Network (SimLEARN) program. Before joining VA, Dr. Okuda, who is an emergency medicine physician, served as the director and assistant vice president of the Institute for Medical Simulation and Advanced Learning for the New York City Health and Hospitals Corporation. http://www.simlearn.va.gov/
Manish Garg, MD, Associate Professor and Assistant
Residency Program Director in Clinical Emergency Medicine at Temple University Hospital has been selected by this year’s fourth-year class to receive the Russell and Pearl Moses Memorial Endowed Medical Award for Outstanding Teaching at Temple University Hospital. Nominations come from housestaff members of the various departments at Temple University Hospital, and the final choice is made by the senior class.
Michael T. Fitch, MD, PhD has been appointed
to serve on the Editorial Board for the Association of American Medical Colleges (AAMC) MedEdPORTAL.
People to People Citizen Ambassador Programs is organizing a delegation of specialists in public
health preparedness to travel to Brazil in December 2011. SAEM members and anyone involved in public health and emergency preparedness is encouraged to apply as a delegate. The delegation leader is Dr. Linda C. Degutis, director of the National Center for Injury Prevention and Control of the Centers for Disease Control (CDC) and a past president of the American Public Health Association (APHA), and we hope for a strong showing of public health professionals. A number of unique opportunities are planned, including dialogue with public health and preparedness professionals in Brazil, and the opportunity to share techniques, training and preventive and reactive public health preparedness principles. Cultural activities will highlight the sights and sounds of the country. You can find more information, or enroll online, at www.peopletopeople.com/lindadegutis.
Christopher King, MD, FACEP has been named Professor and Chair of the Department of Emergency Medicine at Albany Medical College.
Hot Off the Presses: The New Global Emergency Medicine Academy Ian B.K. Martin, MD — University of North Carolina at Chapel Hill It is with great pleasure that the SAEM International Emergency Medicine (IEM) Interest Group announces the formation of the Global Emergency Medicine Academy (GEMA). This exciting news comes on the heels of years of consideration and months of work on a proposal by IEM Interest Group members. The SAEM Board of Directors approved formation of GEMA with great enthusiasm. The Global Emergency Medicine Academy will launch in earnest at the Annual Meeting in Boston this June. All SAEM members are encouraged to join GEMA and to participate in the Academy’s inaugural events at the upcoming Annual Meeting. Academy Missions • To improve the global delivery of emergency care through research, education, and mentorship. • To enhance SAEM’s role as the international emergency medicine organization that augments, supports, and shares advances in global research, education, and mentorship. Academy Logo
Academy Leadership President: Ian B.K. Martin, MD Vice-President: Scott Weiner, MD, MPH. Vice-President: David M. Walker, MD Secretary-Treasurer: Vicken Y. Totten, MD
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Advisor: Kathleen Clem, MD Advisor: C. James (Jim) Holliman, MD Advisor: Kenneth V. Iserson, MD, MBA Advisor: Christine M. Houser, MPhil, MD Advisor: L. Kristian Arnold, MD, MPH Advisor: Mark Hauswald, MD Academy Events at Annual Meeting Saturday, June 4th—Location: Provincetown 0800-0855 GEMA Business Meeting 0900-1000 IEM Fellowships Showcase 1000-1030 BREAK 1030-1125 Research Forum 1130-1230 Panel Discussion: “Professionalization of the Humanitarian Sector” 1830- GEMA “Kick-off” Party Sunday, June 5th—Location: Berkeley/Clarendon 1030-1200 Didactic: “Know Before You Go (And Before You Send Your Residents): Developing quality international EM rotations” Other Global Emergency Medicine Events at Annual Meeting Thursday, June 2nd 1230-1330 International Medical Education oral abstracts (Location: Salons A-B) 1600-1700 Disaster Preparedness moderated posters (Location: Falmouth) Sunday, June 5th 0800-0930 Emergency Services in the World lightning orals (Location: Salons C-D)
Contact: Tom Catalano, Director of Marketing P 800 447 3177, x366 C 541 510 2219 tcatalano@hsi.com
FOR IMMEDIATE RELEASE Health & Safety Institute Presents EMS Therapeutic Hypothermia Training Workshop March 31, 2011 – EUGENE, OR –Health & Safety Institute (HSI) is pleased to announce a first-of-its-kind workshop on therapeutic hypothermia created specifically for pre-hospital emergency medical service providers. Noted industry presenters will review therapeutic hypothermia in the pre-hospital setting for post-cardiac arrest patients through a review of various cooling methods and protocols and a close examination of the practical issues surrounding its implementation. Participants in the workshop will receive 3.5 continuing education hours (CEH). The workshop will be held May 20, 2011, from 1:30 – 5:30 p.m. at the Red Rock Resort in Las Vegas, NV, during the 2011 HSI International Conference—The Power of Change. Leading the panel of three presenters is Dr. Benjamin Abella, MD, MPhil, Emergency Medicine, University of Pennsylvania. “Therapeutic hypothermia is revolutionizing the care of cardiac arrest victims, and it is becoming increasingly important that EMS providers and managers understand the nuts and bolts of this treatment option,” Dr. Abella explains. The panel also includes Dr. Bentley Borrow, MD, Emergency Medicine and EMS, Maricopa Medical Center, Arizona and Marion Leary, BSN RN, Emergency Medicine and Medical Intensive Care, University of Pennsylvania. This continuing education activity is approved by HSI, an organization accredited by the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS). For more information and to register for the workshop, visit hsi.com/2011conference. Attendees of the workshop do not have to be registered for the conference to participate.
### Health & Safety Institute (www.hsi.com) Eugene, Oregon-based Health & Safety Institute (HSI), the largest privately held emergency care and response training organization in the world, joins together American Safety & Health Institute (ASHI), MEDIC First Aid®, 24-7 EMS®, 24-7 Fire, EMP Canada, First Safety Institute (FSI), and GotoAID. Since 1978 HSI companies have partnered with more than 16,000 approved training centers and have authorized more than 200,000 professional safety and health educators, who have certified more than 19 million emergency care providers in the US and more than 100 countries throughout the world. HSI's vision is to be the preferred training resource for safety and health training centers. “We Make Learning to Save Lives Easy®”
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Contactt Informatio on: Susan L. Walaszek The Inte ensivist Group Director, A Administration 866.344.054 43 swalaszek@ @theintensivistgroup.co om
INNO OVATIVE RE ESOURCES, IMPROVED CRITICAL L CARE AN ND BETTER OUTCOME ES The e Intensivistt Group Lau unches New w Program a at Provena Mercy Med dical Centerr LAKE ZURICH, IL L — April 21, 2011 — Th he Intensivis st Group hass recently implemented a another adva anced critica al care p program, now w in the Intensive Care Unit U (ICU) att Provena M Mercy Medica al Center in Aurora. Thiss new progra am will vastly y improve ca are and outc comes for crritically ill pattients, while lowering co osts for patie ents and the Mediccal Center alike. “One o of the most challenging c parts of my job is finding g innovative e ways to imp prove care a and decrease hospital costs and risk,” sa ays Dan Hattcher, MD, ch hief medical officer at Prrovena Merccy Medical C Center. “We keep patients at the center of wh hat we do, and a that is why we embra aced The In tensivist Gro oup’s ground dbreaking m model for treatin ng critically illl patients.” The In ntensivist Grroup has app pointed Kenneth Cruz, MD, M who hass more than 10 years of experience as both a practiccing intensiv vist and an IC CU program m medical dirrector, to lea ad the new p program as th he departme ent’s medica al directo or. The critic cal care prog gram uses proven principles to lowe er mortality a and complica ation rates, rreduce the time p patients requ uire ventilato or assistance e, speed reco overy, and sshorten ICU stays. “This p proven meth hod of ICU care c saves liv ves,” says Cruz. C “Hospittals that imp plement thesse programs typically see e significant improve ement in the eir quality ou utcomes — such s as patie ents acquirin ng fewer dan ngerous infe ections in the e hospittal, for exam mple. Becaus se fighting se erious illness s requires exxtensive mo onetary resou urces, the co ost of care eventu ually drops, too.” “Prove ena Mercy Medical M Centter’s ICU patients will be enefit from c ritical care sspecialists’ e expert care,” Cruz explains. “The pro ogram follow ws a success sful method that t uses fou ur simple bu ut key param meters: intenssivist-led, multid disciplinary IC CU teams; evidence-bas e sed guidelines and proto ocols; proce ess and outcome measurement; and d ongoin ng collabora ation with the e medical sta aff.” The In ntensivist Grroup is the le eading national provider of critical ca are services to community hospitalss around the countrry. Since its inception in 2001, it has s been owne ed and opera ated by boarrd-certified ccritical care p physicians who d design and apply a innovattive approac ches to inten nsive care. B By optimizing g the training g, experiencce and instinccts of talente ed intensivistts, clinician teams t and other o hospita al profession nals, it helpss critically ill p patients recove er faster. The Intensivistt Group runs s intensive care units an d telemedicine program ms throughou ut the Midwe est and M Middle Atlantic states. To o learn more about The Intensivist I G Group, please e visit www.theintensivisstgroup.com m. Provena Mercy Medical Cente er is a ministry of Proven na Health, a not-for-proffit Catholic h health system m that includes six hospitals, 17 long g-term care and a senior re esidential fa acilities, 36 cclinics, five h home health agencies, hospicce, private duty, and oth her health-related activities operating g in Illinois. Sponsored by the Francciscan Sisters of the Sacred Hea art, the Servants of the Holy H Heart of o Mary and tthe Sisters o of Mercy of tthe Americass, Provena Health h ministries provide p healling and hop pe in the spirrit of Jesus C Christ. Visit w www.proven na.org/videoss to see Provena Health’s mission in action. a ###
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Institute of M edicine Elects Roger J. Lewis, M D, PhD Kenneth Robinson, MD for the Faculty Development Committee Roger J. Lewis, MD, PhD was elected to membership in the Institute of Medicine (IOM) of the National Academies in 2009.
is excited about the opportunity to address economic and public health problems facing our country to further the greater good and to be able to study questions that are a high priority for the country in a nonpartisan and apolitical manner.
Dr. Lewis received his PhD in Biophysics in 1986 and his MD in 1987 from Stanford University. He completed clinical training in emergency medicine in 1990 and is currently a Professor at the David Geffen School of Medicine at UCLA and the Vice Chair for Academic Affairs in the Department of Emergency Medicine at HarborRoger J. Lewis, MD, PhD UCLA Medical Center. Dr. Lewis’s expertise centers on clinical research methodology, including adaptive and Bayesian trial design, and he participates in the design and analysis of numerous laboratory, clinical, and health services research studies. His areas of interest include adaptive and Bayesian clinical trials; translational, clinical, health services and outcomes research; emergency department crowding and disaster preparedness, interim data analysis; the role and function of data-monitoring committees; and difficulties surrounding informed consent in emergency research studies. Dr. Lewis serves as a research mentor for numerous fellows and junior faculty and frequently lectures on the topics of clinical research design and the statistical analysis of clinical trials. Dr. Lewis serves as the chair of data and safety monitoring boards (DSMB) for both federally-funded and industry-sponsored clinical trials.
The IOM has provided Dr. Lewis the unique opportunity to study and attempt to solve a wide range of public health issues; his perspective is greatly aided by the tremendous background that his career in EM has provided him, allowing him to view a much wider range of health care issues realistically. The opportunity to continuously learn and to remain interested in his work is important for him as an academician.
Dr. Lewis is a Past President of the Society for Academic Emergency Medicine (SAEM) and feels that his experience in SAEM was vital in preparing him for his role in the IOM. He describes SAEM as a unique organization in which relatively junior faculty have the opportunity to gain leadership and management experience, inter-organizational skills and experience participating at the national level. SAEM provided him the opportunity, over many years of work, to develop these skills and to interact with many other national organizations, such as CORD, ABEM and ACEP. He has found these skills invaluable in his role in the IOM, interacting with national leaders from the other medical specialties. Dr. Lewis describes the IOM as both an honorary organization and a working organization. It is gratifying for him to be recognized by peers and academicians from all of the medical specialties. He attributes this recognition to the work previously performed by many academic Emergency Medicine physicians whose efforts have led to academic Emergency Medicine’s reputation as a specialty. The activity and influence of academic Emergency Medicine on the IOM reaffirms that EM is respected and that we have an important perspective on the health care issues facing our country. Most importantly, Dr. Lewis enjoys the working aspect of the IOM. He
Dr. Lewis is proud to represent academic Emergency Medicine in the IOM and would like to thank his predecessors from Emergency Medicine for their efforts in the Institute of Medicine.
Academy of Emergency Ultrasound (AEUS) We are pleased to announce that the SAEM Board of Directors unanimously approved conversion of the SAEM Emergency Ultrasound Interest Group to an Academy this March 2011. An overriding goal of the newly created Academy of Emergency Ultrasound (AEUS) is to foster education and research within and across the specialty of clinician-performed ultrasonography. The Academy of Emergency Ultrasound will be holding elections for the position of Chair-Elect (2012-2013), Treasurer (2011-2012), Research Officer (2011-2012), Education Officer (2011-2013) and Secretary (2011-2013) electronically prior to the 2011 SAEM Annual Meeting in June. Please contact Nova Panebianco, Academy Task Force Chair, or Beatrice Hoffmann, AEUS Interim Chair for election details.
Nova Panebianco M.D., M.P.H. Academy Task Force Chair Nova.panebianco@uphs.upenn.edu Resa Lewiss, M.D. AEUS Chair-Elect Beatrice Hoffmann – M.D., PhD. AEUS Interim Chair — bhoffma8@jhmi.edu James Moak, M.D. AEUS Honorary Past Chair
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Institute of M edicine Elects Tom P. Aufderheide, M D Dr. Tom P. Aufderheide was elected to membership in the Institute of Medicine (IOM) of the National Academy of Sciences in 2009. Dr. Aufderheide is an internationally respected translational research scientist in emergency cardiac care and was one of 65 individuals in the United States elected to this prestigious organization in 2009. After obtaining his MD from the University of Minnesota in 1979, where he stayed on to complete Tom P. Aufderheide, MD residency training in Internal Medicine in 1982, Dr. Aufderheide then completed an Emergency Medicine residency in 1986 at the Medical College of Wisconsin. He is currently a tenured Professor of Emergency Medicine and Associate Chair of Research Affairs at the Medical College of Wisconsin. Dr. Aufderheide’s scholarly accomplishments have had farreaching consequences for improving emergency cardiac care in the United States. He initiated the use of 12-lead electrocardiography in the prehospital setting for early diagnosis and treatment of ischemic cardiac disease. His leadership of the national Public Access Defibrillation trial led to a doubling of survival rates from out-of-hospital cardiac arrest. His research on effectiveness of CPR for patients in cardiac arrest identified the detrimental effects of hyperventilation and of incomplete chest recoil during CPR, and his innovative investigations of CPR have doubled its effectiveness for cardiac arrest. Dr. Aufderheide has authored more than 150 peer-reviewed publications, including
two New England Journal of Medicine articles, as well as 27 book chapters, and he has edited or co-edited more than 39 textbooks. Dr. Aufderheide’s interests in emergency cardiac care blossomed early in his career and he credits the Society of Academic Emergency Medicine (SAEM) with establishing a high standard of academic excellence that helped set him on such a successful path. SAEM offered a forum for presentation and discussion of his early academic pursuits, and provided a source of academic mentorship. Dr. Aufderheide comments, “SAEM helped me become connected to other more experienced investigators in the field of emergency research who mentored me, gave me advice on designing clinical trials, on implementing clinical trials, and on optimizing analysis of data.” Dr. Aufderheide expresses gratification on two levels following his election to the IOM. He is honored that such a respected institution has recognized his contributions to emergency cardiac care. Secondly, he views IOM appointment as a tremendous opportunity to collaborate with a multidisciplinary group of individuals who have such high level of achievement in order to promote improved health care nationally. The driving force behind Dr. Aufderheide’s extraordinary impact on the field of emergency cardiac care can be summarized in one word: passion. “I am passionate about improving patient outcomes and have attempted to investigate issues that have potential national impact within the field of emergency cardiac care.” His passion for this task has carried him through numerous impediments encountered along the way and fuels his ongoing drive for continued meaningful contributions. As a recently elected IOM member, his ability to contribute on a national level will continue to flourish.
VIRTUAL ISSUES “Virtual issues” will be a key feature of the journal’s new home page on our publisher’s recently-implemented platform, Wiley Online Library. A virtual issue is basically just a collection of articles on a given topic - so the EMS virtual issue, for example, will be a running compilation of all EMS articles that we publish. The idea is that a reader will go there to look for a particular article, but then will see our other offerings on that topic as well - increasing our full-text download numbers and helping ensure the broadest dissemination of our authors’ work. See the “Clinical Reviews in Asthma” virtual issue on the web site of Clinical & Experimental Allergy here, for an example of how this works and what it looks like: http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-222 (Note: you must be logged into your member profile on the SAEM website to access this link.) Stay tuned for updates!
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WOM EN IN ACADEM ICS:
Association of American M edical Colleges Data A Few Excerpts About Women In Academia In General & Emergency Medicine As A Specialty This is information from the report shown below. This is a very interesting report and should be used as a reference for information on Women in Academics.
And SO Emergency medicine residents: Overall: • 1998, women comprised 27% 1998, women = 37% • 2008, women comprised 40% 2008, women = 45% So, we are increasing our numbers overall in the specialty. But how are we doing in Academics?
The web link URL is: https://services.aamc.org/publications/index. cfm?fuseaction=Product.displayForm&prd_id=295
HMM, remember this is overall, not just the clinical distribution, where Emergency Medicine lives.
Figure 3 shows the total number of men and women residents between academic years 2004–05 and 2008–09. The number of women residents is steadily increasing, whereas the number of men residents has been slowly declining since 2005.
Emergency Medicine comparatively Assistant Professors — EM, 30 % are women Other clinical specialties: • Lowest is Ortho at 16% • Highest is OB/GYN at 59% Associate Professors — EM, 23% are women • Lowest is Ortho at 12% • Highest is Public Health and Preventive Medicine at 47% Full Professors — EM, 13% are women • Lowest is Ortho at 4% • Highest is Public Health and Preventive Medicine at 31% Emergency Medicine is somewhere in the middle, we have work to do in academics!
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AWAEM: Networking Lunch During the CORD Academ ic Assem bly AWAEM held a networking lunch during the Council of Residency Director’s (CORD) Academic Assembly. The purpose of the lunch was to facilitate women educators making new friends, seeing old ones, and having the opportunity to discuss matters of importance to women in academic emergency medicine. The lunch was a big success, with over 24 women in attendance. The discussions were lively and centered on career issues, balancing life and work, and finding out the value of joining AWAEM and how to become involved after joining. A number of topics were discussed and suggestions made for activities that AWAEM could support which would be of value to women educators. Below is a list of the topics discussed. While they are varied, they have an important theme: what needs to be done to support the recruitment, retention, and advancement of women in academics. Topics of interest to attendees are listed in Table 1 (above right). Attendees also had suggestions for activities for AWAEM. Interestingly, AWAEM is already working in many of these areas. See Table 2 (right). Stacey Poznanski, who helped co-ordinate the luncheon, and I were overwhelmed by the enthusiasm of the women who attended. We were also happy to discover that the needs voiced by these women are being worked on by the Academy. More than ever, I am convinced that the Academy is needed and will help many women. The Academy can provide information, educational courses, brainstorming of solutions to problems and answers to questions, and, perhaps most importantly, companionship and affirmation that women can fulfill their dreams of having a successful career and a fulfilling personal life, and can truly make a difference in academic emergency medicine. Currently, the Academy is coordinating networking lunches during each of the SAEM regional meetings on research. Women should attend these to meet other women with similar concerns and possible solutions, and, perhaps most importantly, for the friendship, companionship, and affirmation that women in academic emergency medicine desire. A special thanks to Barbara Mulder, Executive of CORD, and to Maryanne Greketis.
Academic Emergency Medicine News on FACEBOOK (on SAEM’s website)
Please be sure to regularly frequent and follow many activities of the journal on SAEM’s Facebook. Comments on articles are featured there, as well as journal announcements. Another way to keep up to date with the latest information relevant to Academic Emergency Medicine, as well as other emergency medicine topics, happenings, etc!
Table 1
Table 1
Topic Topic Women and wellness Women and wellness Medical marriages Job sharing Medical marriages Negotiating Job sharing Maternity leaveNegotiating when working in: University, contract group, hospital, locum Maternity leave when working in: tenens University, contract Best practices on various subjects of group, hospital, tenens interest to women in academics
locum
Best practices on various subjects of interest to women in academics
Table 2 Suggestion Gather information Tableon2funding sources for research on topics of interest to women’s health and women academics.
AWAEM Accomplishments Marna Greenberg is chair of the committee working on this. They have completed a list of funding sources which will be Suggestion AWAEM Accomplishments published on the AWAEM website and Marna Greenberg is chair of Gather information on funding for updated. will besources periodically Increased communication including AWAEM has a Facebook page andon an eresearch on topics aofchat interest to women’s working this. They have room, Facebook and face newsletter. Information list on signing on to sources which health and“room”. women academics. of funding AWAEM’s Facebook page can be found on the AWAEM website,published and the e- on the AWAEM w will be periodically updated newsletter is posted on the website. a) PostingIncreased of FAQs and answers on AWAEM hasa articles interest to women communication including chat of AWAEM has a Facebook pa the AWAEM in academics and, even more importantly, room,website Facebook and face “room”. newsletter. Information on s has short articles, written by women in AWAEM’s Facebook page c academic emergency medicine, dealing oninterest the AWAEM website, an with many of the topics of to women who attended thenewsletter networking is posted on the w lunch. a) Posting of FAQs and answers on AWAEM has articles of inte
the AWAEM website
in academics and, even more has short articles, written by academic emergency medici with many of the topics of in women who attended the ne lunch.
AWAEM AWARENESS To All SAEM Members:
Ever think about joining AWAEM, but just haven’t done it yet? You were once a member, but you think your membership may have lapsed?
Think you are still a member, but you haven’t heard from us in a while?
If any of these situations apply to you, there is no better time than the present to take action and get involved in the Academy for Women in Academic Emergency Medicine! There is an amazing group of people working behind the scenes everyday to promote the recruitment, retention, advancement and leadership of women in academic emergency medicine throughout their careers. You could be one of them! Click here to see our Welcome Letter to new members, highlighting just a fragment of what we have to offer. Due to some recent technical difficulties, there has been some confusion surrounding the membership status of many of our members. We are actively working to fix this issue. In the meantime, we do not want you to lose out on any of the valuable resources at your fingertips. Here’s what to do... If you have never been a member or know your membership has expired, log into your SAEM account, click on “Pay for dues, donations, and interest groups,” and sign up. It’s that easy! If you think you are a member, but have not been receiving the recent eNewsletters (December and Feb issues), then consider checking on your membership. Contact Michelle Iniguez (miniguez@saem.org) for further information. We are looking forward to working with you and for you in the future. And don’t forget...the Annual AWAEM Luncheon is June 4th at the SAEM Annual Meeting in Boston. Sign up at www.saem.org today!
SIncerely, The Team at AWAEM
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Academ ic Resident Section On behalf of the SAEM GME Committee, we are pleased to re-introduce the “Academic Resident” section of the SAEM newsletter. Quarterly articles will focus on topics of interest and importance to emergency medicine residents, with topics recurring on a roughly 3-year cycle. It is our hope that you will find these articles to be useful tools in your academic/professional development. We encourage your feedback and suggestions regarding additional content areas that would be of value to residents and recent residency graduates. Feel free to email comments and suggestions to techsupport@saem.org
Jonathan Davis, MD, Georgetown University | Douglas McGee, DO, Albert Einstein | Jacob Ufberg, MD, Temple University
SAEM Annual Meeting 2011 Resident Survival Guide From: SAEM Membership Committee — Jamie Collings, MD — Christopher Fee, MD — Daniel Handel, MD The following information is meant to make the SAEM Annual Meeting more useful and fun for resident attendees. SAEM is different from most CME meetings in that the focus is research and resources for academics, as opposed to lectures based upon patient management. As a result, it can be difficult at first to know how to approach the meeting. Unlike at ACEP, at SAEM you won’t find the huge exhibit hall with all of the new toys. In order to help you navigate the Annual Meeting, the SAEM Membership Committee has come up with some suggestions to help you get more out of it. Try to see a variety of things during the meeting and explore the interest groups and didactic sessions. Challenge yourself to make it to at least one moderated poster session and one lightning oral presentation, a couple of oral abstracts, one day of IEME exhibits, and at least one interest group. If you do that and maybe a couple other things we have listed, then you will definitely get more out of the meeting. Breakdown of the meeting components: 1. C PC (Wednesday, June 1, 8am - 5pm): There are 6-7 rooms ongoing all day. The cases are always interesting and worth seeing if you have time. Be quiet when you enter so you don’t interrupt the speakers (try to enter during a break). 2. AEM Consensus Conference: Interventions to Assure Quality in the Crowded Emergency Department. Requires preregistration (Wednesday, June 1, 8am - 5pm): Developing a research agenda for interventions aimed at assuring quality of care during crowded periods. 3. Plenary Papers (Thursday, June 2, 8 - 9:30am): presentation of the 5 papers that the Program Committee felt were the most important and useful for the entire group so they get the distinction of everyone’s undivided attention. Make an effort to attend. 4. SAEM Board of Directors Q&A (Thursday, June 2, 5 - 6pm) 5. Opening Reception (Thursday, June 2, 6 - 7:30pm) 6. Chief Resident Forum (Friday, June 3, 8am - 4pm) 7. Fellowship Fair (Friday, June 3, 4:30 - 6:30pm) 8. Fun Run (Saturday, June 4, 7 - 8am) 9. A wards & Annual Business Meeting (Saturday, June 4, 2 - 3:30pm) 10. O ral Abstracts: This year over 1,100 abstracts were submitted and approximately 655 were chosen. Each day a select few receive the distinction of being presented as Oral Abstracts. These are grouped together and presented with an extended discussion of 15-20 minutes each.
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11. Lightning Oral Presentations: In a reprise of last year’s pilot initiative, authors who otherwise might have been assigned to traditional standing posters present their research in front of an audience in a rapid-fire format. 12. Moderated Posters: Each day a subset of posters will be available for viewing at your leisure. A small number of these will have a specific time where a moderator leads a discussion of posters related to a similar topic. The audience can ask questions after the brief presentation by the author. This is a distinction for these posters and allows a little more explanation/formal presentation as opposed to a typical poster. Try to attend at least one moderated poster session. 13. Posters: As said above, each day posters are available for viewing when you have some free time. They are hung in one of the large exhibit halls and you can wander through and read at your leisure. Due to space limitations, posters are not up for the entire meeting. Check the listing and visit the posters you find interesting. Authors will be available for the posters listed in the program to answer questions. 14. Photography case exhibit: Visit the exhibit hall and check out the submitted photos. There are interesting unknowns and you can compete for a prize awarded at next year’s meeting. 15. I EME Exhibits: Since most of the physicians who attend this meeting teach medical students and residents, there is an opportunity to showcase the different techniques they use. The residents and faculty who have developed these are available for 2 hours each day to discuss their projects (12:30 - 2:30pm Fri; 4:30 - 6:30pm Sat). Check these out - they are usually very interesting. 16. Didactic Sessions: Each year multiple faculty submit and others are invited to present didactic sessions. These are aimed at faculty development, teaching, education, and research methodology. Here are some that you might find interesting, there are many others listed in the program: THURSDAY, JUNE 2, 2011 #814 The Role of Research in Practice Change 12:30 - 2:00 pm #684 SAEM Online: Advancing Education and Research Collaboration in Cyberspace — 12:30 - 2:00 pm #804 Saying Dead, Dealing with Directives and Forging ahead with Family Presence: Innovative Teaching Methods in Palliative Care — 1:30 - 2:30 pm
#773 The New Spin on Mentorship: Successful Models for Modern Emergency Medicine — 2:00 - 3:30 pm #739 Improve Your Teaching: Evidence_based Teaching Workshop using Articles that will Change Your Teaching Practice — 2:30 - 4:00 pm #795 Teaching Professionalism in the Age of Gen Y and Facebook — 4:00 - 5:00 pm FRIDAY, JUNE 3, 2011 #783 Testosterone, Estrogen and Chaos: Gender Differences in Communication — 9:00 - 10:00 am #755 Coping with Rejection in Research - Resiliency Strategies to Effectively Move Forward After a Setback 11:00 AM - 12:00 noon #688 Teaching and Assessing Clinical Reasoning and Medical Decision_Making in Emergency Medicine: The Missing Link in Resident and Student Education 2:30 - 4:00 pm #790 Curricular Advances in Resident and Medical Student Education — 4:00 - 5:00 PM SATURDAY, JUNE 4, 2011 #777 Work_life Balance in Academic Emergency Medicine: Not Necessarily a Quixotic Quest — 9:00 - 10:30 AM #763 Understanding Teacher Learner Boundaries in Emergency Medicine: When the Line Blurs — 9:00 - 10:30 AM #793 Writing the Abstract and Manuscript that will be Accepted — 10:30 - 11:30 AM #710 AWAEM Annual Luncheon — 11:30 - 12:30 AM #714 Emergency Neurological Life Support — 12:30 - 2:00 PM #767 Novel Applications in Bedside Sonography 3:30 - 5:00 PM
SUNDAY, JUNE 5, 2011 #766 The Next Match: What Academic EM Departments Want When They Hire — 8:00 - 9:30 AM #723 Tips in Successful Negotiating: A Critical Skill for Your Career — 9:00 - 10:00 AM #806 Critical Career Decisions, Part 1: Should I Choose Academic EM? — 9:30 - 10:30 AM #658 Get Published Now! — 10:00 AM - 12:00 Noon #803 Critical Career Decisions, Part 2: Should I Apply for a Fellowship? — 10:30 AM - 12:00 Noon 17. Interest Groups: Find one that interests you—everyone gets one free interest group with their membership. The complete listing of times and options are in the program. Below are some that you might find interesting. • Academic Informatics • Airway • CPR/Ischemia/Reperfusion • Disaster Medicine • Diversity • ED Crowding • EMS • Evidence Based Medicine • Ethics IG • Health Services Research • International • Neurologic EM • Palliative Medicine • Patient Safety • Pediatric EM • Public Health • Sports Medicine • Trauma • Ultrasound • Uniformed Services • Wilderness Medicine
Why Maintain SAEM Membership After Completing Residency? So what does SAEM have to offer you once you complete your residency? As the premier organization for academic emergency medicine, many of its benefits for those of you planning an academic career are obvious. There are, however, lesser-known benefits for those entering academia as well as for those of you on the trajectory for community-based practices. For early-career academic faculty, SAEM membership provides opportunities for 1. Networking 2. Research collaboration 3. Task force and committee participation 4. Interest group opportunities 5. Mentorship What early academic faculty may not realize is that future promotions will require regional, national and, perhaps, international recognition. Letters of recommendation and/or a list of references who can support this are required as well, often from individuals outside of your home institution and more senior to the faculty member up for promotion. Involvement on SAEM task forces, committees, and interest groups will expose you to academic leaders from around the country. Interacting
with these research and educational leaders through face-to-face meetings (the SAEM Annual Meeting, ACEP, etc.), conference calls, and email exchanges will provide you with an opportunity to demonstrate your organizational skills, enthusiasm, and other talents. Participation in these activities not only serves to get you involved in activities of interest to you on a national level, but also exposes you to potential future collaborators, mentors, and references. You never know, these interactions my lead to future job opportunities as well. For those of you planning careers in community-based practices, membership in SAEM provides you with an opportunity to maintain a network of academic practitioners, to stay abreast of innovative educational techniques, and to participate in collaborative research activities, among other benefits. These are particularly valuable to those who plan to work at institutions that serve as secondary institutions for rotating housestaff (EM or others). Don’t forget that SAEM offers a graduated membership fee for recent residency graduates. While the full active membership fee is $545, the cost is only $325 for your first year after graduation (it’s the same as a resident, $160, if you are a fellow) and $450 your second year out. Discounted faculty group memberships are available for $480.
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Planning for an Academic Career: Strategies for EM Residency (& Beyond) Authors: Joanne L. Oakes, MD Associate Program Director, Associate Professor, Department of Emergency Medicine, The University of Texas Health Science Center at Houston, Houston, TX & Jonathan E. Davis, MD Associate Program Director, Associate Professor, Department of Emergency Medicine, Georgetown University Hospital & Washington Hospital Center, Washington, D.C. INTRODUCTION There are many reasons why an emergency physician (EP) may choose an academic career pathway: teaching, intellectual stimulation, a desire to contribute to residency education and the greater body of knowledge of emergency medicine (EM), and many others. Some physicians enter residency with the intent to pursue an academic career, while others decide to pursue an academic track later during residency, fellowship training, or after years of community practice. This article will discuss several key considerations in choosing academics and how to plan your residency training if you may be interested in pursuing an academic career. CHOOSING ACADEMICS Keeping All Doors Open One strategy to ensure that all potential EM career options remain open is to strive to become a “totipotent” EP during the course of residency training, with excellence in both clinical EM and in scholarship. Scholarship involves the creation or dissemination of knowledge through teaching, writing, application or research. Residency is the time to lay the initial foundation in each of these areas – a foundation that will grow and mature with continued experience over time. It’s Never Too Late! When, if ever, is it too late to choose academics? The short answer: it is never too late. However, the development and refinement during residency of essential skills for success in academics will prepare you if you decide to pursue academics later. Not all academic EPs chose an academic career pathway immediately after training. It is possible to successfully shift from community practice to academics, although making this transition a success may become more challenging over time due to the skill set required for a successful academic career. PLANNING YOUR RESIDENCY TRAINING Differences in Planning Strategies Based on Program Format The requisite skills for success in academics can be readily achieved during a 3-year or 4-year residency program. The goal is to begin building one’s academic skill set during residency, regardless of program format. Electives during residency that may further academic skills include dedicated teaching, research or writing projects, or other niche areas of interest, such as sonography, international EM, emergency medical services (EMS), disaster medicine, or critical care. A 4-year format may provide additional time for advancing academic skills through additional available elective time. Fellowship training following a
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3-year format may also provide academic skill development within a particular career focus. It may be difficult, if not impossible, for a new graduate of a 3-year training program to obtain a first-year faculty position at a 4-year program. This becomes less of an issue following completion of one year in practice (or fellowship training) for PGY 1-3 EM residency graduates. In addition, the majority of training programs (and hence the majority of academic faculty positions) are in the PGY1-3 format ( Of 152 total programs, 87.5% are PGY 1-3 format based on December 2010 RRC data). The Essential Skill Set Residency is the time to acquire the requisite academic skill set, which includes clinical, teaching, research, writing, administrative, and “people” skills. 1. Clinical Skills –The most important aspect of emergency practice remains excellence in patient care. Superior clinical skills in history taking, physical examination, risk stratification, use of evidence-based medicine, and cohesive, efficient clinical decision-making should be acquired and refined during residency training (and beyond). 2. Teaching Skills – Scholarship involves the creation or dissemination of knowledge. Teaching is one form of dissemination. Clinical (or bedside) teaching skills are learned primarily through the supervision and mentoring of junior residents, interns and medical students. Ask for feedback from mentors, peers, and your students. Many residencies offer a “how to teach” curriculum to upper-level residents. Teaching tutorials are available online, and the American College of Emergency Physicians (ACEP) offers a teaching fellowship for EM physicians. Didactic teaching skills are equally crucial for academic success. The adage “practice makes perfect” rings especially true for oral presentation skills. The more experience and comfort you gain with teaching in small and large groups early in your career, the better they will serve you in the future. 3. Research Skills – Discovery through research (whether clinical, educational or bench) is another essential academic skill. During training, it is most important to be involved with the discovery process. Knowledge of the fundamentals of study design, institutional review board (IRB) processes, data collection/analysis, as well as experience with bringing-it-alltogether as an abstract or manuscript are essential research experiences. Whether this involves a single small-scale project or in-depth experimentation in the laboratory is variable, and remains highly individualized. 4. Writing Skills – Expressing oneself in prose is essential for effective synthesis and dissemination of knowledge. Again, the more experience you gain with this process, the better prepared you will be for future academic success. Writing skills are necessary for abstracts, manuscripts, IRB and grant applications, curriculum, lectures, policies – essentially everything. Writing skills may also be developed and refined by authoring review articles, textbook chapters, or by serving as an editor. Seek out writing opportunities during residency, and ask for feedback from mentors. 5. Administrative Skills – An exceptional way to gain administrative experience is to get involved with committee work, whether at the local (residency program, hospital), regional, or national level. In addition, working towards and achieving committee leadership
positions is a great way to further refine your organizational, writing, task completion, leadership, speaking and networking skills. Leadership positions within your program, such as chief resident duties, also provide additional administrative experience with tasks such as scheduling, budgeting, conflict resolution, counseling, and advocacy. 6. “People” Skills – Although all of the aforementioned skills are essential for a career in academics, it is difficult (if not impossible) to effectively utilize any of them without effective “people” skills. You must learn to manage, lead, and communicate with others in your different roles. You must learn to give and receive feedback, work in teams, and develop active listening skills. Mentors are a great resource in this regard – many “people” skills are learned and refined by role modeling. Seek feedback from faculty members you respect and admire. Network with other physicians in different settings, which may stimulate ideas or allow collaboration on future projects. Obtaining Academic Skills During Clinical Training With the wide array of skills needed for success in academics, it may seem daunting to obtain any (let alone all) of them during residency training. However, it is important to remember that exposure takes precedence over mastery during residency. Trying to “do it all” may be counterproductive, leading to premature burn-out and career dissatisfaction. Familiarity with the academic process is paramount. Most academic faculty members have particular areas of interest and expertise, their “niche,” where they focus their efforts. Gain exposure to many skills, with a focus on particular skills of greatest interest to you. The Importance of Great Mentorship A mentor is “a wise or trusted counselor or teacher,” which in EM might be an upper-level resident or a faculty member. A good mentor is one who is willing to share knowledge from prior experiences with leadership, administration, research, and clinical teaching, and who is willing to direct you to additional resources for learning. Start first within your residency program. Who are the leaders? Who are the great communicators or teachers? Who are the productive researchers? Who presents nationally and publishes? Who will give useful, constructive feedback for your career journey? Participation in local, regional or national EM organizations also provides countless opportunities for mentorship through presentations, forums, networking, and collaboration. Chief Residency – Pros & Cons The decision to pursue a chief residency position can be challenging, as the duties and responsibilities will vary from program to program. The “pros” of any chief position are numerous – you will gain valuable administrative experience with residency issues, from remediation and discipline to policy-making and quality improvement. You will have opportunities to use and improve teaching, communication and writing skills. Opportunities for publications or work on projects with faculty members may be available. The chief is viewed as a leader among his or her peers, a resident advocate, and a problem solver. The “cons” of a chief year include questions of time and “the hassle factor.” The first question to answer is, “Will this be worth my time?” Some chief positions are funded as an additional year after graduation, with the chief functioning as a junior faculty member in addition to performing administrative duties, sometimes combined into an administrative fellowship. Other chief positions are incorporated into the final year of residency, combining the rigors of senior year with additional leadership demands. The senior-as-chief role may create tensions among peers within the same level of training, and may add significant time burdens to training, demanding strong organizational skills. “The hassle
factor” for you as chief is the knowledge that you are often the first person to hear from faculty, residents, program directors, and off-services when problems arise. Some view this as troubling, while others view this as invaluable growth experience. Overall, the learning and leadership opportunities offered through participation as a chief resident are vast. There may be some heartache with all the hard work, but most former chief residents walk away from the experience with great insight into the rewards and rigors of residency leadership and life in academics. Graduate Degrees – Pros & Cons Obtaining a graduate degree in public health, epidemiology, education, research, business or law (to name a few) may be advantageous to one’s academic EM career, as it creates a focus for future work, whether for teaching, research, funding or writing. You will have expertise in a particular area, have time to pursue your thesis or project(s), and gain invaluable opportunities for lifelong mentorship and collaboration with experts outside of EM. As an expert, you may be called upon to participate in local, state, or national policymaking, committees, or teaching. An additional degree is also considered an advantage in the competitive academic job market. The disadvantages of pursuing a graduate degree include time and money. Does the pursuit of the degree require that you leave EM for a significant period of time? Is there adequate protected time to achieve your goals? Will the time away from clinical income be repaid through job satisfaction later? Will you be able to use your degree in your EM work? The decision to pursue a graduate degree will ultimately be determined by an individual’s career goals and interests. While it’s not for everyone, those who choose to pursue a graduate degree to complement a career in EM often find they have gained unique skills to enhance career satisfaction in the academic EM world. LOOKING BEYOND RESIDENCY Academic Jobs: What are YOU Looking For? What are THEY Looking For? Academic departments want motivated, interested, enthusiastic, productive, and well-rounded faculty members who will contribute to the department’s overall mission. When considering an academic job, focus on the institution’s work environment. Are faculty members using their abilities to the fullest? What career paths are possible at the institution? How much support is there for innovative ideas both within the department as well as in the institution? Is startup funding available for new projects? How are the faculty rewarded for their efforts? What is the promotion structure like? What is the turnover rate? What is the mission of the department? What are your opportunities for ongoing professional development? Comparing the institution’s values with your goals is essential to finding a position that is a good fit. Advising and mentoring are essential – ask your mentors for their thoughts and feedback. CONCLUSIONS The foundations of success in academics are excellence in both clinical EM and in scholarship. Residency training is the time to pursue these skills, which can be refined with time and experience. The requisite academic skill set includes clinical, teaching, research, writing, administrative, and “people” skills. Focus on skills of particular interest to you while gaining exposure to the entire academic skill set. This approach will prepare you for future success should you choose to pursue an academic career pathway.
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2011 SAEM Young Investigator Award Winners Congratulations to the winners of the 2011 SAEM Young Investigator Awards!
Lieutenant Commander John J. Devlin, MD, is described as
a rising star not only in Military Emergency Medicine, but in Emergency Medicine in general. His research has translated directly to improvements in battlefield medicine that are saving lives in theater while improving civilian trauma care throughout the world. He has done this while receiving “Outstanding Educator” awards and deploying to conduct research and training in direct support of Joint Special Operations Command operations worldwide. Dr. Devlin is the US Navy Surgeon General SME on Simulation vs. Live Tissue training in GME. In this capacity, he has briefed the House Armed Services Committee in the use of live animals in GME, and served as panel member on the DOD Joint Analysis Team for Use of Live Animals in Medical Education and Training, a military/private industry collaboration that has led to numerous advancements in military medical training. Dr. Devlin is a primary investigator of the effectiveness of hemostatic agents in exsanguinating extremity injuries. He was invited by the Defense Medical Standardization Board Consensus Conference as an expert to standardize the animal model used for hemostatic agent research, and develop the ballistic model for effectiveness testing, education, and training. This is collaborative research, with Dr. Devlin leading the Navy Team tackling the effectiveness arm of hemostatic agents, while the US Army Institute of Surgical Research pursues the efficacy and safety aspects.
Dr.
Renee Hsia started her faculty career in 2007 at UCSF after her master’s training in health policy, planning, and financing at the London School of Economics and the London School of Hygiene and Tropical Medicine, and emergency medicine residency at Stanford University, where she received her first resident research grant from the Emergency Medicine Foundation. In the past three and a half years, she has had 31 peer-reviewed publications published or accepted (20 as first or senior author); 22 research or concept papers; 2 invited editorials; 10 oral abstracts (7 as first or senior author, including one chosen in “Cutting Edge: Highlights of Emergency Medicine Research” for the 2008 ACEP Scientific Assembly), 19 poster abstracts (12 as first or senior author, 2 international), and 5 book chapters. Dr. Hsia’s research interests are in health services issues related to increasing access to emergency care, including healthcare costs and financing issues. Her research program focuses on population access to emergency departments and trauma centers in the U.S.; the distribution of emergency care across income areas; and factors associated with closure of emergency services,
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Dr. Devlin is a consultant for the University of Calgary team developing a hemorrhagic shock model for use by Canadian Defense Department researchers. He has published or submitted four papers on wound and homeostasis, along with review articles, case series, and six letters primarily about trauma, transfusions hemorrhage and shock. He has four military grants of nearly a quarter million dollars for study of battlefield interventions for shock, airway intervention and pneumothorax. He has presented twice at the NATO tactical combat casualty care research symposium in London, and at an undergraduate research conference regarding the scientific method and challenges associated with research. He has received the Portsmouth EM Outstanding Junior Faculty Teaching Award (2009), the Council of EM Residency Directors’ Academic Achievement Award (2008), and the Virginia Chapter ACEP John P. McDade Research Award (2008). As evidenced above, Dr. Devlin has amassed an impressive resume and continues to lead research efforts that will save lives on the battlefield and at home. He has accomplished all this only 2 ½ years out of residency, while working as full-time clinical faculty with no shift credit, and while traveling overseas for months at a time to support the mission of Joint Special Operations Command. Dr. Devlin has accomplished, and will continue to accomplish, much to deserve the accolades associated with this award. Todd A. Parker, MD Louis J. Ling, MD
and how these closures affect patient outcomes. Her background in health economics allows her to analyze market-based factors affecting access, and her work has shown that systems-level disparities in our healthcare safety net can be documented empirically. She is involved in a multi-site collaboration of the West Coast Emergency Services Translational Research Network (WESTRN) with other emergency medicine researchers. She is site PI for several projects that stem from this network. Dr. Hsia’s work has received several awards, including the 2009 SAEM Mid-Atlantic Best in Session Presentation and 2009 Best Paper Award for ACEP. She served as a working group leader in SAEM’s 2010 Consensus Conference, where she coled “Beyond Regionalization: Integrated Networks of Emergency Care.” In three years, she has obtained grants and awards totaling approximately $913,000, including grants from UCSF as PI, and two prestigious national grants, one from the National Institutes of Health (the KL2 award), and another from the Robert Wood Johnson Foundation, the Physician Faculty Scholars Award. As a member of the SAEM Research Fellowship Task Force, Dr. Hsia helped develop applications for the new SAEM credentialing of research fellowships. She spoke on “Beyond the Ambulance Bay: Social Emergency Medicine” at the June 2010 meeting
2011 SAEM Young Investigator Award Winners and will serve at the 2011 meeting in two didactic sessions, on research fellowship selection and on navigating large datasets. She is writing a chapter for the mentorship section of a research primer for the ACEP Research Section. Dr. Hsia also has a significant international presence, with numerous collaborations in trauma and surgery. She is part of a global research collaboration that has implemented and studied the training of lay providers in prehospital care in Uganda, and was appointed as a faculty member of UCSF Global Health Sciences, where she continues this work on a more researchoriented perspective on the field of international health. Dr. Hsia speaks Mandarin, Cantonese, Spanish, and French, and provides emergency care to patients with a variety of backgrounds as an attending physician at San Francisco General Hospital.
Dr. Alex Manini Within 5 years of graduation from residency, Dr. Alex Manini has achieved status as an NIH-funded clinical investigator with several important scientific publications in the fields of emergency medicine, medical toxicology, and drug abuse research. Dr. Manini completed emergency medicine residency at the Massachusetts General Hospital/Brigham and Women’s Hospital, and did his fellowship in medical toxicology and Master of Science in clinical investigation at New York University School of Medicine. Since joining the faculty at Mount Sinai School of Medicine, Dr. Manini has authored multiple important research articles and successful grant proposals, including being awarded a K23 career development award from the NIH/ National Institute on Drug Abuse in May of 2009. He has also been named as a co-investigator on an R21 grant from NIH/ National Institute on Drug Abuse funded in 2010 to evaluate novel treatments for heroin dependence. Currently, Dr. Manini’s main scientific focus is the investigation of predictors of adverse cardiovascular events associated with drug overdose. Dr. Manini has been a prolific author and researcher, with over 30 peer-reviewed journal articles, including 12 first-authored original research articles. His 14 research platform presentations have been presented regionally, nationally, and internationally at important scientific conferences around the world; from these Dr. Manini has co-authored over 30 published abstracts. He was
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In a short time, Dr. Hsia has also mentored numerous residents and students, and has guided several of them to more than half a dozen published research articles. There is no doubt that Dr. Hsia’s impact and future potential are significant, both in the field of emergency medicine research and for emergency medicine researchers. Her health services research agenda, as well as her collaborative work with others, bode well for the field, and will help research in our specialty to advance. Michael L. Callaham, MD Louis J. Ling, MD
recently awarded the “Best Platform Award” from the American Association of Poison Control Centers for his abstract presented at the 2009 North American Congress of Clinical Toxicologists. Dr. Manini’s early success with grantsmanship as a young investigator is truly impressive. He was awarded a K23 mentored patient-oriented career development award (grant #1K23DA026476, PI Manini) from NIH/NIDA in May 2009, entitled “Predicting adverse cardiovascular events in emergencies due to drug overdose.” He is co-investigator on a R21 research award (grant # R21DA 027781, PI: Hurd) from NIH/NIDA in 2010, entitled “Cannabidiol as a treatment intervention for opiate relapse.” However, Dr. Manini’s completed research grants are also testament to his potential in research in his field. He was awarded the 2008 Speakers’ Fund: Towards the Science of Patient Care, awarded by the City of New York, to investigate agreement between the medical examiner and medical toxicologist in poisoning fatalities. He has received funding from the NIH Clinical Loan Repayment Program (grant #KAAJ5086, PI Manini) since 2007. His prior completed research grants include funding from Massachusetts General Hospital, Dade Behring Corporation, UCSF Medical School, and the American Heart Association. From a history of continued success, it is clear that Dr. Manini will continue to compete successfully for federal grant money to support his crucial research well into the future. We expect that he will have a long-lasting impact on medical toxicology, drug addiction and emergency medicine. Andy Jagoda, MD Louis Ling, MD
Academic Emergency Medicine Now Offers CME Credit ACADEMIC EMERGENCY MEDICINE is now offering continuing medical education (CME) credits for reading select articles in the journal and successfully completing a test on the content. Physicians interested in completing the exam should log on to www.wileyblackwellcme.com. Upon successfully finishing the activity, physicians will receive an electronic certificate of completion, which can be printed and saved online under the user’s profile. The program is free to subscribers of the journal. Stay tuned for updates!
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SAEM EXCELLENCE IN RESEARCH AWARD 2011 Adam
J. Singer, MD is an outstanding academic emergency physician who is one of the most prolific emergency physicians.in the United States, in terms of quantity and quality of his publications. He has over 300 publications, of which over 200 are peer-reviewed original research publications. He has received numerous investigator-initiated grants. Not only is his work voluminous, but also it is of the highest quality. Some of his work includes development of the first clinically relevant tool for assessing the cosmetic outcome of healed lacerations. Using this data tool, he has performed multiple clinical studies on the optimal methods of wound management, evaluating such areas as irrigation, cleansing, anesthesia and effect of practitioner experience. The results of these studies have impacted the clinical care of millions of patients with laceration and acute wounds. One trial of great importance was the first randomized controlled US trial comparing octylcyanoacrylate tissue adhesive to standard wound closure. The results of this trial led to the FDA approval of Dermabond, the first tissue adhesive approved for use in the US. It is noteworthy that the design of this trial used the cosmetic outcome scale that Dr. Singer co-developed to assess long-term treatment results. Dr. Singer has also contributed to the field of thermal burns. He has developed several novel animal models and outcome measures and has evaluated state of the art therapies for burns including inhibitors of TGF-β, TNF-α, and mesenchymal stem cells. Dr. Singer’s accomplishments are exemplified by the extramural funding that he has received, including $2.5 million from the
Department of Defense, $1 million from the Navy, and, most recently, $1.7 million from the NIH to evaluate novel therapies aimed at reducing burn wound progression. Dr. Singer is also a co-investigator or collaborator on several NIH SBIR grants totaling over $1 million. In addition, Dr. Singer has received several million dollars in research support from industry over his career. Dr. Singer’s areas of research have also included acute coronary syndromes and pain evaluation and management in the ED. His research has been published in the most widely-read journals of our field (Annals of Emergency Medicine and Academic Emergency Medicine), as well as in well-cited general medicine and surgical journals. The importance of his research has been highlighted by his three first author manuscripts in The New England Journal of Medicine. Dr. Singer is also a superb educator. He can take his breadth of knowledge and reduce it to an understandable level for even the most junior trainee, evident from his numerous awards from the resident to faculty level. He is the editor of a pocket manual for emergency medicine residents and rotating residents and editor of an evidence-based text for management of lacerations and acute wounds. He has given many invited lectures, both nationally and internationally. Dr. Singer has served as a role model for hundred of undergraduate students, graduate students, medical students, fellows, and attending physicians. Dr. Singer has made significant contributions locally to SAEM and is currently Secretary-Treasurer. He is the reviewer of multiple journals, an Associate Editor of AEM, chaired the abstract selection committee and the grant selection committee for SAEM, and has been a member of the ACEP Scientific Review Committee. Louis J. Ling, MD
SAEM LEADERSHIP AWARD 2011 Dr. Judd Hollander has been an
active member of many SAEM committees, including the Program Committee, Nominating Committee, Financial Development Committee, Annual Meeting/ Program Committee, Awards Committee, Industry Relations Task Force, and the SAEM-ACEP NIH Task Force. He has been on the Board of Directors, President and currently is Chair of the Research Fellowship Credentialing Committee.
crowding. Another important change was the growth of emergency medicine research. The Institute of Medicine report on emergency care had already been released. He worked to establish the ACEP-SAEM Joint NIH Task Force and was able to open the door to the NIH and increase support for emergency care research. As this effort was maturing, Dr. Hollander became the inaugural chair of the SAEM Research Fellowship Task Force to credential research training programs. The work of this Task Force, along with other coordinated efforts from ACEP and SAEM, ultimately led to the first NIH emergency medicine training grant (K12) RFA. His leadership with a large group clearly facilitated these events..
During his tenure on the Program Committee, he worked to redesign work flow and scientific rigor in the annual meeting selection process, studied and redesigned a new abstract scoring system, and mentored more junior members to take on leadership roles.
Dr. Hollander felt that SAEM was greatly enhanced by the creation of the Academy within SAEM. Over the ensuing three years, he helped create the Clerkship Directors of Emergency Medicine Academy, and in that time three other academies have been created.
As President-Elect and President, he helped create the Research Foundation, established a separate educational fund, and created new committees to collaborate with other organizations on guideline development and with federal agencies addressing ED
Dr. Hollander’s leadership is not limited to SAEM, but can also be found in his research and his mentoring. He has more than 300 publications in peer-reviewed journals and textbooks. He has conducted or led many multi-center studies. He has been a
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steering committee member of numerous multi-center clinical trials; served on multiple guideline committees; and organized the collaboration between SAEM, ACEP, AHA and ACC to develop standardized reporting guidelines for risk stratification studies of ED patients with potential acute coronary syndromes.
Institutional Research Training Grant and NIH K23s. Mentees at all levels have won national awards for their mentored work, including Best Medical Student Presentations, Best Resident Presentation, Best Young Investigator Presentation, and career productivity (SAEM Young Investigator Award and ACEP Research Award).
Dr. Hollander created the Academic Associate Emergency Medicine Research Program, which forms the backbone of one of emergency medicine’s most successful and most replicated clinical research programs. He shared this curriculum with other institutions and now multiple EM programs use this model. He has mentored 7 investigators on foundation grants, the SAEM
Judd has an extensive track record of bringing people and organizations together, as well as of mentoring SAEM members at all levels. Deb Houry, MD Louis J. Ling, MD
SAEM HAL JAYNE EDUCATIONAL EXCELLENCE AWARD 2011 It is our distinct pleasure to present the distinguished Hal Jayne Educational Excellence Award to James G. Adams, MD.
James G. Adams, MD, completed
residency at the University of Pittsburgh in 1991, where he served as Chief Resident. He then served four years in the United States Air Force (USAF), during which he became chairman at the flagship teaching hospital Wilford Hall Medical Center. During his tenure, the department of emergency medicine was honored for both high quality of clinical care and high quality of resident education. The residency program consistently achieved some of the highest in-service scores in the United States and attained nearly a 100% pass rate on the board exams, largely due to educational innovations in the curriculum. Dr. Adams spearheaded a program for research fellowship training for emergency medicine faculty, which has produced current RO1 funded investigators in civilian universities. His accomplishments were recognized with a USAF Achievement Medal for distinctive service. Upon completion of his military commitment in 1995, he joined the Brigham and Women’s Department of Emergency Medicine as the Director of Clinical Operations. As one of the founding faculty of this Harvard-affiliated department, he contributed to a team that successfully established a residency in 1996. From 1997 to 2000, he was honored with 7 awards by the residents, including 2 for Best Role Model and 3 for outstanding contribution as a teacher, lecturer, and clinician, and for overall dedication to the residency. His commitment and dedication was commemorated with the inauguration and continuation of a Brigham and Women’s Department of Emergency Medicine leadership award.
At Northwestern, he has helped lead the advancement of the educational programs, developed fellowship training, and elevated performance of didactic and clinical experiences. His academic work is related to ethics, professionalism, quality management and organizational performance. He has been a member of or led national quality committees that have promoted national standards in medical care, working with the National Quality Forum, the Centers for Medicare and Medicaid, the Joint Commission, the American College of Emergency Physicians and other national organizations. He has led numerous national ethics committees, task forces, and writing groups related to professionalism and ethics in emergency medicine. Dr. Adams has served in leadership positions on multiple committees and task forces for several medical professional societies, with his SAEM service including the Board of Directors from 2002 – 2005. He is the current president-elect of the Association of Academic Chairs of Emergency Medicine. He has also been active on multiple editorial boards, including those of Journal Watch, Academic Emergency Medicine and Rosen’s Emergency Medicine. In summary, Dr. James G. Adams has been an influential local, national and international educator. Dr. Adams has inspired a legacy of vision in those he has taught and mentored. He has inspired a vision of quality in education, patient care and professionalism. Those mentored by him recount how he inspires a vision of possibility – believing in others to such an extent that they truly believe in themselves as well.. Tiffany M. Osborn, MD, MPH
Academic Emergency Medicine on the Wiley Online Library Platform Make sure you keep checking the journal’s home page on the recently implemented platform, Wiley Online Library (WOL) - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1553-2712. Many new features appear in the form of “modules” and will be updated on a regular basis. The new platform is more robust and easier to navigate, with enhanced online functionality. Visit often and stay tuned for updates!
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SAEM SPECIAL RECOGNITION AWARD 2011 Catharine (Cathy) Burt and Linda McCaig have been key
drivers of the annual CDC emergency department survey included in the National Hospital Ambulatory Medical Care Survey (NHAMCS) since its inception in 1992. The National Center for Health Statistics (NCHS), a branch of the CDC, is located in Hyattsville, Maryland. As Chief of the Ambulatory Care Statistics Branch and later of the Ambulatory and Catharine Burt Hospital Care Statistics Branch, Cathy Burt provided leadership and motivation for both the National Ambulatory Medical Care Survey, a survey of office practice, and its counterpart in the hospital setting, NHAMCS. Without her fire and skills of persuasion, the exhaustive annual reports on ED practice would never have materialized. These surveys are massive projects involving the training of widely scattered Census Bureau field representatives, coordination with other federal and private contractors, statistical analysis, and, finally, Linda McCaig the shepherding of reports past a gantlet of editors. Cathy was herself the author of many insightful reports important to the practice of emergency medicine, including a key publication on the prevalence of “safety net care” among EDs, and a 2006 publication on national ED staffing, capacity, and ambulance diversion. This latter publication brought quantitative information on ED crowding into the national
policy discussion, and to this day is the only objective, nationally representative estimate of the number, size, and volume of emergency departments in the United States. Cathy’s commitment to the surveys was exhaustive: staying late, editing and writing papers on her days off, and encouraging her staff to do be equally committed. Unfortunately for emergency medicine, she recently retired to North Carolina, where she is now collaborating with the University of North Carolina to study that state’s emergency department data. Linda McCaig began her career in the clinical arena, but, after epidemiologic training at Johns Hopkins School of Public Health, found herself at NCHS. Linda has been instrumental in developing, conducting, and analyzing NHAMCS ED surveys since 1992. Over the years, Linda has become the guardian of the ED survey, progressively adding policy-relevant data items to the survey. In a soft-spoken way, she has been an unstoppable force, each year overcoming new obstacles to produce the numbers that speak for our profession. In addition to this primary task, the planning and production of the annual survey, Linda has also been a prolific writer. She has been the analyst or co-author on numerous scientific papers used in policy discussions on important national trends and the future of emergency medicine. These two unsung heroes have been intimately connected with emergency medicine for many years, and could often be seen together at national ACEP and SAEM meetings. The specialty and especially the academicians of emergency medicine owe them a great deal for their commitment to the details which will remain a feature of the national ED survey. Deb Houry, MD Louis J. Ling, MD
SAEM ADVANCEMENT OF WOMEN IN ACADEMIC EMERGENCY MEDICINE AWARD WINNER 2011 Dr. Katherine Heilpern is well
known to all SAEM members, having served in every leadership role in the organization, including the presidency. She is the 2011 recipient of the SAEM Advancement of Women in Academic Emergency Medicine Award. Dr. Katherine Heilpern graduated from The University of Virginia and Emory University School of Medicine, completed her postgraduate training at Temple University, and is board certified in both Internal Medicine and Emergency Medicine. She served on the faculty of the Division of Emergency Medicine at Temple University School of Medicine from 1990 – 1996, where she was Director of Undergraduate Education. She took a brief break from Temple University to work for a year at Indian Health Service in Fort Defiance, Arizona. In 1996, Dr. Heilpern joined the Division of Emergency Medicine at Emory University, where she has been Director of Undergraduate Medical Education, interim Residency Director, Vice Chair for Academic Affairs, and the Ada Lee and Pete Correll Professor and Chair of the Department of Emergency Medicine. Until she became chair, she was also a part-time Assistant Dean. In all of her roles, she has been a highly visible role model for women students and faculty. In 2002-2003, Dr. Heilpern was a fellow in the Executive Leadership in Academic Medicine (ELAM) Program for Women, a prestigious training program for women leaders in academic
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medicine. She currently mentors other ELAM fellows and graduates. One of Dr. Heilpern’s stated ELAM goals was to incorporate into her professional life a national community of women health care leaders from whom she could learn, with whom she could share, and with whom she could ultimately teach. Now, as a senior leader, she does exactly that. At Emory University, she helped improve the status and expand the role of women. Her leadership style of inclusiveness, transparency, and honesty is an example to others. She encourages and empowers women to aspire to leadership roles in Emergency Medicine and has opened pathways for women to follow, and helps them navigate the way. One of her faculty commented that the single phrase that sums up Dr. Heilpern is “True North” - know your goals and stay on course. When you’ve strayed, look at your compass and get back on the path. She currently serves on the Board on the Health of Select Populations for the Institute of Medicine and as a contributor to the Academic Leader Program for the American College of Emergency Physicians. Dr. Heilpern has been recognized many times for her excellence in leadership and teaching. In summary, Dr. Katherine Heilpern is truly an SAEM member whose outstanding efforts and achievements have promoted the careers of women in academic Emergency Medicine. She has devoted endless energy to mentoring the next generation of women in academic Emergency Medicine. Congratulations, Dr. Heilpern, on being named the recipient of the 2011 Advancement of Women in Academic Emergency Medicine Award. Rita K Cydulka, MD, MS
Michigan State University Kalamazoo Center for Medical Studies
Associate Program Director The Department of Emergency Medicine and the Center for Vascular Biology Research (CVBR) at Beth Israel Deaconess Medical Center is seeking a fulltime biomedical scientist in the area of vascular biology. We are seeking candidates with the skills, training, and productivity to be a successful independent investigator in basic or translational research in vascular biology. The research should involve fundamental mechanisms of disease directly or broadly related to acute and/or critical illness. The CVBR is an interdepartmental consortium of over 25 core investigators working in contiguous research space with expertise in pulmonary vascular disease, sepsis, translational medicine, diabetes, structural biology, atherosclerosis and angiogenesis. The Department of Emergency Medicine and the CVBR strongly encourage interactions among research and clinical faculty and provide opportunities to access specimens collected as part of a number of active clinical/translational research initiatives. We also provide unparalleled opportunities for collaborative interactions within the basic and applied vascular biology research community at Harvard Medical School and its affiliated teaching hospitals. The successful candidate will receive an appointment to the faculty of Harvard Medical School at a rank that is commensurate with his/her qualifications. Applicants must hold a PhD and/or MD degree. Beth Israel Deaconess Medical Center and Harvard Medical School are Equal Opportunity Employers. Women and minorities are particularly encouraged to apply. Please send applications or nominations via email, together with a current curriculum vitae, a statement outlining existing and planned research activities and career goals and the names of three professional references to: Dr. Nathan I. Shapiro, MD, MPH Vice Chairman of Research Department of Emergency Medicine Beth Israel Deaconess Medical Center, 1 Deaconess Road, CC2-W Boston, MA 02215 Nshapiro@bidmc.harvard.edu
The Department of Emergency Medicine at Michigan State University .DODPD]RR &HQWHU IRU 0HGLFDO 6WXGLHV VHHNV WR ÂżOO WKH QHZO\ FUHDWHG position of Associate Program Director. 2XU ZHOO HVWDEOLVKHG HPHUJHQF\ PHGLFLQH UHVLGHQF\ SURJUDP HQWHUV WZHQW\ UHVLGHQWV SHU \HDU LQ D IRUPDW :H WUHDW QHDUO\ SDWLHQWV DQQXDOO\ LQ RXU WZR /HYHO , WUDXPD FHQWHUV 2XU LQQRYDWLYH UHVLGHQF\ FXUULFXOXP IHDWXUHV SDUWLFXODU VWUHQJWKV LQ FULWLFDO FDUH (06 DQG DLU PHGLFLQH PDNHV H[WHQVLYH XVH RI PHGLFDO VLPXODWLRQ DQG SUR YLGHV H[FHOOHQFH LQ FOLQLFDO WUDLQLQJ :H VHHN D KLJK HQHUJ\ LQGLYLGXDO ZLWK D GHPRQVWUDWHG SDVVLRQ IRU medical education and residency leadership. The Associate Program 'LUHFWRU ZLOO UHSRUW WR WKH 3URJUDP 'LUHFWRU DQG EH UHVSRQVLEOH IRU assisting in and sharing the leadership of the Program and all its edu cational activities. &DQGLGDWHV VKRXOG EH $%(0 $2%(0 FHUWLÂżHG ,QGLYLGXDOV ZLWK IHO ORZVKLS WUDLQLQJ DUH HQFRXUDJHG WR DSSO\ 7KLV SRVLWLRQ SURYLGHV DQ DSSURSULDWH DFDGHPLF DSSRLQWPHQW KLJKO\ FRPSHWLWLYH FRPSHQVDWLRQ DQG EHQHÂżWV DPSOH SURWHFWHG WLPH DQG D GHOLJKWIXO IDPLO\ IULHQGO\ XQLYHUVLW\ FRPPXQLW\ LQ ZKLFK WR OLYH DQG ZRUN ,QWHUHVWHG FDQGLGDWHV VKRXOG IRUZDUG D FRYHU OHWWHU DQG &9 WR 'DYLG 2YHUWRQ 0' 0%$ )$&(3 )$&3 Professor of Emergency Medicine Michigan State University Kalamazoo Center for Medical Studies 2DNODQG 'ULYH .DODPD]RR 0LFKLJDQ )$; RYHUWRQ#NFPV PVX HGX
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SAEM Newsletter May/June 2011 ½ page DH 139548 AMMP
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Is Fellowship for M e? Jody A. Vogel, MD Denver Health Medical Center Residency is an exciting and exhilarating journey. Over several years’ time, one works hard to develop the vast array of clinical, leadership and management skills required to become a practicing emergency physician. As senior year approaches, it becomes clear that the predictable routine of being a resident is nearing its conclusion, and important decisions are on the horizon. Similar to the time and thought that were invested in choosing a specialty, the decision regarding the immediate post-residency path will require both personal reflection and a thoughtful evaluation of long-term career goals. Residency graduates have the option to complete postgraduate training or to accept a position as a practicing emergency physician. Frequently this can be a difficult decision. Some residency graduates may ask why anyone would want to subject themselves to more training after completing residency. Others wonder if post-graduate training is truly a necessity for their personal career interests. The purpose of this article is to provide a brief overview of fellowship training opportunities and to discuss some of the advantages and disadvantages of postgraduate training. There are a wide variety of fellowships available to emergency medicine residency graduates (Table 1). Information about the types of fellowships can be found on the SAEM website at http://www.saem.org/saemdnn/Home/Communities/Fellows/ Fellowship/tabid/78/Default.aspx. Reviewing the online information about fellowship training opportunities is one method of identifying post-graduate training options. However, it is also important to obtain information from faculty mentors, particularly if the faculty member practices in the subspecialty area of interest. Faculty mentorship is vital to the fellowship application success. The faculty member may be knowledgeable about programs of interest and can offer guidance regarding training sites and the application process. A mentor may also be willing to advocate for the applicant who desires training at a specific program or in a certain geographic location. Unlike the application process for residency, there is no national match or standard application for fellowship positions. The timeframe for the evaluation and selection of a fellowship program is dependent on the fellowship selected by the applicant. A fellowship is a focused time of study with supportive mentorship to facilitate the growth and development of the trainee within the subspecialty area. It is an opportunity to develop the foundation for an area of expertise, or a niche, within emergency medicine. The fellowship may incorporate several projects within the field of study, such as research, scientific writing, and national presentations of study outcomes. The program may include unique teaching opportunities as well as national networking, committee membership, and conference attendance. Frequently the fellowship provides access to special coursework or a graduate degree. Fellowship training facilitates the development of the skills required for an academic career in emergency medicine. Residency training is appropriately focused on attaining medical knowledge and clinical skills. Even if a resident is highly involved in education
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Table 1. Post-Graduate Training Opportunities Program Type
Duration
Administration
1 – 2 years
Cardiovascular Emergencies
1 – 2 years
Clinical Research
1 – 2 years
Critical Care
1 – 2 years
Disaster Medicine
1 – 2 years
EMS
1 – 2 years
Geriatric Emergency Medicine
1 year
Health Policy
1 – 2 years
Hospice/Palliative Care
1 – 2 years
Hyperbaric
1 year
Injury Prevention
1 – 2 years
International Emergency Medicine
1 – 3 years
Medical Education
1 – 2 years
Medical Informatics
1 – 2 years
Neurologic/Neurovascular
1 – 2 years
Observation
1 – 2 years
Palliative Care
1 – 2 years
Pediatric Emergency Medicine
2 – 3 years
Research
1 – 2 years
Simulation Education
1 – 2 years
Sports Medicine
1 year
Toxicology
1 – 2 years
Trauma
1 – 2 years
Ultrasound
1 – 2 years
Wilderness Medicine
1 year
and research during residency, it is simply not possible to achieve mastery of the academic skill set which is necessary for success. Essential skills for academic success include teaching, medical writing, basic statistics, grant writing, and study design. In a survey of emergency medicine residents, the respondents rated their training in medical writing, statistics, grant writing, and study design as only fair.1 Program directors agreed that residency graduates lack academic skills, indicating that only 29 percent were well prepared for a career that involved research.2 Practicing academicians believe that residency training did not prepare them for the rigors of academia3, and note that insufficient research training is a significant barrier to their ability to achieve academic productivity.4
Achieving productivity as an academic emergency physician is critical to success and correlates with career satisfaction. Fellowship graduates have fewer concerns about their academic performance and note increased career satisfaction as compared to their peers.5 Individuals without fellowship training were more likely to express discontent and uncertainty related to their career. These findings may be associated with the fact that fellowship trained individuals are not only more prepared for the demands of academia, but also are frequently able to negotiate reduced clinical responsibilities to be able to participate in research and other leadership opportunities directly related to their interests. The ability to tailor time to specific career interests is likely to increase academic productivity and enhance overall career satisfaction.6 Fellowship training facilitates the rewards of academic productivity. Fellowship trained faculty have a greater number of publications, are more successful in obtaining grant funding, and are more likely to be promoted.7 Post-doctoral training duration is positively correlated with a faculty member’s research activity and service as a principal investigator on a peer-reviewed research grant.8 Recently, it has been suggested that the time to obtaining grant funding for research is less for individuals who have completed fellowship training. Fellowship training also facilitates important mentoring relationships which are critical to success in academia. Individuals who associate and collaborate early with senior scientists are more likely to be productive researchers themselves. Data demonstrate that the most productive researchers have strong mentored relationships with senior investigators.6,9 While a person could establish mentored relationships as a junior faculty member, dedicated research time in fellowship may facilitate more rapidly both the mentor-mentee relationship and earlier research productivity. Autonomy has been suggested to be negatively correlated with productivity during a researcher’s first year as a faculty member.10 Post-graduate training provides dedicated time to immerse oneself in a field of study and achieve productivity in the area of interest. This is an especially important opportunity since commonly a junior faculty member is expected to both work clinically and assume a number of administrative duties, leaving little time for research or projects of interest. As a junior attending, it can be especially difficult to decline requests from the academic chair to become involved with multiple administrative obligations. Lack of dedicated time to obtain necessary research skills has been noted by junior academic faculty to be the greatest obstacle to success in academia.3 As a junior faculty applicant, fellowship training may offer a significant competitive advantage when seeking an academic appointment. Previously, obtaining a position in academia without fellowship was common due to a shortage of academic emergency medicine faculty.6 However, the expectations for incoming junior faculty have changed, and many institutions are trending toward hiring primarily fellowship trained graduates, particularly in geographically desirable locations. As a fellowship trained applicant, one has a niche within emergency medicine, and the value of having expertise to supplement the existing knowledge of one’s future colleagues should not be underestimated. Although there are a number of significant advantages to fellowship, one certainly must consider the financial ramifications of additional training. Fellowship delays the onset of the typical
practicing emergency physicians’ salary which can be a significant financial disincentive. This factor must be weighed against the aforementioned benefits and the marketability that one can secure through fellowship training. Some fellowships, especially those with a strong research emphasis, may offer the flexibility of increased financial earning potential through grant-funded salary support. A fellowship trained graduate may also have administrative appointments or responsibilities that will provide a salary benefit, such as serving as the Emergency Medical Services Director. While fellowship does involve a time investment and delay of financial compensation, the dividends one may reap are substantial, including advanced skill development along with increased marketability, productivity, and career satisfaction. The decision regarding whether to pursue fellowship is a personal one that requires an honest assessment of one’s personal and professional career goals. Success and happiness will surely follow for those who consider the available options and wholeheartedly pursue their own passion. If you would like more information on fellowship training, please join us for the SAEM Annual Meeting June 1st thru 5th in Boston. At the meeting, the SAEM Fellowship Fair will provide one-on-one access to a diverse array of fellowship directors from around the country. This program will be held on June 3rd from 4:30 til 6:30 pm. Attend the fellowship fair to network with fellowship directors and to get the most up to date information on post-graduate training opportunities. On Sunday, June 5th, please join us for the didactic “Should I Apply for a Fellowship” from 10:30 am til noon. In this session, fellowship training opportunities will be reviewed, and the advantages and disadvantages of post-graduate training will be discussed. The experts will answer the popular question, “Is fellowship now required for an academic career?” Information on the new SAEM Institutional Research Fellowship Program and certified research training sites will be provided. A panel of recent fellowship graduates will discuss characteristics to consider when evaluating a fellowship program, tips for application success, and outcomes that resulted from fellowship training. We very much look forward to seeing you in Boston! References 1. Neacy K, Stern SA, Kim HM, et al. Resident perception of academic skills training and impact of career choice. Acad Emerg Med. 2000;7:1408-15. 2. Stern SA, Kim HM, Neacy K, et al. The impact of environmental factors on academic emergency medicine resident career choice. Acad Emerg Med. 1999;4:262-70. 3. Broaddus VC, Feigal DW. Starting an academic career. A survey of junior academic pulmonary physicians. Chest. 1994;105:1858-63. 4. Sanders AB, Fulginiti JV, Witzke DB, et al. Characteristics influencing career decisions of academic and nonacademic emergency physicians. Ann Emerg Med. 1994;23:81-7. 5. Anderson KD, Mavis BE. The relationship between career satisfaction and fellowship training in academic surgeons. Am J Surg. 1995;169:329-33. 6. Stern S. Fellowship training: a necessity in today’s academic world. Acad Emerg Med. 2002;9:713-716. 7. Taylor JS, Friedman RH, Speckman JL, et al. Fellowship training and career outcomes for primary care physician-faculty. Acad Med. 2001;76:366-72. 8. Levey GS, Sherman CR, Gentile NO, et al. Postdoctoral research training of full-time faculty in academic departments of medicine. Ann Intern Med. 1988;109:414-8. 9. Cameron SW, Blackburn RT. Sponsorship and academic career success. J Higher Educ. 1981;52:369-77. 10. Katz RL. Job longevity as a situational factor in job satisfaction. Admin Sci Q. 1978;23:204-223.
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¸ Clinician-Educator ¸ Clinical Researcher ¸ ¸ Clinical Toxicologist ¸ The Department of Emergency Medicine at the Brody School of Medicine at East Carolina University is expanding its faculty. We are seeking BC/BP emergency physicians for tenure or clinical track positions at the rank of assistant professor or above, depending on qualifications. Our current faculty possesses diverse interests and expertise leading to extensive state and national-level involvement. Through this expansion we hope to increase our depth and further develop programs in clinical toxicology and clinical research, and our cadre of clinicianeducators. The emergency medicine residency is well-established and includes 12 EM and 2 EM/IM residents per year. We treat more than 90,000 patients per year in a state-of-the-art ED at Pitt County Memorial Hospital. PCMH is a rapidly-growing level I trauma, cardiac and regional stroke center. Our tertiary care catchment area includes more than 1.5 million people in eastern North Carolina, many of whom arrive via our integrated mobile critical care and air medical service. Greenville, NC is a livable, family-oriented university community located ninety minutes from the Crystal Coast. Cultural and recreational opportunities are abundant. Compensation is competitive and commensurate with qualifications; excellent fringe benefits are provided. Successful applicants will possess outstanding clinical and teaching skills and qualify for appropriate privileges from ECU Physicians and PCMH. Screening begins July 1 and will remain open until filled.
Imagine being part of a team that makes a discovery. Emergency Medicine Faculty UMDNJ-Robert Wood Johnson Medical School is searching for faculty physicians for its Department of Emergency Medicine on the New Brunswick campus. Candidates should be residency trained board certified/eligible in Emergency Medicine (ABEM, ABOEM). Clinical responsibilities include direct patient care and attending supervision of residents and medical students in the Robert Wood Johnson University Hospital Emergency Department. The department has a residency program in Emergency Medicine and has an established EMS fellowship, is developing a research program and increasing Emergency Medicine education within the medical school. Academic responsibility includes contribution to all aspects of the Department’s growth. Robert Wood Johnson University Hospital serves as the medical school’s primary teaching affiliate. Robert Wood Johnson is a 580 bed Level One trauma center with an annual ED census of greater than 65,000 adult visits. A separate pediatric Emergency Department sees approximately 20,000 patients per year. RWJUH has an active EMS system. Qualified candidates should send a letter of intent and curriculum vitae to: Robert Eisenstein, MD Associate Professor & Vice Chairman, Department of Emergency Medicine, Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, MEB 104, New Brunswick, New Jersey, 08903. Email: eisensrm@umdnj.edu Call: 732-235-8717, or Fax: 732-235-7379. Academic appointment is commensurate with experience. UMDNJ is and Affirmative Action/Equal Opportunity Employer.
Confidential inquiry may be made to Theodore Delbridge, MD, MPH, Chair, Department of Emergency Medicine (delbridget@ecu.edu). Must apply online by using ECU OneStop on the main ECU page: www.ecu.edu. ECU is an EEO/AA employer and accommodates individuals with disabilities. Applicants must comply with the Immigration Reform and Control Act. Proper documentation of identity and employability required at the time of employment. Current references must be provided upon request.
www.ecu.edu/med
www.uhseast.com
Heal the sick, advance the science, share the knowledge.
SAEM NEWSLETTER 05/01/2011 Faculty Positions in Division6151839-NYPC47281 of Pediatric Emergency Medicine The Mayo Clinic Department of Emergency Medicine in Rochester, Minnesota is seeking faculty members for its Division of Pediatric UMDNJX Emergency Medicine. The Division is looking for applicants that are: • Skilled in pediatric emergency medicine with an emphasis 3.5”onxprovision 4.75”of clinical care • Committed to the teaching of medical students and residents in pediatrics, emergency medicine, and family medicine Colleen Gilrain • Interested in advancing the care of acutely ill and injured pediatric patients in thev.2 region of Southeastern Minnesota, Northern Iowa,
and Western Wisconsin through quality improvement initiatives in the region • Interested in working in a collaborative practice with a committed group of emergency medicine and pediatric subspecialty providers • Board certified in pediatric emergency medicine or board certified in pediatrics and emergency medicine • Eligible for Minnesota medical licensure
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Options are also available for qualified candidates to be involved as Division Director or as a member of the child abuse evaluation team, inpatient pediatric practice, or a pediatric sedation practice.
Mayo Foundation is an affirmative action and equal opportunity employer and educator. Post-offer/preemployment drug screening is required.
© 2010 NAS
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The practice setting is the St. Mary’s Hospital Emergency Department in Rochester, Minnesota with an annual volume of 75,000 visits per year, including over 14,000 pediatric visits. The practice involves the care of all levels of acutely ill and injured children at a recently recertified Level One adult and pediatric Trauma Center. All pediatric subspecialties are available through the Mayo Eugenio Litta Children’s Hospital, a state-of-the-art pediatric facility. Multiple opportunities for collaboration and career development are available through faculty members in both the Department of Emergency Medicine and the Department of Pediatric and Adolescent Medicine. Academic appointment is provided through the Mayo College of Medicine. A highly competitive salary along with an outstanding benefit package is offered. Located in Southeastern Minnesota, Rochester is a growing and diverse community of over 100,000 people. An excellent school system and safe community characterize the values of the city. To learn more about Mayo Clinic and Rochester, MN, please visit http://www. mayoclinic.org/physician-jobs/
For further information, please contact: Brent R. Asplin, MD • Chair, Department of Emergency Medicine Mayo Clinic College of Medicine 1216 Second Street SW • Rochester, MN 55902 Phone: (507) 255-6501 • email: asplin.brent@mayo.edu
The Department of Emergency Medicine at the University of Alabama School of Medicine is seeking talented residency-trained Emergency Medicine physicians at all academic ranks to join our faculty. The University offers both tenure and non-tenure earning positions. The University of Alabama Hospital is a 903-bed teaching hospital, with a state of the art emergency department that occupies an area the size of a football field. The Department treats over 75,000 patients annually and houses Alabama’s only designated Level I trauma center. The Department’s dynamic, challenging emergency medicine residency training program is the only one of its kind in the State of Alabama. The University of Alabama at Birmingham (UAB) is a major research center with over $440 million in NIH and other extramural funding. The Department of Emergency Medicine is a site for the NIH-funded Resuscitation Outcomes Consortium (ROC) and for the Protocolized Care of Early Sepsis Shock trial (ProCESS). The Department has been highly successful in developing extramural research support in this warmly collaborative institution. Birmingham, Alabama is a vibrant, diverse, beautiful city located in the foothills of the Appalachian Mountains. The metropolitan area is home to over one million people, who enjoy recreational activities year round because of its mild southern climate. Birmingham combines big city amenities with Southern charm and hospitality. A highly competitive salary is offered. Applicants must be EM board eligible or certified. UAB is an Affirmative Action/Equal Opportunity Employer. Women and minorities are encouraged to apply. Please send your curriculum vitae to: Janyce Sanford, M.D., Associate Professor & Chair of Emergency Medicine, University of Alabama at Birmingham; Department of Emergency Medicine; 619 South 19th Street; OHB 251; Birmingham, AL 35249-7013
The University of Nebraska Medical Center, Department of Emergency Medicine is recruiting an additional faculty member who has completed an ultrasound fellowship and is committed to developing an academic career. With an accredited three-year emergency medicine residency program with 22 residents, this is a great opportunity to help shape the future of emergency medicine in this region. The Center for Clinical Excellence, which opened in November 2005, houses the Emergency Department and provides services for over 50,000 annual visits. This is an established ultrasound program with QA, credentialing and billing processes already developed. The ED currently has three ultrasound systems available. Respond in confidence to: Robert Muelleman, M.D., Professor and Chairman, Department of Emergency Medicine, University of Nebraska Medical Center, 981150 Nebraska Medical Center, Omaha, NE 68198-1150 (402-559-6705). Individuals from diverse backgrounds are encouraged to apply.
I AM WHERE I NEED TO BE. Dr. Charlotte Derr has been able to pursue her love of academics and medicine by practicing at a leading teaching facility that partners with TeamHealth. This unique environment encourages collaboration and innovation, while continually improving her skills as a doctor. There are plenty of emergency medicine jobs out there. Find the one that’s right for you at:
888.861.4093
www.MYEMCAREER.com
Charlotte Derr, MD, FACEP, Associate Program Director and Emergency Ultrasound Director (right), with resident Jennifer Fredericks, MD, PhD
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CALLS AND M EETING ANNOUNCEM ENTS For details and submission information on the items below, see www.saem.org and look for the Newsletter links on the home page or links within the Meetings section of the web site.
Call For Papers
Consensus Conference Follow-Up Manuscripts Submissions in any category (Original Contributions, Brief Reports, etc.) that describe research that was initiated to address a research agenda topic generated at one of the prior Academic Emergency Medicine consensus conferences should be identified as such in the cover letter that accompanies the manuscript, when the manuscript is submitted for review. Authors should state to which consensus conference the manuscript relates, and should also state which issue(s) discussed or raised at that consensus conference is/are addressed by the manuscript. Attempts will be made to publish consensus conference follow-up manuscripts as a group, rather than individually, and if authors are aware of other papers underway from that same conference’s research agenda, they are encouraged to coordinate submission with the authors of those other papers. Contact: Gary Gaddis, MD, PhD (ggaddis@saint-lukes.org).
Great Plains Regional Meeting September 10, 2011 in St. Louis, Missouri For information contact Michael Mullins, MD at mullinsm@wusm.wustl.edu
2011/2012 SAEM Grant and Scholarship Information SAEM is pleased to offer a variety of grants available for competitive application. The grant below has an upcoming deadline: SAEM / ACMT Michael P. Spadafora Toxicology Scholarship – Scholarship fund to encourage Emergency Medicine residents to pursue Medical Toxicology fellowship training. The 2012 recipient will attend the American College of Medical Toxicology (ACMT) spring course in San Diego, CA from March 15-18, 2012. Application Deadline (2012 conference): August 1, 2011 Additional upcoming SAEM grants include: SAEM Institutional Research Training Grant ($75,000/yr. for 2 years) – The Institutional Research Training Grant (IRTG) is intended to identify, develop, and fund promising institutions dedicated to providing high quality training to research fellows in emergency medicine. Application Deadline: August 1, 2011 SAEM Research Training Grant ($75,000/yr. for 2 years) – The Research Training Grant (RTG) is intended to provide funding to support the development of a scientist in emergency medicine. Application Deadline: August 1, 2011 For more details as well as detailed application instructions, please go to the SAEM website www.saem.org and click on “Grants” under the “Grants & Awards” tab.
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Don’t miss this exceptional educational opportunity! The SAEM 2011 Leadership Forum will be a two-day Business of Academic Emergency Medicine Boot Camp, May 31 & June 1, 2011. Two-Day Session Cost: $175.00. Coffee/tea provided in AM both days. May 31, 2011: Lunch on your own, Networking Reception provided. June 1, 2011: Lunch provided. The knowledge and business skills that will be discussed at this Leadership Form are essential tools for anyone leading or hoping to lead a program or department. Participants will be taught by leaders in academic emergency medicine and will be introduced to topics such as cost accounting, reimbursement, revenue generation, finances of research, human resource issues and risk management. In addition, participants will learn various business skills such as strategic planning, developing budgets and business plans, marketing, and utilizing balanced scorecards. Leaders in academic emergency medicine must have an understanding of these topics and skills in order to be able to attract the appropriate resources and to effectively manage and lead their department or program. The program will include the following subjects and speakers: Cost Accounting Reimbursement Finances of GME Strategic Planning, Budgeting Revenue Generation Finances of Research Business Plan Marketing Balanced Scorecard Malpractice, Risk Management Human Resource Management Managing Multiple Priorities
Jim Bihun, MD Rob Shesser, MD Mary Jo Wagner, MD Ann Chinnis, MD Rich Wolfe, MD Bill Barsan, MD Stephen Thomas, MD Neil Sikka, MD Kate Heilpern, MD Tracy Sanson, MD Leslie Zun, MD Brian Zink, MD
On-line registration: http://www.saem.org/saemdnn/Meetings/ AnnualMeeting2011/tabid/1457/Default.aspx
AEM Author Announcements CrossCheck Academic Emergency Medicine now employs a plagiarism detection system. By submitting your manuscript to this journal, you accept that your manuscript may be screened for plagiarism against previously published works.
Department of Emergency Medicine Yale University School of Medicine Advancing the Science and Practice of Emergency Medicine Residency Program Director and Section Chief The Department of Emergency Medicine at the Yale University School of Medicine seeks to fill the position of Residency Program Director and Chief of the Section of Education. The Department has a fully- accredited four-year residency hosting 52 residents at two teaching hospitals, including the Level One Trauma Center at Yale-New Haven Hospital, which treats 90,000 patients annually. Our didactic curriculum makes extensive use of small-group discussions, audience response technologies, e-learning, and simulation. This year we launched an Area of Concentration Program, to allow residents to explore subspecialties of EM in greater depth. These include Global Health, Public Health, Critical Care, EMS, Toxicology, Ultrasound, and Education. Current fellowship programs in the Department include ultrasound, prehospital care, and global health. The Section of Education consists of seven faculty members, including the Director of Medical Student Education and the Director of Simulation. The successful candidate will be expected to lead the residency and provide visionary leadership for the Section during this time of rapid expansion of the Department. Eligible candidates must be residency-trained and board-certified in emergency medicine, and eligible for appointment at the Associate or full Professor rank. At least three-to-five years of experience in resident education, with progressive responsibility, is required. A national reputation is expected, as evidenced by publications, presentations at national meetings, and involvement in national organizations. Protected time and salary will be commensurate with education, training and experience. The Department provides an environment fostering faculty development with strong mentorship. We have an outstanding track record of federal and foundation funding, as well as a mature research infrastructure supported by a faculty Research Director, a Director of Resident Research, a staff of research associates, administrative assistants, and pre-/post-award grant support. The Department currently has in excess of $18 million in Federal funding, including 5 R01 grants. Yale University is a world-class institution providing a wide array of benefits and research opportunities. To apply, please forward your CV and cover letter to Gail D’Onofrio, MD, Chair, marked to the attention of Jamie Petrone via email: jamie.petrone@yale.edu, or mail: Yale University School of Medicine, Department of Emergency Medicine, 464 Congress Ave, P.O. Box 208062, New Haven, CT 06519-1315. Yale University is an affirmative action, equal opportunity employer. Women and members of minority groups are encouraged to apply.
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FROM THE PROGRAM COMMITTEE SAEM Annual Meeting… In the News… Many of our colleagues’ accomplishments will be recognized by the press as newsworthy for the general public, both before and during the SAEM Annual Meeting. Among the many didactics and abstracts to be presented at the Annual Meeting, you may see some of the following on the web, TV news, or radio.
DIDACTICS SCHEDULE
Note: The Membership Committee particularly recommends Didactics marked with a ++ for Residents. Thursday, June 2, 2011 ++* The Role of Research in Practice Change 12:30 – 2:00 pm * Collaboration and Education: Defining the Future of Pediatric Care in Emergency Medicine 2:00 pm ++* The New Spin on Mentorship: Successful Models for Modern Emergency Medicine 2:00 – 3:30 pm ++*Improve Your Teaching: Evidence-based Teaching Workshop using Articles that will Change Your Teaching Practice 2:30 – 4:00 pm Friday, June 3, 2011 *The Science of Peer Review 10:00 – 11:00 am ++* Coping with Rejection in Research – Resiliency Strategies to Effectively Move Forward After a Setback 11:00 am – 12:00 pm * NIH Roundtable 1:00 – 2:00 pm ++* Teaching and Assessing Clinical Reasoning and Medical Decision-Making in Emergency Medicine: The Missing Link in Resident and Student Education ** SPIVEY LECTURE ** 2:30 – 4:00 pm * Beyond the Ivory Tower: Solutions for Faculty Development, Research and Education in Community-based Tertiary Care Centers 3:30 – 5:00 pm ++* Work-life Balance in Academic Emergency Medicine: Not Necessarily a Quixotic Quest 9:00 – 10:30 am Saturday, June 4, 2011 *Designing Great Education Research 12:30 – 2:00 pm ++* Novel Applications in Bedside Sonography 3:30 – 5:00 pm Sunday, June 5, 2011 ++* Critical Career Decisions, Part 1: Should I Choose Academic EM? 9:30 – 10:30 AM ++*Get Published Now! 10:00 am – 12:00 pm *Guiding Junior Researchers through the Design and Completion of Time-Limited Research Projects 11:00 am – 12:00 pm
ABSTRACTS SCHEDULE
Wednesday, June 1, 2011 *Etoricoxib Prevents ‘First Of Ramadan’ Headache 2:00 - 4:00 pm - Lightning Oral *Ibuprofen Prevents Altitude Illness: A Prospective, Double-blind, Randomized Controlled Trial 2:00 - 4:00 pm - Lightning Oral *Diagnostic Characteristics Of S100A8/A9 In A Multicenter Study Of Patients With Abdominal Pain Suspicious For Acute Appendicitis 2:00 - 4:00 pm - Lightning Oral *Pharmacokinetics of High-Dose Oral Thiamine Hydrochloride 2:00 - 4:00 pm - Lightning Oral Thursday, June 2, 2011 *Hydroxocobalamin Versus Sodium Thiosulfate In The Treatment Of Acute Cyanide Toxicity In A Validated Swine (sus Scrofa) Model 8:00 - 9:30 am - Plenary *Association Between The Timing Of Antibiotic Administration And Outcome In Patients With Septic Shock 8:00 - 9:30 am - Plenary *Serum Levels Of Glial Fibrillary Acidic Protein (GFAP) Distinguish Mild Traumatic Brain Injury From Trauma Controls And Predict Intracranial
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Injuries On CT In Mild And Moderate Traumatic Brain Injury 8:00 - 9:30 am - Plenary *Impact Of England’s Four Hour Emergency Throughput Target On Quality Of Care And Resource Use 8:00 - 9:30 am - Plenary *Triage Nurse Administered Oral Corticosteroids: An Effective Innovation In Children With Moderate To Severe Acute Asthma Exacerbations 8:00 - 9:30 am - Plenary *Waiting With An Emergency: Short-term Mortality And Hospital Admission Following Departure From Crowded Emergency Departments 10:00 - 11:30 am - Lightning Oral *Effect Of A Decision Aid On Patient Knowledge, Patient Satisfaction, Safety And Resource Use In Low Risk Emergency Department Patients With Chest Pain: A Randomized Trial 10:00 - 11:30 am - Oral *Clinical Teaching Site Does Not Affect Examination Performance In An Emergency Medicine Clerkship 3:00 - 5:00 pm - Poster *Broken Teeth, Broken Promises 3:00 - 5:00 pm - Poster *Disparities By Insurance Status: Auditing Access To Emergency Department Follow-up Specialty Care For Children 3:00 - 5:00 pm - Poster *20 Years Of Nrmp Data In Emergency Medicine: Analysis Of Data And Future Implications 3:00 - 5:00 pm - Poster *The End Of Ambulance Diversion: Changes In Emergency Department Length Of Stay And Ambulance Turn-around Time 3:00 - 5:00 pm - Poster *Can The Heart Score Be Used To Further Risk Stratify Patients With Low Timi Scores? 3:00 - 5:00 pm - Poster *Trends In Critical Care Provided At United States Emergency Departments 2001-2008 3:00 - 5:00 pm - Poster *National Trends In Use Of Computed Tomography In The Emergency Department 3:00 - 5:00 pm - Poster A Mixed-methods Study Of Quality Of Care Provided Patients Boarding In The Emergency Department: Comparing Emergency Department And Inpatient Responsibility Models 3:00 - 5:00 pm - Poster Friday, June 3, 2011 *The Clinical Utility Of Virus Identification In Children Hospitalized With Bronchiolitis 9:30 - 11:00 am - Oral *Nasopharyngeal Aspirate Lactate Dehydrogenase Levels Predict Bronchiolitis Severity In A Prospective Multicenter Emergency Department Study 9:30 - 11:00 am - Oral *The Role Of The Emergency Department In Hospital Readmissions: Trends And Characteristics In Disposition Among Visits For Recently Hospitalized Patients In The United States 2005-2008 11:00 - 12:00 pm - Lightning Oral *The Mortality Benefit Threshold For Patients With Low-risk Suspected Pulmonary Embolism 11:00 am - 12:00 pm - Oral *Predictors Of Rapid Discharge After Aeromedical Transport To The Emergency Department 1:00 - 3:00 pm - Poster *Can Nebulized Naloxone Be Used Safely And Effectively By Emergency Medical Services For Suspected Opiate Intoxication? 1:00 - 3:00 pm - Poster
*Reduction In Emergency Department Blood Culture Contamination With Implementation Of Sterile Blood Culture Collection Kits 1:00 - 3:00 pm - Poster *Emergency Department Information System Use and Support of Meaningful Use Criteria 1:00 PM - 3:00 pm - Poster *The Impact Of Scenario-based Training And Real-time Technology Feedback On C P R Quality And Survival From Out-of-hospital Cardiac Arrest 1:00 - 3:00 pm - Poster *A Significant Incidence Of Delayed Hemothorax Following Minor Thoracic Injuries 2:00 - 4:00 pm - Lightning Oral *Association Between Weekend Hospital Presentation And Sepsis Mortality 2:00 - 4:00 pm - Lightning Oral *Prediction Of Post-injury Multiple Organ Failure: Derivation And Internal Validation Of The Denver Trauma Organ Failure Score 2:00 - 4:00 pm - Lightning Oral *Mortality Benefit As Compliance To Cms Quality Core Measures Improves 2:00 - 4:00 pm - Lightning Oral *A Tale Of Two Trends: Utilization Of Computed Tomography In American And Canadian Emergency Departments 3:30 - 4:30 pm Moderated Poster Saturday, June 4, 2011 *Pilot Study Of Glucose-Insulin-Potassium For The Treatment Of Vasopressor Dependent Septic Shock 8:00 - 9:30 am - Oral *Risk Of Intra-abdominal Injury In Children With Blunt Torso Trauma And Normal Abdominal Computed Tomography Scans 9:30 - 11:00 am - Lightning Oral *Identifying Children At Very Low Risk Of Intraabdominal Injuries Undergoing Acute Intervention 9:30 - 11:00 am - Lightning Oral *A Comparison Of Door-to-balloon Time At An Urban St Elevation Myocardial Infarction (stemi) Receiving Center: Walk-in Versus Paramedic Arrival 9:30 - 11:00 am - Oral *Use Of An Organophosphorus Hydrolase Prevents Lethality In An African Green Monkey Model Of Acute Organophosphorus Poisoning 11:00 am - 12:00 pm - Oral *The July Effect: Is Emergency Department Length Of Stay Greater At The Beginning Of The Hospital Academic Year? 12:30 - 2:00 pm - Oral *The Prevalence Of Immediate And Delayed Intracranial Hemorrhage In Patients With Preinjury Anticoagulant Use And Head Trauma 3:30 - 5:00 pm - Lightning Oral *Predictors Of Post-Concussion Syndrome In Children 3:30 - 5:00 pm - Lightning Oral *A New Serum Biomarker For Mild And Moderate Traumatic Brain Injury Is Associated With Intracranial Injuries And Neurosurgical Intervention 3:30 - 5:00 pm - Lightning Oral *The 3-2-1 Plan For Ambulance Diversion Reduction/Elimination 4:30 - 6:30 pm - Poster *A Prediction Rule for Emergency Department Patients With Chronic Obstructive Pulmonary Disease 4:30 - 6:30 pm - Poster Sunday, June 5, 2011 *Comparison Of Diltiazem And Metoprolol In The Management Of Atrial Fibrillation Or Flutter With Rapid Ventricular Rate In The Emergency Department: A Prospective, Randomized, Double-blind Trial 9:00 - 10:00 am - Oral
CHAIR UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE CHATTANOOGA DEPARTMENT OF EMERGENCY MEDICINE The University of Tennessee College of Medicine Chattanooga is seeking applicants for the position of Chairman of the Department of Emergency Medicine with faculty rank commensurate with experience. Qualified individuals must hold the M.D. degree or its equivalent and board certification by the American Board of Emergency Medicine; must have documented and proven experience as a faculty member with experience in academics and currently hold the rank of Associate Professor or above; and must have evidence of scholarly activity. Previous administrative experience is required. The Department of Emergency Medicine has an approved residency program. The goal of our residency is to educate and train excellent practitioners so that they are prepared to enter community practice or subspecialty training. The UT College of Medicine is affiliated with Erlanger Health System, one of the busiest Level One Trauma Centers in the U.S. Approximately 165 residents are appointed currently in nine disciplines. Visit our website at www.utcomchatt.org. The University of Tennessee is an Equal Opportunity/Affirmative Action/Title VI/TitleIX/Section504/ADA/ADEA Employer. Please submit CV and references to:
Chair, Emergency Medicine Search Advisory Committee. University of Tennessee College of Medicine, Chattanooga 960 East Third St. Suite 100 Chattanooga, TN 37403
The University of Nebraska Medical Center, The University of Nebraska Medical Center, Department of Emergency Medicine recruiting isanrecruiting a Department of Emergency isMedicine additional faculty member committed to developing additional faculty member committed to developing an academic career.
an academic career.
With an accredited three-year emergency medicine residency with 22 residents, thisemergency is a great Withprogram an accredited three-year medicine opportunity to help shape the future of emergency residency program with 22 residents, this is a grea medicine in this region. Theshape Center the for Clinical opportunity to help future of emergency Excellence, which opened in November 2005, medicine in this region. The Center for Clinical houses the Emergency Department and provides Excellence, which opened in November 2005, services for over 50,000 annual visits.
houses the Emergency Department and provides
Respond in confidence Robert annual Muelleman, M.D., services for overto:50,000 visits. Professor and Chairman, Department of Emergency Medicine, University of Nebraskato: Medical Center, Respond in confidence Robert Muelleman, M.D 981150 Nebraska Medical Center, Omaha, NE Professor and Chairman, Department of Emergenc 68198-1150 (402-559-6705). Individuals from Medicine, University of Nebraska Medical Center, diverse backgrounds are encouraged to apply.
981150 Nebraska Medical Center, Omaha, NE 68198-1150 (402-559-6705). Individuals from diverse backgrounds are encouraged to apply.
Imagine being part of a team that makes a discovery. EMS Medical Director/EMS Disaster Medicine Fellowship Director UMDNJ – Robert Wood Johnson Medical School, Department of Emergency Medicine UMDNJ-Robert Wood Johnson Medical School is seeking a professional to serve as the EMS Medical Director for Robert Wood Johnson University Hospital and the EMS/Disaster Medicine Fellowship Director for Robert Wood Johnson Medical School. Responsibilities will include delivery of clinical services in the Emergency Department, teaching of physician assistants, medical students and residents rotating through the Emergency Department. Specific responsibilities will also include working collaboratively with Departments and Divisions within the Medical School on collaborative research projects, as well as on assigned Robert Wood Johnson University Hospital (RWJUH) patient care committees, directing the EMS program for RWJUH and the fellowship program. The Department has an emergency medicine residency program and an EMS/Disaster Medicine Fellowship program. Rutgers, UMDNJ-RJWMS and RWJUH comprise the University Center for Disaster Preparedness and Emergency Response (UCDPER). The Department works collaboratively with the UCDPER in conducting research and planning activities. Robert Wood Johnson University Hospital, is a level I trauma center which evaluates and treats over 90,000 visits/year. The hospital serves as our principal teaching affiliate. The EMS system at RWJUH, which covers the Central New Jersey Region, has over 250 pre-hospital providers at all levels. This system is host to the Medical Command Center for New Jersey and is the regional dispatch center. (Pediatric emergency care is located in a separate location in the hospital, and services are provided by the Department of Pediatrics). Candidates should be eligible for appointment at the rank of, Assistant Professor or Associate Professor. Candidate should be board eligible or board certified in Emergency Medicine. EMS management experience or fellowship training preferred. Qualified candidates should send a letter of intent and curriculum vitae to: Robert Eisenstein, MD Associate Professor & Vice Chairman, Department of Emergency Medicine, Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, MEB 104, New Brunswick, New Jersey, 08903. Email: eisensrm@umdnj.edu, Call: 732-235-8717, or Fax: 732-235-7379. Academic appointment is commensurate with experience. UMDNJ is and Affirmative Action/Equal Opportunity Employer.
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HEAD, DEP PARTMENT T OF EMERG GENCY ME DICINE THE UNIVERSITY OF F IOWA ROY Y J. AND LU UCILLE A. CARVER C CO OLLEGE OF F MEDICINE E The C Carver Colleg ge of Medicine e at The Univ versity of Iowa a seeks cand idates for the e position of H Head, Departm ment of Emergency Medic cine. The Carrver College of o Medicine is s a part of a m major researcch university a and ranks 10thh among public medical sch ollege and the University o hools in Natio onal Institutes of Health fun nding. The Co of Iowa Hospitals and Cliniccs are equal partners p in UII Health Care. The hospita al is one of the e largest univversity-owned teaching hosspitals in the Unite ed States and d is adjacent to the Iowa Ciity Departmen nt of Veteranss Affairs Medical Center. T The Department of Emergency Medic cine has a dis stinguished teaching and clinical faculty.. The H Head of the Department D is s the leader off all aspects of o the Departm ment’s enterp prise, serves a as the spokessperson for the fa aculty, and re epresents the Department in interactions s with the Co llege, UI Hea alth Care, and d practitionerss throughout the sstate and natio onally. Respo onsibilities inc clude faculty recruitment a and appointme ents; educatio onal, clinical a and research progrrams; fiscal planning p and management; m ; and short- and a long-term strategic planning. Cand didates must have previous s records con nsistent with appointment a a as a Professo or of Emergen ncy Medicine.. This includ des an MD de egree or equivalent, an outstanding rec cord of accom mplishments in n teaching and service, elig gibility for licenssure in Iowa, and certificattion by the Am merican Board d of Emergen ncy Medicine. The successsful candidate e must have the d demonstrated capacity to fo oster an envirronment in wh hich excellencce in teaching g, research and scholarshiip flourish, as s well a as experience e and a comm mitment to dev veloping and leading cliniccal programs. Candidates must have a record of innovvative and efffective adminiistrative and fiscal f leadership, stature in n academic e mergency me edicine, a record of excellent interpers sonal skills, demonstrated experience promoting p a d iverse workfo orce, and positive interactio ons with stude ents, staff and d faculty. The U University of Iowa is locate ed in Iowa Citty, a vibrant community loccated in the ro olling hills of ssoutheastern Iowa. The comm munity offers excellent sch hools, quality entertainmen e t, literary, mu usical and culttural opportun nities and Big g 10 sporting events. The ssearch comm mittee will acce ept nominatio ons and applic cations until th he position iss filled. Nomin nations should include a brief statement of the attributes s and qualities s of the individual that makke him or her suited for this position and d a curriculum m vitae. To apply for this posiition visit our website at http://jobs.u uiowa.edu/fac culty. Requisition #5932 25 Ronald Weigel, M.D D. Lois J Geist, M.D . Co-Chairs s, Search Com mmittee for Em mergency Me edicine Na ancy Grubb Assistant A to the t Search Co ommittee Office of th he Dean, 200 CMAB The Un niversity of Iow wa Colleg ge of Medicin ne Iowa City, IA 52242-1 1101 T The University y of Iowa is an n equal opporrtunity and afffirmative actio on employer. Women and d minorities arre strongly encouraged to app ly.
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Annual M eeting Exhibitors
Te e d
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We are the nation’s preeminent emergency medicine search and recruitment firm. From chief search t o d i r e c t o r t o s t a f f p o s i t i o n s , Te e d & Company provides comprehensive s e r v i c e t o h o s p i t a l s , s t a f f i n g groups and partnerships. Senior l e v e l p h y s i c i a n s a n d n e w l y graduating residents have found T e e d & C o m p a n y ’ s i n - d e p t h knowledge of the marketplace a resource on which to depend. For expert knowledge and guidance in f u r t h e r i n g y o u r o w n c a r e e r, v i s i t our booth in the exhibit hall. Te e d & C o m p a n y 877-901-0191 www.teedco.com
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VISIT THE BLOOD CME CENTER BOOTH! Located in the Exhibit Hall, from June 2-3, 2011
In the management of mass bleeding, it is crucial to have a clear strategy to prevent coagulopathy and to minimize the need for blood transfusion. JOIN US FOR A DINNER SYMPOSIUM Clinical Decisions in the Emergency Department: Pros and Cons of Managing Oral Anticoagulant-Associated Hemorrhages and Acute Traumatic Coagulopathy, at 6:30 PM on Friday, June 3, 2011, in Salon G, located on the fourth floor. This pro/con format will feature coagulation and trauma experts W. Frank Peacock, MD; Bryan A. Cotton, MD, MPH; and David Garcia, MD. For live symposium updates, follow us on Twitter and Facebook @BloodCME.
LIFEPAK® 1000 Defibrillator
LIFEPAK® 15 Monitor/Defibrillator
THE BLOOD CME CENTER (www.bloodcmecenter.org) is an online educational initiative developed by experts in the field of perioperative hemostasis and blood management to provide high-quality, cutting-edge information to clinicians dedicated to improving the treatment of uncontrolled bleeding. Here you can access exclusive free CME/CNE educational activities about managing hemostasis in surgical and trauma patients.
LUCAS™ Chest Compression System
LIFENET ® System
Science Driven — Guidelines Consistent Stop by our booth at SAEM 2011. ©2011 Physio-Control, Inc. Redmond, WA 98052 USA. All rights reserved. All names herein are trademarks or registered trademarks of their respective owners.
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Peer-reviewed Lectures (PeRLs) Are Coming! Academic Emergency Medicine will be publishing a series of videos of lectures on topics in emergency medicine. These are intended to represent the state of the art in emergency medicine education. Residents, practicing physicians, and medical students may use them for didactic education. The videos should contain both the presented audiovisual materials for the lectures (such as PowerPoint slides) and live video of the presenter. Each video lecture should contain the following information: â&#x20AC;˘ A written abstract describing the content of the lecture â&#x20AC;˘ Lecture title, author, and institutional affiliation on a title slide â&#x20AC;˘ Conflict of interest statement â&#x20AC;˘ A brief overview of the lecture content (~ 1 minute) â&#x20AC;˘ The body of the lecture (< 30 minutes) â&#x20AC;˘ References and further reading (~ 30 seconds) â&#x20AC;˘ Contact information for questions Prospective authors should consider contacting the PeRLs editorial board (through John Burton, MD, Senior Associate Editor: jhburton@carilionclinic.org) for a discussion before starting on video production of a lecture for a determination of topic suitability. Videos can be complex to produce, and given the effort involved, having a discussion with an editor either by e-mail or by phone before producing it is recommended STAY TUNED FOR MORE INFORMATION!
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Ƒ Active - $545.00 Individuals with advanced degree university appointment actively involved in EM teaching or research.
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Ƒ *Active/Associate/YP1 or YP2 Academy - $100.00 ea. Ƒ CDEM Ƒ AWAEM Ƒ Simulation Ƒ Geriatrics
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Ƒ *Medical Student/Resident/Fellow Academy - $50.00 ea. Ƒ CDEM Ƒ Simulation Ƒ Geriatrics Ƒ Young Physician Year Two - $450.00 Second year following
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Ƒ *AWAEM Resident/Medical Student - FREE
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*must be a current SAEM member to join an academy
Ƒ Medical Student - $135.00 Open to medical students interested
in EM. Graduation date:
Interest Groups: Society members are invited to join any of the dedicated Interest Groups listed below. Each membership category includes ONE Interest Group free of charge. Additional Interest Groups can be added for $25.00 each. Ƒ Academic Informatics Ƒ Airway Ƒ CPR/Ischemia/Reperfusion Ƒ Clinical Directors Ƒ Disaster Medicine Ƒ Diversity Ƒ ED Crowding
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SAEM, 2340 S. River Rd, Suite 200 Des Plaines, IL 60018. email: membership@saem.org You may also join at member.saem.org Rev. Date 10/13/2010
Society for Academic Emergency Medicine 2340 S. River Road, Suite 200 • Des Plaines, IL 60018 • 847-813-9823 • saem@saem.org • www.saem.org
Board of Directors Jeffrey A. Kline, MD President Debra E. Houry, MD, MPH President-Elect Adam J. Singer, MD Secretary-Treasurer Jill M. Baren, MD, MBE Past President Brigitte M. Baumann, MD, MSCE Deborah B. Diercks, MD, MSc Cherri D. Hobgood, MD Robert S. Hockberger, MD Alan E. Jones, MD O. John Ma, MD Jody A. Vogel, MD Executive Director James R. Tarrant, CAE Send Articles to: newsletter@saem.org Send Ads to: mgreketis@saem.org The SAEM Newsletter is published bimonthly by The Society for Academic Emergency Medicine. The opinions expressed in this publication are those of the authors and do not necessarily reflect those of SAEM. For Newsletter archives and e-Newsletters Click on Publications at www.saem.org
FUTURE SAEM ANNUAL M EETINGS 2011 June 1-5 Marriott Copley Place, Boston, MA 2012 May 9-13 Sheraton Hotel and Towers, Chicago, IL 2013 May 15-19 The Westin Peachtree Plaza, Atlanta, GA 2014 May 14-18 Sheraton Hotel, Dallas, TX 2015 May 13-17 Sheraton Hotel and Marina, San Diego, CA AEM Consensus Conference June 1, 2011 Topic: “Interventions to Assure Quality in the Crowded Emergency Department”.