SAEM PULSE July–August 2018

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JULY-AUGUST 2018 | VOLUME XXXIII NUMBER 4

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SPOTLIGHT CONTRIBUTING TO THE SCIENCE BEHIND PATIENT CARE, THROUGH RESEARCH An Interview with Jody Vogel, MD, MSc, MSW

RAMS ARE ON THE MOVE! page 28 MEMOIRS OF AN MSA page 30 Leading the advancement of emergency care through education and research, advocacy, and professional development in academic emergency medicine.


SAEM STAFF Chief Executive Officer Megan N. Schagrin, MBA, CAE, CFRE Ext. 212, mschagrin@saem.org Director, Finance & Benefits Doug Ray Ext. 208, dray@saem.org Accountant Hugo Paz Ext. 216, hpaz@saem.org Director, Operations & Governance Kat Nagasawa, MBA Ext. 206, knagasawa@saem.org Manager, Governance Snizhana Kurylyuk Ext. 205, skurylyuk@saem.org Manager, IT Database Zack Cater Ext. 225, zcater@saem.org IT Support Specialist Jovan Triplett Ext 218, jtriplett@saem.org Director, Communications and Publications Stacey Roseen Ext. 207, sroseen@saem.org Specialist, Digital Communications Nick Olah Ext. 201, nolah@saem.org Director, Foundation and Business Development Melissa McMillian, CNP Ext. 203, mmcmillian@saem.org Manager, Business Development John Landry, MBA Ext. 204, jlandry@saem.org

HIGHLIGHTS Director, Membership & Meetings Holly Byrd-Duncan, MBA Ext. 210, hbyrdduncan@saem.org Education Manager Andrea Ray Ext. 214, aray@saem.org Membership Manager George Greaves Ext. 211, ggreaves@saem.org Meeting Planner Alex Elizabeth Keenan Ext. 218, akeenan@saem.org Membership & Meetings Coordinator Monica Bell Ext. 202, mbell@saem.org AEM Editor in Chief Jeffrey Kline, MD AEMEditor@saem.org AEM E&T Editor Susan Promes, MD AEMETeditor@saem.org AEM/AEM E&T Manager Stacey Roseen Ext. 207, sroseen@saem.org AEM/AEM E&T Peer Review Coordinator Taylor Bowen tbowen@saem.org Chair, SAEM Pulse Editorial Advisory Task Force Sharon Atencio, DO sharonatencio@me.com Associate Editor, RAMS Shana Zucker, szucker@tulane.edu

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President’s Comments Embrace the Uncomfortable

Spotlight

Contributing to the Science Behind Patient Care, Through Research

SAEM18 Meeting Wrap-up Diversity and Inclusion

Strategies to Enhance Retention of Underrepresented in Medicine Faculty

Ethics in Action Capacity and Consent

Graduate Medical Education

Running an Effective and Efficient Clinical Competency Committee

SGEM: Did You Know?

Sex and Gender Health Education Summit: Advancing Curricula Through a Multidisciplinary Lens

Wilderness Emergency Medicine

A Day in the Life of Dr. Kenneth Iserson, McMurdo Station Emergency Physician, Ross Island Antarctica

Briefs and Bullet Points Academic Announcements Now Hiring

2018-2019 BOARD OF DIRECTORS Steven B. Bird, MD President University of Massachusetts Medical School Ian B.K. Martin, MD, MBA President Elect Medical College of Wisconsin James F. Holmes, Jr., MD, MPH Secretary-Treasurer University of California Davis Health System D. Mark Courtney, MD Immediate Past President Northwestern University Feinberg School of Medicine

Wendy C. Coates, MD Los Angeles County-Harbor -UCLA Medical Center Christopher Lee Bennett, MD, MA Brigham and Women's Hospital and Massachusetts General Hospital Amy H. Kaji, MD, PhD Harbor-UCLA Medical Center

Angela M. Mills, MD Columbia University Ali S. Raja, MD, MBA, MPH Massachusetts General Hospital Megan L. Ranney, MD, MPH Brown University Richard E. Wolfe, MD Beth Israel Deaconess Medical Center/ Harvard Medical School

SAEM Pulse is published bimonthly by the Society for Academic Emergency Medicine, 1111 East Touhy Ave., Ste. 540, Des Plaines, IL 60018. (847) 813-9823 The opinions expressed in this publication are those of the authors and do not necessarily reflect those of SAEM. Š 2018 Society for Academic Emergency Medicine. All rights reserved. No part of this publication may be reproduced, stored, or transmitted in any form or by any means without prior permission in writing from the copyright holder.


PRESIDENT’S COMMENTS Steven B. Bird, MD University of Massachusetts Medical School 2018-2019 SAEM President

Embrace the Uncomfortable I write this while sitting at the airport waiting for a flight to Salina, Kansas. Why this trip to the “Heartland” in 97 degree weather in June? To suffer. Emporia, Kansas, is home to a “gravel grinder” bicycle race known as Dirty Kanza. A total of 206 miles, including two vertical miles of climbing, in one day. On gravel roads. Without support. When I left for the airport, my wife said, “Have fun.”

"Nothing in the world is worth having or worth doing unless it means effort, pain, difficulty." —Teddy Roosevelt

Which got me thinking ... Who has “fun” at such an event? Not Type 1 fun (i.e., the kind that is enjoyable while it’s happening); but Type 2 fun (i.e., the kind that’s miserable while it’s happening, but fun in retrospect). I think that life is best lived with plenty of Type 2 fun. Only by giving up the security of the easy and not-so-difficult, can we create new opportunity, build personal capability, and prosper. As we do that, we expand our comfort zone and our confidence to take on bigger, bolder, and scarier challenges. These concepts, I believe, are applicable to all aspects of our busy and fragmented lives. The possibility of failure — suffering through a triaged grant application; having

a manuscript rejected, again; not taking on a new job responsibility; or not finishing 206 miles on a bike — is everywhere. And we should embrace it! We should not fear failure. Failing means that you tried, and that eventually, you will succeed. Teddy Roosevelt said, “Nothing in the world is worth having or worth doing unless it means effort, pain, difficulty.” And he was right. Too often we let our failures define us. If you knew that you would be able to handle any and all consequences of a failure, what would you do that you aren’t doing right now? Would you insert or assert yourself more completely in something of significance? What sort of conversations would you have that perhaps you’ve been putting off having? Would you seek some suffering for Type 2 fun? There are amazing SAEM members who, in the future, will achieve tremendous things. I don’t yet know who these members are, but one thing is for certain: They will not be the members who stayed within their own comfort zones. Instead, they will be the members who sought to challenge themselves even when everything seemed to be going perfectly. So, embrace the uncomfortable. Expand yourself in all dimensions. Create those discomforting opportunities to better yourself and those around you. P.S. There is one important exception to pushing yourself outside of your comfort zone ... As I tell graduating residents, “Buy a good mattress and a good pair of shoes, because if you’re not in one, you’re in the other.”

ABOUT DR. BIRD: Steven B. Bird, MD, is vice chair for education in the Department of Emergency Medicine, and the emergency medicine residency director, at the University of Massachusetts Medical School.

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SPOTLIGHT CONTRIBUTING TO THE SCIENCE BEHIND PATIENT CARE, THROUGH RESEARCH

"I personally find the combination of patient-centered care combined with the intellectual stimulation of research irresistible and compelling."

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SAEM Pulse Talks With Jody Vogel, MD, MSc, MSW Jody Vogel, MD, MSc, MSW, is an assistant professor in emergency medicine at the University of Colorado School of Medicine and an attending physician at the Denver Health Medical Center in Denver, where she also served as a chief resident. Following residency she completed a Master of Science in Epidemiology and a Clinical Research Fellowship. During fellowship, Dr. Vogel successfully secured an Individual National Research Service Award from the National Institutes of General Medical Sciences to investigate ways to predict multiple organ failure and improve trauma outcomes. Dr. Vogel is currently the principal investigator for a Mentored Clinical Scientist Research Career Development Award from the Agency for Healthcare Research and Quality to evaluate ways to improve health care access and outcomes for frequent Emergency Department visitors.

How did you become interested in the specialty of emergency medicine?

commitment to the care of vulnerable, at-risk populations.

My career in health care began as a medical social worker on the midnight shift in the emergency department at the University of Michigan. Through this pivotal professional experience, I realized my desire to become a physician. The diversity of medical conditions in the emergency department along with the opportunity to be a part of a team assisting patients from all walks of life with their acute care concerns regardless of their ability to pay was motivating and inspiring. Emergency medicine was a natural fit with my social work background and

Please tell us about how you first became involved with research and decided to become a researcher. Prior to medical school, my interest in the science behind patient care led me to a clinical research position. This experience helped me understand, on a more personal level, the ability of research to incrementally increase the knowledge base of medicine and improve patient care. During medical school, scientific investigations to improve patient care strengthened my passion for a research career. During

Dr. Vogel is a nationally recognized expert in trauma and health services research. She contributes to academia as a peer reviewer for scientific journals, a national scientific grant review study section member, and an editorial board member. Dr. Vogel has been recognized both locally and nationally with multiple awards for her research and academic accomplishments, as well as her empathic, humanistic approach to patient care. Dr. Vogel has served as the resident member of the SAEM Board of Directors, the inaugural chair of the SAEM Resident and Student Advisory Committee, and on the SAEM Nominating Committee. Additionally, Dr. Vogel has served as a member of the SAEM Graduate Medical Education Committee, the SAEM Research Committee, and the SAEM Program Committee. She is an active contributor to the annual SAEM Grant Writing Workshop and is the Program Committee chair for the 2019 and 2020 SAEM annual meetings.

"While some might consider the emergency department a high-stress, chaotic environment, I appreciate it as a safe haven for all who need medical care." 5


"Students, residents, and junior faculty will recognize SAEM as an organization dedicated to supporting their education, research, and development as academicians."

SAEM PULSE | JULY-AUGUST 2018

residency, fellowship, and as a junior faculty member, my continuing interest in research flourished with multiple research projects, presentations, publications, and grants. I remain enthusiastic about my clinical work and academia and continue to find myself eagerly anticipating the next research opportunity.

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Your involvement with SAEM began during residency. How did this shape your perspective on academic emergency medicine? What suggestions do you have for students, residents, and fellows interested in the Society? I vividly recall my first SAEM annual meeting. The novel research and informative educational sessions, along with the collegiality of the meeting environment, were inspiring. Motivated by these experiences, I eagerly sought involvement in the Society and became an active member of SAEM committees. Each of these opportunities increased my understanding of the role of the Society in improving patient care through research and education. I came to fully appreciate the benefits of the collaborative relationships

developed through SAEM to advance emergency care. I would encourage students, residents and fellows to take an active role in SAEM so they may also benefit from the Society’s rich resources. Just as in my case, students, residents, and junior faculty will recognize SAEM as an organization dedicated to supporting their education, research, and development as academicians.

How have the SAEM annual meetings evolved over the ten years you’ve served on the Program Committee? The breadth and scope of the annual meeting has grown substantially over the past ten years. At the upcoming annual meetings, we look forward to new offerings and increased opportunities for engagement, mentorship, and networking. I am honored to be the Program Committee chair during this exciting and evolving time within the Society.

What is the most rewarding part of your position as a physician? The most rewarding aspect of my clinical work is caring for patients and families with an acute care need or concern. While some might consider the emergency department a high-stress, chaotic environment, I appreciate it as a safe haven for all who need medical care. As a physician, it is a privilege to share my expertise and knowledge with patients and families.

What is the most rewarding part of your academic work? There are two components of academia that are especially rewarding. The first is mentoring students, residents and junior investigators to help them realize their potential and experience the joy of academia in a way that compliments their interests. The second rewarding aspect is contributing to the science behind patient care through research. I personally


find the combination of patient-centered care and the intellectual stimulation of research irresistible and compelling.

What life experiences do you believe have made you a better educator? As a social worker in the emergency department, I came to fully appreciate the role of social determinants of health in medical care. Sometimes it is difficult for providers focused on the physical aspects of health to understand why a patient won’t adhere to a recommended treatment regimen or may arrive in the emergency department after hours for a concern that could have been addressed at a primary care office. Being able to combine both the physical and social determinants of health helps facilitate engagement of the health care team in a patient-centered approach to the delivery of emergency care.

“farm to table” restaurant with fresh ingredients and a wonderful bakery where families and friends could gather and thoroughly enjoy wonderful food and great company.

If you weren’t an emergency medicine physician, what would you be doing?

At the end of your career, what would you like to be remembered for?

I would be a farmer, just like my father. With the farm, I would have an on-site

A family friend remembered my father by saying he was a “good, good

man.” My father was genuine and kind, and by example taught me that we all share a common humanity and a responsibility to help others. I would like to be remembered as a genuine, compassionate physician who substantially contributed to the wellbeing of patients by advancing emergency care through my mentorship, teaching, and research.

Maximizing Networking Opportunities at the Annual Meeting: Advice for Early Career Attendees Dr. Vogel has served on the annual meeting Program Committee for 10 years and is the Program Committee chair for SAEM19 in Las Vegas and SAEM20 in Denver. She shares her suggestions on how early career attendees can maximize opportunities for networking at the SAEM annual meeting.

Do your homework. “Research the presenters for sessions you will attend by reviewing their biography, blog, twitter postings, grants, and/or publications. Using this information, prepare a question for the presenter in advance of the meeting. Be prepared to provide a brief verbal synopsis of your work or interest in the topic. Find an opportune moment after the presenter’s session, introduce yourself, and ask your prepared question. “Academicians are highly passionate about their work and love to talk about their interests. If you are a medical student, resident, or junior faculty member and the presenter is a senior faculty member, your genuine interest in his or her area of expertise and your advanced preparation will help successfully facilitate your conversation. A personal connection with the presenter may foster new ideas for your work and even lead to a successful future collaboration.”

Get involved. “The SAEM annual meeting offers many opportunities to expand your academic skillset, network nationally, and become involved in collaborative activities to improve patient care. Join an SAEM interest group, academy, or committee in your topic area of interest, and attend these sessions. Perhaps you will meet a future collaborator, co-investigator, or co-author at the next SAEM interest group, academy, or committee meeting."

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ANNUAL MEETING WR AP-UP

SAEM18 Indy: An Unparalleled Success! SAEM18 was one for the record books, with the highest-ever number of submissions for pre-meeting workshops, didactics, abstracts, and clinical images AND our highest-ever turnout in several categories: • Highest number of exhibitors • Greatest combined number of resident and medical student attendees • Most attendees total

ANNUAL MEETING WRAP-UP

More than 3,100 attendees—the most in history for an SAEM annual meeting—convened in Indianapolis for four days of high-quality career development opportunities, cutting edge education, state of the art original research, and innovation in academic emergency medicine presented by some of the top names in the specialty.

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Energetic Crowd Sets the Pace The energy in the host hotel was high, the vibe was exciting, and Indianapolis proved to be as hip as it was hospitable, with a whole lot happening for after-hours fun-seekers. A record number of RAMS (residents and medical students) brought an extra measure of exuberance, helped along by the appearance of the RAMS mascot who livened up the crowds with his dance moves and high fives. The Ram joined 600plus rambunctious residents and medical students for a fun night of revelry at the annual RAMS Party—held this year at the spectacular Revel Nightclub.

Gail D’Onofrio Opens SAEM18 The opening ceremony took place before a full house, with Gail D'Onofrio, MD, kicking things off with a timely and


ANNUAL MEETING WRAP-UP

compelling keynote address titled, "The Opioid Crisis: Emergency Physicians as Innovators, Policymakers, and Heroes." The keynote was followed by the plenary session presentation of the top seven abstracts. Representing a broad diversity of research in emergency medicine, these abstracts were chosen as the best from among more than 800 submissions.

President Bird Installed Steven Bird, MD, was installed at the opening ceremony as SAEM’s 2018-2019 president. Dr. Bird will hold the president's post for a one-year term. As president, Dr. Bird intends to focus on resident and faculty well-being. Dr. Bird is vice chair for education in the Department of Emergency Medicine, and the emergency medicine residency director at the University of Massachusetts Medical School. Dr. Bird has been actively involved with SAEM since 1998, most recently as President-Elect. Congratulations Dr. Bird!

Opening Ceremony Pays Tribute to Those We've Lost During an "In Memoriam" tribute at the SAEM18 Opening Ceremonies, the Society honored SAEM members who had passed away since the 2018 annual meeting. Among them, prominent Indianapolis physician, Kevin Rodgers, MD, who

Fierce Competition SAEM Masters Secret Series, SAEM Master Scholars, and SAEM Professor Rounds were welcome new additions to this year's annual meeting and our traditional, crowd-pleasing competitions did not disappoint! Once again, the ballroom was transformed into a Dodgeball court, complete with bleachers, hot dogs, popcorn, and cold suds. More than 200 fans cheered on 20 competitive teams, but it was the team from Hackensack University Medical Center that ducked, dipped, and dodged its way to the tournament title. In other competition, the Simulation Academy SimWars was back and better than ever, with 200 new cases and a captivated crowd of 200 fans who filled the space with enthusiastic cheers. Finally, in an exciting finish, Sonogames ended in a first-ever tie for first place... Wrapping up SAEM18 on an appropriately thrilling note.

died tragically in a homicide this past November. Dr. Rodgers, in a surprise presentation, was honored posthumously with the Sagamore of the Wabash Award, Indiana's highest civilian honor. The award, a tribute given to those who have rendered a distinguished service to the state or to the governor, was presented on behalf of Indiana Gov. Eric Holcomb by SAEM member, Jennifer Walthall, MD, MPH, secretary, Indiana Family and Social Services Administration. Accepting the award on Dr. Rodgers' behalf was his wife, Ruth Rodgers, vice president for student development and dean of students at Marian University, Indianapolis.

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These are the Champions!

SONOGAMES® CO-CHAMPIONS

University of California, San Francisco and Harvard Affiliated Emergency Medicine Residency (Brigham and Women's Hospital/Massachusetts General Hospital)

SIMULATION ACADEMY SIMWARS

ANNUAL MEETING WRAP-UP

Your 2018 Simulation Academy SimWars Champions: University of Michigan Emergency Medicine Residency Program

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Hackensack University Medical Center dived, ducked, dipped, and dodged their way to the tournament title! They are your SAEM18 Dodgeball Champions!


SAEM18 CME and Conference Evaluations SAEM18 attendees, the portal is open for you to claim CME with completion of the overall conference evaluations. SAEM wants to hear from ALL attendees, so residents and medical students, step right up and claim your certificate of attendance by completing the overall conference evaluations. All attendee feedback is valuable and helps us improve our program from year to year. Deadline: July 31, 2018.

ANNUAL MEETING WRAP-UP

Post-SAEM18 Need-to-Know

FREE! 225 Hours of SAEM18 Content

SONOGAMES® BEST TEAM UNIFORM

“Jeffersonographers” University of Virginia (top); “Endocavity Probers” Medical College of Georgia (middle); “Scrotal Pearls of Wisdom” University of Arizona (bottom)

All SAEM18 educational content is open access and available online now, at SOAR (SAEM Online Academic Resources). Experience convenient online and mobile viewing of Advanced EM Workshops, didactics, forums, abstracts—225 hours of original educational content from SAEM18. Downloadable PDFs and MP3s provide convenient, on–the-go viewing. Watch presenters' slides while listening to fully synchronized audio.

Download Your Headshot

SONOGAMES® BEST NAME

L: “Country Probes,” West Virginia University; C: “If you liked it then you should’ve put a probe on it," NYU/Bellevue; R: “RUSHian Collusion," Harvard Affiliated Emergency Medicine Residency at Beth Israel Deaconess Medical Center

If you took advantage of the free professional headshot taken in the SAEM booth during SAEM18, they are now available for viewing and downloading at the SAEM Headshot Gallery. Use password SAEM2018.

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Congratulations to this Year’s Award Recipients!

The Hal Jayne Excellence in Education Award

Excellence in Research Award

Kevin Rodgers, MD Given to a member of SAEM who has made outstanding contributions to emergency medicine through the teaching of others and the improvement of pedagogy, The Hal Jayne Excellence in Education Award was presented posthumously to Kevin Rodgers, MD, IUSM Department of Emergency Medicine. Accepting the award on Dr. Rodgers’ behalf, was his wife Ruth Rodgers, vice president for student development and dean of students at Marian University, Indianapolis.

Henry E. Wang, MD, MPH, MS The Excellence in Research Award, presented to a member of SAEM who has made outstanding contributions to emergency medicine through the creation and sharing of new knowledge, was presented to Henry E. Wang, MD, MPH, MS, UTHealth.

The John Marx Leadership Award

The Young Investigator Award

ANNUAL MEETING WRAP-UP

Katherine L. Heilpern, MD The John Marx Leadership Award, honoring an SAEM member who has made exceptional contributions to emergency medicine through leadership locally, regionally, nationally or internationally, (with priority given to those with demonstrated leadership within SAEM), was presented to Katherine L. Heilpern, MD, Emory University School of Medicine

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The Arnold P. Gold Foundation Humanism in Medicine Award Andrew R. Barnosky, DO, MPH The Arnold P. Gold Foundation Humanism in Medicine Award, given to a practicing emergency medicine physician who exemplifies compassionate, patientcentered care, was presented to Andrew R. Barnosky, DO, MPH, University of Michigan Medical School.

The Advancement of Women in Academic Emergency Medicine Award Alyson McGregor, MD, MA The Advancement of Women in Academic Emergency Medicine Award, recognizing an SAEM member who has made significant contributions to the advancement of women in academic emergency medicine, was presented to Alyson McGregor, MD, MA, The Warren Alpert Medical School of Brown University.

Sarah M. Perman, MD, MSCE; Bryn E. Mumma, MD, MAS; Kelly Doran, MD, MHS Presented to SAEM members who have demonstrated commitment and achievement in research during the early stages of their academic careers, (L) Sarah M. Perman, MD, MSCE, University of Colorado; (C) Bryn E. Mumma, MD, MAS, University of California Davis School of Medicine; and (R) Kelly Doran, MD, MHS, New York University School of Medicine.

The Resident Educator Award

Resident Researcher Award

Nida F. Degesys, MD The Resident Educator Award, given annually to a senior emergency medicine resident who has demonstrated exceptional aptitude and passion for teaching during residency, was presented this year to Nida F. Degesys, MD, University of California San Francisco/San Francisco General Hospital Emergency Medicine Residency.

James Daley, MD, MPH, MS The Resident Researcher Award, given annually to senior emergency medicine residents who have demonstrated exceptional promise and early accomplishment in the creation of new knowledge, was presented this year to James Daley, MD, MPH, MS, Yale New Haven Hospital.


Emergency medicine academicians in seven plenary presentations explored a variety of subjects related to the practice of emergency medicine during a special plenary session held on Wednesday, May 16, the opening day of SAEM18. The Plenary Session, which includes the top abstracts as selected by the SAEM18 Program Committee, is traditionally a highlight of the annual meeting program. “Our seven plenary abstracts represented a broad diversity of research in emergency medicine. These abstracts were chosen as the best among hundreds of submissions and we were proud to be able to present them at the SAEM annual meeting in Indianapolis,” said Danny Pallin, MD, MPH, SAEM18 Program Committee Chair.

Plenary Abstract Presenters Henry Wang, MD, MS University of Texas Health Science Center at Houston Laryngeal Tube vs Endotracheal Intubation in Adult Out-of-Hospital Cardiac Arrest: The Resuscitation Outcomes Consortium Pragmatic Airway

ANNUAL MEETING WRAP-UP

Plenary Session Abstract Presentations

Shaw Natsui, MD, MPA University of California Los Angeles Assessing Emergency Department Guideline Concordance and Outcomes After Outpatient Cardiac Stress Testing

Read the full plenary abstracts in the 2018 Annual Meeting Supplement.

“What was your biggest takeaway?” SAEM18 plenary abstract presenters discuss their research.

David Zheng Massachusetts General Hospital Socioeconomic Status and Bronchiolitis Severity Among Hospitalized Infants

Lauren Klein, MD, MS Hennepin County Medical Center/ Minneapolis Medical Research Foundation Intramuscular Midazolam, Olanzapine, Ziprasidone, or Haloperidol for Treating Acute Agitation in the Emergency Department David Zheng

Wesley Self, MD, MPH Vanderbilt University Medical Center Balanced Crystalloids vs Saline for Intravenous Fluid Therapy: Results of Two Pragmatic Trials

Dr. Lauren Klein

Venkatesh Thiruganasambandamoorthy, MD, MSc University of Ottawa Prospective Multicenter Validation of the Canadian Syncope Risk Score

Brian Driver, MD Hennepin County Medical Center Bougie Use in Emergency Airway Management: A Randomized Trial of 757 Patients Dr. Brian Driver

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2018 Medical Student Excellence in Emergency Medicine Award Recipients The Society for Academic Emergency Medicine congratulates this year’s recipients of the 2018 SAEM Medical Student Excellence in Emergency Medicine Award. The award is offered to each medical school in the United States and internationally to honor an outstanding medical student. Gideon Cohen Albany Medical College

Kendrick Kennedy Medical Universtiy of South Carolina

Jessica Andrusaitis University of California - Irvine

Jordan Hunter Arizona College of Osteopathic Medicine

Joshua Bragg Memorial University of Newfoundland

Vincent Zi-Shun Lee University of California Davis

Henrik Galust Northeast Ohio Medical University

Banjamin Supat University of California San Diego

Jennifer Ober Larsen University of Pittsburgh School of Medicine

Aaron Wibberley Northwestern University Feinberg School of Medicine

Kadia Wormley University of California, San Francisco School of Medicine

Ryan Latulipe University of Rochester School of Medicine and Dentistry

Gage Stuntz Ochsner Clinical School - University of Queensland

Caroline Meehan University of Chicago Pritzker School of Medicine

Tyler J. Goldbach University of South Alabama

Patrick Fink Oregon Health and Science University

Alexander Dayton University of Connecticut School of Medicine

Evan Strobelt Baylor College of Medicine Arch Wooten Jones Brody School of Medicine at East Carolina University Ryan Devivo College of Osteopathic Medicine of the Pacific Jonathan Kamler College of Physicians & Surgeons of Columbia University Kathryn Kaminski Cooper Medical School of Rowan University Nadia Faiq David Geffin School of Medicine Chichen Qiu Drexel University College of Medicine Tyler J. Stannard, MD East Tennessee State University Quillen College of Medicine Malav Mukund Patel Florida State University College of Medicine Peter Mullins George Washington University School of Medicine and Health Sciences Hayley O'Brien Georgetown University School of Medicine John Benjamin Arevalo Harvard Medical School Tyler E. Heavin Indiana University School of Medicine

ANNUAL MEETING WRAP-UP

Jeremy Shin John A Burns School of Medicine

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Jordan Anthony Grush Kansas City University of Medicine and Biosciences Danny Udrea Loma Linda University School of Medicine Kelli Irvin Harris Louisiana State Universtiy School of Medicine at Shreveport

Paul Ginart Perelman School of Medicine University of Pennsylvania

Adam Koby University of Florida - Gainesville

Melodie M. Blockmon University of Pikeville - Kentucky College of Osteopathic Medicine

B. Ethan Brown University of South Carolina School of Medicine Greenville Kelsey Hundley University of South Florida

Evan Russell Queen's University

Lauren Schuessler University of Kansas

Logan Kyle Walsh University of Texas Medical Branch at Galveston

Uchechukwu Anigbogu Rush Medical College

Mary Beth Hatch University of Louisville School of Medicine

Jenna R. Nofziger University of Toledo, College of Medicine and Life Sciences

Brandon T Schwartz Rutgers New Jersey Medical School Maxwell Blodgett Rutgers-Robert Wood Johnson Medical School Kristen Adorno, MD Sidney Kimmell Medical College at Thomas Jefferson University Carissa Solari SUNY Downstate Medical Center Rachel Posey Texas College of Osteopathic Medicine Nicholas Sterling, PhD The Pennsylvania State University College of Medicine Zachary Oleskey The University of Arizona, College of Medicine Maurice Hajjar The Warren Alpert Medical School of Brown University Jonathan Meadows Touro College of Osteopathic Medicine Samantha Huo Tulane University

Carleigh Benton University of Maryland School of Medicine Justin Chapman University of Massachusetts Medical School Simone Miller University of Massachusetts Medical School William Patterson University of Miami Miller School of Medicine - Miami Campus Amy Maier University of Miami Miller School of Medicine - Regional Medical Campus John Greco University of Michigan Tracy Marko University of Minnesota Medical School Dustin Bratton University of Mississippi Medical Center Joseph Ross Sinnott University of Missouri - Columbia School of Medicine

Lindsay Miller University of Vermont Larner College of Medicine Esteban Bubillos-Torres University of Virginia Peter T. Serina University of Washington Emily Wanamaker Upstate Medical University Elizabeth Sherrill Vanderbilt School of Medicine Nehal Naik Virginia Commonwealth University Nicklaus Ashburn Wake Forest University School of Medicine Ryan Kronen Washington University Patrick Bedard Weill Cornell Medicine Phylicia Irons West Virginia University

Salvador Rios University of Missouri - Kansas City

Jacob Brugger Western Michigan University Homer Stryker MD School of Medicine Emergency Medicine

Duncan Grossamn University of New England College of Osteopathic Medicine

William Trautman Wright State University, Boonshoft School of Medicine Karrin S. Weisenthal Yale School of Medicine

Sam Ganier LSUHSC New Orleans

2nd Lieutenant Colin Henderson Uniformed Services University of Health Sciences, F. Edward Herbert School of Medicine

Ryan Brandt Medical College of Georgia at Augusta University

Nicholas Seara University at Buffalo, Jacobs School of Medicine & Biomedical Sciences

Michael Mian University of North Carolina - Chapel Hill

Jasmine Ann Neeno Medical College of Wisconsin

Brian Whiteside University of Alberta

Sean Patrick University of Ottawa


Exhibitors American Academy of Emergency Medicine (AAEM) American Academy of Emergency Medicine / Resident and Student Association (AAEM/RSA) AcelRx Pharmaceuticals, Inc. American College of Emergency Physicians (ACEP) Geriatric Emergency Department Accreditation Program AI Care LLC Allergan USA, Inc Alteon Health Ambu American College of Medical Toxicology (ACMT) ApolloMD Bristol-Myers Squibb / Pfizer Biodynamic Research Corporation (BRC) BTG International Care Through Challenger Corpororation Charleston Area Medical Center

Clarius Mobile Health Dr. Fuji / ACIGI Relaxation Edelberg and Associates Emergent Medical Associates (EMA) EMrecruits Envision Physician Services Fisher & Paykel Healthcare Guthrie Clinic Hackensack Meridian Health Happy Doc Summer Camp Hays Innovations HCA Healthcare Indian Health Service Infinity Healthcare INRO Medical Designs Indiana University – Purdue University Indianapolis - Kelley School of Business (IUPIU) Indiana University School of Medicine | Department of Emergency Medicine Integrative Emergency Services (IES) Janssen Pharmaceuticals

Kaiser Permanente/ The Permanente Medical Group, Inc. KARL STORZ Endoscopy America, Inc. Leading Edge Medical Associates (LEMA) Mayo Clinic MedForums Mindray OPYS Physician Services OSF Healthcare Penn State Hershey Medical Center Philips Portola Pharmaceuticals QGenda LLC Schumacher Clinical Partners Shift Administrators Shire Simulab Corporation Smith & Nephew Society for Academic Emergency Medicine (SAEM) SonoSim

Sound Physicians - Emergency Medicine Splash Medical Devices TeamHealth The Dental Box The LAM Foundation Tower Health Texas Tech University Health Sciences Center El Paso – Deptartment of Emergency Medicine (TTUHSC) TrueLearn, Inc. University of Pittsburgh Medical Center - Emergency Medicine (UPMC) US Acute Care Solutions (USACS) United States Army 3rd Medical Recruiting Battalion VBM Medical Inc. VisualDX Vituity West Virginia Unviversity Medicine (WVU) - Department of Emergency Medicine Zero Gravity Skin

ANNUAL MEETING WRAP-UP

Many Thanks to Our SAEM18 Exhibitors and Sponsors!

Sponsors SonoGames® Sponsors: Philips

Clarius Mobile Health

SonoSim

SonoSite/FUJIFILM

Mindray

Feminem

Butterfly Network

Sfinx Games

SIMWARS Sponsors:

Wifi Sponsor:

SonoSim Vituity Laerdal Medical B-Line Medical

Vituity

Dodgeball Sponsor: American Academy of Emergency Medicine / Resident and Student Association (AAEM/RSA)

Thank You to Our Sonogames Sponsors!

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ANNUAL MEETING WRAP-UP

SAEM18 Photo Album

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SAEM's booth offered free tee shirts, complimentary headshots, and a chance to win registration and accommodation to SAEM19 in Las Vegas!

Friendly SAEM staffers, Doug, Zack, and George wait to register SAEM18 attendees.

Participants at SonogamesÂŽ 2018 were especially competitive this year.

The SAEM18 Residency & Fellowship Fair attracted an enthusiastic crowd.

Having a great time at the SAEM18 Residency & Fellowship Fair.

Photo op at the SAEM18 Opening Reception! Green screen = Indy Motor Speedway!

Consensus Conference participants worked hard to develop a pediatric EM research agenda.

With four full days of cutting edge educational offerings on the agenda, there was something for everyone SAEM18.

One of the more than 100 didactics presented over three days.

SAEM18 was an opportunity to share ideas, learn from others, and network with some of the top minds in academic EM.


SAEM18 FACEBOOK PHOTO ALBUMS

Big Wheels, Elvis impersonators, Sgt. Pepper's Lonely Hearts Club Band? Just your average Sonogames®.

SAEM18 attendees were treated to a playtime with puppies during a satellite symposium on "pet therapy."

Feel free to tag yourself, and watch for updates on SAEM’s Facebook photos page. #SAEM18

ANNUAL MEETING WRAP-UP

SAEM18 Photo Album

• Tuesday, May 15 • Wednesday, May 16 • Thursday, May 17 • Friday, May 18

AWAEM and ADIEM got together for lunch, networking, and lively discussions.

Opportunities for sharing ideas, discussion, and brainstorming were in steady supply at SAEM18.

LOOKING AHEAD Save the Date!

The SAEM BOD — mulleted, mustachioed, tatted up and ready to take on all competitors at Dodgeball 2018.

Epic is too small a word to describe this year's RAMS Party at Revel Nightclub.

The SAEM19 Program Committee, under the guidance of new 2018-2019 Chair, Jody Vogel, MD, is already hard at work to make SAEM19 a stellar success. We look forward to seeing you in Las Vegas, May 1417, 2019 at the lush, AAA 4-diamond Mirage.

SAEM19 Submission Deadlines Advanced EM Workshops Submission dates: August 1–September 17, 2018 Didactics Submission dates: August 15–October 1, 2018 Abstracts Submission dates: November 1 2018–January 2, 2019

The SAEM18 Clinical Images exhibit offered a lot to see.

Batman, and his buddies Dr. Kline and Dr. Carpenter, before the start of the Wellness Run.

Innovations/IGNITE! Submission dates: November 1 2018–January 14, 2019

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DIVERSITY AND INCLUSION Strategies to Enhance Retention of URM Faculty By Ava Pierce, MD and Marquita Hicks, MD Faculty diversity in United States medical schools has been linked to student diversity, to the cultural sensitivity of graduates, and to the campus climate. We must work to not only increase the number of Underrepresented in Medicine (URM) faculty in academic medicine, but to also enhance retention of those faculty. Strategies that can be employed to enhance retention of URM faculty include institutional support through resources and utilization of social relationships.1

Institutional Support Ava Pierce, MD

Institutional Support Through Resources can include: • Retention packages • Leadership Programs (e.g., Executive Leadership in Academic Medicine, Minority Faculty Leadership Development Seminar, etc.) • Linking legitimate diversity enhancement efforts to annual evaluations/financial incentives within departments/divisions • Widely disseminating information about funding opportunities available to URM fellows and junior faculty • Encouraging URM junior faculty to acquire additional training in grant writing • Encouraging participation in NIH/other funding opportunities to assist with URM faculty development

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Marquita Hicks, MD

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"Mentoring is a critical component of faculty career advancement in academic medicine."

• Having departmental/division leadership watch for and prevent the isolation/ gradual marginalization of URM faculty2 • Using the model from the National Initiative on C-Change institutions to promote sex and race equity through innovative activities that facilitate institutional culture change3,4 • Instituting programs modeled after the National Center for Leadership in Academic Medicine to increase professional opportunities for all faculty4,5 Utilization of Human capital and Social Relationships can include:

• Mentoring Programs • Coaching Programs2

Mentoring Programs

Mentoring is a critical component of faculty career advancement in academic medicine. URM faculty frequently receive less mentoring and they often experience unique career challenges. Institutionally supported mentoring programs with detailed plans for program sustainability are crucial for program success.6 Mentors can help junior faculty delineate career goals and enhance productivity; they can also provide education about the rules that govern the academic environment. Faculty members who have mentors report that they have: • higher career satisfaction • more confidence than their peers • more productive careers • more support for their research careers6 The challenges that URM faculty face include overt and covert racism, marginalization, and participation in a disproportionate share of activities that do not advance careers (such as serving on numerous committees and advising URM students and residents).6 Good mentoring practices that have helped to enhance URM retention faculty include one-on-one mentoring by an experienced investigator; group-based skill-building seminars; access to pilot grants; and support for conducting pilot studies.6

Coaching Programs

Adding coaching to traditional mentoring programs may help to enhance retention of URM faculty. Early results in the study, Coaching to Augment Mentoring to Achieve Faculty Diversity: A Randomized Controlled Trial, by Williams, suggested that an academic career-coaching model can effectively supplement traditional research mentoring and promote persistence towards academic careers. Study participants received group and individual coaching with coaches that had no research or evaluation roles. The study


showed how group career coaching can effectively supplement traditional oneto-one research mentoring; provide new role models for underrepresented minority students; and provide theory-based lenses through which to engage in open conversations about race, gender, and science careers.7 The coaching model builds on four theories from the social sciences, which reveal the social and cultural factors that impact all young scientists, particularly those from URM groups and women; they are: 1.) Identity formation; 2.) Social Cognitive Career Theory (SCCT); 3.)cultural capital; and 4.) communities of practice.8 Coaches may be particularly useful in instances when mentors can’t provide such vicarious learning opportunities. In Career Coaches as a Source of Vicarious Learning for Racial and Ethnic Minority PhD Students, Williams noted three main ways in which coaches of any race or ethnicity were useful to their students. First, the coaches earmarked time for dedicated career guidance. Secondly, they felt both parties were able to openly and honestly discuss their experiences

in academic medicine, aided by the fact that coaches and students came from different institutions. Lastly, students felt that their coaches were useful because they provided new and alternative models for what it means to be a successful scientist.8 Coaching can be an important way to address the lack of structured career development that URM faculty receive if it is lacking in their home training environment.8 Strategies must be employed to increase mentoring and coaching, decrease isolation, and foster an environment of inclusion so that we enhance retention of URM faculty in academic medicine.

REFERENCES

1. X ierali, I., Fair, M., & Nivet, M. (2018). Faculty Diversity in U.S. Medical Schools: Progress and Gaps Coexist. Retrieved from https://www.aamc.org/download/474172/data/december2016f acultydiversityinu.s.medicalschoolsprogressandgaps.pdf 2. P eek, M., Kim, K., Johnson, J., & Vela, M. (2013). “URM Candidates Are Encouraged to Apply”. Academic Medicine, 88(3), 405-412. doi: 10.1097/acm.0b013e318280d9f9 3. P ololi LH, Krupat E, Schnell ER, et al. Preparing culture change agents for academic medicine in a multi-institutional consortium: The C-change learning action network. J Contin Educ Health Prof 2013;33:244 - 257 4. R odríguez, J., Campbell, K. and Mouratidis, R. (2014). Where Are the Rest of Us? Improving Representation of Minority

Faculty in Academic Medicine. Southern Medical Journal, 107(12), pp.739-744. 5. D aley SP, Broyles SL, Rivera LM, et al. A conceptual model for faculty development in academic medicine: the underrepresented minority faculty experience. J Natl Med Assoc 2011;103:816 - 821. 6. B eech, B., Calles-Escandon, J., Hairston, K., Langdon, S., Latham-Sadler, B. and Bell, R. (2013). Mentoring Programs for Underrepresented Minority Faculty in Academic Medical Centers. Academic Medicine, 88(4), pp.541-549. 7. Williams, S., Thakore, B., & McGee, R. (2016). Coaching to Augment Mentoring to Achieve Faculty Diversity. Academic Medicine, 91(8), 1128-1135. doi: 10.1097/ acm.0000000000001026 8. Williams, S., Thakore, B. and McGee, R. (2016). Career Coaches as a Source of Vicarious Learning for Racial and Ethnic Minority PhD Students in the Biomedical Sciences: A Qualitative Study. PLOS ONE, 11(7), p.e0160038.

ABOUT THE AUTHORS: Ava Pierce, MD, is an associate professor in the Department of Emergency Medicine at the University of Texas Southwestern Medical Center, where she is also the director of the Emergency Medicine Research Associate Program. Dr. Pierce is also the president of SAEM’s Academy for Diversity and Inclusion in Emergency Medicine (ADIEM). Marquita N. Hicks, MD, is an associate professor in the Department of Emergency Medicine at the University of Alabama at Birmingham (UAB) where she also serves as the Director of Community Engagement in the UAB School of Medicine Office for Diversity and Inclusion. Dr. Hicks is president-elect of ADIEM.

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ETHICS IN ACTION Capacity and Consent By Alina Fomovska, MD Louisa is an 80-year-old woman with a history of paranoid schizophrenia who presented to the emergency department (ED) with a rapidly expanding neck mass, which over the course of the preceding months had made it difficult-to-impossible for her to eat, drink, or speak. Upon arrival to the ED, she was hemodynamically stable and at least temporarily able to protect her airway. A CT scan demonstrated a large, nodal mass completely collapsing her esophagus and impinging on her trachea.

"When faced with a patient who does not have capacity to make a decision, we may be prompted to consider what a 'reasonable person' in a given

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situation might chose."

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Louisa was admitted to the ICU and the ear, nose, and throat (ENT) team discussed a tracheostomy for further airway protection. The team noted that while the patient agreed to the procedure, her adult daughter signed the consent because the patient at times appeared quite confused. The tracheostomy was performed successfully, and subsequently more information emerged about the patient’s psychiatric history. The daughter reported that Louisa had a long-standing history of paranoid schizophrenia, including many delusions centered around medical care. She refused to take medications or see doctors, and she had a history of multiple psychiatric hospitalizations. Despite that, until recently, her daughter described her as “very high functioning”: she lived alone, took care of her basic needs, and even did her own grocery shopping. Over the course of the past several months, however, there had been a significant decline in her functional status and Louisa’s daughter, unable to persuade her to seek medical or psychiatric care, had filed an APS (Adult Protective Services) report one week prior to admission. After the tracheostomy, Louisa was calm, able to engage in conversation, and clearly suffering from delusions and psychosis. She wrote letters describing herself as the princess of Prussia and insisting that she was the president of the United States. She frequently declined medications out of concern for their mind-controlling properties. Pathology of the mass showed diffuse large B cell lymphoma, an aggressive

cancer that nonetheless may respond well to chemotherapy. With treatment, it would be reasonable to expect a decrease in the size of the mass, possibly to the point that a tracheostomy would no longer be required, and Louisa would be able to eat, speak, and breathe on her own. Thus treatment, in addition to adding years of life, could play a significant role in improving the patient’s quality of life. Louisa adamantly refused chemotherapy. Although conversations about the reasons for her refusal were limited by her inability to speak, the tone seemed similar to her prior treatment refusals: she was worried about mind control, and nothing could convince her that this was not the purpose of the intervention. She did not appear to have an understanding of her disease process and could not reason about the risks and benefits of the proposed treatment. This case demonstrates a conflict between the ethical principles of beneficence and autonomy — our duty to do what is good and right by the patient, and our duty to respect the patient’s right to make decisions according to his or her own tenets of self-actualization. In weighing these two principles in conflict, we typically consider several aspects of a case: 1. The consequences and potential gravity of refusing an intervention; 2. the risks of the intervention offered; 3. the patient’s understanding of those risks; and 4. the patient’s ability to make a decision that is in accordance to his or her previously stated values. A patient’s capacity to make a decision is a crucial component in considering this conflict. Several components of this case made resolving this conflict a more complex question still. Louisa’s psychiatric illness made her unable to understand information relevant to her health care or to fully appreciate the situation and its consequences, suggesting that she did not have capacity. Typically, in this situation, a surrogate decision maker is sought. Family members often fulfill this role, and medical providers frequently


"...a patient lacking capacity may still have the ability to express preferences regarding his or her care." ask family members to make decisions based on the values the patient may have expressed in the past (e.g. “What would your mother have wanted were she well?”). Louisa’s delusions, however, were so long-standing that it was difficult to identify a time when they were not a part of her belief system. In this case, as frequently in others, we may not have the security of previously-stated values to guide our decision making in resolving an ethical conflict. Furthermore, the treatment offered was uncomfortable, potentially risky, and long in duration. While Louisa did not have capacity to make the decision about whether or not to undergo chemotherapy, she had been able to express clear wishes against it. Her daughter might consent to the treatment, but by virtue of her refusal, Louisa changed the balance of the risks and benefits of the intervention. Even though she did not have capacity to decline the treatment,

proceeding with chemotherapy in the face of her refusal would likely include extreme measures, including possibly prolonged restraints and chemical sedation, which in turn take on amplified risks and downsides. The distress and damage caused by this course of action runs the risk of not only failing to do what is good and right by the patient, but violating another, arguably more central, ethical principal: Do no harm. Finally, Louisa’s decision, if considered outside of her psychosis, is not in and of itself, unreasonable. When faced with a patient who does not have capacity to make a decision, we may be prompted to consider what a “reasonable person” in a given situation might chose. We apply this principle frequently when providing life-saving emergency interventions when consent cannot be readily obtained (e.g., the unconscious trauma victim, or the injured child whose parents are en route to the hospital). In this case, however, it may be difficult to apply such guidance — an elderly patient with an aggressive cancer may reasonably chose to pursue chemotherapy; he or she may also reasonably decline it. Simply because Louisa does not have capacity to decline a treatment should not commit her to receiving it, particularly in a situation when it may be reasonable to refuse it. Louisa’s family expressed hope that her psychiatric condition might be stabilized such that she would be more equipped

to make decisions about the trajectory of her treatment. She was started on an antipsychotic medication, and the symptoms of her psychosis improved, but did not entirely resolve, and she continued to decline chemotherapy and other medical interventions. With the involvement of multiple medical teams, including psychiatry, palliative care, and ethics, Louisa’s family decided to forgo further curative therapies, and she was ultimately discharged home on hospice. When weighing the principles of autonomy versus beneficence and considering whether a patient should be able to refuse treatment, we rely on our understanding of their capacity to make the decision. However, in some situations, as in this case, a patient lacking capacity may still have the ability to express preferences regarding his or her care. In that case, his or her preference may be considered in the balance of risks and benefits of the proposed intervention. Considering the full scope of “reasonable” interventions may further expand the available options for the decision. ABOUT THE AUTHOR: Alina Fomovska, MD, is a chief resident in emergency medicine at the University of California, San Francisco. Her academic interests include palliative care in the emergency department setting, provider wellbeing, and psycho-social determinants of health.

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GRADUATE MEDICAL EDUCATION

Kelly Barringer, MD

Cullen Hegarty, MD

Andrew King, MD, FACEP

Running an Effective and Efficient Clinical Competency Committee By Kelly Barringer, MD, Cullen Hegarty, MD and Andrew King, MD

SAEM PULSE | JULY-AUGUST 2018

Background

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The Accreditation Council for Graduate Medical Education (ACGME) implemented the milestones as an assessment tool in 2013. Simultaneously, it also mandated the development of clinical competency committees (CCCs) as part of the Next Accreditation System (NAS). The primary objective of CCCs is to assess each resident’s progress and development along the milestone spectrum, while obtaining more objective methods of assessment. The intent is to provide better feedback to residents, while identifying struggling residents earlier.1 Initially, the ACGME provided little direction regarding the best way to structure CCCs. The intent was to provide each individual program the flexibility to institute a structure that would work best given the characteristics of their program.2 This perceived lack of direction can result in a challenge as programs continue to struggle with the best method to effectively and efficiently manage these committees, evaluate residents, and carry out the tasks mandated to the CCC. While there are multiple articles and a Clinical Competency Committee Handbook for residency programs from the ACGME, there is still minimal data and no established best practices for instituting and running and effective and efficient CCC.3,4 Our goal with this article is to summarize the available information and review the available recommendations and practices among emergency medicine programs.

Establishing the CCC Leadership and Membership The chair of the CCC must be directly appointed by the residency program director (PD).3 There is variability in who leads the CCC. A survey of emergency medicine (EM) residency programs in 2015 found that the chair is typically one of the associate or assistant program directors (71.6% of the time). In the remaining circumstances, the committee was chaired by another core faculty member (14.7%) or the PD (12.1%).5 The size and membership of the committee is flexible depending upon the needs of the program. The ACGME defines the minimum CCC size as three faculty members;3 however, it suggests that five to seven members is probably ideal to encourage discussion among members. Eight to ten members is likely the maximum number for optimal function.4 The CCC should primarily be composed of education faculty who teach and observe residents; however, not all members are required to be faculty. The ACGME states that committees can “consider how nonphysician faculty members can provide valuable input” and consider those individuals who have extensive contact and experience with the residents in patient care for inclusion in the CCC. Some options might include PhD educators, nurses, advanced practice providers, pharmacists, and therapists.1 Chief residents may serve if they are doing an extra year of training, but not if they are currently residents in the program.4


There is significant variability in how emergency medicine (EM) residency programs structure their CCCs; however, in most programs, the voting members of the committee consisted of selected core faculty (75.6%) and the residency leadership.5 Meeting Frequency All CCCs are required to meet twice yearly to complete resident milestone evaluations.1 The number of times CCCs meet is variable, yet most meet more frequently. In EM residency programs, just over half of the committees met quarterly, while one third of them met monthly.5 There should be time dedicated annually to educate CCC members on the milestones to ensure that faculty reach a common understanding on the meaning of each milestone as it relates to their specific specialty.6

Preparing for Effective Meetings Milestone Mapping Prior to CCC meetings, the committee should evaluate how the milestones are being assessed. There are many different assessment tools that can be used by residency programs. These tools should be mapped to the milestones and reviewed to identify gaps in assessments.6 Assessments should include many forms of assessment from as many evaluators as possible. A single tool is insufficient to judge something as complex as clinical competency.4 There are multiple options described by the ACGME for assessing a resident’s progress along the milestone continuum, which include end of shift evaluations, summative rotation evaluations,

"There should be time dedicated annually to educate CCC members on the milestones to ensure that faculty reach a common understanding on the meaning of each milestone as it relates to their specific specialty" 360 evaluations, direct observation, longitudinal evaluations, simulation, quality improvement projects, etc.4 Obtaining multiple data points for each milestone is vital as it will strengthen the validity of the evaluations.7,8

Conducting and Effective and Efficient CCC Meeting Review Process There are no specific guidelines from the ACGME on how to review residents prior to or during CCC meetings; therefore, there are several different ways programs may choose to review residents and these may depend on a variety of factors. One option is to have all members review every resident and compare notes at the meeting. Another option might be to have each member review a different resident and share their review with other members of the group. The size of the residency program can influence the way residents are reviewed – smaller programs may be able to have multiple members review each resident, while that may be time prohibitive for larger programs. Some programs may choose to have one committee member provide an in-depth review of each

resident and report their findings to the CCC. Additionally, a CCC may include the resident’s mentor, coach, or advisor in the CCC committee meetings both as a reviewer and an advocate for the resident. The majority of EM programs have systems to match residents with a faculty member or advisor.6 Of these EM programs, about a third include the faculty mentor as part of the CCC to review his/her resident’s progress.6 During the Meeting There continues to be little direction from the ACGME regarding the best method to both manage CCC meetings and review residents; therefore, each residency program has a great deal of autonomy in managing their respective CCC to meet the needs of their program. The most effective way to review residents will depend upon the characteristics of each individual program and committee. Most EM programs meet to review the entire program (39.5%) or a single class (27.2%) during a single meeting.6 Larger programs may find it difficult to review an entire program at a single meeting. continued on Page 24

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member or the faculty, or by written communication.4

Conclusion

There are multiple strategies each program can implement to ensure an effective and efficient CCC, conduct resident assessments, and communicate recommendations to program leadership. There is minimal formal direction from the ACGME aside from a basic theoretical framework regarding best practices, which allows for significant flexibility within individual programs. This leads to a wide variety of practices across different programs. As emergency medicine educators, we need to continue to evaluate and develop best practices regarding resident assessment and the clinical competency committee.

REFERENCES

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GRADUATE MEDICAL EDUCATION continued from Page 23

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A few programs implemented a more continuous approach of reviewing a few residents during biweekly meetings.6

approach to meeting facilitation rather than an open forum for members to share general comments may help.4

Milestone assessment summaries are the primary focus of each CCC meetings.1 The meetings should be conducted in a way to allow open discussion and promote an effective group process because this has been shown to produce better decisions.4 Several studies found that a number of learner deficiencies were discovered during formal, productive group discussions.4 These productive discussions will produce better feedback for the learners. The committee chair should ensure that the meetings provide adequate time for discussions.4

After the CCC Meeting

During CCC deliberations the discussion of struggling residents can easily monopolize the meeting time, while little time is spent on those residents who are consistently excelling or performing well. Some EM programs (6.1%) reported that they only reviewed struggling residents at their meetings.6 While it is important to have enough time during meetings to discuss those who are struggling, programs need to be careful not to neglect learners who are excelling who will also benefit from robust feedback. Chairs should ensure adequate time for discussion for each resident. Maintaining a structured

According to the ACGME common program requirements, the CCC is required to report semiannual milestone evaluations.3 The committee is also required to notify the program director not only of the residents’ progress in meeting milestones but also the committee’s recommendations for promotion, remediation and dismissal. While the CCC is responsible for providing recommendations for resident status within the residency program, the program director ultimately has the final responsibility for the decisions.1 Following the meeting, the discussion about each resident should be captured, documented and included in the resident’s academic record. All residents should receive timely feedback after CCC meetings. There is no formal mandate from the ACGME regarding the direct role of the CCC in sharing evaluation and meeting summaries with the residents. Program leadership should decide how and when to share the information around a resident’s progress.1 This can be accomplished in a multitude of forms such as being communicated to them directly by the program director, by an advisor, a designated CCC member or another

1. Accreditation Council for Graduate Medical Education (ACGME). The Clinical Competency Committee (CCC). Available at: http://www.acgme.org/acgmeweb/Portals/0/ PDFs/SlideDecks/SLIDEDECK-FDCCC2013.pptx 2. Accreditation Council for Graduate Medical Education (ACGME). Frequently Asked Questions: Clinical Competency Committee and Program Evaluation Committee. Available at: www.acgme.org/acgmeweb/Portals/0/PDFs/FAQ/ CCC_PEC_FAQs.pdf. 3. Accreditation Council for Graduate Medical Education (ACGME). Section V.A.1 of the ACGME common program requirements, effective July 1, 2013. Available at: https:// www.acgme.org/Portals/0/PFAssets/ProgramRequirements/ CPRs_2017-07-01.pdf 4. ACGME clinical Competency Committees Handbook for Programs. Andolesek K, Padmore J, et al. 2017. 5. H ow do Emergency Medicine Residency Programs Structure their Clinical Competency Committees? A Survey. Doty C et al. Acad Em Med 2015. 22:1351–1354 6. A systematic approach toward building a fully operational clinical competency Committee. French J et al. Journal of Surgical Education Volume 71/Number 6 November/ December 2014 7. A merican Educational Research Association. American Psychological Association. National Council on Measurement in Education. Standards for Educational and Psychological Testing. Washington, D.C.: American Educational Research Association, 1999. 8. D owning SM. Validity: on the meaningful interpretation of assessment data. Med Educ. 2003;37(9):830-837.

ABOUT THE AUTHORS: Kelly Barringer, MD, is an assistant professor and chair of the Clinical Competency Committee at the University of Minnesota Medical School. She is also an emergency medicine senior staff member at Regions Hospital St. Paul, Minnesota. Cullen Hegarty, MD, is an associate professor and residency program director at the University of Minnesota Medical School. He is also an emergency medicine senior staff member at Regions Hospital St. Paul, Minnesota. Andrew King, MD, is an assistant professor, assistant residency program director, and medical education fellowship director at The Ohio State University Wexner Medical Center. @akingermd


SGEM: DID YOU KNOW?

Sex and Gender Health Education Summit: Advancing Curricula Through a Multidisciplinary Lens A report by Alyson J. McGregor, MD, MA Our understanding of the enormous impact patient sex and gender have on health care continues to advance. However, the lack of systemic integration into health education limits the ability to translate this new knowledge into patient care. In April, the University of Utah School of Medicine addressed this deficit, hosting the Sex and Gender Health Education (SGHE) Summit, which was developed to support and progress the integration of sex and gender differences into health professionals’ education. The Summit expanded multidisciplinary opportunities by convening health education leaders from five major professions: medicine, nursing, pharmacy, dentistry, and allied health. More than 250 participants from 170 institutions— including health education faculty, student leaders, and professional and non-profit organizational representatives with an interest in progressing sex and gender inclusion into health professionals’ education—took part in the 2-1/2 day Summit. In addition to a keynote address by Dr. Cara Tannenbaum, scientific director of the Institute of Gender and Health of the Candian Institutes of Health Research (CIHR), the Summit agenda included a competitive poster session; educational and panel discussions, two workshops; and a capstone presentation by Dr. Lucinda Maine, executive vice president and CEO of the American Association of Colleges of Pharmacy. Additionally, many emergency medicine leaders were involved in the planning, presentations and workshop facilitations. Tangible outcomes an anticipated as a direct result of the SGHE Summit. In the coming months, in addition to the release of the e-proceedings from the Summit, the Journal of Women’s Health will be publishing a special section on Integrating Sex and Gender into Health Professions Education. This special section will feature manuscripts that will provide data on successful models of sex and gender curricula integration, along with SGHE Summit outcomes and the introduction of the concept of Multi-Professional Achievable Required Knowledge (MARK)—the creation of sex and gender student-based competencies across health professions. Many curriculum influencers, content experts, student champions, and institutional members comprised this movement and helped to create a road map for integrating sex- and gender-based medicine into medical education. They are the change agents that will lead this initiative toward the next level of advancement of health care education. Embracing this type of effective collaboration toward the integration of sex and gender into health professions curricula is the next step toward improving health outcomes. ABOUT THE AUTHOR: Alyson J. McGregor, MD, MA, is an associate professor of emergency medicine at the Warren Alpert School of Medicine of Brown University. She is the director for the Divison of Sex and Gender in Emergency Medicine (SGEM) and co-director for SGEM Fellowship.

Please send contributions for this column to coeditors Lauren Walter and Alyson J. Mcgregor at sgem@lifespan.org. If you are an SAEM member and are interested in adding the Sex and Gender in Emergency Medicine Interest Group (SGEM IG) to your membership, simply sign in to your SAEM profile and join today. SAEM members who are already part of the SGEM IG can find more information and resources by visiting the SGEM IG Community Site.

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WILDERNESS EMERGENCY MEDICINE A Day in the Life of Dr. Kenneth Iserson, McMurdo Station Emergency Physician, Ross Island Antarctica By Nathaniel Mann, MD

Photo of the author, Dr. Nathaniel Mann.

"Get experience, even short-term, as soon as you can. One of the first questions you’ll be asked is ‘What experience have

SAEM PULSE | JULY-AUGUST 2018

you had?’"

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You’ve probably heard of Dr. Kenneth Iserson. Most emergency physicians have. He’s the author of hundreds of scientific articles and numerous books on emergency medicine and biomedical ethics, including the popular Improvised Medicine, but he is probably best known for his work at the United States Antarctic research center, McMurdo Station. McMurdo Station is a United States Antarctic research center on the south tip of Ross Island, which is near the continent of Antarctica. Built on the bare volcanic rock of Hut Point Peninsula on Ross Island, McMurdo is the largest Antarctic station and the solid ground farthest south that is accessible by ship. For Dr. Iserson, Antarctica was, in a way, the final frontier. With a career that had already taken him to every other continent in the world, he pursued a position at McMurdo to be involved in a unique professional experience. During two stints totaling 15 months on the southern continent, Dr. Iserson served as the lead physician, meaning he had

Dr. Iserson with emperor penguins in Antarctica.

additional duties beyond patient care. He took charge over expected tasks such as managing the pharmacy and laboratory, preparing field medical kits, and a variety of administrative tasks. But he also had some unexpected duties, like serving as the food service and preparation inspector and, most unusual of all, practicing advanced dental care—including tooth extractions and patient bite adjustment with power tools. The summer season at McMurdo is the busiest, and although the average high temperature remains a chilly sub-freezing, the community swells in population. Several physicians and other providers comprise a medical team that supports about 1,300 individuals from across the continent and at the adjacent, New Zealand-owned station. When winter comes, however, there is only a single physician and physician assistant to care for the approximately 150 people who remain. The result is a remote primary care population that suffers mostly primary care issues. Major trauma and/ or hypothermia is rare (although the clinic also serves as an inpatient facility), but the gravity of an illness or injury is enhanced by the remoteness of the continent. Extraction

Hut Point Peninsula, where Discovery Hut is located, adjacent to McMurdo Station and built around 1901 by the explorer Robert Falcon Scott.


Globe at the ceremonial South Pole, about 150 feet from the geographic pole (which moves around).

of a critically ill individual may take days or weeks, depending on the weather. The extreme conditions result in a high premium being placed on medical selfreliance and improvisational skills. To prepare for practice in such a remote and often resource-poor setting, Dr. Iserson stresses the importance of obtaining the broadest medical knowledge base possible and focusing on more practical and reliable “older techniques.” While there is a certain level of attractiveness to a standout career in wilderness medicine at sites such as Antarctica, Dr. Iserson provides this cautionary advice: “Don’t think you can make a living doing this; it should be seen as an interesting avocation.” Although having worked short periods abroad throughout his career, Dr. Iserson’s stints at McMurdo did not come to fruition until after his retirement from academic emergency medicine. As with the vast majority of physicians working in wilderness medicine, he relied on his medical practice to support himself financially during his time on

"The extreme conditions result in a high premium being placed on medical self-reliance and improvisational skills." Ross Island. And like most physicians who have found success within wilderness medicine, Dr. Iserson has diversified his career. His home base is still in Tucson, where he is professor emeritus of emergency medicine at the University of Arizona, medical director (emeritus) of the Southern Arizona Rescue Association (search and rescue), a supervisory physician with Arizona’s Disaster Medical Assistance Team, and a member of the American Red Cross disaster response team. He also runs Recursos Educativos en Español para la Medicina de Emergencia (REEME), which freely distributes more than 700 Spanishlanguage PowerPoint presentations on emergency medicine. Over the course of his career, Dr. Iserson has practiced or taught on all seven continents, although

he now limits his medical practice to global and disaster medicine. Dr. Iserson’s career has exemplified what it means to fill the niche of wilderness medicine. He has served as an example to many who aspire to similar clinical careers. His final piece of advice to those considering professional work in the field: “Get experience, even shortterm, as soon as you can. One of the first questions you’ll be asked is ‘What experience have you had?’” ABOUT THE AUTHOR: Dr. Mann is a second-year fellow in wilderness medicine at Massachusetts General Hospital. He is an avid climber whose clinical interests lie in high altitude medicine and search and rescue.

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RAMS ARE ON THE MOVE: JOIN US! By Chad Mayer, MD, PhD - 2018–2019 RAMS Board President

SAEM18: RAMS Recap After barely a year in existence, RAMS turned out in force to SAEM 2018, resulting in the greatest resident and medical student attendance ever at an SAEM annual meeting. From Dodgeball to Speed Mentoring, and including the all-night RAMS party at Revel, there was no end to the exciting opportunities available to RAMS at SAEM18 or to the energy and enthusiasm RAMS brought to the event. During the SAEM18 opening session, the first elected RAMS board was officially installed. They took up their positions with an eye toward the future, prepared to take forward the many projects begun by the inaugural board, but also with an eager anticipation for implementing newly hatched ideas and initiatives. The RAMS turnout at SAEM18 is clear evidence that there couldn’t be a better time for residents and medical students to get involved in RAMS. Are you wondering if RAMS is for you? Have you been considering joining a RAMS committee, but have been waiting for just the right time? If you can answer “yes” to any of the questions below, then RAMS is indeed for you, and the time to get involved is right now!

"AS RAMS GOES FORWARD, WE WILL WORK HARD TO DIVERSIFY AND INCLUDE MORE RESIDENTS AND MEDICAL STUDENTS FROM AROUND THE COUNTRY AND BECOME MORE OF A PRESENCE UNDERNEATH THE UMBRELLA OF SAEM."

The RAMS mascot leads the RAMS Dodgeball team in a rousing cheer.

Say “Yes” to RAMS! Are you wondering what it takes to make it in academic emergency medicine? RAMS is committed to preparing every medical student and resident who is interested in EM academics with the tools and resources to achieve their goals. Are you unsure what the pathway to getting into a particular fellowship or niche may be? RAMS is already working on developing Academic Road Maps to provide you with a framework of what to pursue and how to approach next steps. Do you need a mentor because your program (or even your state) doesn’t offer the fellowship you’re interested in? The Professional Development Committee held an amazing Speed Mentoring event at SAEM18; in addition, our new podcast series, RAMS Ask-a-Chair,


The first elected RAMS Board is installed at the SAEM18 Opening Ceremony.

features directors from around the country whose stories are filled with pearls and advice for early career starting points. Do you have an exciting idea for a project and an interest in doing research, but need funding and mentorship? The Awards Committee has worked hard to put together exciting new awards and small grants including opportunities to travel to research workshops and obtain the jumpstart in how-to and mentoring you may need to develop an exciting career pushing the boundaries of clinical knowledge. Are you interested in tackling wellness and the epidemic of burnout in emergency medicine? The Wellness Committee is developing articles and organizing the annual meeting events around the topic of wellness. The committee is poised to grow even more this year as SAEM and other major emergency medicine organizations create task forces and collaborate to create resource repositories to help combat career fatigue. Are you excited about FOAMed and want to promote quick clinical tips or other resources for RAMS? The Social Media and FOAMed Committee has created #TestPrepTuesday, but there’s still six more days to fill with content and many exciting opportunities available through the RAMS Twitter feed. These are just some of the opportunities available when you get involved with RAMS and/or on a RAMS committee.

The Road Ahead: Paved With Opportunities As RAMS goes forward, we will work hard to diversify and include more residents and medical students from around the country and become more of a presence underneath the umbrella of SAEM. As an established organization we have many exciting projects that are ongoing and new ones that were proposed by the RAMS committees at SAEM18. RAMS committees, and indeed RAMS itself, is driven by the residents and medical students who give of themselves and their time. This means that by signing up for a RAMS committee, you can have a direct impact on committee projects. What’s more, by becoming involved in RAMS committees early in your career,

and working towards leadership opportunities as you advance through residency, you will be poised to take advantage of the a multitude of RAMS and SAEM resources and mentorship opportunities. Consider signing up to serve on a RAMS committee and do your part to positively shape the landscape of academic emergency medicine. ABOUT THE AUTHOR: Chad Mayer, MD, PhD, is a PGY2 at The Ohio State University Wexner Medical Center. He received his undergraduate degree in biochemistry from Seattle Pacific University and his MD/PhD from Boston University.

Join a RAMS Committee Click through the RAMS Committee descriptions below to find one (or more) that’s right for you. Once you find a good match for your interests, contact Snizhana Kurylyuk, governance manager, at skurylyuk@saem.org or by calling (847) 257-7234 to participate. The 2018-2019 term for RAMS Committees begins in July and lasts until the SAEM Annual Meeting in May 2019.

Awards Committee Career Development and Mentorship Committee Education Committee Membership Committee Research Committee Social Media and FOAM Committee Wellness and Resilience Committee 29


MEMOIRS OF AN SAEM18 MEDICAL STUDENT AMBASSADOR By Austin Tam, ScB, MS4, Alpert Medical School of Brown University If you attended SAEM18 in Indianapolis this past May, then you must have seen a fleet of young volunteers in stylish sapphire blue sportswear jackets assisting attendees and presenters at different events. These were the SAEM18 Medical Student Ambassadors (MSAs). I was among them. This past winter we had all applied for and were granted the privilege of being among those who were selected for the position of MSA at SAEM18. There were about 40 of us total, encompassing all years of medical school, including a postmatch 4th year. Several were MSA veterans, including one of the MSA co-chairs who is now an emergency medicine resident.

"MY EXPERIENCE AS A MEDICAL STUDENT AMBASSADOR HAS UNLOCKED DOORS FOR ME

The co-chairs, Alex Huh (PGY-2 at Pittsburg) and Riley Grosso (an attending at Case Western Reserve University), were in charge of managing the team of MSAs. They prepared us for our role by setting up a Slack channel to organize communications and logistics among us. They also helped select the Head MSAs who took on leadership roles to plan meals, group activities, and other daily affairs. Alex had the additional, significant task of pairing each of us with an emergency medicine mentor based on our academic interests or geographical preferences. This was one of the perks of being an MSA! These mentors met with us during the annual meeting to answer questions and provide application advice. Riley did an incredible job of organizing and configuring all of our daily schedules to accommodate our lecture requests (those we were interested in and preferred to be assigned to). The MSA program would not have been as successful were it not for the dedication and hard work of the co-chairs. By the time the annual meeting rolled around, we were excited to take on our roles as MSAs. At orientation we received our iconic blue zip jackets (for which we received many compliments as well as inquiries on if/how/where they could be purchased). It was also during orientation that our MSA duties were outlined for us: obtain audience headcounts for our assigned lectures, assist in lecture AV and logistical issues, direct attendees to events, and general conference troubleshooting (including requesting room temperature control, which proved crucial when assigned to a crowded, sweltering presentation room).

IN EMERGENCY MEDICINE

Beyond our work assignments we were required to attend daily morning planning meetings with SAEM staff, as well as MSA lunch talks, and to generally make the most of every opportunity given to us while at SAEM18.

AND PROVIDED ME WITH A

Head MSA, Adrian Cotarelo, a medical school friend and a veteran MSA from last year, was the one who convinced me to apply to be an MSA at SAEM18. Adrian planned many fun, after-hours activities in Indianapolis for our team to enjoy once we finished working our shifts. These excursions brought all of us closer together and were some of the highlights of the annual meeting.

PASSPORT OF INVALUABLE MENTORSHIP, NETWORKING, AND CAREER ADVICE."

Among the week’s highlights: •W e robbed a bank! Actually, we escaped from “The Bank Heist Room” at The Escape Room USA…with no seconds to spare. •W e enjoyed the local fare. We sampled the famous breadsticks at Kilroy’s and and went on the Sun King Brewery Tour. •W e went clubbing. The RAMS Party was off-the-hook! Open bar + catered buffet + dance floor = mindfulness?


The Medical Student Ambassador Dodgeball team made it all the way to the semi-finals!

The RAMS party was off-the-hook! Open bar + catered buffet + dance floor = mindfulness?

The Medical Student Ambassadors looked sharp as tacks in their sapphire blue jackets.

•W e dodged balls. The MSA dodgeball team, FOOSH (Fall On OutStretched Hand), made it all the way to the semi-finals. •W e learned. MSA lunch talks presented advice on creating CVs, applying to away rotations, and how to be a competitive EM applicant. We also attended poster showcases, lectures, the opening session keynote presentation, and IGNITE! sessions to update ourselves on the current literature and research of the field •W e made connections. My mentor pairing was Aaron Brody, from Wayne State University SOM. Our common interest was social emergency medicine (SEM) and population health research. He hosted an evening social for the SEM interest group during annual meeting week, which proved to be a great networking opportunity. •W e modeled! We volunteered our bodies to be ultrasound models for Sonogames®. Luckily, ultrasound gel is moisturizing and easy to clean. My experience as an SAEM Medical Student Ambassador has unlocked doors for me in emergency medicine and provided me with a passport of invaluable mentorship, networking, and career advice. I highly recommend this opportunity to my emergency medicine-minded peers. Consider applying to become an MSA for SAEM19. If selected, you’ll walk away with the best and greatest annual meeting souvenir of all: Incredible memories that you will revere during your blossoming training and career in emergency medicine. ABOUT THE AUTHOR: @AustinTamEM, ScB, is an MS4 in the Alpert Medical School of Brown University where he is also an inaugural member of the Primary Care-Population Medicine Program and an ScM candidate in Population Medicine. Austin is a RAMS Education Committee Member and a member of the SAEM Social Emergency Medicine Interest Group.

The SAEM Medical Student Ambassador Program Each year in December, the SAEM Program Committee looks for enthusiastic and responsible medical students from around the country to work directly with SAEM leadership to assist in the planning, coordination, and execution of SAEM’s Annual Meeting. Program Benefits •O pportunity to attend the full SAEM annual meeting and participate in didactics, poster sessions, and educational activities •W aiving of your SAEM annual meeting registration fee •P airing and scheduled one-on-one meetings with an academic EM mentor •P ersonal letter from the SAEM Program Committee chair addressed to your Dean of Student Affairs to acknowledge your contributions Applications for the Medical Student Ambassador program opens in December. Medical students at any level of training may apply.

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BRIEFS AND BULLET POINTS SAEM NEWS Junior Faculty, Fellows, and Senior Residents: Have you Signed Up for ARMED Yet?

Applications are being accepted for the next Advanced Research Methodology Evaluation and Design (ARMED) course. Taught by leading experts in academic emergency medicine, the purpose of this course is to arm participants with the fundamental knowledge and skills to design a high-quality research project and grant proposal to jumpstart their research careers. The course is targeted to fellows, junior faculty within five years of graduation, and senior residents who are interested in pursuing a career in research.

Scholarships for Underrepresented Minorities

Did you know that the Clerkship Directors in Emergency Medicine (CDEM) maintains a list of visiting elective scholarship programs for underrepresented minorities? The list of 29 scholarship programs is updated regularly, as new scholarship opportunities arise.

Contribute Your Content to SOAR

Are you interested in having your blog or podcast added to our growing library of SAEM Online Academic Resources (SOAR)? Do you have a suggestion for a website or video you’d like to see added to SOAR? Just complete the submission form on the FOAMed Resources page, we’ll review your submission, and if it passes muster, we’ll share it on our SOAR page!

Take Care of Yourself

Have you checked out SAEM’s wellness and resilience portal? This growing reservoir of wellness and physician resources and literature aligns with SAEM’s Statement on Commitment to Clinician Well-Being and Resilience.

Call for Proposals: 2020 SAEM Consensus Conference

SAEM is accepting proposals for the 2020 SAEM Consensus conference, to be held May 12, 2020 at SAEM20 in Denver. Submission deadline is September 1, 2018, 5 p.m. CT. Application details can be found online.

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RAMS REPORT

June and July Ask-a-Chair Podcasts Are Now Live

The third and fourth podcasts in the RAMS Ask-a-Chair series, featuring questions submitted for chairs by residents and medical students, are now live on SAEM’s website. The guest for the June RAMS Ask-a-Chair podcast is Harvard Associate Professor of Emergency Medicine, Richard E. Wolfe, MD, chair of emergency medicine at Beth Israel Deaconess Medical Center. The guest for the July podcast is Robert McNamara, MD, FAAEM, professor and chair of emergency medicine, Lewis Katz School of Medicine, Temple University. Moderator for both podcasts is SAEM resident member, Amanda Ventura, MD, University of Cincinnati College of Medicine.

Follow @SAEM_RAMS on Twitter

SAEM residents and medical students, if you’re on Twitter, you need to follow @SAEM_RAMS on Twitter for exclusive news and informational content pertinent to you. Do you have resident- or studentoriented content you’d like to push out to the masses? Submit a request to have it published via RAMS Twitter!

SAEM JOURNALS Academic Emergency Medicine

Call for Papers: Influence of Gender on the Profession of Emergency Medicine

Academic Emergency Medicine is now accepting papers for a special issue, to publish in early 2019, dedicated to original research papers and systematic reviews that focus on the role of biological sex and/or female gender identity with respect to workplace experiences, professional advancement, practice environment, work satisfaction and burnout, and the general clinical practice of emergency medicine. Topics must address the condition of being female and in the professional practice of emergency medicine, favoring a focus on the period after completion of residency and/or fellowship training, including academic and community practice. Instructions for authors and more specific details may be found on SAEM's website. Please read these instructions carefully. Submissions will be

There’s an App for That! AEM Journal

Don’t miss a single issue of AEM. Download the AEM mobile app to read the latest academic EM research on the go!

Community App

Keep up with your SAEM community and stay in the loop via SAEM’s Community app. The app gives you all the features you enjoy on the Community Site, but in a mobile format. Download at iTunes or Google Play. accepted until October 30, 2018, 5 p.m. PT via ScholarOne, our online submission site. Please direct any questions to Jeff Kline (jefkline@iu.edu).

AEM Education & Training

Submission Deadline for Special Issue is Just Two Weeks Away!

Academic Emergency Medicine Education and Training is inviting submissions from SAEM academies, committees, and interest groups, for a special issue of AEM E&T that will publish in late 2018. This special issue will highlight the proceedings from the SAEM Annual Meeting relevant to education and training. In addition to the standard manuscript types, conceptually-based white papers submitted by SAEM academy, committee, and interest group members that share cutting edge ideas and concepts unique to their areas of expertise-with an emphasis on education and training in emergency medicine-will be accepted. Instructions for authors and more specific details may be found on SAEM’s website. Please read these instructions carefully. Papers will be submitted via ScholarOne, our online peer review management system. All papers will undergo peer review. Deadline for submissions is July 15, 2018.


What Research is Creating a Buzz? Read the most shared SAEM journal articles published in 2017, based on Altmetric score.

Academic Emergency Medicine:

Members of the AEM and AEM E&T Editorial Boards at the Soldier and Sailors Monument, Indianapolis.

Podcasts

Check out our latest Journal Podcasts

Academic Emergency Medicine AEM Education and Training

SAEM FOUNDATION

SAEM Foundation Announces New Grants

The SAEM Foundation has recently expanded its grant portfolio and increased funding for many programs beginning with the August 1, 2018 submission deadline. The flagship Research Training Grant now provides $300,000 over two years ($150,000 per year) for recipients to obtain research skills in emergency medicine. The Education Project Grant now provides up to $20,000 per year in funding for recipients. To view a full listing of grant offerings through the SAEM Foundation, visit the SAEM Foundation What We Fund webpage. All applications are due at 5 pm CT on August 1, 2018.

SAEM Foundation in Partnership With SAEM Academies

The SAEM Foundation is proud to partner with the following SAEM Academies to provide grant opportunities for members. Deadlines to apply for each of the five grants is August 1, 2018. • Academy of Emergency Ultrasound (AEUS) Research Grant - $10,000 • S AEMF/Global Emergency Medicine Academy (GEMA) Research Pilot Grant - $10,000 -

• S AEMF/Academy of Women in Academic Emergency Medicine (AWAEM) Research Grant - $5,000 • S imulation Academy Novice Research Grant $5,000 • A cademy for Diversity and Inclusion in Emergency Medicine Research Grant - $3,000

REGIONAL MEETINGS Great Plains

Call for Abstracts and Didactics

Abstracts and didactics are now being accepted for the SAEM Great Plains Regional Meeting, to be held September 21-22, 2018, in the Eric P. Newman Education Center at Washington University in St. Louis (View Agenda). Submissions are due August 1, 2018 at greatplainsregional@saem.org. For detailed information and submission specifications, please visit the Great Plains Regional Meeting website.

IN OTHER NEWS NIH Releases Strategic Plan for Data Science

The National Institutes of Health (NIH) has released its first ever Strategic Plan for Data Science to capitalize on the opportunities presented by advances in data science. The plan describes NIH’s overarching goals, strategic objectives, and implementation tactics for promoting the modernization of the NIH-funded biomedical data science ecosystem. Over the course of the next year, NIH will begin implementing its strategy, with some elements of the plan already underway.

Topical Tranexamic Acid Compared With Anterior Nasal Packing for Treatment of Epistaxis in Patients Taking Antiplatelet Drugs: Randomized Controlled Trial Current Status of Gender and Racial/ Ethnic Disparities Among Academic Emergency Medicine Physicians Clinical examination for acute aortic dissection: A systematic review and meta-analysis

AEM Education and Training: Not Another Bedside Lecture Active Learning Techniques for Clinical Instruction Identifying the Emergency Medicine Personality: A Multisite Exploratory Pilot Study Learning Analytics in Medical Education Assessment: The Past, The Present, and The Future

NIH will continue to seek community input during the implementation phase.

Part One of CDC Antibiotic Training Course is Now Online

The first section of the new CDC Training on Antibiotic Stewardship is now available. The online training course offers participants up to eight hours of free continuing education (CE). When completed, it will be accessible in multiple modules offered in four sections. The first section is available now, with additional content releasing later this year. You must create an account on CDC Train to register for the course. Course objectives include: • optimizing antibiotic prescribing and use to protect patients and combat the threat of antibiotic resistance, • informing healthcare professionals about proper antibiotic prescribing, and • encouraging open discussion among physicians and patients.

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ACADEMIC ANNOUNCEMENTS Medical College of Wisconsin Ian B.K. Martin, MD, MBA, has been appointed professor and chair of the department of emergency medicine and professor of Medicine (General Internal Medicine) at the Medical College of Wisconsin (MCW), effective September Ian B.K. Martin, MD, MBA 10, 2018. Dr. Martin will also become emergency physician-in-chief of the Froedtert and MCW Health Network. Dr. Martin currently serves as professor and chair of emergency medicine at the West Virginia University (WVU) School of Medicine. He also serves as professor in the Department of Medicine and physician-in-chief, WVU Medicine Emergency Medicine Practices. Dr. Martin will be relocating from West Virginia with his wife, Erica M. Arrington, MD, who will be joining MCW as associate professor, Department of Psychiatry and Behavioral Medicine (Child and Adolescent Psychiatry). Dr. Martin is the president-elect of SAEM and has been actively involved with the Society for many years, most recently as secretary-treasurer, and previous to that, as an at-large member on the SAEM Board of Directors. He has held several positions of leadership at SAEM, including founder and president of the Global Emergency Medicine Academy (GEMA); co-chair of the SAEM Finance Committee; chair of the International Committee; chair of the Global Emergency Medicine Subcommittee of the SAEM Fellowships Credentialing Task Force; and chair of the Committee of Academy Leaders (COAL). Dr. Martin was recently awarded the Marcus L. Martin, MD Leadership Award – the highest honor given by SAEM’s Academy of Diversity and Inclusion in Emergency Medicine (ADIEM).

NewYork-Presbyterian/Weill Cornell Medical Center Katherine L. Heilpern, MD, has been named senior vice president and chief operating officer of NewYork-Presbyterian/Weill Cornell Medical Center, effective in August. She joins from the Emory University School of Medicine and Emory Healthcare, where Katherine L. Heilpern, MD she served as chair of the department of emergency medicine and held several other key leadership roles. Dr. Heilpern served as president of SAEM and is the recipient of many awards from the Society, including the SAEM Award for the Advancement of Women in Academic Emergency Medicine and, most recently, the John Marx Leadership Award.

Rahul Sharma, MD

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Rahul Sharma, MD, emergency physician-inchief at NewYork-Presbyterian/Weill Cornell Medical Center, has been named the inaugural chair of the new academic department of emergency medicine. Dr. Sharma will also become chief and medical director of the NewYork-Presbyterian Emergency Medical Services (EMS) enterprise.

Thomas Jefferson University

Roger Band, MD

Kristin Rising, MD, MS

Anna Marie Chang, MD, MSCE

Roger Band, MD, has been promoted to professor in the department of emergency medicine at Sidney Kimmel Medical College of Thomas Jefferson University. Dr. Band is also the vice chair, Strategic Out of Hospital Initiatives, at Sidney Kimmel Medical College. Kristin Rising, MD, MS, assistant professor of emergency medicine in the department of emergency medicine at Sidney Kimmel Medical College of Thomas Jefferson University, has been appointed to the 20182019 Technical Expert Panel (TEP) for the Centers for Medicare and Medicaid Services Quality Measure Development Plan at TJU. Anna Marie Chang, MD, MSCE, assistant professor of emergency medicine in the department of emergency medicine at Sidney Kimmel Medical College of Thomas Jefferson University, has been appointed the assistant director of Clinical Trial Innovation for Jefferson Clinical Research Institute (JCRI).

Drs. Rising and Chang, along with Judd Hollander, MD, professor of emergency medicine at TJU, are also part of a team of researchers from Sidney Kimmel Medical College at Thomas Jefferson University that received a major $3.1 million grant from the National Institute of Diabetes and Digestive Judd Hollander, MD and Kidney Diseases to reduce the need for emergency diabetes care in older African Americans.

Emory University David Wright, MD, has been appointed interim chair of emergency medicine at Emory University School of Medicine faculty where he currently serves as professor and vice chair for innovation and discovery in emergency medicine, director of emergency neurosciences, and director of Emory’s Injury Prevention David Wright, MD Research Center. Dr. Wright also holds adjunct faculty roles in the Nell Hodgson Woodruff School of Nursing and in the Wallace H. Coulter Department of Biomedical Engineering.

University of Pennsylvania

Benjamin Sun, MD, MPP

Benjamin Sun, MD, MPP, has been appointed chair of the department of emergency medicine in the Perelman School of Medicine at Penn Medicine, effective September 1, 2018. Dr. Sun joins Penn Medicine from Oregon Health & Science University (OHSU) in Portland where he serves as a professor with tenure.


Crozer-Keystone Health System

Wake Forest University

Ralph J. Riviello, MD, has been named the new chair of emergency medicine at CrozerKeystone Health System. Dr. Riviello joined Crozer-Keystone after five years as professor of emergency medicine at Drexel University College of Medicine. Dr. Riviello is known for his groundbreaking work in forensic Ralph J. Riviello, MD emergency medicine and for helping victims of violence, abuse, neglect, and sexual assault. Dr. Riviello is a member of the Association of Academic Chairs of Emergency Medicine (AACEM) and a graduate of the AACEM Chair Development Program (CDP).

Michael T. Fitch, MD, PhD, professor and vice chair for academic affairs in the department of emergency medicine, has been named associate dean for faculty affairs at the Wake Forest School of Medicine. In this additional new role, he will work closely with a strong team in the Faculty Affairs office to help Michael T. Fitch, MD, PhD support clinical and basic science faculty.

University of Florida J. Adrian Tyndall, MD, chair of the department of emergency medicine at the University of Florida College of Medicine, has been named one of five fellows of the Association of American Medical College’s Council of Deans (COD) Fellowship Program for the 2018-2019 program. The COD Fellowship Program is J. Adrian Tyndall, MD designed to enhance the development of future leaders in academic medicine and intended for senior faculty members, including department chairs and assistant and associate deans, who are interested in being considered for deanships.

Manoj Pariyadath, MD, has been promoted to associate professor in the department of emergency medicine at Wake Forest School of Medicine in Winston-Salem, North Carolina. Dr. Pariyadath has served as faculty at Wake Forest since 2006, where he developed, and Manoj Pariyadath, MD served as the director of, a program in pointof-care emergency ultrasound. For the past several years he has also served as medical director of the adult emergency department.

Harvard Medical School Jeremiah Schuur, MD, MHS, was promoted to associate professor of emergency medicine at Harvard Medical School. Dr. Schuur is vice chair of clinical affairs and chief of the division of health policy translation in the department Jeremiah Schuur, MD, MHS of emergency medicine at Brigham & Women's Hospital, in Boston.

SUBMIT YOUR ANNOUNCEMENT! The SAEM Pulse Academic Announcements section publishes academic appointments, promotions, retirements, grant awards, research announcements, published papers, etc. Send your content (50-75 words max) to newsletter@saem.org. The next content deadline is August 1, 2018 for the September/October 2018 issue.

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NOW HIRING POST YOUR OPEN JOBS IN FRONT OF OUR QUALIFIED CANDIDATES! Accepting ads for our “Now Hiring” section! Deadline for the next issue of SAEM Pulse is August 1. For specs and pricing, visit the SAEM Pulse advertising webpage.

Emergency Medicine Physicians

EMERGENCY MEDICINE ACADEMIC FACULTY OPENING

Ochsner Health System in Louisiana is seeking staff physicians to join our multi-hospital, 75-physician Emergency Medicine Department. Opportunities exist at our facilities in the GREATER NEW ORLEANS REGION and its SURRONDING COMMUNITIES including our main academic, tertiary care facility, where a new Emergency Medicine program will be launch in 2019. Additional locations include our West Bank, Kenner, Baptist, Slidell, and St. Charles Parish Hospital.

Assistant Residency Program Director, EMS Director, Ohio Valley Medical Center • •

Join the core faculty at this community-based EM program, serving a total patient population of 50,000/year. Located along the beautiful Ohio River, the EM Residency offers the opportunity to rotate at New River Gorge for a Wilderness Medicine program. • Highly competitive financial/ benefits package • Physician equity ownership for all full-time physicians • Industry-leading & companyfunded 401k (additional 10%) • Yearly CME/BEA (Business Expense Account) • Student loan refinancing as low as 2.99% • Groundbreaking paid parental leave

Email jobs@usacs.com Call 844-863-6797 Visit usacs.com

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• Pioneering paid military leave • Short- and long-term disability (own occupation) • Comprehensive medical, dental, vision and Rx coverage • The best medical malpractice including tail coverage • Professional development programs • Location flexibility and career stability of a national group

• • •

Opportunity Details: Ochsner Medical Center is a major transfer center with extreme case complexity seeing 65,000+ visits/year All facilities utilize Epic electronic health records integrating care across the system and facilitating seamless multi-hospital practice Operational excellence with 1.6% LWBS and 30 minutes D2D system average Employed physician group that offers competitive fair market compensation plus benefits All specialties available for consultation and easy one-call transfer from our community emergency departments to our main campus Ochsner Health System is Louisiana’s largest non-profit, academic, healthcare system. Driven by a mission to Serve, Heal, Lead, Educate and Innovate, coordinated clinical and hospital patient care is provided across the region by Ochsner's 30 owned, managed and affiliated hospitals and more than 80 health centers and urgent care centers. Ochsner is the only Louisiana hospital recognized by U.S. News & World Report as a “Best Hospital” across four specialty categories caring for patients from all 50 states and more than 60 countries worldwide each year. Ochsner employs more than 18,000 employees and over 1,200 physicians in over 90 medical specialties and subspecialties, and conducts more than 700 clinical research studies. Ochsner Health System is proud to be a tobacco-free environment. For more information, please visit ochsner.org and follow us on Twitter and Facebook. Interested physicians should apply to: https://ochsner.wd1.myworkdayjobs.com/ en-US/OchsnerPhysician/job/New-Orleans---New-Orleans-Region---Louisiana/ Physician--Emergency-Medicine--All-Regions_REQ_00022121/apply. Sorry, no J1 visa opportunities. Ochsner is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, disability status, protected veteran status, or any other characteristic protected by law.


EMERGENCY MEDICINE

Join new energetic employed hospital group Charleston Area Medical Center is seeking to employ full-time and per diem emergency medicine physicians (ABEM or AOBEM). Serving a multi-county area, the four emergency departments see more than 100,000 patients per year. This regional, tertiary medical center also sponsors an accredited emergency medicine residency program.

Facility opportunities: CAMC Memorial Hospital – 30 beds with 4 assessment beds CAMC General Hospital – Level 1 Trauma Center with 26 beds and additional fast flow areas CAMC Teays Valley Hospital – 10 beds with 2 assessment beds CAMC Women and Children’s Hospital – 20 beds • Mid-level coverage all shifts • 24/7 hospitalists coverage • Complete specialty and surgical support • Strong administrative support

Salary and benefits: Competitive compensation package based on national benchmarks Generous sign-on bonus Retention bonus Critical staffing bonus Night shift bonus Complete CAMC benefit package Occurrence based malpractice insurance CME stipend plus 5 CME paid days off Professional fees/dues and subscriptions allowance Charleston, WV is a vibrant diverse community and offers an excellent family environment, with unsurpassed recreational activities and outstanding school systems. If quality of life is important to you and your family, Charleston is the perfect balance of lifestyle and career. For consideration, please submit CV to carol.wamsley@camc.org or call (304) 388-3347 for additional information. 33446-A18

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{ Job Opportunities }

Assistant Medical Director Pediatric Emergency Medicine Leadership Assistant Program Director Vice Chair, Research

What We’re Offering: • We’ll foster your passion for patient care and cultivate a collaborative environment rich with diversity • Salaries commensurate with qualifications • Sign-On Bonus • Relocation Assistance • Retirement options • Penn State University Tuition Discount • On-campus Fitness Center, day care, credit union and so much more! What We’re Seeking: • Experienced leaders with a passion to inspire a team • Ability to work collaboratively within diverse academic and clinical environments • Demonstrate a spark for innovation and research opportunities for Department • Completion of an accredited Emergency Medicine Residency Program • BE/BC by ABEM or ABOEM • Observation experience is a plus

What the Area Offers: We welcome you to a community that emulates the values Milton Hershey instilled in a town that holds his name. Located in a safe family-friendly setting, Hershey, PA, our local neighborhoods boast a reasonable cost of living whether you prefer a more suburban setting or thriving city rich in theater, arts, and culture. Known as the home of the Hershey chocolate bar, Hershey’s community is rich in history and offers an abundant range of outdoor activities, arts, and diverse experiences. We’re conveniently located within a short distance to major cities such as Philadelphia, Pittsburgh, NYC, Baltimore, and Washington DC.

FOR ADDITIONAL INFORMATION PLEASE CONTACT: Susan B. Promes, Professor and Chair, Department of Emergency Medicine c/o Heather Peffley, Physician Recruiter, Penn State Health Milton S. Hershey Medical Center 500 University Drive, MC A595, P O Box 855, Hershey PA 17033 Email: : hpeffley@pennstatehealth.psu.edu or apply online at: http://hmc.pennstatehealth.org/careers/physicians The Penn State Health Milton S. Hershey Medical Center is committed to affirmative action, equal opportunity and the diversity of its workforce. Equal Opportunity Employer – Minorities/Women/Protected Veterans/Disabled.

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Featured Director and Faculty Opportunities Ultrasound Fellowship Director

Clinical and Core Faculty

Toxicology Fellowship Trained EM Physician for Core Faculty

Clinical Faculty

Osceola Regional Medical Center. Kissimmee, FL. EM Residency Program affiliated with the University of Central Florida College of Medicine. Contact Shawn Stampfli at 404.663.4770

Aventura Hospital and Medical Center. Miami, FL. EM Residency Program affiliated with the Herbert Wertheim College of Medicine at Florida International University and Nova Southeastern University. Contact Ody Pierre-Louis at 727.507.3621

Clinical Faculty

Oak Hill Hospital. Tampa Bay, FL. New EM Residency Program affiliated with the University of South Florida Morsani College of Medicine. Estimated start date July 2018. Contact Ody Pierre-Louis at 727.507.3621

Clinical Faculty

Coliseum Medical Center. Macon, GA. New EM Residency Program affiliated with Mercer University’s School of Medicine. Estimated start date July 2019. Contact Christie Sharpe at 865.531.9984 St. Lucie Medical Center. Port St. Lucie, FL. PBCGME affiliated Osteopathic EM Residency Program. Contact Amy Anstett at 954.295.1524

Clinical and Core Faculty

Southeastern Regional Medical Center. Lumberton, NC. Affiliated with Duke Health University EM Residency Program. Contact Barbara Lay at 727.507.3608

Send CV to: MakeAChange@evhc.net Call: 844.437.3233

Brandon Regional Hospital. Tampa Bay, FL. New EM Residency Program affiliated with the University of South Florida Morsani College of Medicine. Start date July 2018. Contact Esther Aguilar at 727.519.4851

DEPARTMENT OF EMERGENCY MEDICINE

Tipton

Currently seeking research scientists outstanding clinical educators and researchers for faculty positions at all of our academic health centers and community-based hospital sites. ACADEMICS

RESEARCH

Largest medical school student body in the U.S. with required EM clerkship, ACGME accredited emergency medicine and emergency medicine/pediatrics residency programs, multiple ACGME accredited fellowships

Robust departmental research focus. High institutional and departmental NIH ranking

BENEFITS Generous employer-sponsored retirement plans, access to employee contributed plans including 401k, 403b and 457b, medical (including HSA and FLEX saving options), dental, vision, life insurance, short and long-term disability insurance

COMPENSATION Competitive salary with annual academic and quality bonus opportunities. Generous CME allowance, licensure, DEA, CSR, ISMA, EM Board expenses, ACEP and SAEM memberships, public

Clinton

Muncie Fishers

Carmel Avon

Indianapolis

Terre Haute

SITES Currently staffing physicians and APPs at 10 sites including our academic medical center: IU Health Methodist, IU Health Riley Hospital for Children and Eskenazi Health Hospital; and our community-based sites: IUH West, IUH Ball, Union Terre Haute, IUH North, IUH Saxony, IUH Tipton, Union Clinton

We're Recruiting!

service loan forgiveness eligibility, IU tuition benefit

JOB BUILDS Dual Employment opportunities with both IUHP practice plan and IU School of Medicine, full-time academic, community, split model job builds available

emjobs@iu.edu

(317) 880-3881

Indiana University is an EEO/AA employer, M/F/D/V

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JOIN OUR TEAM AS A TOXICOLOGY DIRECTOR IN TAMPA, FLORIDA TeamHealth seeks a board certified Toxicology Director to join us and oversee the poison control center affiliated with Tampa General Hospital in the beautiful Tampa area of Florida. Responsibilities include: n Bedside consults for toxicology patients admitted through the Emergency Department (ED) or transferred to the ED at Tampa General Hospital n Case reviews n Death abstract reviews n Attendance at staff and networking meetings n Participation in professional education and teaching responsibilities at the poison center, Emergency Medicine (EM) residency program, Tampa General Hospital, University of South Florida and community conferences n Protocol and guidance development review assistance n Clinical shifts in the ED TeamHealth provides an excellent salary, benefits and access to tools and resources to enhance professional development and connect to a network of 20,000 clinicians. For more information or to apply for this job, contact Robin Lorber at 954.632.7751 or robin_lorber@teamhealth.com.

TH-11234 Classified ad size: 7.5x4.75 island pub: SAEM Pulse (JUN 2018)

ACADEMIC EM PHYSICIAN OPENINGS

Own your future – and join a group with 8 EM Residency sites nationwide! Opportunities including Assistant Research Director, Assistant Residency Program Director, EMS & Core Faculty. One mission: to care for patients. As the largest physician-owned acute care group with 8 EM Residency sites nationwide, we are able to attract outstanding clinicians. Once you’re here, we trust that you’ll be blown away by our culture, our excellence in clinical education, and our commitment to our shared mission: to care for patients. Join us today.

Contact us today to learn more about these exciting opportunities!

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Become an owner and get first-rate benefits when you join our team. You’ll also get the support you need and the culture you want. • Highly competitive financial/ benefits package • Physician equity ownership for all full-time physicians • Industry-leading & companyfunded 401k (additional 10%) • Yearly CME/BEA (Business Expense Account) • Student loan refinancing as low as 2.99% • Groundbreaking paid parental leave

Email jobs@usacs.com

Call 844-863-6797

• Pioneering paid military leave • Short- and long-term disability (own occupation) • Comprehensive medical, dental, vision and Rx coverage • The best medical malpractice including tail coverage • Professional development programs • Location flexibility and career stability of a national group

Visit usacs.com


NOW HIRING

in Emergency Medicine The academic Department of Emergency Medicine at the CU School of Medicine is dedicated to excellence in clinical care, teaching and mentoring, research and scholarship, and innovation. Denver is a highly desirable place to live, work, and raise a family. We offer salaries commensurate with qualifications, relocation assistance, physician incentive program, CME allowance, and a comprehensive benefit Fellowships package.

ACADEMIC POSITIONS COMMUNITY POSITIONS • Community Practice Physicians

• Faculty (all ranks) • Critical Care (ACCM pathway preferred) • Research • Ultrasound

• Administration, Operations & Quality • Climate & Health Science Policy • Critical CareAnesthesia • Emergency Medical Services • Research • Toxicology • Ultrasound • Wilderness Medicine

Learn more about us at:

www.medschool.ucdenver.edu/em For additional information, please contact: Frances Schulz, HR Manager, Emergency Medicine frances.schulz@ucdenver.edu

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EMERGENCY MEDICINE RESEARCH FACULTY Weill Cornell Medicine’s new academic Department of Emergency Medicine, led by Dr. Rahul Sharma, seeks Clinician Research faculty to join the Department at the Assistant, Associate or Professor on the Investigation Pathway. The successful candidate should have the requisite experience and training to continue a successful research career, and have a strong record of scholarship with national recognition in clinical, translational, biomedical, or health services research. Of particular interest are candidates who have experience with varied funding mechanisms. Faculty rank will be determined by the qualifications and experience of the successful candidate. We are particularly interested in candidates who have expertise and a track record of funding in Healthcare Innovation, Technology Development, Informatics, EMS, Global EM, Wilderness Medicine, Pediatric EM, Medical Education, Resuscitation Medicine, and Simulation. We offer a highly competitive salary, a generous support package to ensure the candidates transition and continued success, a comprehensive benefits package, and a generous retirement plan. Research infrastructure needed for success is already present within the Department, including research coordinators, a Research Associate Program, statistical support, and administrative support.

In addition to providing excellent care, and teaching house staff and medical students, the new clinician researcher will mentor junior colleagues, engage in the training mission of the department, and create collaborations throughout the medical center. He or she is expected to focus on creating new knowledge, securing extramural research funding, producing scholarly output, and engaging in the educational component of our program as it relates to research. The Emergency Department at New York Presbyterian-Weill Cornell Medical Center serves as one of the major campuses of the fully accredited four-year New York Presbyterian Emergency Medicine Residency Program. Our Emergency Department is a high volume, high acuity regional trauma, burn and stroke center caring for more than 90,000 adult and pediatric patients. Faculty also have the opportunity to work at our New York Presbyterian-Lower Manhattan Hospital ED campus, which is a busy community hospital seeing 45,000 annual visits. We offer programs in Medical Toxicology, Geriatric Emergency Medicine, Wilderness Medicine, Global Emergency Medicine, Simulation and Ultrasound. In addition, we offer fellowships in Geriatric Emergency Medicine, Healthcare Leadership and Management, Pediatric Emergency Medicine as well as PA and NP residencies in Emergency Medicine.

Please send curriculum vitae and cover letter to: Sunday Clark, ScD, MPH Chair of Search Committee Weill Cornell Medicine suc2010@med.cornell.edu New York Presbyterian Hospital-Weill Cornell Medicine is an equal opportunity employerMinorities/Women/Vets/Disabled encouraged to apply.

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Teach Medicine in a Health System Built to Advance Health, Transform Lives Emergency Medicine Residency Ultrasound Medical Director Tower Health is seeking a BC Emergency Medicine physician, fellowship trained in Ultrasound, to serve as our Residency Ultrasound Medical Director for Reading Hospital, located in West Reading, PA. EM Faculty members support the allopathic EM Residency Program that is new for 2018 at Reading Hospital. The ideal candidate will have a strong passion for academics. The EM Faculty will be responsible for: • Working with the Emergency Medicine academic leadership to provide direction and vision for EM education at Reading Hospital • Assisting in the education/development of EM Residents and other EM learners • Mentoring residents and students in their academic mission

Requirements: • • • • •

MD or DO degree Board certified in Emergency Medicine Licensed to practice medicine in Pennsylvania Attending experience in an academic emergency medicine program is preferred EM fellowship experience is preferred

What we offer: • • • •

Competitive salary Medical, vision, and dental insurance Life insurance Malpractice insurance

• • • •

Liberal paid time off Educational Loan Assistance CME allowance 403(b)/457(b) retirement plans

About Reading Hospital Tower Health is one comprehensive health system made up of six leading hospitals as well as an expanded network of outpatient facilities and premier physicians delivering life-changing services and a Health Plan that services a population of 2.5 milllion people. With more than 750 beds, Reading Hospital is a leader in advancing our community’s health and wellness and is one of the region’s major referral hospitals in a number of specialties, including cardiovascular services, neurosciences, oncology, pediatrics and women’s health. The hospital is also a Level II trauma center and hosues the busiest emergency department in Pennsylvania with 135,000+ visits annually. Reading Hospital is a leader in breakthrough technologies, including the Hana table anterior approach to hip replacement, robotic da Vinci Surgery System® and Trilogy® Radiosurgery. Reading Hospital is a member of the Alliance for Academic Independent Medical Centers (AIAMC) and the Council of Teaching Hospitals (COTH) of the AAMC. Reading Hospital is also a member of the Johns Hopkins Research Network and the Jefferson Research Network. Tower Health and Drexel University are currently undertaking the joint development of a branch campus of Drexel University College of Medicine near Reading Hospital. The expected welcome date for the medical school's first class is summer 2019. Berks County maintains a perfect balance of urban, rural and suburban settings. Our community offers diverse outdoor and cultural activities, outstanding schools and quality of life with easy accessibility to shore points, airports and major metro areas, such as Philadelphia, New York City, Baltimore, and Washington, DC. For more information, please contact: Carrie Moore, MBA Physician Recruiter (484) 628-8153 carrie.moore@towerhealth.org Hospital website: towerhealth.org Career website: careers.towerhealth.org

EOE

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EMERGENCY MEDICINE ACADEMIC FACULTY OPENING Assistant Research Director, University Medical Center of Southern Nevada Join the faculty at this 3-year EM program, serving a diverse patient population of 90,000/year. Established in 2006, the EM Residency is comprised of 30 residents and prides itself on a tremendous sense of camaraderie.

• Highly competitive financial/ benefits package • Physician equity ownership for all full-time physicians • Industry-leading & companyfunded 401k (additional 10%) • Yearly CME/BEA (Business Expense Account) • Student loan refinancing as low as 2.99% • Groundbreaking paid parental leave

• Pioneering paid military leave • Short- and long-term disability (own occupation) • Comprehensive medical, dental, vision and Rx coverage • The best medical malpractice including tail coverage • Professional development programs • Location flexibility and career stability of a national group

The Department of Emergency Medicine (EM) at the University of California Davis, Health is conducting a faculty search for EM physicians in either a clinician/educator or clinician/researcher track. Candidates must be residency trained in EM (or Pediatric EM training) with board certification/eligibility and be qualified for licensure in California. At least one year of post-residency clinical experience and/or fellowship training is preferred. Candidates are expected to enter at the Assistant/Associate level, commensurate with experience and credentials. EM faculty members at UC Davis who have preference for night shifts work fewer clinical shifts each month. The University of California, Davis, Medical Center, one of the nation’s “Top 50 Hospitals,” is a 613 bed academic medical center with approximately 80,000 emergency department visits annually, including approximately 20,000 pediatric visits. The emergency services pavilion opened in 2010 and is state-of-the-art. Our program provides comprehensive emergency services to a large local urban and referral population as a level 1 trauma and burn center, paramedic base station and training center. The department also serves as the primary teaching site for a fully accredited EM residency program and nine different EM fellowship programs. Our residency training program began more than twenty years ago and currently has 54 residents. The Department has a separate area for the care of children and is one of the leading centers in the Pediatric Emergency Care Applied Research Network (PECARN). Salary and benefits are competitive and commensurate with training and experience. Sacramento is located near the northern end of California's Central Valley, close to Lake Tahoe, San Francisco, and the "wine country" of the Napa and Sonoma Valleys. Sports enthusiasts will find Sacramento's climate and opportunities ideal. Interested candidates should submit a letter outlining interests and experience, and curriculum vitae to: recruit.ucdavis.edu/apply/JPF01809 Erik Laurin MD, Professor and Search Committee Chair (eglaurin@ucdavis.edu) UC Davis Department of Emergency Medicine 2315 Stockton Blvd., PSSB 2100 Sacramento, CA 95817 The University of California is an affirmative action/equal opportunity employer.

Email jobs@usacs.com Call 844-863-6797 Visit usacs.com

Emergency Medicine Physician Emergency Medicine Physician

e Division of Emergency Medicine at Washington University School of dicine is currently recruiting Emergency Medicine Physicians to join our owing academic faculty. The division has a well-established four-year Theand Division of Emergency MedicineCare at Washington School of idency program fellowships in Critical Medicine,University EMS, Pediatric Medicine is currently recruiting Emergency Medicine Physicians to join our ergency Medicine, Research, Toxicology and Ultrasound. The division is growing academic faculty. The division has a well-established four-year eking physicians, Instructor level above,inwho can contribute to our residency program andand fellowships Critical Care Medicine, EMS, Pediatric nical, education, and research missions. must be ableThe to work inis Emergency Medicine, Research,Physicians Toxicology and Ultrasound. division seeking physicians,departments Instructor levelat and above, who can Hospital contributeand to our ult and pediatric emergency Barnes-Jewish clinical, education, and research missions. Physicians must be able to work in Louis Children's Hospital. adult and pediatric emergency departments at Barnes-Jewish Hospital and St. Louis Children's Hospital.

quired qualifications: Required ard Certified or Boardqualifications: Eligible in Emergency Medicine. Board Certified or Board Eligible in Emergency Medicine. eptional candidates with alternate board certifications, such as Internal Exceptional candidates with alternate board certifications, such as Internal dicine, will also be considered. Medicine, will also be considered.

arn more at emed.wustl.edu/facultyjobs Learn more at emed.wustl.edu/facultyjobs

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Recognized as one of the nation's most affordable cities, St. Louis features renowned suburbs with top-ranked schools, abundant outdoor activities and midwest hospitality. Recognized as one of the nation's most affordable cities, St. Louis features renowned suburbs with top-ranked schools, outdoorqualified and Washington University School of Medicine seeksabundant exceptionally activities and midwest hospitality. diverse faculty; women, minorities, protected veterans and disabled candidates

are strongly encouraged to apply.

Washington University School of Medicine seeks exceptionally qualified and diverse faculty; women, minorities, protected veterans and disabled candidates are strongly encouraged to apply. Interested candidates should send or email a letter of interest and

curriculum vitae in confidence Interested candidates should send orto: email a letter of interest and Brent E. Ruoff, M.D. curriculum vitae in confidence to: Brent E. Ruoff, M.D. Associate Professor Associate Professor Chief, Division of Emergency Medicine Chief, Division of Emergency Medicine Washington University School of Medicine Washington University School of Medicine CB 660S.S. Euclid • St. Louis, MO 63110 CB8072, 8072, 660 Euclid Ave.Ave. • St. Louis, MO 63110 ruoffb@wustl.edu ruoffb@wustl.edu


Academic Emergency Medicine The BerbeeWalsh Department of Emergency Medicine at the University of Wisconsin School of Medicine & Public Health in Madison, Wisconsin is seeking the following professionals interested in furthering a career in academic emergency medicine.

Pediatric Emergency Medicine Section Chief EM faculty provide clinical services in the Emergency Departments of the University of Wisconsin Hospital and Clinics (University Hospital), American Family and Children’s Hospital, and other UW Health approved sites. University Hospital is a busy, universitybased, referral hospital; one of only two academic medical centers in the state and a Level 1 Trauma and Burn center for both adult and pediatric patients. EM faculty supervise EM and off-service residents, as well as medical students. The successful candidate will join a faculty of both emergency physicians and pediatric emergency physicians. Responsibilities include the clinical care of pediatric emergency department patients and time spent in education and teaching activities to medical students, residents and other learners in the academic medicine setting. Clinical research is encouraged and should be anticipated as part of this role. Additional time will be devoted to administrative responsibilities.

Associate Clerkship Director/ Director of Medical Student Education This highly-motivated academic Emergency Physician will join our Education Leadership Team. Our medical student program includes an innovative and dynamic curriculum with a required medical student rotation in addition to a fourth-year Acting Internship. Students benefit from a rich clinical learning environment designed to integrate experiences for a wide range of learners, including residents from our 3-year residency training program (12 residents per year). Robust professional development opportunities exist for this position as well as freedom to innovate while working as part of a close-knit education leadership team. Both positions are entitled to a competitive salary structure commensurate with qualifications, relocation assistance, CME allowance, and a comprehensive benefit package. To inquire, send your curriculum vitae and cover letter (indicating position of interest) to:

agh@medicine.wisc.edu • Azita G. Hamedani, MD MPH MBA Chair, BerbeeWalsh Department of Emergency Medicine Suite 310, MC 9123 800 University Bay Drive, Madison, WI 53705

Madison, the vibrant capital of Wisconsin and home of the University of Wisconsin, has the best of all worlds: natural beauty and outdoor recreation, stimulating cultural offerings, distinctive restaurants & shops, a spirit of fun, urban culture, natural beauty, and small town charm.

The UW Madison is an EEO/AA Employer. Minorities and women are encouraged to apply. Wisconsin caregiver and open records laws apply. A background check will be conducted prior to employment.

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19 Celebrating

of bringing EM ACADEMICIANS together!

Las Vegas, Nevada – May 14-17


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