14 minute read
President’s Comments United in Facing the Major Issues That Face Us
22
Amy H. Kaji, MD, PhD
United in Facing the Major Issues That Face Us
After what seemed like a whirlwind of a year, this will be my final column in SAEM Pulse. Looking back on the accomplishments over the past year, SAEM has much to be proud of: we reached record membership numbers, launched a new website, hosted over 9,000+ attendees on live webinars, awarded close to $700,000 for the 2021-2022 cycle of research and education grants, announced new funding opportunities, and had record submissions for our journals. We also led our first ARMED MedEd cohort and are excited to be hosting our first eLEAD cohort.
Over the past 12 months we've partnered with our sister emergency medicine (EM) organizations to issue more than a dozen joint statements which reflect our Society’s commitment to addressing issues at the forefront of our specialty. I encourage you to take the time to read through them.
More than ever, our specialty is united in facing the major issues that face us. As Federal funds allocated for medical research continue to diminish, SAEM will continue to advocate for our specialty and think outside the box in terms of funding sources. In doing so, we will look to not just our sister EM organizations, but to other medical and surgical specialties where we have overlapping research interests.
COVID-19 initially led to a stark decrease in emergency department (ED) visits, thereby seemingly decreasing the need for EM providers. While we welcomed 2,702 newly matched residents into the emergency medicine family in 2022, our specialty had 219 unfilled positions in the 2022 Match. Yet, outside of the deviation of 2021, the number of 2022 applicants appears in line with recent years. There were 81 more positions to fill in emergency medicine in 2022 than in 2021. This continues a pattern of significant and swift growth for the specialty – since 2018, emergency medicine has added 643 residency positions, an increase of 28.2 percent. Still, we will need to better understand all of the different factors that may be affecting applicant career decision-making.
We have now all largely returned to preCOVID visit numbers and are experiencing boarding and nurse staff shortages. COVID-19 highlighted the need to reconsider the scope of EM practice, as it is clearly moving beyond the physical space of the adult and pediatric ED and into paramedicine, telemedicine, urgent care, observation medicine, critical care, street medicine, etc. How we define our specialty is dynamic, and our workforce will need to be sized accordingly. In a nutshell: The future of our specialty is full of opportunities and remains bright.
More specifically, the future of SAEM is bright. I will soon turn over the reins to Dr. Angela Mills, who is extraordinary in her abilities to effectively lead, collaborate, and achieve consensus to move forward toward our vision and carrying out SAEM’s mission. Dr. Mills has carefully shaped the objectives for the upcoming year for the SAEM committees and task forces and is committed to supporting SAEM academies and interest groups to be productive and innovative.
We are drawing close to May 10, which marks the first day of the 2022 SAEM Annual Meeting in New Orleans! After living in the virtual meeting world for two long years of COVID 19 and its associated variants and surges, our members are ready to embrace one another in person. While we are grateful for the virtual platforms that allowed our society to support one another through the uncertainty of the management of the disease, being faceto-face uniquely facilitates knowledge transfer, intellectual discourse, and the strengthening personal connections. Replete with cuttingedge educational content, networking events, career development opportunities, experiential learning competitions, and other activities, SAEM22 will be extra special to all of us, and I look forward to seeing you there!
ABOUT DR. KAJI: Amy H. Kaji, MD, PhD is a professor of clinical emergency medicine and vice chair of academic affairs in the department of emergency medicine at Harbor-UCLA Medical Center at the David Geffen School of Medicine at UCLA.
CONNECTING RESIDENTS AND MEDICAL STUDENTS TO ACADEMIC LEADERS IN EM
An Interview With Hamza Ijaz, MD
Hamza Ijaz, MD, is a PGY-3 emergency medicine resident at the University of Cincinnati. He is the incoming SAEM RAMS President and currently serves as the RAMS Secretary-Treasurer. Dr. Ijaz has served on numerous SAEM committees including the Program Committee, ED Administration and Operations Committee, Faculty Development Committee, and Virtual Presence Committee. His interests include medical education, health care leadership and administration, and emergency department operations. Dr. Ijaz grew up in northern Virginia and graduated from George Washington University School of Medicine and Health Sciences.
As the new president of SAEM RAMS, what issues do you feel are most germane to current and future emergency medicine trainees? What steps do you hope to take toward addressing these issues during your tenure as RAMS president?
A lot has impacted our trainees over the past year, starting first with the ACEP Workforce Report and recently with the 200+ unfilled spots for emergency medicine. Despite these hurdles, I am certain that the future is bright for our specialty. For our emergency medicine-bound medical students, SAEM RAMS needs to lead the way in educating and providing advising resources as we incorporate preference signaling into the Electronic Residency Application Service (ERAS®) applications and transition towards a more “normal” application cycle as the pandemic improves.
For our emergency medicine (EM) residents: We hear you. We see you. It has been an incredibly long and enduring couple of years. Nonetheless, you have continued to persevere, advocate, and provide exceptional care for your patients. SAEM RAMS and our entire community owes you our gratitude for your countless sacrifices. We will ensure that we continue having a seat at the table where decisions are made regarding the future of our specialty. SAEM RAMS will advocate on your behalf to ensure that the graduating classes of emergency physicians are held to a high standard. As RAMS President, I feel that it is important to listen to the concerns of our members and to advocate on their behalf. I hope to do just that during my term.
RAMS is exceptionally well-positioned within SAEM to provide opportunities to its members by partnering with the academic leaders in our field. It is my hope to bridge the gap in connecting our exceptional faculty with our members. By connecting our
Dr. Ijaz celebrating his medical degree graduation ceremony with his family.
SAEM faculty with our RAMS members, we can foster a growing community of mentorship and help produce dedicated academicians to advance our specialty. I believe it is important to provide programming relevant to RAMS members at the SAEM Annual Meeting, in addition to frequent webinars and updates in SAEM Pulse to keep our members informed of our efforts. This new term brings exciting opportunities that I hope will be beneficial to all our members.
When, why, and how did you first become involved with RAMS?
My first exposure to SAEM was through the Medical Student Ambassador program. There, I met and learned from countless leaders within our field. Some of my earliest mentors were a result of this program. Eager to gain more exposure and continue developing lasting bonds of friendship and mentorship, I applied for the RAMS Board Member-At-Large position and was fortunate enough to be elected. Since then, I’ve had the pleasure of serving as the RAMS Secretary-Treasurer and now, humbly, your RAMS President. My experiences within RAMS continue to strengthen my belief that RAMS is a community of developing long-term mentorship and leaders within academic emergency medicine.
Why should EM residents and medical students become involved with RAMS? What needs does the group meet or concerns does it address?
It is my belief that RAMS is the premier organization for medical students and residents aspiring to advance our specialty and develop into leaders. RAMS is strategically aligned to benefit its members because of its close interactions with the leaders within SAEM. Through these relationships, we have been able to help our members find and develop their niche. RAMS also seeks to bolster mentorship within our community and enhance the opportunities available to our members so that they may enjoy a prolific career in EM. By getting involved with RAMS, EM residents and medical students should expect their career advancement to occur at a faster pace than would’ve been possible otherwise.
Who or what influenced your decision to choose the academic/EM specialty and if you were not doing what you do, what would you be doing instead?
I was always enamored by the field of emergency medicine. I volunteered as an EMT through the fire department also worked as a scribe in the emergency department (ED) while in college. Those experiences of watching emergency physicians lead resuscitations and help anyone and everyone that walked through the front door, laid the foundation for my interests in EM. During my fourth-year EM rotation, I noticed how EM physicians expertly resuscitate undifferentiated patients while communicating with their loved ones while also discussing complexities in patient management with consultants in a manner that they would also understand. I was in awe. Our specialty’s ethos of taking care of anyone, anytime, anywhere; regardless of their ability to pay resonated strongly with me when I was making my decision and it still holds true to this day. On top of all that, EM is truly a team sport. We are fortunate to work alongside and learn from a variety of professions in the ED to take care of our patients. Add on the community of academic
Dr. Ijaz with his EM-bound medical students on Match Day at George Washington University.
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EM and it’s a complete package. There is a strong sense of support, mentorship, sponsorship, and drive to help you succeed in your endeavors that would be hard to match if I weren’t in academics.
If I couldn’t do what I do today, I would probably become a teacher. I have always enjoyed teaching and consider helping to educate the next generation a humble yet incredibly rewarding act of service. Regardless of where my career in academics takes me, I hope to never lose sight of that mission.
What experiences in life, outside of medicine, do you feel have made you a better educator?
During college, I worked at a clothing retail store as a sales manager. It was very fast-paced and driven by numbers. One of the things I learned during my time in retail was how to quickly connect with the customer to figure out what they needed/wanted. I relate this to medical education in that we face learners with varying backgrounds and levels of interest and as educators, we must meet them where they are and provide them with what they need in that moment.
Stigma is a leading barrier to mental health care for emergency physicians. Many fear that treatment for mental illness could jeopardize their careers or their licenses to practice. What would you say are the key challenges to addressing this stigma?
Although we have made significant strides in recent years, there are still key challenges in addressing the stigma. It starts with educating ourselves and understanding the facts. From there, we need to work on creating a culture of openness and vulnerability within our departments and institutions. When everyone is fixated on showing no flaws, those struggling with their mental health suffer even more.
As a medical profession, we must acknowledge that our work in the ED can be extremely taxing and requires an extensive network of resources for those seeking help with their mental health. We, as emergency physicians, must support and encourage our colleagues seeking mental health resources, not penalize them. The passing of the Dr. Lorna Breen Health Care Provider Protection Act is a monumental step towards improving access to mental health resources and reducing the stigma; however, the work isn’t finished. We must continue to advocate for our colleagues.
What can be done to create a sense of safety for EM physicians and medical trainees that would encourage them to ask for help or self-report when they’re struggling with their mental health?
It starts with the leadership and driving a culture of vulnerability and openness. Creating a strong peer and social support system within our institutions can also serve as a useful adjunct in the mental health resource network. Ensuring that resources are available and easy to access with a trainee’s demanding schedule are essential.
Any tips on surviving, perhaps even thriving, during residency? Similarly, how have you managed stress and attended to your mental health, especially during this unprecedented time of COVID-19?
Find your people. Whether its your coresidents, faculty, friends outside of work, family, or any combination of the above, find your people! Residency is incredibly challenging for a variety of reasons and the Covid-19 pandemic has made it even harder. Identifying activities or individuals that help recharge your wellness “battery” early on in residency is essential to dealing with the ups and downs of the training years. I’ve had the endless support of my loving wife, Danya, who has helped me get through the lows through residency. From early in the lockdown to the recent Omicron surge, having her by my side to talk through the struggles and feelings of frustration, sadness, anger, exhaustion, has been monumental in maintaining my mental health. I’ve also found solace in exercising frequently. Even if it’s for a little bit, I have noticed that on the days that I exercise, I feel not only more energized but happier as well. I strongly encourage everyone to consider physical health as an essential component of mental health.
What do you think the EM specialty and/or SAEM can do to address stress, particularly COVID-19related stress and posttraumatic stress, and improve physician well-being?
I think we need to normalize talking about these topics. SAEM can also advocate on behalf of EM physicians on a national scale. Something SAEM already does is provide an online toolkit for individuals, educators, and institutions, aimed at stimulating education, awareness, advocacy, and policy action related to breaking down barriers to mental health care in EM. Another, relatively easy to accomplish resource, would be to consolidate a list of resources on physician well-being and posttraumatic stress and have them easily accessible across SAEM’s website and social media platforms. Another step we can take as SAEM is to encourage more didactics/abstract submissions on these topics for the SAEM Annual Meeting. Hopefully by bringing these topics to the forefront of our specialty and national meetings, we can create change to improve the well-being of our physicians.
What are you most looking forward to when we meet again, in person, at SAEM22 in New Orleans?
Meeting everyone in person! It’s been two years since we had an in-person annual meeting and I can’t wait to interact with all the incredible people in our specialty. Networking is going to be huge and the excitement of the return to an in-person event is already picking up steam. Can’t wait!
Dr. Ijaz cuddling with his cat, Goku, before going to a shift.
Up Close and Personal
What one thing can you not do without while on shift?
A great attitude! Even with all the tough outcomes we see in the ED, having a great attitude and trying to stay lighthearted (very hard to do) goes a long way towards building team morale.
What is your “go to” work/on-shift hack?
Documenting EKGs in real-time. You look at them and compare them to priors, so might as well document them simultaneously and avoid tracking them down at the end of the shift.
What is a favorite FOAMed resource?
RebelEM
What would most people be surprised to learn about you?
I have an unhealthy love for ice cream. You can ask my coresidents!
Who would play you in the film of your life and what would that film be called?
Andy Samberg in a crossover of Brooklyn Nine-Nine and Scrubs
What is your guilty pleasure?
Ice cream!
What is at the top of your bucket list?
Snowboarding in the Swiss Alps
Who would you invite to your dream dinner party?
Barack Obama, Stephen Colbert, Jon Stewart
