SAEM PULSE November–December 2017

NOVEMBER-DECEMBER 2017

VOLUME XXXII NUMBER 6

INTRODUCING

Meet the inaugural RAMS Board

Alexandra Nordberg, MD 2017-2018 RAMS Board President

Leading the advancement of emergency care through education and research, advocacy, and professional development in academic emergency medicine.

SAEM STAFF

HIGHLIGHTS

Chief Executive Officer Megan N. Schagrin, MBA, CAE, CFRE Ext. 212, mschagrin@saem.org

Manager, Business Development John Landry, MBA Ext. 204, jlandry@saem.org

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President’s Comments

Director, Finance & Benefits Doug Ray Ext. 208, dray@saem.org

Director, Membership & Meetings Holly Byrd-Duncan, MBA Ext. 210, hbyrdduncan@saem.org

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Introducing

Accountant Hugo Paz Ext. 216, hpaz@saem.org

Membership Manager George Greaves Ext. 211, ggreaves@saem.org

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Diversity and Inclusion

Director, Operations & Governance Kat Nagasawa, MBA Ext. 206, knagasawa@saem.org Manager, Governance & Meetings Monica Bell, CMP Ext. 205, mbell@saem.org IT Database Manager/ Systems Administrator Ahmed Khater Ext. 225, akhater@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

"Hi, this is Dr. (Your Name Here)" SAEM Resident and Medical Students (RAMS)

Choosing Wisely

Education Manager Mark Nagasawa, MA Ext. 214, mnagasawa@saem.org

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Ethics in Action

Meeting Planner Alex Elizabeth Keenan Ext. 218, akeenan@saem.org

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5 Things to Know About Indy

Membership Coordinator Andrea Ray Ext. 202, aray@saem.org

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SGEM: Did You Know?

AEM Editor in Chief Jeffrey Kline, MD AEMEditor@saem.org

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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

Physician Involvement in Executions

Sex Differences in Heart Failure

Careers in EM

Opportunities for Career Advancement for Emergency Physicians Interested in Ethics

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Social Media in Academic EM

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Briefs and Bullet Points

Creating FOAMed at Your Institution

Academic Announcements Now Hiring Products and Services

2017-2018 BOARD OF DIRECTORS D. Mark Courtney, MD President Northwestern University Feinberg School of Medicine

James F. Holmes, Jr., MD, MPH University of California Davis Health System

Megan L. Ranney, MD, MPH Brown University

Steven B. Bird, MD President Elect University of Massachusetts Medical School

Amy H. Kaji, MD, PhD Harbor-UCLA Medical Center

Richard E. Wolfe, MD Beth Israel Deaconess Medical Center/ Harvard Medical School

Ian B.K. Martin, MD, MBA Secretary-Treasurer West Virginia University School of Medicine

Angela M. Mills, MD Penn Medicine

Jean Elizabeth Sun, MD Mount Sinai School of Medicine

Andra L. Blomkalns, MD Immediate Past President University of Texas Southwestern at Dallas

Ali S. Raja, MD, MBA, MPH Massachusetts General Hospital

SAEM Pulse is published bimonthly by the Society for Academic Emergency Medicine, 1111 East Touhy avenue, Suite 540, Des Plaines, IL 60018.

The opinions expressed in this publication are those of the authors and do not necessarily reflect those of SAEM. For SAEM Pulse archives visit http://www.saem.org/publications/newsletters Š 2017 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 D. Mark Courtney, MD Northwestern University, Feinberg School of Medicine 2017-2018 SAEM President

“Hi, this is Dr. (Your Name Here)” This is the second in a series of messages on humanism in academic medicine. I wrote in the last issue about lobbying for a coffee machine and a new physician lounge in our hospital as mechanisms to maximize humanto-human communication and relationships.

Update: We have a pretty nice lounge now with physicians from all over the hospital, but still a pretty lame pod-based coffee machine…so I still have work to do. —Mark

"As attendings and residents, we need to model optimal ways of communicating with each other and our colleagues."

Unfortunately, what we have in hospitalbased medicine today is primarily a means of communicating with one another by phone.

We can’t meet the hundreds of other hospital staff in the lounge and form in-person relationships—although it is nice to try. This is where the dreaded phone comes in…

I have the fortune to work an occasional attending-only shift. This means no resident and no physician assistant. It’s pretty much just me making the consult/admit phone calls.

This is both enlightening and disheartening at the same time. Early on I would simply list my name on the webpage request.

And you know what I got back? “Uhhh yeah…this is ortho/transplant/the CCU/the hospitalist etc…” Not infrequently I even got an interruption followed by a confrontational series of questions or demands: “Do an ABG and page me back… We won’t see him until the CRP is back… It can’t be an appy with a normal white count, etc.” All nonsense and at times delivered with derision. I would then say, “No, this is Dr. Courtney. I’m one of the ED attendings and here is what I would like you to do…” Sometimes they would apologize and say they did not realize I was an attending, which of course is beside the point. Why and how have we evolved to this level of confrontational phone interactions in academic medicine? Maybe this is unique to my own experience, but I doubt it. Again, I think it is a function of the lack of personal, human-to-human relationships in the increasingly complex modern medical machine that is an academic medical center.

We teach residents and medical students a great many things in academics using a wide variety of assessment tools, some of which even focus on physician-patient communication. But how do we model or teach how to interact with our fellow physicians? And to what degree is a feeling of work-related wellness sabotaged by the not infrequent negative interactions we have with others on the phone? We can’t solve the myriad challenges that threaten our professional wellbeing simply by communicating better with one another—but it is a start.

As attendings and residents, we need to model optimal ways of communicating with each other and our colleagues. We can do this if we are unified and work consistently to change the tone of how people interact with one another. It starts with recognizing people by their name. Again, this is a baby step but one that I have insisted on relentlessly in person and on the phone. I simply refuse to let a well-intentioned fellow clinician introduce themselves by saying “I’m Ortho…” I wait a bit and then in a friendly way say, “Hey no, ortho is your specialty…What’s your name?

I’m Mark Courtney, one of the ED attendings.

How can I help you?”

Try it out. Whether you’re an attending or a resident, develop your own friendly approach. Learning and practicing medicine can be a depersonalized process at time, but it can be slowly changed by connecting ourselves based on who we are, rather than where we work.

About Dr. Courtney: D. Mark Courtney, MD, MSCI, is director of research and an associate professor in the Department of Emergency Medicine at Feinberg School of Medicine, Northwestern University, Chicago.

Dr. Courtney is the 2017-2018 president of the Society for Academic Emergency Medicine (SAEM).

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INTRODUCING

Introducing RAMS: SAEM’s New Home for Residents and Medical Students

SAEM PULSE | NOVEMBER-DECEMBER 2017

This September SAEM announced a major step within the organization to grow the opportunities for engaging and serving medical students and residents. That step was the creation of a Resident and Medical Student (or more simply, “RAMS”) Board. As stated in the RAMS Board homepage, “The mission of the RAMS Board is to give residents and medical students a stronger voice within the SAEM community by developing educational content and annual meeting programming, promoting mentorship and career development, and identifying leadership and advocacy opportunities of particular interest and importance to our junior members.”

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Existing resources and opportunities for emergency medicine-bound medical students and residents are diverse, both within and outside SAEM. The primary administrative body related to these interests within the society had previously been the Resident and Student Advisory Committee. Members of this group collaborated with various other committees on event planning, newsletter and social media contributions, the development of didactics, workshops, and other efforts. This work ultimately contributed to the SAEM Board of Directors identifying these resident and student-driven successes as a signal that increasing student and resident involvement would yield even greater fulfillment of the society’s mission.

As SAEM continues to further its leadership in the advancement of academic emergency medicine, an area of perpetual emphasis will be the cultivation of its young professionals. Membership for residents and students already remains strong due to SAEM’s many existing resources and opportunities. In fact, these groups constitute half of the total society membership. SAEM leadership thus developed a new board to direct the continued expansion of student and resident programs and services within the organization and provide a means with which to amplify the voice of these groups within the SAEM community. Through the RAMS Board, students and residents will be better able to engage in decisions regarding the direction of the Society—particularly in the development of educational content, annual meeting programming, mentorship, and career opportunities.

Additionally, one of SAEM’s primary goals is to build leaders, and the RAMS board, with its mission of developing leadership and advocacy opportunities of interest and importance to junior members, is an ideal way to meet that mission.

Meet Your 2017-2018 RAMS Board The RAMS Board is made up of medical students, residents, and faculty members, and will continue to consist of a diverse group from various backgrounds. The following individuals make up the inaugural RAMS Board:

Alexandra Nordberg, MD

Jean Sun, MD

2017-2018 President

2017-2018 Secretary-Treasurer

Alexandra grew up in East Bridgewater, MA, attended New York Medical College, and is currently a chief resident, PGY3 at the University of Massachusetts

What is your role on the RAMS Board?

Currently I am working as the inaugural president of the RAMS Board. The RAMS Board is composed of a number of great people dedicated to making this section of SAEM a top-notch, useful and easily accessible resource to residents and medical students interested in emergency medicine. We have lots of great ideas and are working diligently to make everything happen.

What are the biggest benefits of student and resident involvement with SAEM? Being involved in SAEM can open a lot of doors for medical students and residents, regardless of what stage they are in their training. Specifically, for students and residents, SAEM provides many ways to get involved (e.g., with projects or on a committee), to build their professional network, and to find mentors/advisors outside of their institutions. Overall, involvement in SAEM is a great opportunity to challenge yourself outside of the typical student/resident role.

What do you do when you’re not on shift?

I love being outside and spending time with my fiancée and family. Weather permitting, we love hiking, kayaking, eating sea-food, and tasting craft beer. My fiancée also enjoys downhill skiing, but I may be one of the few born and raised New Englanders who is terrified of it! I'm more of a “hot-cocoa” (with marshmallow fluff!) and "good book” kind of person.

How would you summarize your goals for the RAMS Board?

We want RAMS to be a fantastic resource for medical students and emergency medicine residents. Ideally, the RAMS Board will function as an advocate for medical students and residents within SAEM, to help them get the most from their educations and assit them in starting out in their careers. Through a new online platform, events, newsletters, etc., we want RAMS to be a place where students and residents can frequently and easily look to for guidance, advice, and mentoring/networking.

Jean grew up in Portland, Oregon before moving to Los Angeles, California.

She attended the California Institute of Technology and medical school at the University of Southern California Keck School of Medicine, where she served as student body president. Jean is currently a chief resident in the Mount Sinai Emergency Medicine Residency Program in New York City.

What drew you to emergency medicine?

My interest in emergency medicine grew from some crazy adventures in South Africa after college. I rode along in ambulances all over the Western Cape townships as part of a traveling fellowship, and just couldn't get enough. The emergency room was full of colorful people and tough challenges, and I knew instantly that I wanted to be a part of it. Ten years and five countries later, here I am!

How did you first get involved with SAEM? I first became involved with SAEM by asking my program director, Dr. Kaushal Shah, a very simple question: "How do emergency medicine physicians make decisions at the national level?" He said, "Why don't you find out yourself?" and put me in touch with Dr. Ali Raja, who was serving at the time as the SAEM Program Committee Chair. A few months later, I was helping to plan the SAEM 2015 Annual Meeting. The SAEM leadership is full of extraordinary and accomplished senior physicians, but they also welcome new residents and students with open arms. I'm incredibly thankful for the support of the SAEM community. Becoming more involved in SAEM is definitely one of the best decisions I've ever made for both my career and my personal growth.

What are your present responsibilities with SAEM? I currently serve as secretary-treasurer of the RAMS Board, chair of the IGNITE! Sub-Committee of the SAEM Program Committee, and am the resident member of the SAEM Board of Directors. My primary responsibilities in all three of these roles is to act as an advocate for residents and medical students within SAEM, lend a resident perspective to the SAEM academic mission, and find ways to extend more leadership and mentorship opportunities to all of our junior members.

What are the biggest benefits of student and resident involvement with SAEM? In a word: mentorship. The SAEM academic network is tremendous.

As a student or resident, becoming involved in SAEM's committees, interest groups, or academies will give you exposure to senior researchers, clinical experts, and global leaders in emergency medicine from all over the country. No matter if your interests are as general as critical care or medical education, or as niche as setting up an emergency department in a small village in Guatemala, there is someone in SAEM who can help you reach your goals. The SAEM community is incredibly warm and supportive. All it takes is the initiative to get involved!

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Lucia Derks, MD Member-at-Large Lucia grew up in Columbia, South Carolina and attended medical school at Wake Forest University SOM before completing residency at the University of Cincinnati. She is currently working as faculty at Mission Health in Asheville, NC.

What are your present responsibilities with SAEM? I am currently on the SAEM RAMS Board and serve as the cochair for speed mentoring for the SAEM Program Committee.

What do you see as the biggest story in emergency medicine right now?

The opioid crisis is by far our biggest task and hurdle. We cannot force drug companies to make new antibiotics, but we can change how we respond to patient symptoms and reframe the conversation about addiction.

What do you see as the biggest story in emergency medicine right now?

The biggest story in my mind is how health care will change during this presidency, because emergency medicine plays such a huge role as the safety-net for so many people. There could be radical restructuring depending on whether the Affordable Care Act is scrapped or a public option emerges.

What do you do when you’re not on shift?

When not on shift I'm busy with my two kids, or else biking, exercising, and exploring Columbus with my fellow residents.

We have amazing breweries, doughnuts, food, and bike trails in Columbus!

If you had to switch careers, what would you want to do?

Either computer programming or photography. Both allow the freedom and variety that medicine does, and allow you to build your own career while remaining mobile.

How would you summarize your goals for the RAMS Board?

Be a resource for the residents and medical students interested in and already a part of emergency medicine, to help them achieve their goals within the specialty.

What are you most excited about for yourself, emergency medicine, SAEM, and the RAMS Board?

As a new attending, there are multiple challenges involved with learning the lay of the land and establishing oneself. I certainly hope to draw on the energy from SAEM meetings, the Program Committee, and the RAMS board to help me keep striving to do more and be more.

Nehal Naik Member-at-Large Nehal grew up in Santa Barbara, California, and is currently an MS4 at Virginia Commonwealth University School of Medicine

What do you do when you’re not on shift?

Unplug. This is a constant struggle, but I love the outdoors and exercise. I truly believe that to be a good clinician you have to hit the reset button with your activities outside of work.

If you had to switch careers, what would you want to do?

I would be an entrepreneur. I love new ways of approaching problems and coming up with inventive solutions. Unfortunately (or fortunately), most of my inspiration comes from constantly learning, and thus, I would need to replace that aspect as well.

Chad Mayer, MD, PhD Member-at-Large Chad is from the California Bay area, attended Boston University School of Medicine, and is currently a PGY-2 at The Ohio State University (OSU) emergency medicine program

What drew you to emergency medicine?

Being the first one to begin solving a fresh problem, with anyone at any time. I didn't want any patients or complaints to fall out of my scope of practice.

What SAEM leader have you enjoyed working with/being mentored by the most?

I do a lot of work with Dr. King at OSU and have enjoyed being mentored by him and working towards my educational goals as I am part of the medical education track at OSU.

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What are you most excited about for yourself, emergency medicine, SAEM, and the RAMS Board?

I'm excited to see the RAMS Board bring a bigger focus to residents and students interested in pursuing academic careers in emergency medicine by creating didactics and longitudinal training. Engraining research and medical education into the trainee at an early stage is crucial to the success of any academician.

What do you think gets overlooked the most in our field?

Emergency medicine is strategically placed in medicine to understand the needs of our community. We need to continue our academic efforts to promote public health and be leaders within public health policy.

What are the biggest benefits of student and resident involvement with SAEM? Residents and students involved with SAEM get a jump start on their academic careers by learning from titans of academic emergency medicine. From our speed mentoring sessions to committee work, SAEM creates a pathway for success.

What do you do when you’re not on shift?

I'm outside looking for rocks to climb, rivers to raft, or places to salsa dance.

Andrew Starnes Member-at-Large Andrew grew up in Quilcene, a small town in Washington State, and is in his final year of a combined MD/ MPH program at the University of Oklahoma School of Medicine.

How did you first become involved with SAEM? I first became involved with SAEM as a Medical Student Ambassador at the SAEM annual meeting. It was an invaluable experience and I had a great time connecting with students and faculty. I would highly recommend any student interested in academic emergency medicine to take advantage of this incredible program.

What are the biggest benefits of student and resident involvement with SAEM? Through SAEM I’ve been able to participate in meetings, be recognized for research, and gain a much better perspective on the opportunities and resources available to young physicians.

Those kinds of things have really helped me as a student, both in being competitive for matching in residency and being informed about my career choices.

How do you think emergency medicine is poised to evolve?

I think that emergency medicine is one of the nimblest fields of medicine because of our flexibility and the endless demand for our services. As a result, I think we will see more and more systems-based innovations originating in emergency departments that spread across whole health systems and change the face of medicine for the public.

How would you summarize your goals for the RAMS Board?

My goal as a member of the RAMS Board is to encourage more students to get involved and take advantage of the many resources SAEM offers. There is practically an endless number of meetings, workshops, committees, etc. that students can benefit from, but they aren’t aware of how beneficial it is to their careers to become involved with these opportunities early on. I’d like to change that.

Andrew King, MD, FACEP, FAAEM Member-at-Large Andrew was raised in Shelby, Ohio and attended Northeastern Ohio Medical University before completing residency at The Ohio State University (OSU). He is currently an assistant professor, assistant residency program director, and medical education fellowship director at OSU.

What drew you to emergency medicine?

dancing with my mother. I wanted to prevent other children from experiencing a similar tragedy and emergency medicine fulfilled this personal promise.

How did you first become involved with SAEM? Like others, my SAEM involvement began as a resident member.

In addition to my membership on the RAMS Board, I also serve on the Graduate Medical Education and Resident & Student Advisory committees.

What do you do when you’re not on shift?

I enjoy spending time with my beautiful family and participating in various activities with my children. I love watching and participating in sports, and I am an avid fan of The Ohio State Buckeyes, the Cleveland Indians, and the Columbus Blue Jackets.

If you had to switch careers, what would you want to do?

I am a huge fan of sports and of all things Disney. I would love to work for ESPN and discuss baseball, hockey, or football, or work for Disney as a cast member sharing its magic and joy with others.

How would you summarize your goals for the RAMS Board?

As a member of the inaugural board, my goal is to develop a sound vision, budget, and objective goals to increase the impact and footprint of resident and medical student members of SAEM.

Alanna Darling, MD Member-at-Large Alanna grew up in Charlton, Massachusetts and attended the Warren Alpert Medical School of Brown University. She is currently a PGY-1 at the Harvard-affiliated emergency medicine residency at Beth Israel Deaconess Medical Center.

How did you first become involved with SAEM? I got involved with SAEM as a medical student as I was looking for meaningful ways to get involved with the emergency medicine community at a more regional and national level.

What are the biggest benefits of student and resident involvement with SAEM? SAEM connects you with a community of emergency medicine physicians, students, other providers, and researchers at the forefront of what's new and current in emergency medicine. It's an opportunity to learn from a diverse group of people with a wide range of interests, and a chance to contribute to the conversation.

If you had to switch careers, what would you want to do?

Within medicine, I'm hoping to explore an interest in education. If I had to give up medicine, I'd most likely get involved in teaching.

Summarize your goals for the RAMS Board.

One of my goals this year is for the RAMS Board to reach out to medical students and early trainees to help build a community and represent their interests and goals in SAEM.

I committed to a career in medicine at the age of five when I witnessed my grandfather die of a myocardial infarction while

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DIVERSITY AND INCLUSION Choosing Wisely

By Joel Moll, MD, FACEP It’s an exciting time of the year for academic emergency medicine.

Department chairs and medical directors are receiving faculty applications from residents and fellows. Program directors are sorting through a sea of applicants for residency and fellowship training. It’s the life cycle of academic emergency medicine and it is exciting because it is about the future, about possibilities, and about dreams. Decisions made in the fall of 2017 will have long-reaching and lasting impact on our departments, our programs, our specialty, and our patients, so it’s important to choose wisely.

"To be equitable, we must be familiar with and knowledgeable of those who are different from us and whose experiences SAEM PULSE | NOVEMBER-DECEMBER 2017

differ from our own."

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Last year I wrote about a diverse and inclusive match—diversity in every sense of the word and inclusion of all into the house of medicine. Diversity and inclusion is especially important in emergency medicine where we take care of a mélange of people from a multifaceted society, often on the worst days of their lives. We in emergency medicine have a special responsibility to be skilled in taking care of all patients, especially the vulnerable.

Despite the reality that our patients may sometimes not share our values, experiences, or backgrounds, we want to be empathetic physicians who deliver high quality care. The Institute of Medicine (now called the National Academy of Medicine) in a 2001 publication, Crossing the Quality Chasm: A New Health System for the 21st Century, defined six domains of health quality, one of which is equity.

To be equitable, we must be familiar with and knowledgeable of those who are different from us and whose experiences differ from our own. Such knowledge and familiarity has been shown in numerous studies to increase understanding and competency when caring for patients and working with colleagues dissimilar to us.

We must go beyond merely applying our own references and experiences to others; we must be proactively seek out this familiarity and knowledge, otherwise they will likely elude us. Simply being equal in our consideration of our different patients,

different learners, or different colleagues is not a clear, straight path toward diversity and inclusion in emergency medicine. We must go beyond equal consideration and be equitable in our quality of care.

I first became involved with diversity and inclusion efforts in 1979, when I was appointed to the human relations committee at my newly formed, recently integrated junior high school in Ohio. I remember thinking, “all we have to do is treat everyone the same.” My experiences soon demonstrated to me the problem with that assumption. I went from a conservative, white, German family, into a world where I was in the minority. My classmates and school leaders were primarily African-American or Latino and many of them became my friends and mentors—sometimes to the dismay of my extended family. Although I might not have understood it at the time, I now realize that I was fortunate to have had the experience of being exposed to these differences.

This exposure stimulated my intellect and my ethos—not just toward diversity, but in all ways. As I progressed into a similar high school environment, and then on to college, this smorgasbord of experiences was defining in my life. Thus, when I hear that discussions on diversity and inclusion are not needed, or even appreciated, and that we should simply “treat everyone the same,” I think back to what might have happened had I not been exposed to people different from myself. Comparing others to myself and evaluating them through that lens, is not being equitable.

Human tendency is to seek those who are like us. In the past year, I have reflected with sadness and sometimes horror, on the divisions, hateful speech, and violent events that surround us. Clearly, exposure to the diversity of humanity is needed. After all, it’s hard to hate people you’ve grown to know and understand. The driver of the car that killed a peaceful protestor in Charlottesville lived in the same area where I grew up, yet he clearly did not have the same experiences as I.

In medicine, studies have shown that having diverse and inclusive faculty, learners, and patients positively benefits a medical practice. Providers deliver and patients judge care to be more inclusive, competent, and equitable when diversity training and exposure to diverse people groups and experiences is provided.

Corporate studies have found the health of companies and communities are positively impacted by a diverse and inclusive climate. Yet we must not rely on equality alone. Implicit bias remains a strong opponent of change and growth in an American culture that is rapidly becoming more diverse and more complicated. Unfortunately, our colleagues and learners in medicine are not necessarily keeping pace. We cannot continue to apply our personal frames of reference, USMLE scores, and research expectations to everyone we meet and expect to adequately reflect our patients in our learners, our colleagues, or our profession. It’s not about politics or affirmative action, it’s about our personal perspective and the breadth of humanity.

Women, underrepresented minorities (URMs), LGBT (lesbian, gay, bisexual, transgender), those suffering economic hardship, or with disabilities, have experiences worth sharing—and even celebrating—in emergency medicine.

And certainly, that is just the start. We all have gifts to bring forward. Those gifts are different for each of us and therefore cannot and should not be ranked against one another, nor judged in simple measures of equality. Sharing our gifts through our diversity of life references and experiences creates a whole that is greater than the sum of our individual parts—and that benefits us as a society and as a profession. As you review applications this season, whether for faculty, fellows, or residents, ask if you are being equitable, not equal. Are you choosing wisely?

ABOUT THE AUTHOR: Joel Moll, MD, FACEP, is residency program director and associate professor in the Department of Emergency Medicine at the Virginia Commonwealth University School of Medicine.

Joel is the chair of SAEM’s Academy of Diversity and Inclusion in Emergency Medicine (ADIEM).

"Women, underrepresented minorities (URMs), LGBT (lesbian, gay, bisexual, transgender), those suffering economic hardship, or with disabilities, have experiences worth sharing—and even celebrating—in emergency medicine."

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ETHICS IN ACTION Physician Involvement in Executions

By Gerald Maloney, DO

THE CASE: You are participating in a residency didactic session on medical ethics. A number of end-of-life issues are being discussed in small-group sessions, and the topic of physician-assisted suicide has just been broached. As the discussion proceeds, one of your colleagues mentions that your state requires the presence of a physician at all executions. A spirited debate

SAEM PULSE | NOVEMBER-DECEMBER 2017

ensues as to the involvement of physicians

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in judicial executions. You are aware that the AMA Code of Ethics strictly prohibits physician involvement in a legally authorized execution, but one of your colleagues raises some interesting questions: What are the ethical arguments for and against the involvement of physicians in executions?

End-of-life care has been one of the most complex, and commonly encountered, ethical issues in medicine. What began as discussions centering on the appropriateness of certain life-sustaining measures, and when it is appropriate to cease life support (even if that would mean near-immediate death for the patient), has gradually evolved into much more contentious areas. The active involvement of physicians in assisting their patients in committing suicide— an issue brought into the public consciousness by such advocates as Dr. Jack Kevorkian and in some states codified by voter referendum— extended the discussion from immediate end-of-life issues and decisions regarding preferences for care, into a discussion of exactly how actively involved physicians should become in the end of their patients’ lives. Another longstanding issue that has been slowly garnering more attention with reports of problematic executions has been the involvement of physicians in executions.

Currently, 38 states and the federal government permit execution as an option for certain crimes, generally homicides. The preferred method of execution in all states is lethal injection, and lethal injection has accounted for the overwhelming majority of executions since the Supreme Court reinstated capital punishment in 1976.

Lethal injection has supplanted other forms of execution, such as firing squad, hanging, and electrocution, due to its perception of being more humane than the other named methods. Of those 38 states which allow executions, 35 either require or permit physician participation during an execution. However, both the American Medical Association (AMA) and the American Osteopathic Association prohibit physician involvement in execution beyond certifying a death that has already been declared.

Almost every state medical board has provisions prohibiting physician involvement in executions as well, even in states where the law requires physician involvement.

There is great divergence between what is permitted by the AMA Code of Ethics and what has been described by physicians who assist with executions. According to

"The rationale for prohibiting physician involvement is clear: There is no ethical foundation for permitting the administration of medications intended to end a human life." the AMA Code of Ethics, a physician cannot even declare death at the time of execution as they are not attempting to resuscitate the patient. Physicians who have been involved in executions have described monitoring vital signs, writing protocols for lethal injection, administering medications, and inserting intravenous lines. To shield physicians from action by the state medical board, some states have tried to codify that assisting in executions is not the practice of medicine; nearly all states provide significant anonymity protections to physicians who assist in executions.

The rationale for prohibiting physician involvement is clear: There is no ethical foundation for permitting the administration of medications intended to end a human life. Execution involves the ending of a life without any perceivable benefit—it is all harm and no gain. While states may have codified participation in executions as outside the practice of medicine, the physicians involved in executions are nevertheless using their skills as physicians to create harm to their putative patient and thus do not have an ethical foundation for their participation.

Or do they? The ethical argument made by physicians who assist in executions is that they are fulfilling their ethical obligation to the condemned by alleviating pain and suffering at the end of life. The argument made is that these are terminal patients and they too need to have their suffering at the

end of life mitigated. The only difference, they argue, is that the time and place of death is known in advance, and that it is the state and not a disease that is determining the patient’s terminal status.

Thus, by using their knowledge during the execution process, they are helping to ease the suffering of the patient at the end of his or her life.

Despite the well-reasoned and wellintended ethical arguments made by those participating in executions based on their humanitarian impulses, lethal

injection causes the end of a life that would otherwise not have ended at the moment. Regardless of one’s personal beliefs regarding the appropriateness of capital punishment, there is not an ethical argument that can override the compelling ethical prohibition on physician involvement in a process that creates an unnatural death in a non-terminally ill patient. Primum non nocere is one of the most oft-quoted phrases in medicine; if it does not apply to physician involvement in executions, then it is unclear where else it would apply.

ABOUT THE AUTHOR: Gerald Maloney, DO, is associate chief, Emergency Department, Louis Stokes Cleveland VA Medical Center; attending physician, Department of Emergency Medicine, MetroHealth Medical Center; and associate professor of emergency medicine, Case Western Reserve University.

Suggested Reading Gawande A. When law and ethics collide: why physicians participate in executions. N Engl J Med. 2006;354(12):1221-1229.

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THINGS TO KNOW ABOUT INDIANAPOLIS 1. Increased Airlift With the addition of 37 new flights and 15 destinations since 2014, the #1 airport in North America is making it easier than ever to get to Indy. Paris, San Francisco, Seattle, Phoenix, Austin, New Orleans, Boston, the list goes on.

2. Rising Culinary Scene Indy's culinary scene is getting recognition across the country, including from Forbes.com, and FoodRepublic.com. More than 80 local restaurants have opened in downtown Indy in the past five years, with several more led by the city’s top chefs anticipated this fall.

SAEM PULSE | NOVEMBER-DECEMBER 2017

3. Expanding Arts Scene

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The Cabaret will celebrate its 10th year bringing Broadway stars to Indy with the opening of its glamorous new performance space, a perfect setting for their star-studded lineup and private events. Indy's Phoenix Theatre is getting new wings after more than three decades of thought-provoking performances. As part of a new Performing Arts Collective, Phoenix Theatre will have three times the space, telling of the city's growing arts scene.

4. P aths for Pounding the Pavement From the nation's largest half marathon to an urban trail transforming downtown, Indy has trails galore for walking, running, and biking.

5. Fun for the Entire Family Indianapolis is home to the world's largest children's museum and plenty of other spots prime for family bonding.

SGEM: DID YOU KNOW?

Sex Differences in Heart Failure

By Nick Musisca, MD Heart failure (HF) is a common, complex disease, often divided into two primary types. HF with reduced ejection fraction (HFrEF) constitutes the reduced proportion of blood pumped out of a filled ventricle, typically below 40-50%. The sister diagnosis (yes, pun intended) constitutes a preserved ejection fraction (HFpEF). HFpEF pathology is multifaceted, involving increased myocardial stiffness, poor diastolic filling, decreased cardiac response to adrenergic stimulation, as well decreased cellular response to make more ATP. Women are more commonly diagnosed with HFpEF compared to men in general and they are diagnosed at an older age. One study found about 65% of HFrEF patients are men and 66% of HFpEF are women. Men usually develop HF from ischemia whereas women develop it as a result of hypertension, valvular heart disease and arrhythmias. Additionally, there are sex differences in the pathophysiologic mechanism in compensation, specifically, left ventricle remodeling in women is concentric and in men it is eccentric.

Considering these pathophysiologic sex differences in HF, women with HF present more often with orthopnea and rales and less frequently with peripheral edema compared to men. In addition, women tend to present with higher elevation of blood pressure. Diagnostically, while there is evidence that BNP tends to be higher in women with all types of heart failure, there is currently no sex-based cutoff. Women with HFpEF have longer hospitalizations and are treated with diuretics less frequently. Prognostic factors also vary by sex. Anemia is a predictor of all cause and cardiac mortality in women with HFpEF, whereas in men, it is a predictor for HFrEF. Men with HFpEF have higher overall mortality, though mortality data from HF based on sex are inconclusive. Among those with advanced HF requiring cardiac transplant, mortality is greater in women despite shorter waiting times compared to men.

Sex-specific approaches to cardiovascular disease have been increasingly documented in initial presentation (e.g. women are more likely to have NSTEMIs, men have STEMIs) and treatment (women receive PCI less often). Continued sex-specific evaluation of additional cardiac pathophysiological processes, including HF, must be considered and further investigated to optimize outcomes in all persons.

ABOUT THE AUTHOR: Nick Musisca, MD, is an ssistant professor in the Department of Emergency Medicine at the Warren Alpert Medical School of Brown University REFERENCES

Kajimoto, K., et al. Gender Differences in Anemia and Survival in Patients Hospitalized for Acute Decompensated Heart Failure With Preserved or Reduced Ejection Fraction. Am J Cardiol, 120(3), 435-442. 2017. doi:10.1016/j.amjcard.2017.04.043 McGregor, A. J., et al. Sex- and gender-specific research priorities for the emergency management of heart failure and acute arrhythmia: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup. Acad Emerg Med, 21(12), 1361-1369. 2014. doi:10.1111/acem.12526 O'Brien, C., et al. Comparison of 30-Day Readmission Rates After Hospitalization for Acute Myocardial Infarction in Men Versus Women. Am J Cardiol, 120(7), 2017. 1070-1076. doi:10.1016/j.amjcard.2017.06.046

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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Aaron Kuzel

Aaron Brody, MPH

Torben K. Becker, MD, PhD, FAWM

Opportunities for Career Advancement for Emergency Physicians Interested in Ethics

By Aaron Kuzel, Aaron Brody, MD, and Torben K. Becker, MD, PhD, FAWM

SAEM PULSE | NOVEMBER-DECEMBER 2017

Are you an emergency physician interested in ethics or further education in ethics related matters? Perhaps you are interested in ethical issues in the emergency department as part of palliative care training? In our profession, ethical issues are a common occurrence and as these issues arise, physicians will be required to make educated, ethical decisions especially when it comes to palliative care. Therefore, the ethics committee for the Society for Academic Emergency Medicine was tasked to find existing opportunities for emergency physicians interested in these forms of ethics continuing education. The committee sorted through twenty journals with an ethical focus as well as other venues of publication that have a general interest in ethical discussion.

In addition to these venues, the committee also searched for existing fellowships and training programs that provided an opportunity for emergency physicians to train, discuss and develop ideas on pertinent ethical issues to emergency medicine.

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Publication Venues There are many venues of ethics publications that exist for a multitude of fields, especially in the areas of bio- and medical ethics. The committee employed the use of the Thomson Reuters InCites Journal Citations Report (JCR) to compile a list of ethics journals with an explicit focus on medical ethics from the top 30 of the JCR report, ranked by impact factor (Table 1). These journals can be considered as potential publication venues for emergency physicians interested in disseminating their scientific, ethics-related work.

Table 1: Ethics journals in the top 30 of Reuters’ Journal Citation Report 2016 with an explicit medical focus Journal American Journal of Bioethics BMC Medical Ethics Bioethics Journal of Medical Ethics

Impact Factor 6.5 1.618 1.562 1.529

Journal of Empirical Research on Human Research Ethics

1.352

Public Health Ethics Journal of Law, Medicine & Ethics Medicine Health Care and Philosophy Neuroethics Developing World Bioethics Journal of Medicine and Philosophy Health Care Analysis

1.259 1.223 1.067 0.984 0.0898 0.871 0.820

Short-Term Training Courses Multiple short-term training courses are available to emergency physician with an interest in ethics and related topics. The majority of these programs focus on the impacts of palliative care in the emergency department setting, often focusing on communication with patients and their families. Although these programs are geared toward clinical and practical application, participants have used this training to shape their academic career and productivity towards becoming

Table 3: Representative fellowship programs in medical ethics

Table 2: Short-term courses with a focus on ethics and palliative care Program

Location

Certificate Program?

Education in Palliative and End-of-life Care for Emergency Physicians (EPEC-EM)

Northwestern University

No

Improving Palliative Care in Emergency Medicine (IPAL-EM)

Center to Advance Palliative Care (CAPC)

No

Palliative Care Always

Stanford University

No

Coleman Palliative Medicine Training Program

University of Chicago

No

EM Talk

American Academy of Emergency Medicine (AAEM) 2017 Scientific Assembly

No

Certificate in Hospice, Palliative Care and End-of-Life Care

University of South Florida

Yes

Certificate in End of Life Care

Ed2Go online course

Yes

advocates for improved palliative care in the emergency setting.

These programs are listed in Table 2 with the location of the course and whether it is a certificate program.

Fellowships in Medical Ethics Relevant to Academic Emergency Medicine The committee identified several formal ethics fellowships available to emergency physicians. These programs are typically one to two years in length. Fellows of these program complete a project addressing a specific issue, and participate in seminars and ethics rounds on individual patients. The fellowships have specialized tracks for surgeons, pediatricians, geneticists and other specialties, but a track for emergency physicians does not yet exist. However, the programs have had infrequent emergency physician graduates. The MacLean Center, for example, has hosted 340 physicians, and of this number, seven were emergency physicians. An overview of representative programs is listed in Table 3.

Program

Length of Program

Focus

University of ChicagoMacLean Center for Ethics

One Year, Part Time

Current Medical Ethics and Research Geared Toward Physicians

Harvard UniversityCenter for Bioethics

One Year, Part Time

Ethical Analysis and Key Topics in Bioethics

Cleveland Clinic

Two Year, Full Time

Understanding Key Topics in Bioethics, Research, Leadership Opportunities, and Career Building

National Institute of Health (NIH)Department of Bioethics

Two Year, Full Time

Ethical Issues in Research, Genetics, Clinical Practice, and Health Policy

John Hopkins UniversityBerman Institute of Bioethics

Two Year, Full Time

Bioethics Research and Professional Development

Seattle Children’s Hospital

Two Year, Full Time

Bioethics with an Emphasis on Pediatrics

The committee has identified a multitude of opportunities for emergency physicians to become involved with ethics-related scholarship and research. Those interested in advancing their careers and education, have many avenues to explore and receive quality education on ethics. Though not necessarily geared toward emergency medicine, dedicated fellowships and venues of publication exist for emergency physicians to participate in ethical issues and discussions pertinent to the field. The committee hopes to further more opportunities for emergency physicians to tackle more rigorous academic training in ethics.

ABOUT THE AUTHORS: Aaron Kuzel is a third year medical student at Lincoln Memorial University-DeBusk College of Osteopathic Medicine currently serving on the SAEM Ethics Committee. Dr. Brody is an assistant professor in the Department of Emergency Medicine at Wayne State University School of Medicine, Detroit. Dr. Becker is an emergency physician, intensivist and EMS physician at the University of Florida.

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SOCIAL MEDIA IN ACADEMIC EM Creating FOAMed at Your Institution

By Eric Lee, MD There are now numerous academic institutions producing quality FOAMed, including CoreEM, Taming the SRU, and NUEM Blog to name only a few. At SinaiEM, we are also proud to have been early adopters and strong believers in the FOAMed movement. In 2015, we officially created our SinaiEM Division of Social Media. Here are some helpful tips we learned along the way to get started.

Assemble the team

"The most challenging job of all is creating and disseminating your content. The key is to start simple and

SAEM PULSE | NOVEMBER-DECEMBER 2017

be consistent."

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Find the social media-minded people at your institution. We had attendings and residents who were already active out in the FOAMed world. Sinai attendings like Nicholas Genes (@nickgenes) already had a strong presence on social media. Former residents Benjamin Azan (@BenAzan) and Felipe Teran (@FTeranMD) were also active online, and they recruited me and others to coalesce our efforts and develop SinaiEM further. While everyone still had their own active projects, we were all also invested in developing FOAMed at SinaiEM. We remain a primarily resident-driven group, so it’s important to continue to recruit new and interested members from our junior classes.

Find support from your institution Having adequate buy-in from your leadership is truly valuable. We first started with a solid group of residents and found like-minded faculty who would support us before we presented our plans to our leadership.

Once you have a vision and plan, ask for support from your institution, whether that be permission to start the Twitter handle, recognition from external departments, or some financial assistance depending on what phase of development you are in.

Academic institutions care about their social media presence. Remind them of the many benefits, including elevation of their profiles and engagement with larger audiences.

In 2015, we walked into the office of our department chair, completely uncertain of what would result from our meeting.

FOAMed still seemed like a novel idea to some. Would our leadership get it? As it turned out, our apprehensions were unwarranted. Our departmental and residency leadership quickly recognized the

"The beauty of FOAMed is that you don’t need any fancy equipment, just an internet connection and a laptop." value and importance of FOAMed, and they granted us Division status, giving us not only recognition for our efforts but also some helpful financial support.

Get the equipment The beauty of FOAMed is that you don’t need any fancy equipment, just an internet connection and a laptop. But it always helps to have some nice gadgets to play with if you can afford them. Once we had a budget, we were able to do just that. We have a dedicated Macbook Pro for all our conferences and FOAMed projects. We also have a portable microphone and wireless lapel microphones that we use to record all our lectures. We will also video-record select lectures as well. Our only recurring costs are the fees for hosting our website and our Vimeo Plus account that we upload our videos to.

Create your content The most challenging job of all is creating and disseminating your content. The key is to start simple and be consistent. You can create a Twitter account and a website today for free. It’s important to ensure quality of your content, usually by having it reviewed by a senior resident or faculty. Then you just have to be consistent with regular posts or updates to build a following. This can be the most challenging aspect, as it relies largely on the dedication of your group.

Our two main venues are our website and our Twitter (@SinaiEM). The majority of our content is generated from our weekly

academic conferences and a rotating teaching resident who creates new FOAMed content for SinaiEM. We will also occasionally post lectures from regional conferences, especially those done by our own residents and faculty.

Our website features a blog with daily posts on clinical pearls in emergency medicine and a weekly literature review of a core topic in emergency medicine. It also links to our Vimeo which features videos of select lectures and procedures. We also have dedicated sections for critical care and ultrasound resources as well. Content is typically reviewed by a senior resident or faculty member.

We also have a team that will send out regular tweets from our weekly conferences under the #EMConf and #FOAMed hashtags. We also use this to publicize new posts to our website and drive traffic to our content. It not only gives us a way to engage with learners, but also provides a way for the FOAMed world to reach out to us and involve us in conversations online.

Another very important role is to highlight the accomplishments of our residents and faculty. We will often tweet about or retweet new podcasts, publications, or presentations by our residents, faculty, and alumni. It provides a great form

of outreach and builds our SinaiEM community.

Every journey begins with a single step.

Create your Twitter and website now. We’ll see you out there.

(For some more inspiration, check out this blog post from EMDocs highlighting some great residency-sponsored FOAMed!) ABOUT THE AUTHOR: Eric Lee, MD (@EricLeeMD) is a senior resident in the Department of Emergency Medicine at Mount Sinai in New York City. He is the current resident lead of the Social Media Division at SinaiEM.

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I am a

Rock Climber I am

Brian Ichwan I am an

Academic Emergency Physician

Supported in part by

The purpose of the “I am SAEM” campaign is to emphasize the importance of stress management, to improve provider well-being, and to promote academic emergency medicine as a career path. If you or someone you know has a unique or noteworthy outside interest or activity that helps you achieve work-life balance, please share your story with us! Read Brian’s full story at "I am SAEM".

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BRIEFS AND BULLET POINTS SAEM NEWS SAEM Releases Statement on Diversity and Inclusion

The Society for Academic Emergency Medicine (SAEM) recently released a “Statement on Diversity and Inclusion” which commits to the goal of promoting equity, diversity and inclusion in emergency medicine. Read the full statement.

Nominations Are Open for Leadership Positions

Nominations will remain open through Nov. 29 for leadership positions on the following boards and committees. Start the nomination process by clicking one of the links below. Nominations may be submitted by the candidate or by any member.

• SAEM Board of Directors • SAEM Nominating Committee and Bylaws Committee • Foundation Board of Trustees • RAMS • AACEM • Academies

Apply for SAEM Approval of Your Fellowship Program

The SAEM Fellowship Approval Program has been developed for eligible programs to earn SAEM endorsement as an approved fellowship in administration, research, geriatrics, global emergency medicine, and education scholarship. Programs may apply at any time. The approval process may take up to eight weeks, so plan ahead. To view a list of approved fellowships, visit the SAEM Fellowship Directory.

Are You Using SAEM Apps?

Sending messages and staying in the loop with current discussions is easy and simple with the SAEM Community app. The SAEM Community app provides you with all of the features you enjoy on the web version of the SAEM Community Site, but in a mobile format. It is available via iTunes and Google Play. The Academic Emergency Medicine app lets you enjoy the AEM journal on your desktop, tablet, or mobile device. SAEM members should use their member login and password in order to gain access to content on each of these apps.

Explore SAEM Online Education

SOAR (SAEM Online Academic Resources) is SAEM’s new digital home for open

access medical education. SOAR also houses all SAEM17 content, organized by topic, as well as Academy Open Access Education Resources.

SAEM18

Call for Keynote Speaker

The Society for Academic Emergency Medicine is accepting applications for a keynote speaker for SAEM18, the society’s annual meeting and the largest forum in the world for the presentation of original, high-quality research and educational innovation in emergency care. Held on the official opening day of the SAEM18, immediately preceding the Plenary Session, the opening keynote session is the largest gathering of the annual meeting which last year drew more than 3,000 attendees.

For speaker benefits, proposal tips, and application information visit here.

Submissions Up By More Than 50%!

Members, you truly blew us away with all of your proposals for SAEM18 workshops and didactics.

The SAEM Program Committee reports a huge spike in submissions over from last year: • Advanced EM Workshop Day submissions — up by 56% • Didactic submissions — up by 53% Next up: abstracts, innovations, and IGNITE! launch on Nov. 1!

Call for Papers: AEM 2018 Consensus Conference

Announcing a “Call for Papers” for the 2018 Academic Emergency Medicine (AEM) Consensus Conference, “Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps” will be held on May 15, 2018 at the JW Marriott Indianapolis, IN, immediately preceding SAEM18. Original research papers on this topic, if accepted, will be published together with the conference proceedings in the December 2018 issue of AEM.

Opening December 1...

• SAEM18 Registration • Medical Student Ambassador Applications • Clinical Images Exhibit Submissions • Residency & Fellowship Fair Registration

Exhibitor and Sponsor Opportunities at SAEM18

Being an exhibitor or sponsor at SAEM18 will put you in direct contact with close to 3,000 decision-makers in emergency medicine, including academic emergency medicine department chairs, educators, clinicians and residents at the most prestigious universities across the country.

The exhibit floor at SAEM17 in Orlando was very busy and we are looking to build on that success by ensuring that we drive even more traffic into the exhibit hall at SAEM18 in Indianapolis. Add your name to the growing list of SAEM18 exhibitors and sponsors in Indianapolis. Additional information for exhibitors can be found on our website.

SAEM COMMITTEES Awards Committee Accepting Nominations for 2018 SAEM Awards

The SAEM Awards committee is accepting nominations for the 2018 SAEM Awards.

There are currently eight awards open to recognize the very best in academic emergency medicine: • John Marx Leadership Award • Excellence in Research Award • Hal Jayne Excellence in Education Award • Advancement of Women in Academic Emergency Medicine Award • Arnold P Goldman Foundation Humanism in Medicine Award • Young Investigator Award • Best Resident Researcher Award • Best Resident Educator Award We invite you to nominate your exceptional colleagues for these honors. Awards will be presented at SAEM18 Indianapolis. The deadline for nominations is Dec. 9, 2017.

For additional information about the awards and the nomination and selection process, please visit the SAEM Awards webpage.

SAEM INTEREST GROUPS

Announcing New SAEM Interest Groups Interested in becoming a member of a brand new interest group? Here’s your chance! SAEM has four new interest groups that are ready for you to join today:

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• EM Transmittable Infectious Disease and Epidemics (EMTIDE) • Oncologic Emergencies • Social EM and Population Health • Telehealth

which celebrates its 10th Anniversary in 2018, will be held March 11-14, 2018 at Hotel del Coronado in Coronado, CA.

RESIDENTS & MEDICAL STUDENTS

The 2018-19 Certificate in Academic Emergency Medicine Administration (CAEMA) Program is now open for registration! The first session is scheduled to be held March 10-11, 2018 at the AACEM/AAAEM Annual Retreat at Hotel del Coronado in Coronado, CA. Visit our website for more details.

SAEM Lowers Dues for Medical Students!

SAEM is excited to announce its dues have been lowered for medical student members. The new dues are $25/year.

This is reflected on our updated membership application.Contact membership@saem.org with questions.

Sign Up for a RAMS Committee

RAMS is looking for enthusiastic, innovative, and dedicated members to serve on RAMS Committees for the 20182019 academic year. As a committee member during the inaugural year of RAMS, you would play a crucial role in influencing the direction of the Society at large and charting the course for the future of emergency medicine. Operating under the leadership of the RAMS Board, and with full support from the entire SAEM leadership, you would help develop future educational solutions that address the needs and wishes of residents and medical students. To serve on one of the inaugural RAMS Committees, complete the RAMS Committee Interest Survey.

SAEM FOUNDATION Announcing the Next Research Learning Series Event

Register for the next online educational event, Challenges Getting Started in EM Research, Nov. 13, 2017, 2 pm ET. Speakers for the event are Gloria Kuhn, DO, PhD; Esther Choo, MD, MPH; and Wendy Coates, MD. The event is complimentary and hosted by the SAEM Foundation and the SAEM Research Committee. You may also view past events on the SAEM Foundation website. For questions, please contact foundation@saem.org.

AACEM

Plan to Attend the AACEM/AAAEM 10th Anniversary Retreat

Registration is now open for the 2018 AACEM/AAAEM Annual Retreat! The retreat,

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Registration Open for 2018-19 CAEMA Program

IN OTHER NEWS PS-LLSA Requirement Ending

ABEM is committed to improving the value and relevance of the ABEM MOC Program. In response to your feedback, ABEM will no longer require that ABEMcertified physicians complete the Patient Safety LLSA (PS-LLSA). Patient safety– related topics will be included in EM and subspecialty LLSAs. If you have registered for but not completed the PS-LLSA activity, or if you have not registered for it but are interested in participating in the activity, you will have until March 1, 2018 to complete the PS-LLSA. If you have registered for the PS-LLSA and not started the activity, you have the option of requesting that your test fee be applied to another ABEM LLSA. For those who signed up for the associated CME activity, the CME fee can also be transferred. This is a one-time exception to the ABEM Policy on Fees. All requests should be sent to moc@abem.org, and must be received by June 30, 2018. Please include your name and let us know the LLSA you would like to take instead of the PS-LLSA. Even though the PS-LLSA requirement is ending, completion of the PS-LLSA will continue to count toward the four LLSAs needed every five years to meet the LLSA requirement. ABEM is grateful for your feedback and the opportunity to improve your continuing certification.

BWH Establishes Division of Medical Toxicology

Brigham and Women’s Hospital, the major teaching affiliate of Harvard Medical School, has formed the Division of Medical Toxicology. Under the direction of Timothy Erickson MD, the Harvard toxicologists seek to advance the clinical care of the poisoned patient, and excel at resident and medical student teaching. Dr. Erickson is joined by Peter Chai MD and Edward W Boyer MD PhD as faculty members.

Dr. Drew Carlson, Champion of Emergency Care Research, Retiring After 30 Years After nearly 30 years of service in both academia and the federal government, Dr. Drew Carlson, a champion Drew Carlson, MD of emergency care research, will be retiring at the end of the year. In his early years, Dr. Carlson served as faculty at Brown University and Johns Hopkins before joining the Department of Surgery and the Program in Trauma at the University of Maryland. As an NIH funded investigator, Dr. Carlson’s research focused on resuscitation and sepsis. Throughout his academic career, he has been an incredibly strong advocate for teaching and mentoring junior scientists and clinicians and has given so much of his time in pursuit of this endeavor.

After joining the National Heart Lung and Blood Institute in 2008, Dr. Carlson brought with him his passion for training and helped to create NHLBI initiatives to support Institutional K12 programs to train a new generation of emergency care researchers. In addition to these efforts, he has been dedicated to the widespread growth of emergency care research by advocating training and career development opportunities at SAEM conferences and the AHA Resuscitation Science Symposiums. He also served as executive secretary of the Protocol Review Committee for the Resuscitation Outcomes Consortium, a network of participating emergency care systems supported by NHLBI and other agencies in the United States and Canada. Dr. Carlson leaves behind a legacy of leadership and passion in advancing emergency care research.

ACADEMIC ANNOUNCEMENTS New Hampshire Rural Health System

Dave Amin, MD, MBA

Dave Amin, MD, MBA has been appointed Chief Health Officer and Medical Director of the New Hampshire Rural Health System and ACO. Dr. Amin will be responsible for medical leadership and the implementation of population health strategies across the system.

Dr. Amin recently graduated as a Sloan Fellow from the Massachusetts Institute of Technology in Cambridge, MA.

Brigham and Women’s Hospital/Harvard

Ziad Obermeyer, MD

Kei Ouchi, MD, MPH of Brigham and Women’s Hospital has received a prestigious GEMSSTAR award from NIH. Funded under a R03 mechanism, the GEMSSTAR mechanism supports the transition of exciting young investigators into aging research. Dr.Ouchi is an instructor at Harvard Medical School.

University of Florida/UF Health Jacksonville

Leon L. Haley Jr., MD

Leon L. Haley Jr., MD has been named chief executive at UF Health Jacksonville. Dr. Haley joined UF Health Jacksonville less than a year ago as the dean of the University of Florida College of Medicine Jacksonville. He will retain that position, in addition to the CEO role for the hospital. Haley will assume the role of CEO on Jan. 1, 2018.

Kei Ouchi, MD, MPH

Kings County Hospital Center/SUNY Downstate Amado Alejandro Baez, MD, MSc, MPH has been recruited as chief of emergency medicine at Kings County Hospital Center. In his previous job, Dr. Baez served as the academic affairs and founding program director at Jackson Memorial Hospital. Dr. Baez completed his emergency medicine residency training at Mayo Amado Alejandro Baez, Clinic with fellowships in Clinical Research MD, MSc, MPH (Albert Einstein) and Critical Care (Brigham and Women’s Hospital/ Harvard Medical School).

University of Missouri

Matthew T. Robinson, MD

Matthew T. Robinson, MD, medical director of the Emergency Department at University of Missouri (MU) Health Care, has been named chair of the Department of Emergency Medicine at the MU School of Medicine. Dr. Robinson, an associate professor of clinical emergency medicine in the MU School of Medicine, has served as the interim chair of the Department of Emergency Medicine since December 2015.

University of Texas Health Science Center

Henry E. Wang, MD, MS

enry E. Wang, MD, MS, has joined the H Department of Emergency Medicine at the University of Texas Health Science Center at Houston as professor and vice chair for research. Dr. Wang has also received a $1.2 million Science and Technology Acquisition and Retention (STARs) award from the University of Texas System. Dr. Wang has also been promoted to deputy editor of the Annals of Emergency Medicine.

Ziad Obermeyer, MD of Brigham and Women’s Hospital and assistant professor of emergency medicine at Harvard Medical School, has received a $382,595 NIH grant funded under a R56 mechanism. This work continues his line of investigation expanding the role for palliative care in the care of older adults with chronic, severe medical problems.

Patricia Henwood, MD

Peter Chai, MD

Patricia Henwood, MD, Edward W Boyer, MD, PhD, and Peter Chai, MD all of Brigham and Women’s Hospital, have received a $1.6 million DARPA award. They will use all lines of data collection available to smartphone—user activity, texting rates, GPS, motion, etc.—and then apply machine learning protocols to diagnose mild traumatic brain injury and malaria.

Peter Chai, MD, MMS, a medical toxicologist at Brigham and Women’s Hospital, has received a NIH CFAR grant award. Dr. Chai, an assistant professor of emergency medicine at Harvard Medical School, will use digital pills that contain an ingestible biosensor to improve adherence to antiretroviral therapy used as pre-exposure prophylaxis to prevent HIV infection.

Edward W Boyer, MD, PhD has been promoted to Director of Academic Development for the department of emergency medicine at Brigham and Women’s hospital. Dr. Boyer’s emphasis will be on expanding the scope of research of the Brigham, mentoring junior faculty to that cutting edge where successful academic careers Edward W Boyer, MD, PhD begin, and growing the NIH-funded repertoire within the department.

Duke University Traci Thoureen, MD, has been promoted to associate professor in the Duke University Division of Emergency Medicine. Dr. Thoureen first came to Duke in 2002 after her matriculation from Yale Emergency Medicine Residency. During that time she received a Masters of Health Sciences from Duke. She Traci Thoureen, MD spent 2005-2013 as an assistant professor at University of Maryland, but returned to Duke in 2013 as the Director of Simulation. She has subsequently obtained a second master’s degree in clinical informatics and is published in both peer reviewed journals and textbooks.

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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 December 1.

For specs and pricing, visit the SAEM Pulse advertising webpage.

Academic Emergency Medicine Physicians The University of Chicago's Department of Medicine, Section of Emergency Medicine, is seeking full-time faculty members to serve as Emergency Physicians as we prepare to open a new adult emergency department and establish an adult Level 1 Trauma Center.

Academic rank is dependent on qualifications. Applicants are required to be board certified or board eligible in emergency medicine and to be eligible for Illinois licensure by the start of appointment. Responsibilities will include teaching in the educational programs sponsored by the Section and participation in scholarly activity. We seek candidates looking to develop an academic niche that builds upon our faculty expertise in basic and translational research, health equity and bioethics research, geriatric emergency care, global emergency medicine, medical education, prehospital medicine, aero-medical transport, and ultrasound. We host one of the oldest Emergency Medicine Residency programs in the country and serve as a STEMI receiving hospital, a Comprehensive Stroke Center, a Burn Center, and a Chicago South EMS regional resource hospital. The Adult ED has an annual volume of 65,000 and our Pediatric ED cares for 30,000 patients per year, including 1,000 level 1 trauma patients.

This position provides competitive compensation and an excellent benefits package. Those interested must apply by uploading a cover letter and current CV online at academiccareers.uchicago.edu/applicants/Central?quickFind=55160. Review of applications will continue until all available positions are filled.

The University of Chicago is an Affirmative Action/Equal Opportunity/Disabled/Veterans Employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national or ethnic origin, age, status as an individual with a disability, protected veteran status, genetic information, or other protected classes under the law. For additional information please see the University's Notice of Nondiscrimination at http://www.uchicago.edu/about/non_discrimination_statement/.

Job seekers in need of a reasonable accommodation to complete the application process should call 773-702-0287 or email ACOppAdministrator@uchicago.edu with their request.

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CLINICAL & ACADEMIC EMERGENCY PHYSICIANS Rapid expansion in Greenville, SC due to new EM Residency program and community hospital growth Greenville Health System (GHS) seeks BC/BE Emergency Physicians to become faculty in the newly established Department of Emergency Medicine. Successful candidates should be prepared to shape the Emergency Medicine Residency Program and contribute to the academic output of the department.

GHS is the largest healthcare provider in South Carolina and serves as a tertiary referral center for the entire Upstate region. The flagship Greenville Academic Department of Emergency Medicine is integral to the patient care services for the: • Level 1 Trauma Center • Dedicated Pediatric Emergency Department within the Children’s Hospital • Emergency Department Observation Center • Accredited 3-year Emergency Medicine Residency Program

• Five Community Hospital Emergency Departments • Accredited Chest Pain Center • STEMI and Comprehensive Stroke Center • Regional Ground and Air Emergency Medical Systems

*Public Service Loan Forgiveness (PSLF) Program Qualified Employer* Greenville, South Carolina is a beautiful place to live and work. It is one of the fastest growing areas in the country, and is ideally situated near beautiful mountains, beaches and lakes.

Qualified candidates should submit a letter of interest and CV to: Kendra Hall, Sr. Physician Recruiter, kbhall@ghs.org, ph: 800-772-6987.

EOE

Faculty Positions-Emergency Medicine Faculty Positions-Emergency Medicine DISTRICT OF COLUMBIA-The Department of Emergency Medicine of the George University is seeking physicians ourGeorge academic DISTRICT OFWashington COLUMBIA-The Department of Emergency Medicinefor of the practice. Physicians employed byfor Medical Faculty Associates, Washington University isare seeking physicians our academic practice.

Physiciansa are University-affiliated, not-for-profit physician group, and employed

by Medical Faculty Associates, amultispecialty University-affiliated, not-for-profit multispecialty physician group, and receive regular appointments at the receive regular faculty appointments at thefaculty University.

The Department University.

The Department staffingunits for the units of George provides staffing for theprovides emergency ofemergency George Washington Washington the Walter NationalMilitary Military Medical Center, and UniversityUniversity Hospital,Hospital, the Walter ReedReed National Medical Center, the DC Veterans’ Administration Medical Center. The Department and the DC Veterans’ Administration Medical Center. The Department (http://smhs.gwu.edu/emed/) offers educational programs including a four-year (http://smhs.gwu.edu/emed/) offers educational programs including residency, ten fellowship programs, and numerous other teaching, research, and a four-year residency, ten fellowship programs, and numerous other consulting activities. teaching, research, and consulting activities.

We are seeking physicians who will participate in our clinical and educational

We are seeking physicians who will participate in our clinical andRank programs and contribute to the Department’s research and consulting activities. educational programs and contribute and salary are commensurate with experience.to the Department’s research and consulting activities. Rank and salary are commensurate with experience.

Basic Qualifications: Physicians must be ABEM or AOBEM certified, or have

completed an ACGME or AOA certifiedmust Emergency Medicine to the Basic Qualifications: Physicians be ABEM or residency, AOBEMprior certified, datehave of employment. or completed an ACGME or AOA certified Emergency Medicine residency, to theComplete date ofthe employment.

Application prior Procedure: online faculty application at http://www.gwu.jobs/postings/45021 and upload a CV and cover letter. Review of

Application Complete the online faculty application at Only applications willProcedure: be ongoing beginning November 1, 2017 until positions are filled. http://www.gwu.jobs/postings/45021 andDepartment upload a Chair, CV and cover letter. complete applications will be considered. Contact Robert Shesser M.D., at rshesser@mfa.gwu.edu the position.

Review of applications willwith be questions ongoingabout beginning November 1, 2017 until positions are filled. Only complete applications will be considered. Contact Only complete applications will be considered.

Department Chair, Robert Shesser M.D., at rshesser@mfa.gwu.edu with The university about is an Equal Employment Opportunity/Affirmative Action employer that does not unlawfully questions the position. discriminate in any of its programs or activities on the basis of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity or expression, or on any other basis Only complete applications will be considered. prohibited by applicable law.

The university is an Equal Employment Opportunity/Affirmative Action employer that does not unlawfully discriminate in any of its programs or activities on the basis of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity or expression, or on any other basis prohibited by applicable law.

Yale University School of Medicine Department of Emergency Medicine EMERGENCY DEPARTMENT MEDICAL DIRECTOR The Department of Emergency Medicine at Yale University School of Medicine is currently seeking a Medical Director to oversee the clinical operations of our ED at the St. Raphael’s Campus of Yale-New Haven Hospital with approximately 60,000 visits per year. Yale-New Haven Hospital is an urban level 1 trauma center with three emergency departments and annual census of greater than 180,000 visits. The Director will join a well-established, multidisciplinary team that enjoys an excellent working relationship with our nursing and hospital administrative leadership who are jointly committed to providing excellence in clinical care and ensuring a culture which prioritizes patient safety. As a faculty member in the Department of Emergency Medicine at Yale School of Medicie, the director will be an integral member of the administrative section, working directly with the Vice-Chair of Operations, assuming a leadership role in education and research activities as part of the premier Emergency Medicine Residency and administrative fellowship.

Candidates must be Emergency Medicine trained and board-certified. The ideal candidate must demonstrate excellence in clinical, interpersonal and administrative skills, with previous experience in clinical operations and management.

Yale University is a world-class institution providing a wide array of benefits and research opportunities.

To apply, please visit: http://apply.interfolio.com/44993 to upload your CV and cover letter. Specific inquiries about the position may be sent to the Chair: Gail D’Onofrio, MD, MS, via email: jamie.petrone@yale.edu.

Yale University is an Affirmative Action/Equal Opportunity employer. Yale values diversity among its students, staff, and faculty and strongly welcomes applications from women, persons with disabilities, protected veterans, and underrepresented minorities.

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Brody School of Medicine

EMERGENCY MEDICINE FACULTY

BRIGHAM HEALTH DIRECTOR OF RESEARCH OPERATIONS, DEPARTMENT OF EMERGENCY MEDICINE

◊ Clinician-Educator ◊ Clinical-Researcher ◊ Critical Care Medicine ◊

The Department of Emergency Medicine at Brigham Health is seeking a Director of Research Operations. This position will have no clinical responsibilities.

Brigham and Women’s Hospital is a major teaching affiliate of Harvard Medical School. The Department also hosts a successful research program that supports several projects funded by varied sources, including but not limited to the NIH and industry. These projects include clinical trials, observational studies, and quality improvement projects. The Department is actively expanding its research footprint.

The appropriate candidate will be eligible for academic appointment at Harvard Medical School at the rank of Instructor, Assistant Professor or Associate Professor commensurate with experience, achievement, recognition, and participation in teaching and scholarly activities. The position offers opportunities for professional development, a competitive salary, and a comprehensive benefits package. Brigham Health is committed to the personal and professional development of our providers.

The successful applicant will provide administrative leadership for the Department’s research staff. The overall responsibility of the incumbent will be to ensure the successful implementation of research and to supervise the research staff, under the guidance of the Department’s Research Director and Director of Academic Development.

Candidates must have an MD or MBBS and an MPH or equivalent; Must have successfully conducted clinical research as evidenced by academic participation in conferences and peer-reviewed publication in academic journals; Must have experience in research methodology including epidemiology and biostatistics.

Interested candidates should send a letter and Curriculum Vitae to Michael VanRooyen, MD, MPH, Chairman, Department of Emergency Medicine, Brigham and Women’s Hospital. Please apply by email to mdeloge@bwh.harvard.edu.

◊ Pediatric Emergency Medicine ◊ Ultrasound ◊ The Department of Emergency Medicine at East Carolina University Brody School of Medicine seeks BC/BP emergency physicians and pediatric emergency physicians for tenure or clinical track positions at the rank of assistant professor or above, depending on qualifications. We continue to expand our faculty to meet the clinical needs of our patients and the educational needs of our learners. We envision further program development in clinical education, emergency ultrasound, EM-critical care, pediatric EM, and clinical research. Our current faculty possesses diverse interests and expertise leading to extensive state and national-level involvement. The emergency medicine residency includes 12 EM and 2 EM/IM residents per year. We treat more than 130,000 patients per year in a state-of-the-art ED at Vidant Medical Center. VMC is a 960+ bed level 1 trauma center and regional referral center for cardiac, stroke, and pediatric care. Our tertiary care catchment area includes more than 1.5 million people in eastern North Carolina. Additionally, we provide clinical coverage at two community hospitals within our health system. We are responsible for medical direction of East Care, our integrated mobile critical care and air medical service, and multiple county EMS systems. Our exceptional children’s ED opened in July 2012 and serves approximately 25,000 children per year. Greenville, NC is a university community offering a pleasant lifestyle and excellent cultural and recreational opportunities. Beautiful North Carolina beaches are nearby. Compensation is competitive and commensurate with qualifications; excellent fringe benefits are provided. Successful applicants will be board certified or prepared in Emergency Medicine or Pediatric Emergency Medicine. They will possess outstanding clinical and teaching skills and qualify for appropriate privileges from ECU Physicians and VMC.

The University of California, Davis School of Medicine, Department of Emergency Medicine (EM) is conducting a faculty search for EM physicians in either a clinician/educator or clinician/researcher track. Candidates must be residency trained in EM with board certification/preparation and be eligible for licensure in California. At least one year of post-training 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 nationʼs “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 facility opened in 2010 and is state-of-the-art. Our program Confidential inquiry may be made to: provides comprehensive emergency services to Wea arelarge local urban and referral an equal opportunity employer and all qualified applicants will receive Theodore Delbridge, MD, MPH consideration for employmentand without training regard to race, color, religion, sex, sexual population as a level 1 trauma center, paramedic base station center.

The Chair, Department of Emergency Medicine orientation, gender identity, national origin, disability status, protected veteran department delbridget@ecu.edu also serves as the primary teaching status, siteorfor a fully accredited any other characteristic protected by law. EM residency program and eight different EM fellowship programs. Our residency training program began more than twenty years ago and currently has 48 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.

The University of California, Davis School of Medicine, Department of Emergency Medicine (EM) is conducting a faculty search for EM physicians in either a clinician/educator or clinician/researcher track. Candidates must be residency trained in EM with board certification/ preparation and be eligible for licensure in California. At least one year of post-training 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 facility 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 center, paramedic base station and training center. The department also serves as the primary teaching site for a fully accredited EM residency program and eight different EM fellowship programs. Our residency training program began more than twenty years ago and currently has 48 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.

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.

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Department of Emergency Medicine Yale University School of Medicine ADVANCING THE SCIENCE AND PRACTICE OF EMERGENCY MEDICINE The Department of Emergency Medicine at the Yale University School of Medicine has a total of 4 clinical sites: Adult Emergency Services at York Street Campus; Shoreline Medical Center; Saint Raphael’s Campus; and the West Haven VA Emergency Department with a combined ED volume of 195,000 visits per year. We are seeking faculty at all ranks (Clinician, Assistant Professor, Associate Professor, Professor, etc.) with interests in clinical care, education or research to enhance our existing strengths. Interest and/or experience in observation medicine is a plus. The successful candidate may be a fulltime clinician committed to excellence in patient care and emergency medicine education or one that would want to join the academic faculty promoting scholarship to enhance the field of emergency medicine. We offer an extensive faculty development program for junior and more senior faculty. We have a well-established track record of interdisciplinary collaboration with other renowned faculty, obtaining federal and private foundation funding, and a mature research infrastructure supported by a faculty Research Director, a staff of research associates and administrative assistants.

Eligible candidates must be residency-trained and board-certified/-prepared in emergency medicine. Rank, protected time and salary will be commensurate with education, training and experience.

Yale University is a world-class institution providing a wide array of benefits and research opportunities.

To apply, please visit: apply.interfolio.com/43754 to upload your CV and cover letter. Specific inquiries about the position may be sent to the Chair: Gail D’Onofrio, MD, MS, via email: jamie.petrone@yale.edu.

Yale University is an Affirmative Action/Equal Opportunity employer. Yale values diversity among its students, staff, and faculty and strongly welcomes applications from women, persons with disabilities, protected veterans, and underrepresented minorities.

Program Director and Core Faculty Opportunities Toxicology Fellowship Trained EM Physician for Core Faculty

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.

Academic Emergency Medicine Program Director

Brandon Regional Hospital. Tampa Bay, FL. New EM Residency Program. Estimated start date July 2019. Contact Ody Pierre-Louis at 727.507.3621.

Core Faculty

Coliseum Medical Center. Macon, GA. New EM Residency Program affiliated with Mercer University’s School of Medicine. Estimated start date July 2019. Contact Craig McGovern at 727.437.0846.

Clinical and Core Faculty

St. Lucie Medical Center. Port St. Lucie, FL. PBCGME affiliated Osteopathic EM Residency Program.

Contact Sabrina Hadzimesic at 727.507.2509.

Apply today at: MakeAChange@EmCare.com

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EMERGENCY MEDICINE FACULTY New York Presbyterian Hospital-Weill Cornell Medicine is seeking motivated full-time residency-trained academic Emergency Medicine faculty. We are seeking candidates to join a diverse enthusiastic group of academic Emergency Physicians at one of the premier academic medical centers in the nation.

New York Presbyterian Hospital is a national leader in healthcare and consistently ranks in the top 10 of US News & World Report Best Hospitals rankings. For the 2016-17 period, New York Presbyterian Hospital ranked No. 6 in the nation and No. 1 in the New York Metropolitan area.

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. We are located on the Upper East Side of Manhattan and offer programs in Medical Toxicology, Geriatric Emergency Medicine, Wilderness Medicine, Global Emergency Medicine, Simulation and Ultrasound. We also offer a residency in

Emergency Medicine for PAs and NPs. We have dedicated medical scribes for our faculty and have implemented several innovative initiatives focusing on education, improving operational efficiency and the patient experience.

We recently launched the first innovative virtual ED Telehealth initiative in New York City and plan to expand this program with the full support of New York Presbyterian Hospital and Weill Cornell Medicine. Several 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.

Ideal candidates will have an established track record with excellence in education, teaching and outstanding clinical service. Candidates seeking nocturnist faculty positions are highly desirable.

We offer a highly competitive salary, a comprehensive benefits package, and a generous retirement plan. Academic appointment at Weill Cornell Medical College and salary will be commensurate with experience.

Candidates are invited to send their curriculum vitae and cover letter to: Rahul Sharma, MD, MBA, CPE, FACEP Emergency Physician-in-Chief New York Presbyterian Hospital-Weill Cornell Medical Center ras2022@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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Yale University School of Medicine Department of Emergency Medicine Fellowship Programs For specific information including deadlines and requirements, visit: http://medicine.yale.edu/emergencymed/ The Research fellowship is a 2-3 year program focused on training clinician scholars as independent researchers in Emergency Medicine. Scholars will earn a Master of Health Sciences degree from Yale combining clinical experience with extensive training in research methods, statistics and research design. With the guidance of research content experts and professional coach mentors, the scholar will develop a research program, complete a publishable project and submit a grant application prior to completion of the program. The program is credentialed by the Society for Academic Emergency Medicine. For further information, contact Steven L. Bernstein, MD, steven.bernstein@yale.edu.

The fellowship in Emergency Ultrasound is a 1 or 2 year program that will prepare graduates to lead an academic/community emergency ultrasound program.

The 2-year option includes a Master of Health Sciences with a focus on emergency ultrasound research. This fellowship satisfies recommendations of all major societies for the interpretation of emergency ultrasound, and will include exposure to aspects of program development, quality assurance, properties of coding and billing, and research. The program consists of structured time in the ED performing bedside examinations, examination QA and review, research into new applications, and education in the academic/ community arenas. We have a particular focus on emergency echo and utilize state of the art equipment, as well as wireless image review. Information about our Section can be found at http://medicine.yale.edu/emergencymed/ultrasound/ For further information, contact Chris Moore, MD, RDMS, RDCS, chris.moore@yale.edu, or apply online at www.eusfellowships.com.

The fellowship in EMS is a 1-year program that provides training in all aspects of EMS, including academics, administration, medical oversight, research, teaching, and clinical components. The ACGME-accredited program focuses on operational EMS, with the fellow actively participating in the system’s physician response team, and all fellows offered training to the Firefighter I or II level. A 1-year MPH program is available for fellows choosing additional research training. The fellowship graduate will be prepared for a career in academic EMS and/or medical direction of a local or regional EMS system, and for the new ABEM subspecialty examination. For further information, contact David Cone, MD, david.cone@yale.edu.

The Administration fellowship is a 2-year program that will prepare graduates to assume administrative leadership positions in private or academic practice.

The fellow will acquire experience in all facets of emergency department clinical operations, working with department and hospital administrative leaders.

Fellows will complete the Executive MBA program at the Yale School of Management as part of their Administrative Fellowship. In addition, the candidate will assume a leadership role on one or more projects supporting departmental activities. The fellow will work directly with department administrative leadership in conjunction with the Vice Chair for Clinical Operations. For further information, contact Arjun Venkatesh, MD, MBA, MHS, arjun.venkatesh@yale.edu.

The Global Health and International Emergency Medicine fellowship is a 2-year program offered by Yale in partnership with the London School of Hygiene & Tropical Medicine (LSHTM). Fellows will develop a strong foundation in global public health, tropical medicine, humanitarian assistance and research.

They will receive an MSc from LSHTM, a diploma in Tropical Medicine (DTM&H) and complete the Health Emergencies in Large Populations (HELP) course offered by the ICRC in Geneva. In addition, fellows spend 6 months in the field working with on-going Yale global health projects or on an independent project they develop. For further information, contact the fellowship director, Hani Mowafi, MD, MPH, hani.mowafi@yale.edu.

NIDA K12: Partnering with Yale’s Clinical and Translational Sciences (CTSA), Robert Wood Johnson Foundation Clinical Scholars Program, the Center for Interdisciplinary Research on AIDS (CIRA) and the VA Connecticut Healthcare we are offering the Yale Drug Abuse, HIV and Addiction Scholars K12 Research Career Development Program. The DAHRS K12 Scholars Program provides an outstanding 2-3 year research training experience that offers a Master of Health Science, a mentored research program as well as career and leadership development activities. For further information, contact Gail D’Onofrio, MD, MS, gail.donofrio@yale.edu.

The Wilderness Medicine fellowship is a 1-year program that provides the core content of medical knowledge and skills in being able to plan for and to provide care in an environment that is limited by resources and geographically separated from definitive medical care in all types of weather and evacuation situations. The fellow will be supported to obtain the Diploma in Mountain Medicine and other Wilderness Medical education. The fellow will become a leader and national educator in the growing specialty of wilderness medicine. For further information, contact David Della-Giustina, MD, FAWM, david.della-giustina@yale.edu.

The Medical Simulation fellowship is a 1-year program that provides training in all aspects of simulation education, including high fidelity mannequin simulation with computer program training, acquisition of debriefing skills and procedural simulation. The fellow will participate in all educational programs for medical students, residents and faculty at the new Yale Center for Medical Simulation (opened the winter of 2014-15). The fellow will receive training in research methodology through the Research Division of the Department of Emergency Medicine and participate in the medical education fellowship through Yale Medical School. The fellow will attend a one week Comprehensive Instructor Workshop at the Institute for Medical Simulation in Boston. The fellow will also have the opportunity to participate in an international exchange through the Yale-China Association Xiangya School of Medicine. For further information, contact Leigh Evans, MD, leigh.evans@yale.edu.

The Clinical Informatics fellowship is a 2-year program that provides ACGME-approved training in all aspects of clinical informatics. The program is administered through the Yale Department of Emergency Medicine. In the first year, the fellow will rotate between the Yale-New Haven Health and Veterans Affairs. Major blocks will be devoted to electronic health records, clinical decision support, databases and data analysis, and quality and safety. Experiential learning will be combined with didactic classes and conferences. The second year is dedicated to advanced learning and project leadership. The fellow will attend the American Medical Informatics Association annual meeting. The program prepares fellows for Clinical Informatics Board examination. For further information, contact Ted Melnick, MD, MHS, edward.melnick@yale.edu.

The Educational Leadership fellowship is a 1 or 2-year program that provides the training and education to develop academic emergency physicians to have the skills, knowledge and experience to be strong educators and leaders in Emergency Medicine education with the focus on developing leaders in EM residencies or in Undergraduate Medical Education. The fellow will be an Assistant Residency Program Director and an integral member of the education faculty. They will be supported to attend leadership training as well as using other internal resources, CORD and ACEP to further their education. For further information, contact David Della-Giustina, MD, FACEP, FAWM, david.della-giustina@yale.edu.

All require the applicant to be BP/BC emergency physicians and offer an appointment as an Instructor to the faculty of the Department of Emergency Medicine at Yale University School of Medicine. Applications are available at the Yale Emergency Medicine web page http://medicine.yale.edu/emergencymed/ and are due by November 15, 2017 with the exception of the Wilderness Fellowship, which are due by October 15, 2017.

Yale University and Yale-New Haven Hospital are affirmative action, equal opportunity employers and women, persons with disabilities, protected veterans, and members of minority groups are encouraged to apply.

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EMERGENCY MEDICINE FELLOWSHIP OPPORTUNITIES New York Presbyterian-Weill Cornell Emergency Medicine is pleased to offer fellowship opportunities for graduating residents and junior faculty.

The New York Presbyterian-Weill Cornell Emergency Department is an academic, high volume, Level I trauma center, burn center, and stroke center, caring for over 90,000 adult and pediatric patients annually. New York Presbyterian-Lower Manhattan Hospital, is our busy culturally diverse community hospital, caring for over 45,000 patients annually. We recently launched the first innovative virtual ED Telehealth initiative in New York City and plan to expand this program with the full support of New York Presbyterian Hospital and Weill Cornell Medicine.

New York Presbyterian Hospital is a national leader in healthcare. For the 2017-18 period in the US News & World Report Best Hospitals, New York Presbyterian Hospital ranked No. 8 in the nation and No. 1 in the New York Metropolitan area.

Healthcare Leadership and Management Fellowship with Executive MBA/MS: Two year Healthcare Leadership and Management Fellowship, which also includes completion of the combined Executive MBA/MS in Healthcare Leadership program offered through Weill Cornell Medicine and the Cornell University SC Johnson College of Business.

• Two year non ACGME fellowship with PGY level salary • Full tuition for Executive MBA/MS in Healthcare Leadership from the SC Johnson College of Business & Weill Cornell Medicine • Clinical shifts built around MBA/MS program • Ideal candidates are recent Emergency Medicine Residency graduates or Junior Faculty with a proven managerial & leadership track records, who are committed to gaining invaluable leadership experience while earning a graduate-level management degree Please find EMBA/MS program information at: https://gradschool.weill.cornell.edu/programs/exec utive-mba-ms-healthcare-leadership Interested candidates should submit their CVs to: Rahul Sharma, MD, MBA, CPE, FACEP Emergency Physician-in-Chief ras2022@med.cornell.edu Robert Tanouye, MD, MBA - Assistant Fellowship Director - rot9046@med.cornell.edu

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Geriatric Emergency Medicine Fellowship: The Geriatric Emergency Medicine Fellowship at NewYork-Presbyterian Hospital/Weill Cornell Medical Center is accepting applications for the 2018-2019 academic year.

The Geriatric Emergency Medicine (GEM) Fellowship at NewYork-Presbyterian Hospital/Weill Cornell Medical Center is a unique one or two-year, nonACGME GEM Fellowship designed to offer recent Emergency Medicine Residency graduates an opportunity to develop an understanding of the complexities and specific needs of the increasingly large older adult population who require emergency care. The two-year track allows the Fellow to concurrently obtain a Masters in Clinical Investigation and Health Services Research from Cornell University. The Fellow will be working in the ED as an attending on a modified schedule, with commensurate salary, and have a faculty appointment at Weill Cornell Medical College.

Please find both program and application information at: http://www.nypemergency.org/fellowships/geriatric .html?name1=Geriatric+Emergency+Medicine+Fello wship&type1=2Active Michael Stern, MD Chief of Geriatric Emergency Medicine mestern@med.cornell.edu Mary Mulcare, MD - Assistant Director, Geriatric EM mrm9006@med.cornell.edu

PRODUCTS AND SERVICES ACCEPTING ADS FOR OUR NEW "PRODUCTS AND SERVICES" SECTION! Deadline for the next issue of SAEM Pulse is December 1.

For specs and pricing, visit the SAEM Pulse advertising webpage.

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SEE YOU IN

Indianapolis, Indiana – May15-18