Saemsepoct2015final by Society for Academic Emergency Medicine

NEWSLETTER 2340 S. River Road, Suite 208 | Des Plaines, IL 60018 | 847-813-9823 | www.saem.org

SEPTEMBER-OCTOBER 2015

VOLUME XXX NUMBER 5

EM PHYSICIAN IN THE SPOTLIGHT Terry Kowalenko, MD CTSIs: A RESOURCE FOR EM RESEARCHERS Research Committee Aims to Increase Utilization AWAEM AND GEMA Joint Luncheon Explores Work-Life Challenges

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

SAEM Staff Chief Executive Officer Megan N. Schagrin, MBA, CAE, CFRE Ext. 212, mschagrin@saem.org Director of Communication Stacey Roseen Ext. 207, sroseen@saem.org Director of Information Technology James Pearson Ext. 225, jpearson@saem.org Director of Finance & Benefits Doug Ray Ext. 208, dray@saem.org Communications Manager Marilyn Mages, CAE Ext. 202, mmages@saem.org Education Manager LaTanya Morris Ext. 214, lmorris@saem.org

2015-2016 BOARD OF DIRECTORS Deborah B. Diercks, MD, MSc President University of Texas Southwestern at Dallas Andra L. Blomkalns, MD President-Elect University of Texas Southwestern at Dallas D. Mark Courtney, MD Secretary/Treasurer Northwestern University Feinberg School of Medicine Robert S. Hockberger, MD Immediate Past President Harbor-UCLA Medical Center

Executive Assistant to the CEO Monica Orozco White Ext. 206, mwhite@saem.org

Steven B. Bird, MD University of Massachusetts Medical School

Grants & Foundation Manager Melissa McMillian, CNP Ext. 203, mmcmillian@saem.org

Kathleen J. Clem, MD, FACEP Loma Linda University School of Medicine

Marketing & Membership Manager Holly Byrd-Duncan, MBA Ext. 210, hbyrdduncan@saem.org

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

Meeting Planner Maryanne Greketis, CMP Ext. 209, mgreketis@saem.org

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

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

Ian B.K. Martin, MD University of North Carolina School of Medicine

Systems Administrator/Database Analyst Michael Reed Ext. 205, mreed@saem.org

Richard Wolf, MD Beth Israel Deaconess Medical Center/Harvard Medical School

SAEM & Foundation Administrative Assistant Kataryna Christensen Ext. 201, kchristensen@saem.org Education Administrative Assistant Elizabeth Oshinson Ext. 204, eoshinson@saem.org

AEM Staff Editor in Chief David C. Cone, MD david.cone@yale.edu Journal Editor Kathleen Seal kseal@saem.org Journal Manager Stacey Roseen Ext. 207, sroseen@saem.org

Kavita Joshi, MD Resident Member University of Texas Southwestern at Dallas The SAEM Newsletter is published bimonthly by the Society for Academic Emergency Medicine. The opinions expressed in this publication are those of the authors and do not necessarily reflect those of SAEM. For Newsletter archives visit http://www.saem.org/publications/newsletters ÂŠ 2015 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.

Table of Contents

PAGE 8 EM PHYSICIAN IN THE SPOTLIGHT Terry Kowalenko, MD

PAGE 14 2015 ANNUAL MEETING AWARD WINNERS

PAGE 17 CTSIs A RESOURCE FOR EM RESEACHERS

4 5

Presidentâ&#x20AC;&#x2122;s Comments

7 8

Announcements

CEO Message

EM Physician in the Spotlight

10 12

Ethics on Call

14 17

Annual Meeting Award Winners

AWAEM and GEMA Joint Luncheon Explores Work-Life Challenges

CDEM Introduces New Initiatives to Assist Clerkship Directors, Students & Local Communities

AAAEM Builds Partnerships

Choosing the Right EM Program

CTSIs: A Resource for EM Researchers

Time to Reverse the Revolving Door: How Do We Keep Excellent Clinician Educators in Academic Emergency Medicine? Deborah B. Diercks, MD, MSc

Professor and Chair University of Texas Southwestern Medical Center at Dallas I vividly remember leaving my last shift of residency. I walked out of the emergency department and had this realization that, “This is it.” All the education and the long hours of training had worked toward this one point. In a way, it was anticlimactic. I, of course, had some tearful goodbyes and hugs from my colleagues, but there was no big change. The doors to the ED closed, and everything kept working just like it had before I arrived, and just like it would after I departed. Since then, I have welcomed new residents and said goodbye to those finishing their training more times than I care to admit. It is always a pleasure to watch as residents build their fund of knowledge, gain confidence and become great emergency physicians. I have learned something from every resident I have had the pleasure to work with, and some have become lifelong friends. Often, I wonder if there is anything that I could have done during their training to influence their future career paths, to convince them to pursue academic emergency medicine. I understand the lure of a more lucrative career and, perhaps, the lack of enjoyment of research. I also realize that often some of the best clinicians and bedside educators decide not to enter into academic emergency medicine. Over the last decade, the expectations of academic health centers have changed. Many of the centers have placed increased value on clinical care. With this expectation, the financial pressures on academic departments have also shifted. There is an increased expectation to support department staffing and scholarly work through clinical revenue. As a new department chair, I am in the interesting position of creating a faculty group that balances the needs for scholarly productivity within a department that also has substantial clinical needs. Unlike other specialties within an academic institution, emergency physicians genuinely enjoy seeing patients. In addition, our clinicians are excellent bedside educators and essential for training.

September / October 2015

The traditional academic faculty, one composed entirely of researchers and educators, needs to expand to include true clinician educators. The Society for Academic Emergency Medicine recognizes this valuable group and has expanded its offerings at the annual meeting to include topics that are of interest to bedside educators. However, despite this need and recognition, many academic centers struggle to entice clinicians who are essential to bedside education and fundamental to clinical care to stay. Paying a market appropriate salary for the clinical workload is one component of the solution. In addition, significant changes must occur on many institutional levels to develop promotional systems and incentive plans that recognize excellence in clinical care and bedside teaching. I look forward to addressing these challenges facing academic centers and the increasing need for excellent clinician educators. I hope that in the next five years, we see an increase in residents who enthusiastically decide to stay at academic centers and practice emergency medicine. While I have gotten used to saying goodbye to great clinicians as they complete residency, it is my hope that, by imparting a change in our academic institutions and embracing the importance of great clinical education, a few more decide that where they trained is a great place to stay and be a fulfilled clinician.

“It is my hope that, by ... embracing the importance of great clinical education, a few more decide that where they trained is a great place to stay and be a fulfilled clinician.”

Collaboration Sets SAEM Apart Megan Schagrin, MBA, CAE, CFRE SAEM CEO One of SAEM’s most unique distinctions is the way we align our members’ special interests to form academies, committees, and interest groups whose areas of expertise help develop the products and services we offer as an association. We also join together with our consorts in the emergency medicine community — from medical associations to government agencies — to further our combined vision for advancement in academic emergency medicine.

“Our structure of eight academies, 20 committees and 22 interest groups is certainly unique, but it is also what makes us a measurable force within our specialty.” Collaborating from Within The collaboration among these groups and individual experts happens daily. It is the partnership of experience, expertise and desire for better outcomes that makes us all reach a higher level of success. Recently, there have been wonderful examples of collaboration within SAEM. One clear example: the formation of the Sex and Gender in Emergency Medicine (SGEM) Interest Group. The SGEM Interest Group’s mission is to raise consciousness of the impact patients’ sex and gender have in the delivery of emergency care and to assist in the integration of sex and gender concepts into emergency medicine education and research. This expert group will: • Promote sex and gender research collaborations among SAEM members; • Establish a speaker consortium whereby members can be identified as experts for sex and gender differences within a specific subspecialty area; • Present didactics and print articles that assist in educating SAEM members on the importance of patient sex and gender in emergency care; and • Provide mentorship opportunities for students, residents and colleagues in understanding the impact that sex and gender have on the quality of care delivered in an acute-care setting. Our expert members who are coming together on this critical topic are sure to elevate understanding and care.

CDEM & EMRA collaborate on training video for medical students.

Working with Outside Partners We also have seen examples of collaboration between SAEM and outside partners. Recently, SAEM’s Clerkship Directors in Emergency Medicine (CDEM) and the Emergency Medicine Residents’ Association (EMRA) released a brilliant new training video for medical students that demonstrates how to tell a compelling story when presenting a patient’s case. The video offers handy do’s and don’ts that help medical students understand how best to communicate in the emergency department. You can view the video on the SAEM website,http://saem.org/membership/medical-students/ student-resource-collection. Congratulations to all involved with this video. With application, this simple tool is positioned to have a huge positive outcome for our emergency medicine patients and their families. Strengthening Our Voice Collaborations allow opinions to be expressed more powerfully. SAEM recently lent its name to the Friends of AHRQ in a letter that expressed disappointment with the Senate Appropriations Committee, following the passage of a 35-percent reduction in funding for the Agency for Healthcare Research and Quality (AHRQ) in its 2016 fiscal year spending bill. There were 185 organizations that signed on, and, according to the Friends of AHRQ, many organizations will continue to work with senators directly or write their own letters regarding the bill. The Friends of AHRQ encourages organizations to use grassroots and grasstops networks to speak out on the value of AHRQ. To join forces, you can call or write your elected officials, write blog posts and op-eds, tweet #SaveAHRQ, and share your stories. Let Congress Know: • How AHRQ’s resources, tools and datasets enable you to do your work; and • The impact your organization has made as a result of AHRQ.

September / October 2015

Propelling Research Additionally, SAEM is teaming up with our individual members and their academic institutions to demonstrate how our newly focused strategic plan can develop collaborations to propel research. The SAEM Board of Directors just agreed to guidelines that will allow SAEM to participate in grant projects as a subcontractor or subgrantee. SAEM’s distribution channels for grant outcomes make us an ideal partner on research grants. The SAEM Board of Directors will review each request for collaboration to determine whether SAEM should accept the subcontractor or subgrantee assignment. Criteria, among others, include alignment with our core purpose to improve patient care by leading the advancement of academic emergency medicine; determination of any perceived or actual conflicts of interest with the principal investigator or the primary organization and SAEM; and alignment with SAEM’s current ethical standards and codes of conduct. The overarching goal of this new program is increasing external funding for important emergency medicine research. While these are just a sampling of recent projects, it is clear that as an organization we believe in the power of collaboration. Our structure of eight academies, 20 committees and 22 interest groups is certainly unique, but it is also what makes us a measurable force in our specialty. Megan can be reached at mschagrin@saem.org.

Academic-Affiliated Community Physician Medical Toxicologist

Exceptional opportunities in Syracuse, NY for EM trained physicians interested in either a community-based clinical career in an academic department or in Medical Toxicology. The department operates emergency services at nearby community hospitals as well as attending supervision in University Hospital adult and pediatric departments, and the Syracuse Veterans Administration hospital ED. Our toxicologists do consultations to inpatient services and staffing of Medical Toxicology Clinic. Upstate University Hospitals include a Level 1 Trauma Exceptional opportunities in Syracuse, NY for EM trained physicians Center, Burn Center and Children’s hospital. Our department includes coordination of regional emergency interested in either a community-based clinicalMedicine careerandinWound an academic services, EM Residency Program, Poison Control Center, Hyperbaric Care Center; Fellowships indepartment Pediatric EM, EMS, Hyperbaric Medicine, The and Medical Toxicology;operates Simulation Training/Research orWilderness, in Medical Toxicology. department emergency Center; Paramedic Training Program; EMS Physician Response Program. supervision EM offers an excellent services at nearby community hospitals asTeam wellandasFlight attending compensation and benefit package, including relocation expenses or a bonus for signing. Protected time is in University Hospital adult and pediatric departments, and the Syracuse available for research and academic missions. Qualified candidates should contact:

Academic-Affiliated Community Physician Medical Toxicologist

Veterans Administration hospital ED. Our toxicologists do consultations Gary Johnson, MD, Chair, Department of Emergency Medicine to inpatient services and staffing of Medical Toxicology Clinic. Upstate Upstate Medical University University Hospitals include a Level 1 Trauma Center, Burn Center and 750 E. Adams Street, Syracuse, NY 13210 Children’s hospital. OurOffice: department includes coordination of regional 315-464-9500 or Fax: 315-464-9501 Email: johnsong@upstate.edu site: http://upstate.edu/emergency emergency services, EM ResidencyWeb Program, Poison Control Center, Medical University is an affirmative action/equal opportunity employer Hyperbaric Upstate Medicine and Wound Care Center; Fellowships in Pediatric EM, EMS, Wilderness, Hyperbaric Medicine, and Medical Toxicology; Simulation Training/Research Center; Paramedic Training Program; EMS Physician Response Team and Flight Program. EM offers an excellent compensation and benefit package, including relocation expenses or a bonus for signing. Protected time is available for research and academic missions.

Qualified candidates should contact: Gary Johnson, MD, Chair, Department of Emergency Medicine Upstate Medical University 750 E. Adams Street, Syracuse, NY 13210 Office: 315-464-9500 or Fax: 315-464-9501 Email: johnsong@upstate.edu Web site: http://upstate.edu/emergency Upstate Medical University is an affirmative action/equal opportunity employer

2015 Midwest Regional SAEM Meeting Hosted by Mercy St. Vincent Medical Center EM Residency Toledo, OH Abstracts will open August 3 through August 28, 2015 via http://www.saem.org website Schedule: September 24, 2015

Mercy College of Ohio 2221 Madison Toledo, OH

6-7 pm Dinner, “Meet Your Colleagues” 7-9 pm Advanced Airway & Ultrasond Skills

September 25, 2015

The Toledo Club 235 14th Street Toledo, OH

9 am-4 pm

Invited Speakers: D. Mark Courtney, MD, Northwestern University Feinberg School of Medicine “Mentorship: Trends, Tools and Techniques for Both Mentors and Learners” Richard Schwartz, MD, Georgia Regents University “Medical Devices Development – Concept to Commercialization”

Lunch program:

Medical Student – Residency Mixer: Midwest EM Residency Programs

More information, contact: Michael C. Plewa, MD

michael_plewa@mercy.com

September / October 2015

419-251-4204

ANNOUNCEMENTS Timothy J. Mader, MD, clinical professor of emergency medicine at Baystate Medical Center/Tufts University School of Medicine in Springfield, MA, received an NHLBI R21 grant award (1R21HL128230-01) to analyze data from the Cardiac Arrest Registry to Enhance Survival (CARES) and to assess the effectiveness of targeted temperature management on survival and neuroprotection in geriatric out-of-hospital survivors. Dr. Mader was the recipient of the 2005-2006 SAEM Scholarly Sabbatical Award. Carl H. Schultz, MD, professor of emergency medicine and director of research for the Center for Disaster Medical Sciences at the University of California, Irvine School of Medicine, has been selected to receive the American College of Emergency Physicians (ACEP) Disaster Medical Sciences Award at the ACEP15 Scientific Assembly in October 2015 in Boston, MA. He co-edits the reference text Koenig and Schultz’s Disaster Medicine: Comprehensive Principles and Practice, directs the Disaster Medicine Fellowship at UC Irvine, has an appointment as a visiting professor at universities in Belgium and Italy, and has written numerous articles in the field of disaster medicine, including two first-author publications in the New England Journal of Medicine.

Academic Emergency Medicine is going green! Effective 2017, Academic Emergency Medicine will transition to an online-only publication. Robust online tools are currently available for electronic viewing of the journal through the AEM Journal app (available for free in the Apple App Store and coming soon for Android) and through the PDF and enhanced HTML versions available at www.aemj.org. Content alerts, RSS feeds, Twitter and other productivity tools are also available for readers and will continue to develop as the journal moves forward. All other aspects of the journal, including the manuscript submission, review, editing and typesetting processes, will remain the same; the only change will be the elimination of the print journal.

electronic

posters

are

improved

for

2016

SAEM transitioned in 2015 from physical to electronic posters. Although innovative, the first year was not without its challenges. SAEM is renovating the process entirely, based on feedback from attendees as well as presenters for this year in New Orleans. • The number of ePosters being presented have been scaled back this year, focusing on quality over quantity. • Presenters can count on a more intimate ePoster experience with a completely new and improved physical layout, designed specifically to allow for: • More time to present valuable research to attendees • More session rooms with fewer ePoster screens per room • More networking opportunities with both session moderators and audience members who will have time to stroll between posters

A SNEAK PEEK AT THE OCTOBER ISSUE OF ACADEMIC EMERGENCY MEDICINE The October issue of Academic Emergency Medicine (AEM) will be available online as of October 8. Log into www.saem.org to access the journal’s content. Listed below are just a few of the articles that will be included in this issue. • “Findings from 12-lead electrocardiography that predict circulatory shock from pulmonary embolism: Systematic review and meta-analysis” • “The association between ED crowding and the disposition of patients with transient ischemic attack or minor stroke” • “Are mortality and acute morbidity in patients presenting with nonspecific complaints predictable using routine variables?” • “Variation and trends in charges for pediatric care in Massachusetts EDs, 2000-2011” • “The Role of Necroptosis in Burn Injury Progression in a Rat Comb Burn Model” • “Short-term efficacy of a brief intervention to reduce drug misuse and increase drug treatment utilization among adult ED patients” • “The role of Necroptosis in burn injury progression in Rat Comb Burn Model” • “Examination of Learning Trajectories for Simulated Lumbar Puncture Training Using Hand Motion Analysis” • “Ethical Decision-making in the ED”

The Annual Meeting Program Committee is confident that the ePoster scientific presentations at the 2016 SAEM Annual Meeting in New Orleans will be the best ever

September / October 2015

SAEM MEMBER SPOTLIGHT Finding the way to the American Dream An Interview with Terry Kowalenko, MD

The son of Ukrainian immigrants, Terry Kowalenko, MD, was the first in his immediate family to attend college. While completing medical school, Kowalenko found he was unable to rely on his parents for advice, and he did not know a physician who could help him make career decisions. This challenge, however, seemed to have not slowed him down. In fact, Kowalenko does more in one day than some people manage in two. During his first set of rotations at the University of Chicago Pritzker School of Medicine, he enjoyed each new experience. “I wanted to specialize in every rotation because I loved them all,” he says. “That is, until I started in emergency medicine. I realized within the first few days that this specialty had everything I wanted.” On one of his first days on the EM rotation, a critical patient was brought in for care. “Even though she passed away, I was impressed with how the entire team worked to try to save her life,” he says. “I was able to listen as the EM resident spoke with the family and explained what happened. It was this experience that changed everything for me.” “My first EM experience was exhilarating and rewarding,” he says. Because of it Kowalenko, who had been considering a surgical residency, changed the direction of his medical career. He was accepted in an emergency medicine residency program at the University of Cincinnati Medical Center.

September / October 2015

Emergency Medicine: The Right Choice “Emergency medicine has changed more than any other specialty in the last 25 years,” he says. “We have to efficiently and accurately make the determination of how sick the patient is, order the right diagnostics, and initiate treatment. We have become the masters of resuscitation and diagnosis.” In the beginning, procedures were his favorite part of patient care. Now, diagnosis has taken over. “I like the intellectual challenge, “ he says.

“You have to find rewards in what you do everyday. Being part of emergency medicine may not give you a lot of accolades, but it does give you a chance to change people’s lives. ”

EM Practice Now In the last few years, Kowalenko has taken on a lot of responsibility in the Beaumont Health System of metropolitan Detroit. He is currently professor and health system chairman of emergency medicine at Oakland University, William Beaumont School of Medicine. He is also the chair of the Beaumont Medical Group and senior vice president of Beaumont Health. Outside of his specific hospital duties, he serves as the chair for the Society of Academic Emergency Medicine’s (SAEM) Consultative Services Committee. He has served on the SAEM Nominating Committee, is a member of the Global Emergency Medicine Academy, and participates with the Public Health Interest Group. He is the secretary/treasurer for the American Board of Emergency Medicine (ABEM) and will serve as its president in three years. Additionally, he is a member of the American College of Emergency Physicians (ACEP). He is the ABEM liaison and member of the ACEP Quality and Performance Committee and the Quality Measures Technical Expert Panel. He serves on the Federal Government Affairs Committee and is one the Board of Directors of the National Emergency Medicine Political Action Committee. Work-Life Balance When asked about work-life balance, he says that it takes time management and the need to prioritize what’s truly important. “Work-life balance is hard. It’s like a balloon. There is a finite amount of air in it. If you squeeze one end the other end expands. Be careful not to squeeze too hard, or it will explode.” Kowalenko says that because work-life is so busy, he makes sure the priority is to include family on business trips whenever he can. During the 2015 SAEM Annual Meeting, Kowalenko’s wife joined him in San Diego for the weekend. When his children were small, they would also join him on these trips. While he was not always able to attend his children’s soccer games, these special trips made a difference. “You have to take advantage of every opportunity to be with your family. Whether out of town or staying local, it’s about spending time together. It keeps you connected,” he says. That’s why he is close with his family. He and his wife will be married 25 years and continually take time for each other at the conclusion of their respective business trips. He has a 21-year-old daughter, who will be graduating for the University of Michigan in the spring of 2016. His 19-year-old son, a sophomore at Siena Heights University, is on a golf scholarship. Kowalenko also finds time for his own interests. He

participates in martial arts, something he has done since the age of 10. He is a black belt and has tried cage fighting, but decided he did not want to be a human punching bag. He also enjoys hunting, fishing and working out regularly. The Right Medicine “My brother is an emergency medicine physician in a clinical setting. He sees my job as crazy, but I see it as a career. Working solely in a clinical setting would not be satisfying for me,” he says. Kowalenko remembers being strongly influenced by his Ukrainian dance teacher, who was a head nurse in the operating room. “I was only 5 years old, and I knew I wanted to be a doctor.” To this day, Kowalenko loves the academic and clinical components of his job. Kowalenko has found a way to avoid burnout. He tells those going into emergency medicine that they have to love what they do because it’s not an easy specialty, especially as one gets older. “You have to find rewards in what you do everyday. Being part of emergency medicine may not give you a lot of accolades, but it does give you a chance to change people’s lives. You don’t go to work looking for external praise or appreciation. You do it because you have a passion for it.” Dr. Kowalenko can be reached at terry.kowalenko@beaumont.edu.

BRIGHAM AND WOMEN'S HOSPITAL/ BRIGHAM AND WOMEN’S FAULKNER HOSPITAL EMERGENCY MEDICINE ATTENDING PHYSICIANS

Brigham and Women’s Faulkner Hospital (BWFH) is currently seeking emergency medicine attending physicians for our emergency department, a 150bed, non-profit community teaching hospital located in the desirable Jamaica Plain community in southwest Boston. This position is eligible for an academic appointment at Harvard Medical School at a rank of Instructor or Assistant Professor, commensurate with experience, achievement, recognition, and planned participation in teaching and scholarly activities. The position also offers unparalleled opportunities for professional development, a competitive salary, and an outstanding comprehensive benefit package. The successful candidate must have successfully completed a four year residency training program in Emergency Medicine or a three year program followed by a fellowship, and also be board prepared or certified in Emergency Medicine. Interest and demonstrated ability in the practice of community based Emergency Medicine is essential. Interested candidates should send a letter and Curriculum Vitae to Michael VanRooyen, MD, MPH, Professor and Interim Chair, Department of Emergency Medicine, Brigham and Women’s Hospital. Please apply by confidential email to mdeloge@partners.org. Brigham and Women’s Hospital/Harvard Medical School are Equal Opportunity/Affirmative Action Employers actively committed to increasing the diversity of our faculty; people with disabilities, veterans, women and members of underrepresented minority groups are therefore strongly encouraged to apply.

September / October 2015 TEXT

ETHICS ON CALL Dopesick Decision-making By Mark John Neavyn, MD

The nurse approached with that exasperated “I-got-thispatient” kind of look. He described a patient who was picked up by EMS for unresponsiveness, was bradypneic with miotic pupils, and awoke with disdain after receiving 2 mg of naloxone intravenously. The patient, Ms. H, was brought in despite her wishes to avoid the ED. She refused to share with nursing or EMS what was taken and how much. The nurse asked for a restraint order because the patient is high, but I get the sense that the nurse would like nothing more than to look the other way while the patient absconds to the opium den whence she came. Evaluation of Autonomy The principle of respect for patient autonomy allows patients to refuse lifesaving therapy in the emergency department. The major concern for Ms. H is the likelihood of renewed opioid toxicity as naloxone occupation of the mu receptors begins to fade. Before we can allow a patient to refuse care, we must be certain the patient has the capacity to make medical decisions. Assessing capacity includes: 1.) determination of whether the patient can communicate a choice; 2.) judgment of the patient’s ability to understand the explanation of the medical condition and the proposed treatment and alternatives; 3.) measurement of the patient’s appreciation of the medical condition and what the outcome will likely be with or without the treatment; and 4.) determination of the presence of reason

September / October 2015

and rationality in the patient’s decision-making process. This last component of decisional capacity is arguably the most vulnerable to physician interpretation and is at the crux of the dilemma with Ms. H. Certain withdrawal states can cause delirium such that reason and rationality is lost. The most common drug withdrawals in this category include sedative-hypnotics, alcohol, and dopamine agonists such as amantadine and bromocriptine. Opioid withdrawal in an otherwise healthy adult is uncomfortable, but does not affect a patient’s sensorium in the same way. The craving for opioid, however, can be overwhelming. Add to that craving a severe physical illness and a patient’s motivation to avoid further discomfort can compete with reason and rationality. Naloxone-induced opioid withdrawal is messy in both a gastrointestinal and bioethical sense. The suggested initial dosing of naloxone in opioid-dependent patients is 0.04 mg IV bolus titrated to respiratory rate greater than 10. Often, opioiddependent patients are given excessive amounts of naloxone, inducing acute opioid withdrawal syndrome. Naloxone is administered emergently in the setting of severe bradypnea. Consequently, we justify adverse effects by avoiding respiratory failure. However, this cavalier attitude toward excessive doses of naloxone can be harmful, particularly in the setting of multidrug ingestions because the patient remains somnolent while experiencing opioid withdrawal symptoms. This is a recipe for aspiration and a complicated airway.

If we exclude multidrug ingestions and focus solely on opioid overdose, we are still left with a major complication from judicious naloxone use: How do we determine decisional capacity if the patient is in pain and actively vomiting? The patient is motivated to seek relief from those symptoms outside of the emergency department. By actively causing pain and discomfort, regardless of the motivation to do so, we have placed the patient in a vulnerable position and have threatened the patient’s autonomy. The patient is forced to decide between the ongoing noxious symptoms caused by the healthcare provider or leaving against medical advice and seeking relief elsewhere. Handling Refusal of Care Refusal of care in the emergency department is a common occurrence. As emergency medicine physicians, our medical decision-making is often hurried and filled with distraction. A heuristic approach to these medical decisions can improve our response times and decrease our vulnerability to mental distraction. Unfortunately, our assessment of decisional capacity in the setting of intoxication and withdrawal cannot be neatly illustrated in an algorithm. When assessing a patient’s decisional capacity, we must take into account the medical question we are asking the patient. Is the patient being asked to consent for emergent surgery for a life-threatening condition, or is the patient being consented for simple, uncomplicated laceration repair? A patient can lack capacity in critically important decisions, but maintain capacity to weigh in on lesser questions. Capacity is not binary. This is an important distinction in the setting of intoxication and withdrawal states, which are also moving targets as a patient’s level of intoxication invariably declines over time. Given enough time, intoxication transforms into a withdrawal state in the drug-dependent patient. Between these two vulnerable periods lies a window of capacity in which the patient is able to rationally illustrate the decision regarding a specific medical intervention.

In addition, her decision to choose treatment of withdrawal over treatment of potential overdose recurrence could be a potentially rational one, depending on whether she had been using a long-acting opioid. The determination of decisional capacity for Ms. H. was tenuous and required supporting evidence. This case illustrates not only the difficulty of determining capacity in opioid-dependent patients but also what is at stake in the determination. During my discussion, the patient developed increasing anxiety and tachypnea, but she was distinctly lacking other more obvious symptoms of withdrawal. I put her back on the pulse oximeter; her oxygenation was 90 percent. After a quick auscultation of her chest, I realized the patient had developed noncardiogenic pulmonary edema. If this patient had managed to leave the emergency department prior to developing this known complication of opioid toxicity, she almost certainly would have died. Conversely, if the patient had been restrained because she “lacked capacity,” she would have become increasingly agitated as the drowning sensation of noncardiogenic pulmonary edema set in, which may have led to a disastrous outcome. In the end, a tincture of time allowed us to monitor and treat this patient appropriately. It is vitally important that we consider the patient’s autonomy before administering an excess of naloxone. By using heroic doses of naloxone instead of small easily titrated boluses, not only do we create a potentially complicated airway but also risk stripping the patient of autonomy.

“I put her back on the pulse oximeter; her oxygenation was 90 percent. After a quick auscultation of her chest, I realized the patient had developed noncardiogenic pulmonary edema.”

Ethical Judgment My major concern for Ms. H was the risk of renewed opioid toxicity. I had to be sure the patient was firmly within the window of capacity before she was allowed to leave against medical advice. I sat and spoke with the patient and let her know I understood the discomfort she was experiencing and that, while she was under my care, I would make sure she was more comfortable. The patient lacked concern for ongoing opioid toxicity; she did not believe that her life was in danger. The patient expressed several times that she wanted her withdrawal symptoms to be resolved. Using the components of decisional capacity described earlier, I was concerned that she did not appreciate the severity of her medical condition and the consequences of refusing treatment. Unfortunately, since she was not forthcoming with her ingested drug, it may have been possible she had more information regarding her current medical condition than I did. Without knowing precisely what she ingested, I could not fully determine the chance of recurring opioid toxicity.

About the Author:

Dr. Mark Neavyn is an emergency physician and medical toxicologist. He is the director of medical toxicology and attending emergency medicine physician at Hartford Hospital in Hartford, Connecticut and is a member of that hospital’s ethics committee in addition to the SAEM ethics committee. Dr. Neavyn has particular interest in the ethical treatment of intoxicated patients, in both recreational use and intentional self-harm, when fundamental principles of autonomy, beneficence, nonmaleficence, and/or justice are in question.

September / October 2015

BUILD CONFIDENCE IN YOUR EM PROGRAM Choosing the Right EM Program By Adam Kellogg, MD

Many emergency physicians have strong opinions as to which length of training is better: 3 years or 4 years. This often directly correlates with the duration of training they themselves completed. However, some graduates of threeyear programs feel that a longer program is better, just as some four-year graduates wish they had been done in three. These arguments are frequently built around the financial implications, the quality of the training and the impact on career options. There are advantages and disadvantages to both formats. However, which is the overall “better” option may be the wrong question to ask. What matters more is the best fit for the individual applicant. The “$200K” Mistake Viewing a fourth year of training as a $200,000 mistake is a common perception among those who trained at a three-year program, or those who regret doing a four-year program because the extra year cost them a significant amount of attending income. The financial argument against four years of training is hard to dispel if your primary driver is monetary. If making as much money as you possibly can as quickly as you can is highly important to you, then you are probably not agonizing over this decision. Targeting an intense clinical education at a three-year program is likely to leave you satisfied with your training experience.

September / October 2015

Conversely, if you are considering an academic career, you will be giving up far more of your total earning potential than will be lost in one extra year of training (academic emergency physicians are usually paid less than their peers in community practice). There is a similar reduced financial impact of an extra year of training if you choose to work in a highly competitive market where emergency physicians are paid less. More Is Always Better Four years can be considered better training simply by virtue of being longer. However, competency is achieved at variable times. Some residents are already competent after two years of training while others may need more than four. In general, having a fourth year of directly supervised practice gives you a greater chance of achieving competency, or even proficiency, while supervised. However, as a clinician, you may not find yourself confident in your skills and practice patterns until your fifth or sixth year in emergency medicine, but by then you will be an attending on either pathway. A different way to think about this would be to consider your confidence as a clinician, more than your actual competence. Having more supervision during the first few formative years should appeal to those who have concerns about when they will achieve competency and proficiency.

The Pathway to Academics Historically, four years of training was considered an advantageous path to an academic job, particularly as a four-year program is unlikely to hire the graduate of a threeyear program to supervise its senior residents, who are the same postgraduate level. This advantage has diminished over time as post-residency fellowship training has become more common. If you are considering an academic career, several advantages to an additional year of training do stand out. You have more time during your training to figure out the direction of your career. I am the associate program director at a three-year residency, and I see my brand-new third years having to make career-altering decisions that would be easier to make a year later. You also have more time during training to explore and develop areas of interest, to get involved in research, and to actually complete projects. You will often be better prepared as a teacher when your senior year of training includes supervising junior residents, which is much more common at four-year programs. This pre-attending supervisory experience can both develop your teaching skills and allow you to make a more informed decision about pursuing an academic career. Fellowship training is now commonly seen as the best path to an academic position. Many graduates of four-year residencies are opting to complete a fellowship to gain the additional expertise and to cultivate a specific niche within emergency medicine. The shift toward fellowship training has made completion of a three-year residency a much more viable path to an academic career, particularly if, as a student, you already know your career destination and which fellowship will get you there. The extra time in training is only as valuable as what you actually accomplish. Doing more training or getting a certificate or additional certification is not the same as being productive in that time. Avoid approaching the fellowship decision as though completing one, regardless of effort invested, will get you the job that you want. Similarly, it is entirely possible that in a three-year residency you can accomplish the things that will make you an impressive candidate for an academic position. However, you will need to be particularly driven and focused to make that happen. The Verdict Ultimately, this discussion is not about which option is better because that answer does not exist. What matters is which program is the right fit for what you need from your training. That fit may relate to the length of the training program, the composition of the curriculum or the mentorship that you will receive there. The best program for you is going to be the one that best fits your personality, your learning style and your needs and future goals, regardless of how many years that program lasts. If you make your choice for these reasons, you will be satisfied with your training regardless of its length.

The Resident and Student Advisory Committee works to meet the needs of SAEM members who are residents and medical students. It collaborates to improve the recruitment and retention of resident and student members. Go to www.saem.org under Committees for more information.

About the Author:

Adam Kellogg is an Associate Residency Director at Baystate Medical Center and an Assistant Professor of Emergency Medicine at Tufts University School of Medicine. He is a long-standing member of the SAEM Resident and Student Advisory Committee and the current chair of the CORD Student Advising Task Force.

Department of Emergency Medicine The Department of Emergency Medicine at Advocate Christ Medical Center is expanding and seeks outstanding physicians to join our faculty. Our institution is a tertiary care center with emphasis on advanced cardiac and stroke care, and is the only Level I Trauma Center serving the south side of Chicago. Our high acuity emergency department cares for more than 100,000 patients annually, including 34,000 pediatric visits to our dedicated pediatric emergency department. Advocate is committed to growth. Along with a new outpatient pavilion that opened in 2014, an additional inpatient tower will be completed in 2016, and construction of a new 84 bed emergency department will begin in early 2015. Applicants must be board eligible or board certified in Emergency medicine or Pediatric Emergency Medicine, and dedicated to education and clinical excellence. Additional interests in research, ultrasound, simulation and administration are highly valued. Our three-year emergency medicine program matches 12 residents annually, and fosters a friendly environment of camaraderie, support, and service. Many faculty members and residents live in downtown Chicago and enjoy all that this world-class city has to offer. Compensation and benefits are highly competitive. Academic appointments are available for qualified applicants through the University of Illinois. Advocate Christ Medical Center was ranked one of Truvenâ&#x20AC;&#x2122;s â&#x20AC;&#x153;100 top hospitalsâ&#x20AC;? in 2014, one of only 15 major teaching and academic centers so designated nationally. Interested applicants should electronically submit a letter of interest along with their curriculum vitae to: Brian.Sayger@Advocatehealth.com Advocate is an Equal Opportunity/Affirmative Action Employer.

September / October 2015

ANNUAL MEETING AWARD WINNERS SAEM presents awards in recognition of excellence in our field, contributions improving the health of society, and academic achievements. All applications are submitted electronically and specific guidelines for each award are listed at www.saem.org/about-saem/saem-awards. Nominees are selected by the Awards Committee, and winners are based on guidelines shown for each award. Watch the website for application information for the 2016 awards beginning on October 1, 2015. 2015 ADVANCEMENT OF WOMEN IN ACADEMIC EMERGENCY MEDICINE AWARD Gloria Kuhn, DO, PhD, Professor and Vice Chair Academic Affairs, Department of Emergency Medicine, Wayne State University School of Medicine Gloria Kuhn, DO, PhD, is an established expert in medical education, publishing original peer-reviewed manuscripts and lecturing nationally on resident assessment, faculty development, creation of an educator’s portfolio, professionalism, bedside teaching, and management of resident stress and burnout. She has served as chair of the SAEM Subcommittee for Educational Research and the SAEM Uniting Education and Research Task Force; chair of the Subcommittee on Development of Assessment Tools for the ACGME Milestones; chair of the Council on Emergency Medicine Residency Directors (CORD) Educational Planning Committee and Efficacy of Training Committee; a member of the CORD Board of Directors; and the co-director of the CORD-sponsored course, “Navigating the Academic Waters.” She has been honored with the American College of Emergency Physicians (ACEP) Award for Outstanding Contribution in Education (2006), the CORD Impact Award (2007) and the CORD Distinguished Educator Award (2014). Dr. Kuhn is well-known for her commitment to advancing women’s careers, working over the past 15 years to support women in academic emergency medicine. She chaired the SAEM Task Force on Women in Academic Emergency Medicine and helped create the Academy for Women in Academic Emergency Medicine (AWAEM). She served as president of AWAEM and as chair of its Nomination Committee. She continues to serve on the AWAEM Senior Task Force. She has been a prominent supporter of women in medicine at Wayne State University, where she won the Women in Medicine and Science Leadership Award.

2015 HAL JAYNE EXCELLENCE IN EDUCATION AWARD James A. Gordon, MD, MPA, Director, Massachusetts General Hospital (MGH) Learning Laboratory, and Chief, Division of Medical Simulation, Department of Emergency Medicine, MGH; Professor of Emergency Medicine, Harvard Medical School James Gordon, MD, MPA, was one of the first emergency medicine residency graduates to be awarded a fellowship in the Robert Wood Johnson Clinical Scholars Program at the University of Michigan Medical Center. This fellowship identified him as one of a new generation of young scholars in the field of emergency medicine. Dr. Gordon took an early leadership role in the emerging field of simulationbased medical education. For this work, he received the SAEM Young Investigator Award in 2002. After founding the medical simulation program at Harvard Medical School, Dr. Gordon chaired SAEM’s national specialty efforts in medical simulation. This initiative, capped by the first federally-funded research consensus conference, positioned academic emergency medicine as a national leader in this new area of medical education and scholarship.

September / October 2015

In addition to his SAEM work, Dr. Gordon represented emergency medicine as a founding board member of the International Society for Simulation in Healthcare, and co-founded the Institute for Medical Simulation. The Institute, based at the Center for Medical Simulation in Boston, has trained more than 2,000 faculty worldwide. Dr. Gordon also founded the Division of Medical Simulation in the Department of Emergency Medicine at Massachusetts General Hospital, along with one of the first simulation/education fellowship programs in the country.

2015 EXCELLENCE IN RESEARCH AWARD Clifton W. Callaway, MD, PhD, Professor and Vice Chair of Emergency Medicine, Department of Emergency Medicine, University of Pittsburgh School of Medicine Clifton Callaway, MD, PhD, has served as a faculty physician in the Department of Emergency Medicine at the University of Pittsburgh School of Medicine since 1996. As executive vice chair for the Department of Emergency Medicine, he is responsible for investigative efforts and works to effectively deploy resources to successfully implement training programs and collaborative research. He has had a long career in investigating the neurosciences. Dr. Callaway is a key thought leader who helped restart the field of cardiac arrest research, developing not only new ideas but also translating those to improved patient outcomes. Over the last decade, his research has focused on the study of brain injury after global ischemia, particularly cardiac arrest and resuscitation. In the past six years, Dr. Callaway has developed a clinical platform for research in cardiac arrest patients through a consultation service that sees more than 90 percent of the patients who survive CPR at the hospital. He and his team have enrolled more than 50 percent of these patients in observational or minimal risk studies. Dr. Callaway is a key member of the Resuscitation Outcome Consortium, funded by the National Heart, Lung and Blood Institute; he holds leadership roles not only in that organization but also in many other multi-site trials. His work involves both bench and clinical research. Therapeutic hypothermia, drug and electrical therapy for arrest, monitoring neurologic function after restoration of pulses, and improving lay and first responder care during collapse are better integrated and delivered due to his efforts.

2015 YOUNG INVESTIGATOR AWARD

William Meurer, MD, MS, Assistant Professor, Departments of Emergency Medicine and Neurology, University of Michigan Health System

Ziad Obermeyer, MD, M.Phil, Assistant Professor, Departments of Emergency Medicine and Health Care Policy, Harvard Medical School

William Meurer, MD, MS, is the emergency medical director of the University of Michigan Health System Comprehensive Stroke Center. He is a core faculty member for the University of Michigan/St. Joseph Mercy Residency. His clinical and research focus is on the early care of patients with acute neurological emergencies. In addition, he is a principal investigator of the National Institute of Neurological Disorders and Stroke Clinical Trials Methodology Course and a co-investigator in the Clinical Coordinating Center of the Neurological Emergencies Treatment Trials (NETT) Network. His work in the field focuses on the design of clinical trials with adaptive and flexible components. Dr. Meurer works to improve the care of patients with acute neurological disease both through his work on the acute stroke team and as a researcher. He has authored more than 80 original publications, including 65 original scientific papers. In 2012, he received the SAEM Best Junior Faculty Presentation Award. In 2014, he received the Sylvan Green Award at the annual meeting of the Society for Clinical Trials. The award recognized his abstract “Attitudes and Opinions Regarding Confirmatory Adaptive Clinical Trials: A Mixed Methods Analysis from the ADAPT-IT Project.”

2015 JOHN MARX LEADERSHIP AWARD Brian J. Zink, MD, Frances Weeden GibsonEdward A. Iannuccilli Professor and Chair, Department of Emergency Medicine, Alpert Medical School, Brown University; Physician-in-Chief, Emergency Medicine at Rhode Island, Newport, The Miriam and Hasbro Children’s Hospitals Brian Zink, MD, has received numerous awards throughout his career, including the Emergency Medicine Foundation Career Development Award in 1991, the Golden Apple Award for Outstanding Faculty Contribution to Resident Education in 1994, and an Excellence in Teaching Award in 1995. Dr. Zink was recognized on a national level with the SAEM Hal Jayne Excellence in Academic Award in 2007 and the American College of Emergency Physicians (ACEP) Outstanding Contribution in Education Award in 2008. In 2010, Dr. Zink received the Dean’s Award for the Advancement of Women Faculty from the Alpert Medical School at Brown University. At the Alpert Medical School, Dr. Zink has furthered the growth of the Department of Emergency Medicine, transforming the department of 62 physicians to the present-day thriving department of more than 105 full-time physicians. Dr. Zink has made faculty development a priority, creating numerous programs to reach this goal. He also serves on numerous committees within the Alpert Medical School and the Lifespan Healthcare System, including the Lifespan Board of Directors. Dr. Zink served on the SAEM Board of Directors and was SAEM president in 2000-2001. He is a past president of the Association of Academic Chairs of Emergency Medicine (AACEM) and is the director of the AACEM Chair Development Program. His scholarly interests include the history of emergency medicine, alcohol effects in trauma, brain injury, and medical student career development. He is the author of Anyone, Anything, Anytime – A History of Emergency Medicine. He served as a historian on the Emergency Medicine Residents Association (EMRA) Legacy Initiative documentary “24/7/365: The Evolution of Emergency Medicine,” which was released in October 2013.

Ziad Obermeyer, MD, M.Phil, is an assistant professor of emergency medicine and health care policy at Harvard Medical School and is an active emergency medicine physician at Brigham and Women’s Hospital in Boston. His research combines insights from clinical medicine with methods from biostatistics, computer science and econometrics to translate large observational datasets into meaningful inferences at patient and provider levels. While still in medical school and residency, Dr. Obermeyer produced four major papers on global health that have each been cited at least 50 times. He was recruited as an associate physician in the Department of Emergency Medicine at Brigham and Women’s Hospital. Upon being hired, he became the first faculty member in the history of that department to receive a Harvard Medical School appointment at the level of assistant professor directly out of a residency program. Dr. Obermeyer has been highly successful in obtaining national funding for his research endeavors. He was the first practicing clinician to win the NIH Director’s Early Independence Award, a $1.6 million award for exceptional junior faculty who have established an independent research program without having participated in a fellowship training program. He has led analyses of global household surveys, U.S. national Medicare claims and clinical electronic health records, which have resulted in first-author publications in the Journal of the American Medical Association, The BMJ and PLOS Medicine, as well as media coverage in the New York Times, Nature, Science, The Wall Street Journal and other publications.

2015 YOUNG INVESTIGATOR AWARD Megan L. Ranney, MD, MPH, FACEP, Assistant Professor, Department of Emergency Medicine, Rhode Island Hospital/ Alpert Medical School, Brown University Megan Ranney, MD, MPH, FACEP, an assistant professor in the Department of Emergency Medicine at the Rhode Island Hospital/Alpert Medical School at Brown University, is the founder and director of the Brown Emergency Digital Health Innovation (EDHI) Program. This program focuses on research involving the use of technology to improve healthcare delivery. She also serves as an assistant professor in the Department of Health Services, Policy, and Practice at the Brown School of Public Health. Dr. Ranney’s primary research interests include developing and testing digital health interventions for high-risk emergency department patients. In 2013, Dr. Ranney received a K23 Mentored Career Development Award from the National Institute of Mental Health (NIMH). As principal investigator, she is developing a text-message-based depression intervention for adolescents with a history of peer violence. She also serves as a coinvestigator on an NIMH-funded R34 and a PCORI grant. Dr. Ranney is a sought-after research mentor for undergraduate, medical and public health students, residents, and junior faculty, both at Brown University and beyond. In 2010, she received the Dean’s Excellence in Teaching Award for her outstanding research mentorship. In 2014, Dr. Ranney received the Faculty Research Award from the Department of Emergency Medicine at the Alpert Medical School. Due to her work with EDHI, she received the 2014 Rhode Island Bioscience Award, which recognizes scientists, researchers, thinkers and culture changers who challenge the status quo.

September / October 2015

ABEM NEWS Table 1. Five Most Frequently Attested QI Activities Rank Activity

Attestations

Cumulative Percent

Acute myocardial infarction: percutaneous coronary intervention (PCI) within 90 minutes of arrival (includes door to balloon time activities)

1,201

12.8

Door-to-doctor times

1,172

25.3

Throughput time measures

1,045

36.4

Acute Myocardial Infarction (AMI): 877 Aspirin on arrival

45.8

Sepsis pathways (includes goal-directed care)

54.4

810

* Kowalenko T, Carius ML, Korte RC, Miller MC, Reisdorff EJ. Emergency department quality improvement activity: an inventory from the American Board of Emergency Medicine maintenance of certification program. Acad Emerg Med 2015 Mar;22(3):367-72 (Table 2).

Research Update: Quality Improvement Activities in the Emergency Department The ABEM MOC Program requires every ABEM-certified physician to attest to participating in a quality improvement (QI) activity every five years. Understanding the type and frequency of these QI activities could inform the EM community about the variety of QI activities in which emergency physicians are involved. These QI activities could provide ideas for the development of additional quality measures. To explore this idea, Kowalenko et al.* performed a retrospective descriptive study of self-reported QI activity attestations from the ABEM MOC Program during 2013. The type, number, and cumulative frequency of activities were reported. ABEM received 9,380 attestations for QI activities in 91 different categories. The five most commonly reported activities are reported in Table 1. These top activities comprised more than half (54.4 percent) of attestations; 89.9 percent was comprised by the top 21 categories. Of these 21 categories, 10 involved clinical protocols, nine were time-centered measures, and two were patient-centered activities. The report demonstrates the diverse QI activities that occur in emergency departments across the United States. The majority of reported projects were nested in a few categories, following recognized areas of emphasis in emergency care, particularly in areas using time-sensitive metrics.

September / October 2015

ABEM Elects New Board of Directors Barry N. Heller, MD, was elected President of the American Board of Emergency Medicine (ABEM). Dr. Heller has been an emergency physician at St. Mary Medical Center for 32 years, where he has served as chair of the Department of Emergency Medicine, chief of staff, and vice president of Medical Affairs. Dr. Heller received a BA degree in biology from Brown University in Providence, Rhode Island; a medical degree from Indiana University in Indianapolis, Indiana; and completed residency training in emergency medicine at Harbor-UCLA Medical Center in Torrance, California. Michael L. Carius, MD, was elected President-Elect of the American Board of Emergency Medicine (ABEM). Currently, Dr. Carius is assistant clinical professor in the Department of Traumatology and Emergency Medicine at the University of Connecticut School of Medicine in Farmington, Connecticut; emeritus chair, Department of Emergency Medicine at Norwalk Hospital in Norwalk, Connecticut; and practices emergency medicine at Bridgeport Hospital in Bridgeport, Connecticut, and Milford Hospital in Milford, Connecticut. ABOUT ABEM Founded in 1976, the American Board of Emergency Medicine, (ABEM) develops and administers the Emergency Medicine certification examination for physicians who have met the ABEM credentialing requirements. ABEM has nearly 30,000 emergency physicians currently certified. ABEM is not a membership organization, but a nonprofit independent evaluation organization. ABEM is one of 24 Member Boards of the American Board of Medical Specialties. ABEM Mission The ABEM mission is to ensure the highest standards in the specialty of Emergency Medicine.

EXAM REMINDERS! â&#x20AC;˘ The fall 2015 Sports Medicine Certification and Recertification Examinations will be administered November 16-21; the last day to apply is September 21. â&#x20AC;˘ The last day to apply for the November 8, 2015, administration of the Undersea and Hyperbaric Medicine Recertification Examination (in Los Angeles, California) is October 23.

CTSIs: A Resource for EM Researchers By Kabir Yadav, MDCM, MS, MSHS Elizabeth Burner, MD, MPH Andrew Monte, MD The Research Committee serves as a resource for preparing materials to help SAEM’s members improve their research skills, and for finding funding opportunities to support their research and the presentation of such research through didactics, abstracts, articles, workshops, and other channels. For more information go to www.saem.org and find committees. The National Center for Advancing Translational Sciences (NCATS) at the National Institutes of Health (NIH) was established with the mission “to catalyze the generation of innovative methods and technologies that will enhance the development, testing and implementation of diagnostics and therapeutics across a wide range of human diseases and conditions.” Under this mandate, NCATS has funded 62 Clinical and Translational Science Institutes (CTSIs) based at research centers throughout the United States. CTSIs have the ability to provide small grants, laboratory testing, nursing support, data-management solutions and data analysis, as well as significant research training in support of translational science research. The SAEM Research Committee was concerned that few emergency medicine (EM) researchers have utilized their local CTSI resources to their full potential.

In response to the committee’s inquiry, Dr. Brown organized a discussion with Petra Kaufmann, MD, MSc, head of the Division of Innovation at NCATS; Gene Passamani, MD, consultant for the Division of Innovation; Craig Newgard, MD, MPH, co-lead of ECTRC; William Barsan, MD, principal investigator with the Neurologic Emergency Treatment Trials Network; and Kabir Yadav, MDCM, MS, MSHS, SAEM Research Committee representative. The group discussed the desire for increased involvement of emergency care researchers and opportunities in the CTSIs. The discussion particularly focused on the center’s vision for leveraging CTSIs for national research network capacity building. Subsequently, a letter from the Research Committee to Dr. Brown was crafted to aid his advocacy across the National Institutes of Health. Dr. Brown continues his strong support for emergency care research through the OECR. A recent notice focuses on the intent to fund a national, transfederal emergency care research network (http://grants.nih.gov/grants/guide/notice-files/NOTNS-15-021.html), with support from Trial Innovation Centers being set up by NCATS. As the funding climate for emergency care research continues to improve, EM researchers should use their local CTSI infrastructure to support their current research efforts and to develop their research skills and ideas. Additionally, they should engage with the ECTRC to seek collaborators across the country.

The Research Committee seeks to expand the knowledge of and opportunities available to EM researchers through an annual objective that aims to determine and facilitate resource availability through these awards. To meet this objective, members of the Research Committee met with the CTSI working group liaison, Sandra Schneider, MD. Dr. Schneider is also the founding member of the Emergency Care Translational Research Collaborative (ECTRC). The ECTRC was built upon successful regional inter-CTSI efforts for emergency care research. The ECTRC currently includes emergency care researchers at 53 CTSIs nationwide and also interacts with representatives of NIH institutions. The ECTRC recently completed a survey of EM researchers that indicated an underutilization of CTSI resources. With this information, ECTRC leadership and the Research Committee felt that this was an opportunity to engage Jeremy Brown, MD, director of the NIH Office of Emergency Care Research (OECR).

About the Authors:

Kabir Yadav, MDCM, MS, MSHS, is an associate professor of emergency medicine at the Harbor-UCLA Medical Center. Elizabeth Burner, MD, MPH, is an assistant professor of emergency medicine at the Keck School of Medicine at the University of Southern California. Andrew Monte, MD, is an assistant professor of emergency medicine at the University of Colorado School of Medicine. All are members of the SAEM Research Committee.

September / October 2015

AWAEM and GEMA Joint Luncheon Explores Work-Life Challenges By Stacey Poznanski, DO AWAEM President, 2015-2016 Bhakti Hansoti, MBChB, MPH GEMA President, 2015-2016 The Academy for Women in Academic Emergency Medicine (AWAEM) Annual Luncheon has been a part of AWAEM since its inception. The first luncheon, which occurred at the 2010 Annual Meeting in Phoenix, served as a venue for women to network. Kathy Clem, MD, AWAEM’s first president, recalls, “We had no idea how many would come. We put out the invitation, and didn’t expect a very high turnout. The room was sold out in short order!” Thankfully, this sold-out event didn’t stop more people from seeing what this Luncheon was all about. “People just kept coming,” recounts Sue Watts, AWAEM’s immediate past president. “The noise level was incredible and energetic! I don’t know that we ever got a final head count.” AWAEM’s former presidents were in attendance and have fond memories of carrying in extra chairs for everyone to cram around tables, share lunches, and network

FINDING WAYS TO NETWORK SUCCESSFULLY AWAEM participants discussed the importance of networking and why developing these skills are important. Outcomes included how and why physicians need to network both at home and outside their institutions.

How to network: • Physicians can start networking by being friendly; introduce yourself with a handshake and a smile. People will remember you. • When in a group, make sure to introduce everyone. • Take advantage of downtime opportunities at meetings (bar, social media, breakout groups). • Invite a physician to your home institution as a guest lecturer and host them for lunch. • Join interest groups and get involved.

WHY NETWORKING IS IMPORTANT • EM is a small world with very approachable people; opportunities happen via word of mouth. • Gain new opportunities for your career/fellowship. • Learn about unpublished projects. • Gain outside perspective. • Learn your next career steps.

September / October 2015

with regional colleagues about work/life balance, she said. In no time, it became quite evident that AWAEM and its popular luncheon were here to stay. “During my first AWAEM Luncheon the very next year, it already felt integral to what we were as an Academy.” With networking at its core, the Luncheon also has become a place for collaboration and recognition. The event opens by acknowledging award winners and others who have been vital to promoting the AWAEM mission. The bulk of the time is spent hosting facilitated discussions that highlight current AWAEM projects and critical issues for women in academic EM. These discussions are then shared with our members throughout the year in our bimonthly newsletter, AWAEM Awareness. In recent years, topics have included negotiation, gender research, promotion, best practices, and starting local women in EM groups. The topics often mirror AWAEM’s Annual Meeting didactics as an opportunity to directly discuss personal application of the concepts being taught. Many of AWAEM’s most successful projects have directly stemmed from conversations that began at the Annual Luncheon, including ongoing research on retirement and a taskforce dedicated to senior women in academic EM. Dr. Clem summarizes it best: “None of us expected the response or anticipated the enthusiasm for this first luncheon… [It] provided unprecedented opportunity. We learned about the need, crafted the venue, and have made this an event not to be missed. It is now a tradition.” Academies Find Common Issues This year, AWAEM invited GEMA to the Annual Luncheon, encouraging members to expand collaboration between academies. It was a perfect time to find common issues among attendees. While each group talked about their individual issues, joint collaborative topics included promotions, getting published, finding mentors, becoming leaders in global health and developing negotiation skills whether as a junior or senior faculty member. The goals for this year’s luncheon and breakout sessions were to help prepare and coach AWAEM members to promote and prepare for work-life challenges. This could include how to take on uncomfortable work responsibilities, ask for a promotion, and find ways to promote one’s own skills. Other hot topics included: Implementing best practices, starting an EM group for women, finding new roles and responsibilities, family leave issues.

MANAGING TRAVEL WITH FAMILY The round table provided GEMA members the ability to discuss individual projects, funding and study design. Additional GEMA hot topics included: Research careers in global health, mentoring, getting more women involved in global health and maintaining a global health fund of knowledge. But above all, the luncheon was an attempt to acknowledge that while SAEM members have a diversity of special interests in the form of academies, common challenges and solutions exist. The luncheon speaks to the true essence of SAEM, and highlights how peer mentorship and collaboration can spark innovative ideas to build academic careers in emergency medicine. Participants can leave understanding how to negotiate their contracts, establish breast pumping solutions in the clinical environment (AWAEM presented Chris Ross and Maryanne Greketis an award for this) or find friends with common interests for collaboration. To give you a taste of some of the rich conversations that occurred at this year’s luncheon, facilitators have shared their thoughts on “Finding Ways to Network Successfully” led by Judith Linden, “Managing Travel with Life” led by Stephanie Kayden and “Buying Down Your Clinical Time” led by Gail D’Onofrio. Please join us for next year.

Becoming a global health physician and traveling with family is a large issue for GEMA members. Participants at this round table discussed how they were able to achieve their goals. Suggestions for successful outcomes included: 1. Take into account your partner’s needs. 2. Be aware of developmental milestones and choose travel time that best fulfills your wants and needs when raising a family. 3. Make sure to task appropriately. 4. Choose meetings accordingly; you cannot be “everywhere.” 5. Time management is key once a commitment is made. 6. Use resources: Extended family (+/-); stay at home mothers, nannies, colleagues. 7. Collaborate with projects that will afford productivity and sustainability. 8. Never forget that “income” is needed to make it work, so long term goals and choice of job is extremely important as one is building a career. 9. Creation of a mentor site to help men and women with families who want to travel abroad would be an invaluable resource.

FACILITATE LIFE BUYING DOWN CLINICAL TIME All academicians face the universal challenge of needing more time, and the perpetual nightmare for every junior faculty is how to buy more clinical time. At this luncheon we were given a Chair’s perspective on this issue. Here are some tips: 1. Seek to align your “ask” to the Department’s mission and goals.

Faculty Positions-Emergency Medicine DISTRICT OF COLUMBIA-The Department of Emergency Medicine of the George Washington University is seeking physicians for our academic practice. Physicians are employed by Medical Faculty Associates, a University-affiliated, not-for-profit multispecialty physician group, and receive regular faculty appointments at the University. The Department provides staffing for the Emergency Units of George Washington University Hospital, the Walter Reed National Military Medical Center, and the DC Veterans’ Administration Medical Center. The Department sponsors a four-year residency, ten fellowships and a variety of student programs. We are seeking physicians who will participate in our clinical and educational programs and contribute 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 certified Emergency Medicine residency, prior to the date of employment.

Application Procedure: Complete the online faculty application at http://www.gwu.jobs/postings/27537 and upload a CV and cover letter. Review of applications will be ongoing, and will continue until positions are filled. Only complete applications will be considered. Contact Robert Shesser MD, Chair, Department of Emergency Medicine, directly with any questions about the position at: rshesser@mfa.gwu.edu. The George Washington University and the George Washington University Medical Faculty Associates are 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.

http://smhs.gwu.edu/emed/

2. Ask for a defined clinical time reduction for a defined task. (Agreeing to decreased clinical time in perpetuity that must be internally funded by the Department may not be realistic.) 3. Consider going to less than a full FTE for a defined period of time to meet an academic goal (with the clear understanding and agreement that when this goal is met, you will return to a full FTE and this will include decreased clinical time if goals are met). 4. Practice your “ask” with a trusted colleague who understands the limitations and opportunities in your department before meeting with your Chair. 5. Understand the financial limitations of your department – don’t ask for something your Chair can’t provide without coming up with a way to pay for it 6. Find matching opportunities, i.e. Dean pays for a part, department pays for part. 7. Be creative in finding sources for funding – grant funding is the gold standard, but there are sources beyond industry/ foundation/NIH grants. 8. Successful non-grant funding sources identified at our table included: a. School of Medicine funding for CapStone or Disaster course training. b. Consider instructor courses such as ATLS/BTLS/ITLS/APLS c. Hospital Administration funding – CMIO, COO, Medical directorship, LEAN instructor, nurse educator for defined topic, Transfer Center Director, Director of Patient Experience

Most importantly, negotiation is in your purview, but as you September / October 2015 the solution. 19 lay down your “ask” you will also need to provide

PROVIDING RESOURCES TO THOSE IN NEED CDEM Introduces New Initiatives to Assist Clerkship Directors, Students & Local Communities An Interview with David Gordon, MD, and Nicholas Kman, MD, FACEP

While the Clerkship Directors in Emergency Medicine (CDEM) is the oldest academy of SAEM, it certainly has not been resting on its laurels. CDEM represents the interests of undergraduate medical educators in emergency medicine. CDEM became SAEM’s first academy in 2008 and currently has 164 members, including nearly all of the 160 clerkship directors, according to Nicholas Kman, MD, FACEP, associate professor of emergency medicine at The Ohio State University Wexner Medical Center and immediate past president of CDEM. “CDEM is the voice of undergraduate education in emergency medicine,” Dr. Kman said. “We work hard to continually provide resources, information and education to our clerkship directors to help them do their jobs.” New Training Video Covers Case Presentations CDEM partnered with the Emergency Medicine Residents’ Association (EMRA) to release the new training video “Patient Presentations in Emergency Medicine,” which teaches medical students how to present a patient’s case concisely in the frenetic environment of the emergency department. The video is available on the SAEM website, http://saem.org/membership/medical-students/studentresource-collection.

September / October 2015

“There’s an art to presenting in the emergency department; there are a lot of distractions,” Dr. Kman said. “Students need to get into that mindset while presenting. The video is a great tool to use during orientation and is a way to formalize the process of presenting across all clerkships, so all of our students are hearing the same thing before they step out onto the floor.” David Gordon, MD, CDEM’s president-elect and a member of CDEM since its inception, was the video’s narrator and was instrumental in its creation.

“I was happy to see the objectives set by the SAEM Board in its strategic plan relating to advancing education,” Dr. Gordon said. “I believe CDEM will be able to provide great help to SAEM in fulfilling those objectives.”

“I was very pleased with how the video turned out, and the early feedback is that people have been pleased and found it very useful,” said Dr. Gordon, associate professor of surgery and medical director of the clinical skills lab at Duke University Hospital. “It was a lot of work, but it was a fantastic experience and a lot of fun. An unintended benefit of the video was the furthering of our partnership with EMRA. We learned a lot about each other and how we can work together in the future to further our mutual missions.” Dr. Kman envisions the development of more training videos that might address how to conduct difficult conversations with patients and how to deliver bad news, among other issues.

New Website for Emergency Medicine Students In addition, on the student-education front, CDEM has developed the website www.cdemcurriculum.org, a one-stopshop that offers a variety of resources for emergency medicine students. Giving Back to Communities Looking forward, Dr. Gordon says CDEM has plans over the next year that will continue to build upon current programs and efforts, while making a concerted effort to learn more about the needs of CDEM members, as well as how CDEM can participate in giving back to and serving local communities. “I am hoping we can learn more about the needs of local communities,” Dr. Gordon said. “We have been approached by EMRA to work together on this initiative.” The result is an “EM Day of Service,” an online initiative that will be launched in September. Dr. Gordon says this will be the first event in what he hopes will be a continuing effort. In addition, Dr. Gordon says plans in the future include an in-depth needs assessment of CDEM’s members. “Ideally, it would be nice each year for us to do something to help promote education in emergency medicine.” Strong Relationship with SAEM Dr. Kman says that CDEM has enjoyed great benefits from being an academy within SAEM. “We are very lucky to be part of SAEM,” Dr. Kman said. “It is very large and has many resources and members. In turn, SAEM has grown to see our value as educators and has given us opportunities now to share our knowledge with the larger SAEM membership. It has been a very productive relationship.”

“We would like to do a series of videos,” Dr. Kman said. “We don’t want our clerkship directors to have to reinvent the wheel. We want to provide resources without having them to develop things from scratch.” Collaborating with CORD CDEM will publish an educational supplement in the Western Journal of Emergency Medicine in mid-October. The effort is in collaboration with the Council of Emergency Medicine Residency Directors (CORD) and will focus on educational research in emergency medicine and the importance of building curricula and utilizing simulations and assessments. “This was a great joint venture with CORD. There was no place for educational research in emergency medicine; there was no journal built for that,” Dr. Kman said. “I was really pleased to see that we had more than 100 submissions on educational research for the supplement. Of those, 20 to 30 will be published. This tells me that the publication of this supplement created great interest and will be well-received.”

Dr. Gordon says he also sees the benefits of the current relationship between CDEM and SAEM. CDEM will be a driving force to support SAEM’s strategic goals going forward. “I was happy to see the objectives set by the SAEM Board in its strategic plan relating to advancing education,” he said. “I believe CDEM will be able to provide great help to SAEM in fulfilling those objectives.”

David Gordon, MD, associate professor of surgery, medical director, Clinical Skills Lab and CDEM president-elect. Nicholas Kman, MD, FACEP, is associate professor of emergency medicine at The Ohio State University Wexner Medical Center and immediate past president of CDEM

For more information:

Clerkship Directors in Emergency Medicine (CDEM) is an academy representing the interests of undergraduate medical educators in emergency medicine. CDEM was formed and became SAEM’s first academy in 2008. You can find CDEM at www.saem.org under Academies.

September / October 2015

AAAEM Builds Partnerships An interview with Kirsten Rounds

The Academy of Administrators in Academic Emergency Medicine (AAAEM) provides a networking environment for those who manage the administrative and business functions for Emergency Departments in academic and community settings. This, however, does not completely reflect the Academy’s purpose.

Education Is Key

“Our goal is to reach out and build partnerships. We support department chairs in the best possible way,” says Kirsten Rounds, RN, MS, AAAEM president. Rounds is currently the senior executive administrator for the University Emergency Medicine Foundation and the Alpert Medical School of Brown University, Department of Emergency Medicine in Providence, Rhode Island.

The retreat, a three-day professional development/educational program in conjunction with the Association of Academic Chairs of Emergency Medicine (AACEM), provides many opportunities for information, involvement, and a chance to learn about current trends.

AAAEM was formed to foster networking amongst administrators and their peers in academic emergency medicine. It is the first academy that is geared toward administrators in academic emergency medicine. “The interactions in AAAEM provide an understanding of what our closest colleagues are doing. This enables us to learn from them and make changes for the better. It also provides administrators with a way to understand and interact with their physician colleagues,” says Rounds. Survey the Profession AAAEM provides key information to emergency medicine professionals through its benchmark and salary surveys (which are published in Academic Emergency Medicine). The Academy has grown to 95 members representing academic departments across the country, some with multiple clinical affiliations. In the most recent survey, 106 total hospitals responded, representing 91 adult and 15 pediatric emergency departments. The surveys provide key information concerning volume and staffing issues, operational and education metrics, and research. One goal is to help serve patients more efficiently with an overall picture of what emergency medicine looks like. Members who fill out the survey have access to all of the results. The survey compares region, institution type, hospital beds, admissions, and more. It also provides comparisons for academic, academic-affiliated and community departments. The survey allows administrators to have a benchmark comparison to use when negotiating with universities or health systems for resources, programs, hiring, compensation, and more.

September / October 2015

AAAEM’s goal is to increase membership and involvement. One major member benefit that AAAEM provides is the annual retreat. This year the retreat will be held February 21-24, 2016, in Tempe, Arizona. Registration will open in mid-October on the SAEM website.

The program has presentations from both the perspective of the chair and administrator. Topics provide attendees with information on how to make a department successful; working with the dean or hospital president/CEO; faculty development; and more. Rounds believes that administrators and chairs need to work closely together because academic emergency departments are in a state of constant growth. This annual retreat provides a rich opportunity for chairs and administrators to delve into topics and discussions that might not occur during their normal workday. AAAEM Builds Expertise While AAAEM provides members with tangible programs and information, it also helps to build individual skill sets and enhance members’ administrative expertise. This experience gives members another way to make improvements for their department. “The success of AAAEM is directly related to the efforts of the founding members. Our job now is to maintain growth and keep the academy vital.” AAAEM is a dynamic academy that is working hard and making progress. “Over the years, our relationships have grown, in fact, some of my AAAEM colleagues have become my best friends,” says Rounds.

Kirsten Rounds has a BSN in Nursing from Boston College and an MS in Accounting from the University of Rhode Island. She has more than 14 years experience in academic emergency medicine administration. In addition to managing the UEMF physician practice, Kirsten is the current President of AAAEM.

VA Section Chief The Department of Emergency Medicine (DEM) at University of Wisconsin, School of Medicine and Public Health (Madison, WI) is seeking candidates for the position of VA Section Chief. This is an exceptional opportunity for a highly motivated Emergency Medicine Physician (BE/BC) with strong interest in clinical operations and quality improvement. Job responsibilities include leading a collaborative team of emergency department physicians, nurses, and staff to improve the clinical care provided to veterans through process improvement. Compensation and benefits are extremely competitive. Inquiries should be accompanied by a curriculum vitae and may be e-mailed or addressed to:

While a track record in graduated administrative responsibilities is preferred, opportunities also exist for more junior faculty. As part of DEM faculty, the successful applicant will staff upwards of half of his/her clinical shifts at William S. Middleton Memorial Veterans Hospital and half of his/her clinical shifts at University of Wisconsin Hospital & Clinic (UWHC). UWHC is one of only two academic medical centers, and Level I Trauma (adult & pediatrics) and Burn Centers, in the state of Wisconsin. Azita G. Hamedani, MD MPH MBA Chair, Department of Emergency Medicine 800 University Bay Dr., Ste. 310, Madison, WI 53705 agh@medicine.wisc.edu

Department of Emergency Medicine The UW Madison is an EEO/AA employer; Wisconsin open records and Caregiver laws apply. A background check will be conducted prior to employment.

What is the CDP and why was it created?

Who can participate in the CDP?

The AACEM Chair Development Program (CDP) is a leadership training initiative, now in its 3rd year, designed to enhance the capabilities and effectiveness of new and aspiring academic emergency medicine department chairs through skill development, advising, and mentorship. By creating more informed and capable chairs, we hope to improve patient care, education, and research in emergency medicine.

Those eligible for the program include current EM chairs who are within 4 years of their start date at the beginning of the program, and vice chairs or associate chairs who wish to advance to become chairs. Other developing EM leaders may also apply. Selection: Each class of participants will have 12-15 members. Interested candidates must submit an application form (see below). Preference is given to existing chairs.

What type of leadership training does the CDP offer? The CDP consists of five leadership training sessions averaging 8-10 hours, for a total of 40-50 in-person training hours. Sessions will provide new and aspiring chairs with practical, emergency-medicine-specific leadership training and will be held near the SAEM headquarters in Des Plaines, IL (close to Chicago’s O’Hare Airport), and in conjunction with the AACEM/AAAEM Retreat, the SAEM Annual Meeting, and the ACEP Scientific Assembly. CDP faculty instructors include experienced EM chairs, deans and administrators, as well as other leadership development experts. We will focus on areas that may not be covered in other leadership courses. Personal advising and mentorship will be provided. Participants are required to attend at least four of the five offered sessions, and to complete readings and assignments for those sessions they cannot attend. All participants must attend the first and last sessions of the CDP. Participants will receive a certificate from AACEM upon completion of the program.

How much does it cost? Tuition is $3,950 for the course, with travel and lodging expenses paid by the participant.

When does it start? The first session of the AACEM CDP will begin on January 11, 2016 at SAEM Headquarters in Des Plaines, IL.

Applications are due November 6, 2015.

For application materials, please contact Céleste Carrière at ccarriere@lifespan.org For more information on the program, please contact Brian Zink, MD, Brian_Zink@brown.edu or call 401-444-5141.

September / October 2015

BRIGHAM AND WOMEN'S HOSPITAL SURGICAL CRITICAL CARE/ EMERGENCY MEDICINE ATTENDING PHYSICIAN

SURGICAL CRITICAL CARE/EMERGENCY MEDICINE The Departments of Surgery and Emergency Medicine at Brigham and Women’s Hospital and Harvard Medical School seek a board certified physician in Surgical Critical Care and Emergency Medicine. This position is eligible for an academic appointment at Harvard Medical School at the rank of Instructor, Assistant or Associate Professor, commensurate with experience, achievement, recognition, and planned participation in teaching and scholarly activities. The successful MD or MD/PhD candidate must be board prepared or certified in Surgical Critical Care/Emergency Medicine and must demonstrate professional, academic and teaching skills in the fields of surgical critical care and emergency medicine. Send current CV to: Ali Salim, M.D., Chief, Division of Trauma, Burn and Surgical Critical Care, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115 or confidential e-mail kbcarlson@partners.org . Other inquiries call: 617-732-8042. Brigham and Women’s Hospital/Harvard Medical School are Equal Opportunity/Affirmative Action Employers actively committed to increasing the diversity of our faculty; people with disabilities, veterans, women and members of underrepresented minority groups are therefore strongly encouraged to apply.

Brigham and Women's Hospital Harvard Medical School EM INFORMATICS RESEARCHER The Department of Emergency Medicine at Brigham and Women’s Hospital is currently seeking a full-time academic emergency physician to join the department’s Division of Health Policy. The successful candidate will be eligible for an academic appointment at Harvard Medical School at the rank of Instructor or Assistant Professor, commensurate with experience, training and achievement. The position offers excellent academic support including access to grant writing and statistical analysis, unparalleled research opportunities, competitive salary, and an outstanding comprehensive benefit package. The successful candidate will have a track record of innovation and research in informatics and emergency care and a career path leading to independent, grantfunded research in the field. Areas of interest include but are not limited to: clinical informatics, population health informatics, data analytics, and mHealth. More information available listed at http://www.fa.hms.harvard.edu/open-facultypositions/junior-positions/ A history of successful academic scholarship, including successful collaboration, publication, and grant funding are strongly desired. Candidates are required to have completed advanced research training such as a fellowship as well as EM residency training program or be board certified in EM. Interested candidates should send a letter and Curriculum Vitae to Michael VanRooyen, MD, MPH, Interim Chairman, Department of Emergency Medicine, Brigham and Women’s Hospital. Please apply by email to mdeloge@partners.org Brigham and Women's Hospital/Harvard Medical School are Equal Opportunity/ Affirmative Action Employers actively committed to increasing the diversity of our faculty; people with disabilities, veterans, women and members of underrepresented minority groups are therefore strongly encouraged to apply.

TEXT BRIGHAM AND WOMEN’S HOSPITAL AD TEXT ¼ page –ACCEPTED HMS 7/6/2015 SURGICAL CRITICAL CARE/EMERGENCY MEDICINE BRIGHAM AND WOMEN’S HOSPITAL Chair ofPHYSICIAN the Department of Emergency Medicine ATTENDING

HARVARD MEDICAL SCHOOL Pennsylvania Hospital – Associate or Full Professor EMERGENCY MEDICINE INFORMATICS RESEARCHER Clinician-Educator or Academic Clinician SURGICAL CRITICAL CARE/EMERGENCY MEDICINE Tracks

The Departments and Emergency Medicine at Brigham Women’s The Departmentof of Surgery Emergency Medicine at the Perelman School of Medicineand at the University of Pennsylvania seeks candidates for The Department of Emergency Medicine at evidence Brigham and Women an Associate or Full Professor position in the non-tenure clinician-educator or non-tenure academic-clinician track. While Hospital and Harvard Medical School seek a board certified physician in Surgical Critical of scholarship is required in the clinician-educator track, research is not requiredseeking in the academic clinician track. Rank & track willphysician to jo currently a full-time academic emergency Care be and Emergencywith Medicine. This isapplicant eligible will for be anaccomplished academic appointment at commensurate experience. Theposition successful in the area of Emergency Medicine. Applicants department’s Division ofclinical Health Policy. The must successful candidate mustMedical have an M.D. degree have demonstrated excellent qualifications in education, research, & care. Applicants be Harvard School at &the rank of Instructor, Assistant or Associate Professor, board-eligible or board certified in Emergency Medicine. for an academic appointment at Harvard Medical School at the ra commensurate with experience, achievement, recognition, and planned participation in Pennsylvania Hospital (PAH) is part of Penn Medicine and is located at 8th and Spruce Streets in the historic Society Hill district or Assistant Professor, commensurate with experience, training a teaching and scholarly The successful MDprovides or MD/PhD candidate mustand be therapeutic medical services and of Philadelphia. PAH isactivities. a 520-bed acute care facility that a full range of diagnostic functions as a major teaching and clinical research institution. The hospital has over 29,000 inpatient admissions and 115,000 achievement. The position offers excellent academic support inc boardoutpatient prepared or certified in Surgical Critical Care/Emergency Medicine and must visits each year, including over 5,200 births. grant writing and statistical analysis, unparalleled research oppor demonstrate professional, academic and teaching in theannual fieldsvisits. of surgical critical The Department of Emergency Medicine manages moreskills than 30,000 This position reports jointly to the Chair of the competitive salary, and an outstanding comprehensive benefit pa Department of Emergency Medicine/Chief of Emergency Services for the Health System and to the Executive Director of PAH. The care and emergency medicine.

Chair will provide medical leadership for the PAH ED and is accountable for the quality of clinical services, patient experience, engagement and education of the faculty, staff and residents, and the overall integration of the PAH ED into overall emergency The successful candidate will have a track record of innovation a Penn Sendservices currentatCV to:Medicine. Ali Salim, M.D., Chief, Division of Trauma, Burn and Surgical informatics and emergency and a career path leading to ind The successful candidate will demonstrate commitment to integrating the department with the clinical and academic programs Critical Care, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115 or care of the Department of Emergency Medicine at Penn Medicine and will possess administrative experience in clinical operations, funded research in the field. Areas of interest include but are no confidential e-mail kbcarlson@partners.org. Other inquiries call:and 617-732-8042. demonstrated leadership skills, and a strong commitment to education faculty development. Other valuable qualities include clinical to informatics, population informatics, data analytics, collaborative research skills, visionary thinking, and sound financial acumen build on a solid foundationhealth of excellence within an interdisciplinary environment. More information available listed at http://www.fa.hms.harvard.ed Brigham and Women’s Hospital/Harvard Medical School are Equal • Academic Clinician track applicants are not required to do research. positions/junior-positions/ A history of successful academic scho Opportunity/Affirmative Employers to increasing the diversity • Clinician-Educator Action track applicants will beactively expectedcommitted to show evidence of scholarship and may perform collaborative research. should submit their application, CV, and and lettermembers of intent noof later than October 1, 2015. Clinician-educator of ourInterested faculty; applicants people with disabilities, veterans, women track candidates should also submit a statement of research interests. Jill M. Baren, MD, MBE, FACEP, FAAP. Jill.Baren@uphs. underrepresented minority groups are therefore strongly encouraged to apply. upenn.edu and William C. Welch, MD, FACS, FICS William.Welch@uphs.upenn.edu are Co-Chairs of the search committee. We seek candidates who embrace and reflect diversity in the broadest sense. The University of Pennsylvania is an EOE. Minorities/Women/Individuals with disabilities/Protected Veterans are encouraged to apply.

Apply online for the Academic Clinican Track position: https://www.med.upenn.edu/apps/faculty_ad/index.php/g321/d3939 Apply online for the Clinician-Educator Track position: https://www.med.upenn.edu/apps/faculty_ad/index.php/g321/d3941 1

September / October 2015

PEDIATRIC EMERGENCY PHYSICIANS The Department of Emergency Medicine at Albany Medical College is recruiting pediatric

emergency physicians to join our academic faculty. Candidates must be fellowship trained and boardcertified eligible in pediatric emergency medicine and will enter at the assistant or associate professor level based on experience and qualifications.

Albany Medical Center – comprised of the medical college and hospital – is northeastern New York’s only academic health sciences center. Albany Medical College is one of the nation’s oldest medical

schools, founded in 1837. The 714-bed Albany Medical Center Hospital is the only Level 1 Trauma Center in the region and is the busiest trauma center in the state. As the primary referral center for the region, the hospital received over 10,000 transfers last year.

The Department of Emergency Medicine has a well-established residency program that began over 25 years ago and has faculty who are fellowship trained in ultrasound, clinical research, toxicology,

sports medicine, emergency medical services, critical care medicine and pediatric emergency medicine. We have a busy, high-acuity emergency department with an annual census of over 70,000 patients.

n’s Hospital is oin the e will be eligible ank of Instructor and cluding access to rtunities, ackage.

and research in dependent, grantot limited to: and mHealth. du/open-facultyolarship, 1

Albany Medical Center is located in the capital of New York State, with easy access to the

metropolitan areas of New York City, Boston and Montreal. The Capital Region offers safe

communities and excellent schools. There is also close proximity to numerous outdoor activities (skiing, hiking, climbing, camping, etc.) in the Adirondack and Catskill mountains.

Candidates should send a current curriculum vitae and letter of interest to: Christopher King, MD, FACEP

Chair, Department of Emergency Medicine Albany Medical College 47 New Scotland Ave.

Albany, New York 12208 518.262.3443

kingc1@mail.amc.edu

www.amc.edu September / October 2015 25

Point-of-Care Ultrasound Physician | University of Colorado School of Medicine The Department of Emergency Medicine at the University of Colorado School of Medicine is seeking candidates for the position of Point-of-Care Ultrasound Physician Faculty. The University of Colorado Hospital Emergency Department is a 55,000 square foot state-of-the art facility with 100,000 visits per year. The University of Colorado Hospital is a 551 bed tertiary care referral center, level II trauma center, ABA verified burn center, and Joint Commission certified comprehensive stroke center and is part of the University of Colorado Health System. The physician will assist with implementation of all aspects of point-ofcare ultrasound at UCHealth. These include contributing to education, operations and research in a program dedicated to patients, faculty, advanced practice providers, fellows, residents and medical students. Interested candidates should submit a CV, cover and list of references to: http://www.jobsatcu.com:80/postings/89777

letter,

Candidates must have completed a fellowship in Point-of-Care Ultrasound or have comparable experience and be eligible for appointment to the rank of assistant or associate professor. Academic rank and salary will be commensurate with skills and experience. The University of Colorado offers a full benefits package. For more information, please contact: Resa E. Lewiss, M.D. Associate Professor, Department of Emergency Medicine 720-848-6834 | Resa.Lewiss@ucdenver.edu

The Department of Emergency Medicine of the University of Rochester (URMC) is expanding our faculty group. We are seeking Emergency Medicine and Pediatric Emergency Medicine BC/BE Faculty for positions at our primary academic site, as well as our community affiliates and off-campus emergency department. Seeking faculty for: • Academic EM positions • Academic Pediatric EM positions • Community EM positions The Department of Emergency Medicine includes a highly regarded EM Residency, an active research program, and fellowship programs including Pediatric EM, International Medicine, Research, and Ultrasound. Strong Memorial Hospital (SMH) is the academic medical center and is the regional referral and Level 1 trauma center. It has a full complement of specialist consultant services, as well as ED-based social workers, pharmacists, and child-life specialists. SMH sees over 100,000 patients per year, including 28,000 pediatric patients. The new Golisano Children’s Hospital at Strong is set to open in the summer of 2015. Our multiple community EDs and off-campus ED offer physicians the opportunity to practice in varied settings, experiencing a mix of acuity and patients in both adult and pediatric age groups. Successful candidates will be dynamic individuals, interested in a diverse Emergency Medicine experience with great potential for career development, promotion, and longevity within our department. Ample opportunity exists to be actively involved in education, administration, and research. Rochester, New York, located in Upstate New York, offers excellent schools, a low cost of living, and many opportunities both professionally and personally. We have easy access to Canada, including metropolitan Toronto, the Great Lakes, the Finger Lakes and the northeastern United States. Interested applicants please contact: Michael Kamali, MD, FACEP Chair, Department of Emergency Medicine Michael_Kamali@URMC.Rochester.edu 585-463-2970

FACULTY - SCHOOL OF MEDICINE, DEPARTMENT OF EMERGENCY MEDICINE CLINICIAN EDUCATOR MEDICAL TOXICOLOGIST CLINICAL RESERACHER EM/CRITICAL CARE CLINICIAN EDUCATOR The Department of Emergency Medicine at the University of Mississippi Medical Center (UMMC) is seeking full-time candidates at the Assistant Professor, Associate Professor or Professor level. Candidates will be considered if they are well equipped and eager to support the tripartite mission of the medical center (education, research, health care). Applicants must have an MD/DO degree and have graduated or are nearing completion of an accredited Emergency Medicine Residency and will be eligible for unrestricted licensure in the state of Mississippi. UMMC is located in the capital city of Jackson and is the state’s only academic medical center. The Department of Emergency Medicine employs 25 faculty members and is the training setting for 40 Emergency Medicine residents and core rotating medical students and other learners. The department is well-regarded across the nation for its research and involvement in professional organizations. The region boasts the most competitive salaries in the nation, low cost of living, and access to many activities. As the state’s only Level-1 trauma center and with approximately 72,000 adult and 40,000 pediatric patient visits annually, the department is one of the busiest, highest-acuity health-care settings in the region. Interested candidates should submit their CV by email to AEJones@umc.edu or mail to Dr. Alan Jones, UMMC Dept. of Emergency Medicine, Suite 4E, 2500 North State St., Jackson, MS 39216 Rank and salary commensurate with qualifications. The University of Mississippi Medical Center is an Equal Opportunity/Affirmative Action Employer and does not discriminate on the basis of race, color, religion, sex, age, disability, marital status, national origin, or veteran's status.

September / October 2015

Brody School of Medicine

EMERGENCY MEDICINE FACULTY ◊ Clinician-Educator ◊ Clinical-Researcher ◊ Critical Care Medicine ◊ ◊ 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 are expanding our faculty to increase our cadre of clinician-educators and further develop programs in pediatric EM, ultrasound, clinical research, and critical care. Our current faculty members possess diverse interests and expertise leading to extensive state and national-level involvement. The emergency medicine residency is well-established and 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. Our tertiary care catchment area includes more than 1.5 million people in eastern North Carolina, many of whom arrive via our integrated mobile critical care and air medical service. Our new children’s ED opened in July 2012, and a new children’s hospital open in June 2013. Greenville, NC is a fast-growing university community located near beautiful North Carolina beaches. Cultural and recreational opportunities are abundant. Compensation is competitive and commensurate with qualifications; excellent fringe benefits are provided. Successful applicants will be board certified or prepared in Emergency Medicine or Pediatrics Emergency Medicine. They will possess outstanding clinical and teaching skills and qualify for appropriate privileges from ECU Physicians and VMC.

Confidential inquiry may be made to: Theodore Delbridge, MD, MPH Chair, Department of Emergency Medicine delbridget@ecu.edu ECU is an EEO/AA employer and accommodates individuals with disabilities. Applicants must comply with the Immigration Reform and Control Act. Proper documentation of identity and employability required at the time of employment. Current references must be provided upon request.

www.ecu.edu/ecuem/ ● 252-744-1418

September / October 2015

2340 S. River Road, Suite 208 Des Plaines, IL 60018

NON PROFIT ORGANIZATION U.S. POSTAGE PAID SAEM

2015 SAEM ANNUAL MEETING MAY 12 – 15, 2015

EARLY BIRD REGISTRATION IS OPEN REGISTER BY MARCH 13

September / October 2015