May-June 2001

What a GreatMeeting!

Atlanta was Grand!I am honored to serve as the

2001-2002 SAEM President. I amhonored to represent the Society forAcademic Emergency Medicine andI am looking forward to the “Marchto the Arch at St. Lou in 02” for the2002 meeting.

I have the great opportunity tolearn from the many great SAEM presidents who served be-fore me. My term on the Board extends over the following 10presidents: Barsan, Ling, Binder, Sklar, Goldfrank, Dronen,Marx, Syverud, Schneider and Zink. Much has been accom-plished by SAEM during this period of time. It has also beenmy great fortune to witness the academic quality/caliber ofour young SAEM members grow over the years. As Chair ofthe Nominating Committee this past year, I was very muchimpressed by the educational and research accomplishmentsof the nominees for the Young Investigators award. I congrat-ulate the Young Investigator award winners, as well as all theSAEM award winners recognized at the annual businessmeeting and to those who were elected to SAEM positions.Thanks to all the nominees who did not win awards or whowere not elected to positions. You are all winners.

The SAEM Annual Meeting in Atlanta was just grand.When I arrived in Atlanta I felt warm and welcomed. Atlantais a culturally rich city. At the airport in Atlanta, a large muralon the wall at the main terminal caught my attention. It was apicture of children of many races/ethnicities representing“Rainbow Atlanta”. An article, appeared in the AtlantaJournal-Constitution on Sunday, May 6, 2001 while the meet-ing was taking place, entitled “Rainbow Atlanta: Censusshows racial barriers disappearing in the city, suburbs.” Thepeople of Atlanta and the hotel, staff and amenities, were alltop-notch. People were friendly and they provided out-standing services.

The meeting was well attended and well organized. Theatmosphere was exciting and enthusiasm was evidenteverywhere. The membership took advantage of the manyopportunities offered.

The SAEM family is diverse and talented. As I attendedcommittee and task force and interest group meetings, I sawpeople involved who may not have been involved in the past.Residents and faculty were mingling and working harmoni-ously together. This is a sign of a great SAEM family. Meetingparticipants were advancing research and education in emer-gency medicine, which hopefully will improve patient care.

NEWSLETTERNEWSLETTER901 North

Washington Ave.

Lansing, MI

48906-5137

(517) 485-5484

[email protected]

www.saem.org

May-June 2001 Volume XIII, Number 3Newsletter of the Society for Academic Emergency Medicine

PRESIDENT’S MESSAGE

Marcus Martin, MD

(continued on page 19)

Update on SAEM ResearchFunding Programs

Brian J. Zink, MDPast President, SAEMUniversity of MichiganJames Quinn, MDChair, SAEM Grants CommitteeUniversity of California, San Francisco

SAEM began funding research over a decade ago whenMedtronic Physio Control began supporting the EMS Re-search Fellowship. But for many years this was the onlySAEM research training grant. In 1989 SAEM reserves wereused to create the Fund for Academic Emergency Medicine(FAEM), and we began funding a Resident Research YearAward and a Scholarly Sabbatical Grant. In the past year theSAEM designated research as a focus area. After a greatdeal of discussion with SAEM members, investigators, andpast grant recipients the Board decided to drop the FAEMdesignation, which we think may have been confusing tosome members and potential contributors. Now our researchfunding program will be referred to simply as that: the SAEMResearch Fund.

More has changed than just the name — we decided toincrease research funding this year by forming two newgrants. The Resident Research Year Award has been re-named the SAEM Research Training Grant, and the awardperiod is now two years with funding of $150,000. This is aresearch fellowship grant available to EM residents andjunior faculty. A totally new grant, the Institutional ResearchTraining Grant, will allow an EM program to develop a twoyear research fellowship, also funded at $150,000, at theirsite, and to recruit for a fellow to fill that position. As hasbeen previously announced, we also have a new grant thisyear, the one year $50,000 Neuroscience Research Fellow-ship that is supported by AstraZeneca. The EMS ResearchFellowship, sponsored by Medtronic Physio Control, will alsobe offered, and we are pleased to announce that the amountof this grant has been increased from $50,000 to $60,000 peryear. For a full listing of SAEM grants, see the summary onthe last page of this Newsletter.

SAEM is committed to providing even more research train-ing grants. We would eventually like to be able to offer anumber of these grants in each category, rather than just onea year. In order to do this, we will obviously need to increasethe SAEM Research Fund. The Board of Directors, with inputfrom the Financial Development Committee, chaired by ScottSyverud, will be exploring ways to increase funding, includingwhether there is a need for a formal development program.We will be reaching out to the corporate world, and to privatedonors. As SAEM members, we encourage you to contributeto the SAEM Research Fund on an annual basis through the


2

Tales . . . “Moving On”Being members of the human race, there is grouping

of persons with like relations called family that we allconnect with in some fashion. The family focus for eachof us varies and may entail relationships withgrandparents, parents, siblings, spouses, children,grandchildren, uncles, aunts, cousins, nieces, nephews,and yes even pets and the greater SAEM family. “Nosociety is so precious as that of one’s own family”(Thomas Jefferson 1789). My biggest family focus overthe past quarter of a century has been all the above butprimarily my wife, 2 sons 2 daughters, 2 dogs (Binky andPeanut) and 2 cats (Lion and Karma). Along the waythere were turtles, hamsters, guinea pigs, rabbits, fish,frogs, etc. I think you get the picture.

As the SAEM president, you will have to put up withme from time to time as I tell tales from the crib (home)to accompany newsletters. Over the years, each of mychildren has had assigned chores around the house(take out garbage, wash dishes, clean pool). They havebeen encouraged to manage their time (rules such as noTV or telephone calls or games for a period of time afterdinner so that home work could be completed). The dogsand cats also had to follow rules, especially as theyrelate to not leaving unwanted gifts inside the house,messing with the plants by kicking out dirt on the floor ordestroying household structures. There were joyfulmoments brought by the animals such as the litters ofkittens born in the girls’ bedroom closet, puppies born inthe basement, etc. Assignment of chores and time man-agement generally ended with good results. Sometimes,however, the well-meaning child can cause some head-aches by performing unassigned chores.

As I completed my residency in Cincinnati years ago,I prepared to move my family to Pittsburgh. Fish that wehad nurtured for a few years seemingly doubled in sizeovernight, and were floating belly up in the fish tank. Ourmistake was leaving the fish tank and a box of laundrydetergent mistaken for fish food in reach of one of ourtoddlers who fed the fish. I have learned to keep every-thing out of a toddler’s reach. I was sorry to lose thefish, but I had one less packing concern. We have nothad much success with sustaining fish over the years,but dogs and cats (to my wife’s dismay) are proliferativeand perpetual around our house. We no longer have tod-dlers but we certainly have a lot of precious experiencesto remember.

Congratulations to graduating EM residents, fel-lows and to those taking on new jobs. Good luckwith the move for all those facing the challenge thisyear. Don’t forget to forward your new address to theSAEM office.

Marcus Martin, MDSAEM President

AACEM Elections Held in AtlantaThe Association of Academic Chairs of Emergency Medicine(AACEM) convened an all-day meeting and retreat on May 5in Atlanta. The meeting was organized by Brian Gibler, MD,AACEM President. Annual elections were held during theAACEM Annual Business Meeting. Francis Counselman,MD, Eastern Virginia Medical School, was elected President-elect. Jerris Hedges, MD, Oregon Health SciencesUniversity, was elected Secretary-treasurer. Dr. Gibler wassucceeded as AACEM President by John Gallagher, MD,Montefiore Medical Center.

SAEM Election Results AnnouncedDuring the Annual Business Meeting in Atlanta Dr. Zinkreported on the newly established election procedureswhich had been approved by the membership throughamendments to the SAEM Constitution and Bylaws. Dr.Zink noted that these amendments allowed for theSAEM election to take place via mail ballot, rather thanrequiring members to be present at the Annual BusinessMeeting to vote. Dr. Zink reported that ballots for allelected positions were mailed to all active members andthat ballots for the resident member of the Board weremailed to all resident members. Over 750 activemember ballots and over 300 resident member ballotswere returned to the SAEM office and the results wereas follows:

President-elect: Roger Lewis, MD, PhD, Harbor-UCLA

Board of Directors: Carey Chisholm, MD, IndianaUniversityGlenn Hamilton, MD, Wright State UniversityDebra Houry, MD, Denver Health Medical Center

Nominating Committee: Leon Haley, MD, EmoryUniversityJeff Kline, MD, Carolinas Medical Center

Constitution and Bylaws Committee: Linda Spillane,MD, University of Rochester

Because Dr. Lewis was the current SAEM Secretary/-treasurer at the time of his election as President-elect, anunexpired term on the Board remained. Therefore,following the Annual Business Meeting, in compliance withthe Constitution and Bylaws, Marcus Martin, MD, SAEMPresident, announced the appointment of current Boardmember, Don Yealy, MD, University of Pittsburgh, to serveas Secretary/Treasurer. Dr. Martin also appointed FelixAnkel, MD, Regions Hospital, to serve a one-year term onthe Board of Directors to complete the complement ofeleven members of the SAEM Board of Directors.

In addition to the announcement of election results, theannual SAEM awards were formally presented at theAnnual Business Meeting:

Leadership Award: Louis Binder, MD, MetroHealthMedical CenterAcademic Excellence Award: Emanuel Rivers, MD,Henry Ford HospitalResident Research Year Awards: Roland Merchant,MD, Brown University, and Jason Haukoos, MD, Harbor-UCLAEMS Fellowship: Gina Wilson-Rameriz, MD, Universityof New MexicoYoung Investigator Awards: David Wright, MD, EmoryUniversity, Robert O. Wright, MD, Brown University, andTerry Venden Hoek, MD, University of Chicago2000 Annual Meeting Awards: Suzanne Schuh, MD,Emanuel Rivers, MD, Laurence Katz, MD, Xin-liang Ma,MD, PhD, David Wright, MD, D Matthew Sullivan, MD,Geoffrey Jackman, MD, Brigitte Baumann, MD, JoshuaRucker, BSc, and Valerie De Maio

Dr. Zink presented his Presidential Address (see page 7of this Newsletter) and introduced incoming President,Marcus Martin, MD, University of Virginia, who presentedhis first address to the membership during a special re-ception at the Jimmy Carter Center, which was spon-sored by the Department of Emergency Medicine atEmory University.

3

check off on your yearly dues form. Those members who arein a position to be planning the distribution of their estatesand inheritance are encouraged to consider the SAEM Re-search Fund. An investment in the early stage of an EM in-vestigator’s research career can reap enormous benefitsdown the line in research productivity and potential treat-ments for our emergency patients. Contributors can be as-sured that all donated money will go to directly to fundresearch.

SAEM has taken a step forward in becoming a significantforce in research funding for emergency medicine. With thehelp of SAEM members and the community at large, we canreach our goal of providing many quality research trainingexperiences for our young investigators.

Update on Research Funding Programs (Continued)

Jump-Starting Emergency CenterCategorization — An Opportunity

for DepartmentsThe importance of reviewing and categorizing Level

One Emergency Centers has recently received increasedattention (see March/April Newsletter) and was a topic ofdiscussion at the AACEM meeting on May 5, 2001 andthe May SAEM Annual Meeting. Many leaders inEmergency Medicine have agreed that it is crucial to havea number of EM programs apply for Level Onecategorization in the next year in order to have theprocess properly develop.

Two things that have been cited as deterrents forapplying for Level One Emergency Center Categorizationhave been the complexity and time required to completethe application, and cost. The SAEM Board hasaddressed these potential problems by asking the EECCommittee to examine the current application process andsuggest revisions that will make it simpler and less time-consuming. Also,

• The ECC application fee of $500 and associatedexpenses will be waived for any program that appliesfor ECC Level One prior to December 31, 2002

The SAEM Board is committed to the ECC process,and hopes that these changes will serve as a stimulus toacademic emergency medicine programs. Please do nothesitate to contact the SAEM office if you have anyquestions, suggestions or comments about the ECC LevelOne process.

Annual Meeting PresentationAwards Announced

The SAEM Program Committee is pleased to announcethe recipients of the Presentation Awards for the 2001Annual Meeting. Recipients will be recognized duringthe Annual Business Meeting during the 2002 SAEMAnnual Meeting in St. Louis. The awardees and theirassociated abstract citations (including title and co-authors) are listed below:

FACULTY CLINICAL SCIENCE PRESENTATIONSuzanne Schuh, MD, Hospital for Sick Children,TorontoSuzanne Schuh, Allan Coates, Rosemary Binnie,Tracey Allin, Cristina Goia, Mary Corey, Paul T Dick:Efficacy of Oral Dexamethasone in Outpatients withAcute Bronchiolitis. Acad Emerg Med 2001; 8:5:417

FACULTY BASIC SCIENCE PRESENTATIONRaymond Regan, MD, Thomas Jefferson Raymond F Regan, Yizheng Wang, Yaping Guo: Acti-vation of Extracellular Regulated Kinases PotentiatesHeme-mediated Oxidative Injury to Astrocytes. AcadEmerg Med 2001; 8:5: 510-511

YOUNG INVESTIGATOR PRESENTATIONEric W Dickson, MD, University of MassachusettsEric W Dickson, David J Blehar, Robert J Tubbs,Will iam A Porcaro, Robert E Carraway, KarinPrzyklenk: Preconditioning Induction Trigger EvokesCardioprotection via the Opiate Receptor. Acad EmergMed 2001; 8:5: 560-561

BASIC SCIENCE FELLOW PRESENTATIONHenry E Wang, MD, University of PittsburghHenry E Wang, James J Menegazzi, Christopher BLightfoot, Clifton W Callaway, Kristofer C Fertig,Lawrence D Sherman: Effects of Biphasic vs. Mono-phasic Defibrillation on the Scaling Exponent andDefibrillation Outcome in a Swine Model of ProlongedVentricular Fibrillation. Acad Emerg Med 2001; 8:5: 425

RESIDENT PRESENTATIONWende R Reenstra, PhD, Beth Israel Deaconess,BostonWende R Reenstra, Aristidis Veves, Daniel Orlow, JonA Buras: Decreased Proliferation and Cellular Signal-ing in Primary Dermal Fibroblasts Derived from Dia-betics versus Non-diabetic Sibling Controls. AcadEmerg Med 2001; 8:5: 519

MEDICAL STUDENT PRESENTATIONBret Rogers, Thomas Jefferson University Bret Rogers, Yaping Guo, Raymond F Regan: HemeOxygenase-2 Knockout Neurons are Less Vulnerableto Hemoglobin Toxicity. Acad Emerg Med 2001; 8:5:510

Alex Limkakeng, University of Pennsylvania Alex Limkakeng, W Brian Gibler, Charles Pollack,James W Hoekstra, Brian Tiffany, Frank Sites, FrancesS Shofer, Judd E Hollander: Combination of GoldmanRisk and Troponin I for ED Chest Pain Patient RiskStratification. Acad Emerg Med 2001; 8:5: 536

CORD Meets in AtlantaApproximately 200 members attended the Council ofEmergency Medicine Residency Directors (CORD) Meeting inAtlanta on May 7. Steve Hayden, MD, from the University ofCalifornia, San Diego was elected President-elect, SusanDufel, MD, from Hartford Hospital, was electedSecretary/Treasurer, and Mary Jo Wagner, MD, fromSaginaw Cooperative Hospitals, Inc. was elected to the Boardof Directors. The CORD Faculty Teaching Award waspresented to James Ritchie, MD, from Portsmouth NavalHospital. The CORD Resident Academic Achievement Awardwas presented to Andra Blomkalns, MD, from the Universityof Cincinnati and Kevin Merrell, MD, from Denver HealthMedical Center. The next CORD meeting will be held duringthe ACEP Scientific Assembly in Chicago on October 14.

4

Academic Emergency Medicine Annual Report

Michelle H. Biros, MS, MDEditor-In–ChiefHennepin County Medical CenterMinneapolis

Jim Adams, MDSenior Associate EditorNorthwestern Medical CenterChicago

The editors of Academic EmergencyMedicine are pleased to provide youwith this journal report for 2000. Thishas been the seventh year of publica-tion for the journal, and while the look,content, editors and contributors havechanged over time, we remain com-mitted to the production of a high qual-ity spoke-piece for our academic andclinical specialty. We have benefitedfrom your input, and welcome yourquestions, comments and suggestions;please feel free to contact any of theeditors at any time.

In May 2000, the journal becameavailable on line (www.aemj.org). FromOctober 2000 to March 2001, our sitewas hit 37,725 times. The most fre-quently hit journal sections were Clini-cal Investigations (6100 hits), followedby Brief Reports (2868), Clinical Prac-tice (2849) and Basic Investigations(1802). We can also track on a monthlybasis, who is accessing the website.

In addition to seeing the contents ofthe current month’s journal, the on linejournal also provides abstracts of all ar-ticles published in AEM, and full textfrom 1999. Many additional special fea-tures make the on line journal veryuseful to authors and readers alike.References listed in published articlescan be accessed directly from our web-site. Other articles by the same authoror articles of similar content are linkedto published articles. By tracking thenumber of hits we receive, we are ableto provide our readers with lists of themost frequently cited and most fre-quently read articles in any month, overthe year, or since the beginning of thejournal’s publication history. We haveperiodically provided this information inthe journal, and will continue to do soboth in the journal and in the SAEMNewsletter. We are also exploring linkswith funding agencies, research foun-dations, and other potential sources ofresearch and educational support.

Based on the manuscript checklistprovided at the time of manuscript sub-mission, we are able to track “hottopics” in current emergency medicineresearch and education, as defined bythe submitting authors. This trackingallows us to examine where we are withour specialty’s academic evolution andwhere we might as a journal foster ad-

ditional growth and development. Themanuscript checklist is a vital step inour review process as well; the cate-gories designated on this list by thesubmitting authors drives the assign-ment of the associate (decision) editorsresponsible for processing the manu-script, and the reviewers who will pro-vide peer review. Careful considerationof these categories will speed the entireprocess, and we encourage our authorsto carefully consider this when theysubmit their original works. We will con-tinue the policy of providing only con-sensus reviews to the authors; this ad-ditional step in the review process re-duces redundancy or contradiction inthe manuscript review process. Theconsensus review has been popularwith our authors, who often relate thatthe reviews are easy to understand andaddress. A copy of our consensus re-views are also usually supplied to thepeer reviewers. Comparing their re-views with the overall assessment ofthe manuscript provides feedback anda learning tool for our reviewers.

Again this year, the journal has dem-onstrated continued tangible growth.Our subscriptions have topped over6000. Our impact factor, calculatedonly for the last 3 years, has increasedfrom just over 1 in 1998 to a respect-able 1.75 for 1999. From January 1 toDec 31, 2000, we received 578 manu-scripts. As of this writing, decisionshave been made on 574 (a few revi-sions have not yet been received) withan overall acceptance rate of 39%. Theaverage time to first decisions in 2000was 35.4 days and for revisions,decisions were rendered in an averageof 13.4 days The overall turn aroundtime was 28.3 days. A large number ofour manuscripts are submitted electron-ically (send to [email protected]); thisspeeds their in house review, their dis-tribution to decision editors, and theirdelivery to peer reviewers. We also re-ceive most of our peer reviews elec-tronically; undoubtedly this has helpedkeep our turn around times veryreasonable.

We believe our journal has responsi-bilities beyond the publication of excel-lent and relevant original reports ofbasic, clinical and educational ad-vances. As a vehicle for the dissemina-tion of thoughts and visions of emer-gency medicine academicians, educa-tors and clinicians, we have the oppor-tunity to call attention to special con-cerns of our practice. With this in mind,we convened a consensus conferencein May 2000, on “Errors in EmergencyMedicine,” with the purpose of criticaleducation, provocative and thoughtfuldiscussion, and creative development

of research and educational initiativessurrounding this important concept. Ledby Dr. Bob Wears, this conference washeld in conjunction with the SAEMAnnual Meeting, and attended by over90 individuals with diverse backgroundsand from many countries. The pro-ceedings of this conference, as well asa series of articles written in responseto a call for papers on the topic, werepublished in the November issue ofAEM. Because of its success, we havedecided to continue to convene con-sensus conferences on topics of med-ical, socioeconomic and political sig-nificance for practitioners of emergencymedicine. The 2001 AEM consensusconference is “The Unraveling SafetyNet” and was held on May 9, 2001.

Our journal has been incredibly for-tunate in the talent, enthusiasm anddedication demonstrated by our edi-torial board. In 2000, we added severalnew editors to complement our ranks.We welcome Felix Ankel, CharleneBabcock Irvin, Catherine Marco andMarco Sivilotti to the editorial board. Weare privileged to have them among us,and look forward to their contributions.We also most sincerely thank LouBinder, Dane Chapman, John Marx,Paul Pepe, and Andy Zechnich, longstanding editors who rotated off theboard in 2000.

We also offer our sincere thanks toour 233 peer reviewers. Without thegenerous commitment of these dedi-cated individuals, our journal’s qualitywould undoubtedly suffer. Our re-viewers are listed in the December2000 issue. Special thanks to ThomasAuble, Patrick Brunette, LewisGoldfrank, Steven Green, and JohnYounger. Based on their consistentlythorough, t imely and supportivereviews, the editors have designatedthem as Outstanding Reviewers for2000.

We hope our journal has continuedto serve your needs, and that this reportprovides you with a glimpse of ourworkings. Your comments and ideasare very valuable to us, and we hopeyou continue to help direct our vision. Ithas been an honor to work with the edi-torial board, the reviewers, the authorsand our readers in 2000. We look for-ward to another exciting year of con-tinued growth and fruitful collaborationsin 2001.

(continued on next page)

Visit AEM online atwww.aemj.org

5

Academic Emergency Medicine (Continued)

HOT TOPICS, AEM 2000; Top 10(This list is derived from the manuscript checklists of all articles submitted in 2000. Thecategory designation is selected by the authors and drives assignment of the decision editorsand peer reviewers. Authors may designate more than one topic category).

No. of manuscripts received, No of manuscripts acceptedTopic including this designation with this designation

Cardiovascular Emergencies 348 134Educational Concepts 296 101Administration/ QI 260 101General Clinical E Med 259 92EMS 248 82General Pediatrics 228 79Injury Prevention 128 41Infectious disease 126 39Medical Imaging 117 42General Trauma 106 31

MOST FREQUENT USERS OF THEAEM WEBSITE DURING MARCH

2001(based on frequency of individual institutional

addresses accessing the website)

McMasters UniversityWelch Medical Library- JHU

Duke University LibraryNIH Library/ Acquisitions

Texas Medical CenterUniversity of Pittsburgh

University of San FranciscoUniversity of Washington

University of MichiganYale University

1. JF Tucker, RA Collins, AJ Anderson, J Hauser,J Kalas, FS Apple Early diagnostic efficiencyof cardiac troponin I and Troponin T for acutemyocardial infarction Acad Emerg Med Jan01, 1997 4: 13-21.

2. WD Rosamond, RA Gorton, AR Hinn, SMHohenhaus, DL Morris Rapid response tostroke symptoms: the Delay in AccessingStroke Healthcare (DASH) study Acad EmergMed Jan 01, 1998 5: 45-51.

3. JE Hollander, SM Valentine, GX Brogan Aca-demic associate program: integrating clini-cal emergency medicine research with un-dergraduate education Acad Emerg Med Mar01, 1997 4: 225-230.

4. JE Hollander, RS Hoffman, P Gennis, PFairweather, MJ DiSano, DA Schumb, JAFeldman, SS Fish, S Dyer, P Wax Prospective

multicenter evaluation of cocaine-asso-ciated chest pain. Cocaine Associated ChestPain (COCHPA) Study Group Acad EmergMed Jul 01, 1994 1: 330-339.

5. Core Content for emergency medicine. TaskForce on the Core Content for EmergencyMedicine Revision Acad Emerg Med Jun 01,1997 4: 628-642.

6. DJ Karras Statistical methodology: II. Relia-bility and variability assessment in studydesign, Part A Acad Emerg Med Jan 01,1997 4: 64-71.

7. JW Hoekstra, WB Gibler, RC Levy, M Sayre,W Naber, A Chandra, R Kacich, R Magorien, RWalsh Emergency-department diagnosis ofacute myocardial infarction and ischemia: acost analysis of two diagnostic protocolsAcad Emerg Med Mar 01, 1994 1: 103-110.

8. BT Jolly, E Massarin, EC Pigman Color Dop-pler ultrasonography by emergency physi-cians for the diagnosis of acute deep venousthrombosis Acad Emerg Med Feb 01, 19974: 129-132.

9. SO Henderson, RJ Hoffner, JL Aragona, DEGroth, VI Esekogwu, D Chan Bedside emer-gency department ultrasonography plusradiography of the kidneys, ureters, andbladder vs intravenous pyelography in theevaluation of suspected ureteral colic AcadEmerg Med Jul 01, 1998 5: 666-671.

10. SW Burgher, TK Tandy, MR Dawdy Trans-vaginal ultrasonography by emergency phy-sicians decreases patient time in the emer-gency department Acad Emerg Med Aug 01,1998 5: 802-807.

MOST FREQUENTLY CITED, TOP 10 (to March 2001; calculated monthly)Rankings are based on hits received by articles archived on this site only.

MOST FREQUENTLY READ (From AEM site hits only; recalculated) Top 10 Articles October 2000 - March 2001

Full Age of Articletext Total in days from

HTML PDF Abstracts Accesses 03/31/2001 Article

449 126 196 771 182 Section: CLINICAL INVESTIGATIONS Amy C. Plint, Martin H. Osmond, Terry P. Klassen The Efficacyof Nebulized Racemic Epinephrine in Children with Acute Asthma: A Randomized, Double-blindTrial Oct 01, 2000 7: 1097-1103

581 103 0 684 151 Section: COMMENTARIES Michelle H. Biros, James G. Adams, Robert L. Wears Errors in EM: A Callto Action Nov 01, 2000 7: 1173-1174

394 23 261 678 121 Section: CLINICAL INVESTIGATIONS H. Bryant Nguyen, Emanuel P. Rivers, Suzanne Havstad, BernhardKnoblich, Julie A. Ressler, Alexandria M. Muzzin, Michael C. Tomlanovich Critical Care in theED: A Physiologic Assessment and Outcome Evaluation Dec 01, 2000 7: 1354-1361

330 29 292 651 90 Section: CLINICAL INVESTIGATIONS William J. Ruth, John H. Burton, Anthony J. Bock IntravenousEtomidate for Procedural Sedation in ED Patients Jan 01, 2001 8: 13-18

300 24 295 619 59 Section: CLINICAL INVESTIGATIONS Mary Chellis, James E. Olson, James Augustine, Glenn C.Hamilton Evaluation of Missed Diagnoses for Patients Admitted from the ED Feb 01, 2001 8: 125-130

327 18 274 619 59 Section: CLINICAL PRACTICE Robert W. Derlet, John R. Richards, Richard L. Kravitz FrequentOvercrowding in U.S. ED Feb 01, 2001 8: 151-155

312 16 276 604 90 Section: BASIC INVESTIGATIONS Christina L. Schenarts, John H. Burton, Richard R. RikerAdrenocortical Dysfunction Following Etomidate Induction in ED Patients Jan 01, 2001 8: 1-7

320 8 264 592 59 Section: BASIC INVESTIGATIONS Alan C. Heffner, Jeffrey A. Kline Role of the PeripheralIntravenous Catheter in False-positive D-dimer Testing Feb 01, 2001 8: 103-106

296 31 260 587 121 Section: CLINICAL INVESTIGATIONS Erik G. Laurin, John C. Sakles, Edward A. Panacek, Aaron A.Rantapaa, Jason Redd A Comparison of Succinylcholine and Rocuronium for Rapid-sequenceIntubation of ED Patients Dec 01, 2000 7: 1362-1369

255 18 287 560 59 Section: CLINICAL PRACTICE Marc H. Gorelick, Chistopher Lee, Kathleen Cronan, Susanne Kost,Kathleen Palmer Pediatric Emergency Assessment Tool (PEAT): A Risk-adjustment Measure forPediatric Emergency Patients Feb 01, 2001 8: 156-162

3,564 396 2,405 6,365 99.1 (avg age) Totals for Top 10 Articles October 2000 - March 2001

6

Pediatric Emergency Medicine: Making SAEM a Comfortable HomeRoger J. Lewis, MD, PhDHarbor-UCLA Medical CenterSAEM Board of Directors

Most medical care for pediatric medi-cal and surgical emergencies occurs inour nation’s emergency departments,rather than in the offices of pediatri-cians.1 Studies on the preparedness ofpediatricians’ offices to deal with emer-gencies have demonstrated, not surpris-ingly, that many are ill equipped andtheir staff ill prepared to treat true emer-gencies.2-4 With respect to capability forand experience with pediatric emergen-cies, however, emergency departmentsare themselves quite heterogenous.They range from low-volume communitydepartments, for which the presentationof a critically-ill child is unusual, to theemergency departments of specializedpediatric tertiary medical centers, inwhich many of our academic pediatricemergency medicine colleagues prac-tice. The vast majority of children withemergencies, however, are treated ingeneral emergency departments, ratherthan in dedicated pediatric emergencydepartments. Thus, there is a paradoxi-cal contrast between the practice set-tings in which most of these patients re-ceive care, and the practice settings inwhich most academic pediatric emer-gency medicine specialists practice.

This paradox is mirrored in our pro-fessional organizations. During my re-search career, almost serendipitously, Ihave the opportunity to interact with anumber of outstanding academicians inthe field of pediatric emergency medi-cine. While I interact with these col-leagues in a variety of professional set-tings, I do not, in general, see them atthe SAEM Annual Meeting. The major-ity of pediatric emergency medicinespecialists are primarily trained in pedi-atrics and, for historical or cultural rea-sons, identify most closely with pedi-atric societies, for example, the Amer-ican Academy of Pediatrics (AAP), theAmbulatory Pediatric Association(APA), the American Pediatric Society(APS), and the Society for Pediatric Re-search (SPR). To accommodate theirinterests, these organizations have de-veloped specific emergency medicinechapters, sections, or interest groups,which in some cases are quite active.

Although I intend no disrespect ofthese organizations, I believe the cur-rent situation is unfortunate for the fieldof emergency medicine. In many ways,the interests of academic pediatricemergency medicine specialists moreclosely resemble those of the academicemergency physicians who form thebulk of SAEM’s active members, ratherthan those of academic pediatricians.Furthermore, I believe many of the re-

search interests of our members andour colleagues in pediatric emergencymedicine are quite similar. Lastly, theresearch methodologies used in ourtwo fields, the barriers to research, andmany cultural and political considera-tions are similar as well.

The lack of an effective and syner-gistic relationship between the aca-demic emergency medicine community,as represented by SAEM, and the ma-jority of academicians in pediatric emer-gency medicine has real conse-quences. Because we do not frequentlywork side by side on academic, clinical,and research tasks with our pediatricemergency medicine colleagues,neither group fully appreciates thebroad and deep expertise that exists inthe other. This mutual ignorance resultsin lost opportunities for scientific, ad-ministrative, and public health collabor-ations between pediatric and adultemergency medicine specialists. It alsohampers our efforts to improve thequality of pediatric emergency care inemergency departments across thecountry, and to improve the quality ofpediatric emergency medicine trainingwithin our emergency medicine resi-dency training programs.

What, then, can be done to encour-age the full participation of pediatricemergency medicine academicianswithin our Society? A number of yearsago, the SAEM Program Committee de-cided to allow the presentation of ab-stracts at the SAEM Annual Meetingthat had also been presented at na-tional meetings held within 30 daysprior to the SAEM Annual Meeting. Thisallowed for the presentation of ab-stracts that had been presented at theannual meeting of the pediatric aca-demic societies (i.e., the AmericanPediatric Society, the Society for Pedi-atric Research, and the AmbulatoryPediatric Association), which is tra-ditionally held just before the SAEM An-nual Meeting. While this allowed pedi-atric emergency medicine research tobe presented in both venues, it did notaddress the difficulty many facultymembers face in traveling to two na-tional meetings within a month’s time.The SAEM leadership has worked toensure the presence of pediatric emer-

gency medicine specialists on the An-nual Meeting Program Committee andtried to encourage the activities of theSAEM Pediatric Interest Group. Thecurrent SAEM President has also initi-ated an outreach program aimed atpediatric emergency physicians. Whilethe SAEM Board of Directors has con-sidered other options for encouragingthe involvement of pediatricians in oursociety, many have been uneasy at theprospect of singling out a single area ofemergency medicine, because of theappearance of special treatment. Forexample, would it be appropriate tospecifically encourage those with an in-terest in pediatric emergency medicineto attend our meeting, without makingsimilar efforts towards those with aninterest in geriatric emergencies?

Writing as an individual, it is my opin-ion that we have not found a good solu-tion to these issues. I believe we havefailed to engage a significant group ofclinicians and academicians, whosearea of interest falls squarely within thefield of emergency medicine. I wouldlike to encourage all SAEM members toreach out to our pediatric emergencymedicine colleagues and make themwelcome in our Society. Specific propo-sals for increasing the participation ofpediatric emergency medicine academi-cians within our Society should be dir-ected to the Chair of the Pediatric Emer-gency Medicine Interest Group, to theSAEM Board of Directors, or to theSAEM President. All can be reachedvia the national SAEM office.

References1. Institute of Medicine, Committee on

Pediatric Emergency Medical Services.Durch JS, Lohr KN, eds. Institute ofMedicine Report: Emergency MedicalServices for Children. Washington, DC:National Academy Press;1993

2. Flores G, Weinstock DJ. The prepared-ness of pediatricians for emergencies inthe office. Arch Pediatr Adolesc Med1996;150:249-256.

3. Fuchs S, Jaffe DM, Christoffel KK.Pediatric emergencies in office practices:Prevalence and office preparedness.Pediatrics 1989;83:931-939.

4. Heath BW, Coffet JS, Malone P, CourtneyJ. Pediatric office emergencies andemergency preparedness in a small ruralstate. Pediatrics 2000;106:1391-1396.

Password Required to Receive AEM OnlineSAEM members must now use a password to access their online subscription to

Academic Emergency Medicine. All SAEM members are entitled to a receive a freesubscription of both the print copy and online version of AEM.

To activate your subscription go to the website: <www.aemj.org>. Click on thesubscriptions button. Click on the link “activate your member subscription.” Enteryour membership number (which is printed above your name on the mailing label ofthis Newsletter) and click the submit button. You will then be asked to select a username and password. If you need assistance or do not have a member number,send an e-mail to [email protected] or call 517-485-5484.

7

SAEM — State of the Society, 2001Brian Zink, MD*SAEM Past President

The calendar of the Society for Aca-demic Emergency Medicine runs fromMay to May, and the Annual Meeting isalso the annual time of transition. Wehave just announced the results of ourelections and in a few minutes I willwelcome our new President. But first Iwould like, as my final official duty, togive you an assessment of the State ofthe Society, and to share with yousome observations and insights that Ihave gained while serving as President.

Last year in my opening address Iquoted poetry and received a lot ofblank stares. So, this year I will presentthe State of the Society in a format thatis more familiar to academic emergencyphysicians — an ED patient presen-tation. Here goes:

Chief Complaint(s): Not enough time.Not enough money.

Present History: SAEM is a 12 yearold academic medical organizationwhose members are emergency medi-cine faculty, residents, and medical stu-dents. Most members are experiencinglevels of academic discomfort that haveincreased exponentially in the past fiveyears. Most academic Emergency De-partments (ED’s) have seen a 10 to20% increase in patient volumes over ashort period of time, along with hospitalresource cutbacks and a national nurs-ing shortage. Clinical demands haveraised faculty and resident stress levelsand threaten the quality of academiclife. Academic ED’s are experiencing anumber of symptoms, including conges-tion, obstipation, constipation, fre-quency, hesitancy, and urgency. Thesymptoms are made worse by some-thing called HCFA, and there are noapparent relieving factors. Despite themaladies experienced in their clinicalsettings, some SAEM members are en-joying increased success as re-searchers and educators. Many arevolunteering their time on SAEM com-mittees, task forces and interestgroups. This has helped the Society toachieve a great deal in the past year inthe areas of research, faculty develop-ment and national affairs. SAEM is runout of an executive office where astrong tendency toward obsessive workbehaviors has been noted. However,the members do not view this as asignificant problem.

Past History: Since its formation bythe merger of the University Associationfor Emergency Medicine and the Soci-ety of Teachers of Emergency Medicinein 1989, SAEM has grown and changedtremendously. The consistent crowning

achievement each year has been theAnnual Meeting, which is the largestforum for presentation of emergencymedicine research and educationalprograms in the world. The Society’sjournal, Academic Emergency Medicine,has also grown considerably since itsinception in 1995. About 6 years agoSAEM formally started Interest Groups,which are collections of members whohave similar academic interests, andmany of these have developed intoactive groups that have contributedsignificant scholarly work. SAEM has aslight inferiority complex that seems tobe resolving, and its only other chroniccondition is anemia in the research-funding realm, which has been partiallycorrected in the past year.

Review of Systems: Unlike the aver-age academic ED chart’s review of sys-tems, which often says: “all 10 reviewedand negative”, the SAEM review of sys-tems is a key component of the presen-tation. Our systems are the SAEM com-mittees, task forces, and interestgroups. I do not have the time to reporton all of our “systems”, but will com-ment on those that were central to ourfocus areas of research, faculty devel-opment, national affairs, and someothers that did great work this year.

First, research: our message for theyear was that good research requirestraining, a mentor, focus, resources,time, and stable funding. The SAEMBoard of Directors and the ResearchCommittee helped to spread the word,and the Grants Committee, headed byArt Sanders, debuted this year and didan outstanding job of consolidating ourexisting grants and improving theefficiency and quality of grant review. Italso helped to form the new Neurosci-ence Research Fellowship that is sup-ported by AstraZeneca. We patternedthis grant after our long-standing, verysuccessful EMS Research FellowshipGrant, that has been funded for over adecade by Medtronic Physio-Control.The Grants Committee, and other com-mittees also participated in our dialogueabout research, and this eventually leadto the Board’s decision this winter tochange the Resident Research YearGrant to the SAEM Research TrainingGrant, which is a two year, $150,000research fellowship grant. We alsoadded the $150,000 Institutional Re-search Training Grant which providesfunding to an EM program to train a re-search fellow for two years. In makingthis decision, we essentially put ourmoney where are mouths are – if weare to advocate for strong researchtraining for our residents and juniorfaculty, then we must offer grants thatallow for two years of training and a

large amount of protected time. Wealso intentionally put a bit of pressureon the Society in forming these grants.A bit of math will demonstrate thatgiven our current reserves, we cannotfund at this level for more than a fewyears. Since we plan to further expandthe SAEM Research Funding Program,we will need to increase fund-raisingdramatically to meet our goals.

Part of our push in the research areathis year was to highlight those SAEMmembers who have followed a success-ful path in their research careers, and toencourage the exchange of ideas andinformation and informal mentoring thatwill help our more junior investigators.We have seen a great deal of this so farat the Annual Meeting. The maturation ofour research programs could not havecome at a more opportune time, as fed-eral, corporate and foundation supportfor research is at an all time high. Moreand more EM investigators are devel-oping to the point of being able to con-sistently compete for federal researchgrants. We are now sitting on study sec-tions at the NIH, and forming the net-works and collaborations that lead tosustainable research programs.

Our next focus area for the year wasfaculty development. The Faculty Devel-opment Committee under John Galla-gher’s direction has done a great jobputting together a faculty developmentwebsite with a new Faculty DevelopmentGuide that will soon be available thoughtthe SAEM website. As you have seen,this meeting is also full of faculty devel-opment discussions and presentations.

In the area of National Affairs wehave made significant progress in thepast year. Jim Hoekstra chaired theNational Affairs Task Force, and was re-sponsible for coordinating SAEM’s for-mal responses to a number of nationalissues including a response to the Medi-care Payment Advisory Commission onhow regulatory burdens affect ED pa-tients and physicians, and a commenton the Prospective Payment System forHospital Outpatient Services final rule,which related to observation care reim-bursement, and other responses. Wehave also examined the big picture ofhow we should advocate for our emer-gency patients and our trainees at anational level. Currently we do not havethe infrastructure to do this effectively.Last fall, we visited the American Col-lege of Emergency Physicians Washing-ton Office to discuss ways that we couldcollaborate on areas of mutual interestand importance. This has resulted inSAEM being a bit more in the loop, andable to respond quicker to situations thatarise in Washington.


8

The 2001 NRMP Match in Emergency MedicineLouis Binder, MD and Nicholas Jouriles, MDCase Western Reserve University/MetroHealth Medical Center/Cleveland Clinic EM Residency

The results of the 2001 NRMP Match became final on March 22, 2001. Emergency Medicine residency programs offered a totalof 1148 entry level positions (5.0% of total positions in all specialties). The following numbers (taken from the 2001 NRMP DataBook) include information from all programs that entered the 2001 Match:

1999 2000 2001Total # of NRMP positions 22,584 22,722 22,878Overall % of positions unfilled 11% 11% 11%Number of EM programs listed 118 120 120

(103 PG1, 15 PG2) (104 PG1, 16 PG2) (106 PG1, 14 PG2)Total PG1/PG2 entry positions 1063 1118 1148

(912 PG1, 151 PG2) (971 PG1, 147 PG2) (1001 PG1, 147 PG2)EM positions/total NRMP positions 4.7% 4.9% 5.0%

# EM programs with PG1 vacancies 11/103 (11%) 2/104 (2%) 3/106 (3%)# unmatched EM PG1 positions 30/912 (3%) 4/971 (0.4%) 6/1001 (0.6%)

# EM programs with PG2 vacancies 1/15 (7%) 2/16 (12%) 1/14 (7%)# unmatched EM PG2 positions 2/151 (1%) 3/147 (2%) 3/147 (2%)

Total # EM programs with vacancies 12/118 (10%) 4/120 (3%) 4/120 (3%)Total # unmatched EM positions 32/1063 (3%) 7/1118 (0.6%) 9/1148 (0.8%)

Applicant Pool Data

Applicants who ranked only EM programs:1999 2000 2001

US graduates 719 818 825Independent applicants 256 294 279Total applicants 975 1112 1104

Applicants who ranked at least one EM program:US graduates 953 1056 1092Independent applicants 437 492 430Total applicants 1390 1548 1522

US seniors applying only to EMPrograms who went unmatched 28/719 (3.9%) 54/818 (6.6%) 56/825 (6.8%)

Independent applicants applying 168/256 (66%) 185/294 (63%) 190/279 (68%)only to EM programs who went unmatched

Breakdown of filled EM positions by type of applicant:

1999 2000 2001PG1 EM positions 912 971 1001Filled by US graduates 714 (78%) 794 (82%) 825 (82%)Filled by independent applicants 168 (18%) 172 (18%) 170 (17%)Total filled 882 (97%) 966 (99.5%) 995 (99.4%)

PG2 EM positions 151444 41 147 147Filled by US graduates 125 (83%) 110 (75%) 114 (78%)Filled by independent applicants 24 (16%) 34 (23%) 30 (20%)Total filled 149 (99%) 144 (98%) 144 (99%)

Total EM positions 1063444 41 1118 1148Filled by US graduates 839 (79%) 904 (81%) 939 (82%)Filled by independent applicants 192 (18%) 206 (18%) 200 (17%)Total filled 1031 (97%) 1110 (99.3%) 1139 (99.2%)

** For PG1 filled entry positions (995), 825 were filled by US seniors, 81 were filledby US physicians, 53 by osteopathic physicians, 20 by US foreign medicalgraduates, 9 by international medical graduates, 3 by Canadian physicians, and 4by Fifth Pathway graduates.

From these data, several conclusionscan be drawn:

1. After a reduction of 58 entry levelpositions (PG1 and PG2 entry, a 5%decrease) between 1998 and 1999resulting from GME downsizing initi-atives, Emergency Medicine exper-ienced an increase of 55 entry levelpositions in the 2000 match (5%increase) and an additional increaseof 30 entry level positions in the2001 match (additional 2.7% in-crease). With the addition of no newEmergency Medicine residencyprograms in the last year, it appearsthat this growth has occurred due tothe expansion of quotas in existingresidency programs.

2. The overall demand for EM entrylevel positions (i.e. number of appli-cants) remained relatively flat from2000, after raising 11 to 15% lastyear. US seniors within the EM ap-plicant pool increased by 7 to 36seniors (1 to 3% increase), but inde-pendent applicants within the pooldecreased by 15 to 62 applicants (5to 13% decrease). The number ofapplicants (1104 applicants rankedonly EM programs, and 1522 appli-cants ranked at least one EM pro-gram, in competition for 1148 entrylevel spots) is the second highestever within the match, comparedwith last year’s numbers (1112 and1548, respectively). The excess ap-plicant demand over and above thesize of the training base is 243 to374 applicants (21 to 33% surplus),depending on how the parameters ofthe applicant pool are determined.


9

Semi-Final CPC Competition ResultsOn May 5, fifty Emergency Medicine Residency Programs

competed in the Eleventh Annual Semi-Final CPC Compe-tition. A resident from each participating program submitted achallenging unknown case for discussion by an attendingfrom another residency program. The faculty discussant had20 minutes to develop a differential diagnosis and explain thethought process leading to the final diagnosis.

Winning presenters and discussants were selected fromeach of five tracks and these individuals will represent thosetracks at the national competition. The CPC finals will beheld at the ACEP Scientific Assembly in Chicago on October16. It is not necessary to register for the Scientific Assemblyif you plan only to attend the CPC. The CPC Competition issponsored by ACEP, CORD, EMRA, and SAEM.

Congratulations to the 2001 winners!

Track ABest Presenter, Elaine Sapiro, MD, University of California,San DiegoBest Discussant, Annie Sadosty, MD, Mayo Clinic

Track BBest Presenter, Tricia Villanueva, MD, MCP-HahnemannBest Discussant, Victoria Palmer-Smith, MD, EmoryUniversity

Track CBest Presenter, Randy Goldstein, MD, Texas Tech University Best Discussant, Robert Baevsky, MD, Baystate MedicalCenter

Track DBest Presenter, Michael Gisondi, MD, Stanford-KaiserBest Discussant, Darren Braude, MD, University of NewMexico

Track EBest Presenter, Marc Roy, MD, Baystate Medical Center Best Discussant, Mary Ryan, MD, Lincoln Medical andMental Health

3. A small increase in the supply of EM entry level positions,coupled with relatively flat demand for them, resulted in anearly equivalent fill rate for EM programs (99.2%) in 2001compared with 99.4% in 2000. This was the highest fillrate of any specialty in the 2001 Match. The very low num-ber of unmatched postions (nine, or less than 1% of avail-able positions) also reflects these supply and demandtrends.

4. The proportions of EM positions filled by US seniors, USphysicians, and international graduates remained stable in2001 compared with 2000. There was a slight increase inthe proportion of positions filled by US physicians, and aslight decrease in the percentage of positions filled byinternational graduates.

5. The unmatched rate for US seniors applying to EMprograms remained relatively level (from 6.6% in 2000 to6.8% in 2001), again reflecting stability of supply anddemand trends. These data continue to support the notionthat a very reasonable probability remains for most USseniors (93% probability) to match into an EM residency.The unmatched rate for independent applicants has beenin the 60-70% range for the past 3 years, suggestingsignificant difficulties for unsponsored applicants to com-pete successfully for an EM position.

NRMP Match (Continued)

EMF/SAEM Medical Student Grantand Innovations in MedicalEducation Grant Recipients

The Emergency Medicine Foundation and SAEM arepleased to announce the recipients of the 2001-2002EMF/SAEM Medical Student and Innovations in MedicalEducation Grants. Each of the Medical Student Grantrecipients will receive $2,400 and the Innovation in Med-ical Education Grant recipient will receive $5,000 infunding from EMF and SAEM.

William Spivey GrantApplicant: Chaya G. BhuvaneswarInstitution: Stanford University Preceptor: H. Range Hutson, MD Project Title: Do Emergency Department Health Providers’Diagnostic Criteria for Identifying Domestic Violence Pre-senting to the ED Match Those Criteria Identified byDomestic Violence Survivor Focus Groups? A Cross Sec-tional Study

Applicant: Hamal GadaInstitution: Hospital of the University of PennsylvaniaPreceptor: Rober W. Neumar, MD, PhD Project Title: Proteolytic Cleavage of Calcium RegulatoryProteins in Primary Hippocampal Neurons Following Sim-ulated Ischemia

Applicant: Richard KoInstitution: Maricopa Medical CenterPreceptor: Christopher Lipinski, MD Project Title: Laminin and its Effects on Mature NeuronalViability

Applicant: Allyson A. KreshakInstitution: Thomas Jefferson UniversityPreceptor: Bernard L. Lopez, MD Project Title: The Value of Plasma L-arginine and NitricOxide Levels in Predicting the Severity of Acute Vasooc-clusive Sickle Cell Crisis

Applicant: Jonathan LiInstitution: University of California, San FranciscoPreceptor: James Quinn, MDProject Title: Patterns of Complementary and AlternativeMedicine Use in ED Patients and Its Association withHealth Care Utilization

Applicant: Anthony M. NapoliInstitution: Providence HospitalPreceptor: David Milzman, MD Project Title: Effectiveness of Non-Invasive VentilatorySupport (Bi-Level Positive Airway Pressure) to AvoidIntubation in the ED: A Comparison of Hypercapnic vs.Hypoxic Respiratory Failure

Applicant: Lane McNeil Smith Institution: Virginia Commonwealth UniversityPreceptor: Robert Wayne Barbee, PhD Project Title: In Vivo Analysis of Critical Oxygen Deliveryin the Spontaneously Hypertensive Rat

Innovations in Medical EducationValidation of the Educational Intervention “GRIEV_ING”as a Tool to Improve Resident Death Notification Skills,Cherri D. Hobgood, MD, University of North Carolina atChapel Hill

10

Meeting Wilderness Adventure RaceMary Jo Wagner, MDSaginaw Cooperative Hospitals, Inc.SAEM Program Committee

The First Annual Medical Wilderness Adventure Race(Medwar) was held outside of Augusta, GA on April 29, 2001.There were 21 3-4 member teams who participated in the Eco-Challenge type race over a 6-10 hour period. Teams werecomposed of Emergency Medicine residents, faculty, attendings,nurses, physician assistants and EMS personnel.

The race was designed around completing medical challenges.These included multiple extrication tasks, usually requiring theteam to immobilize, then carry an injured team member, whilestruggling through mud and water and traversing over obstacles.Another challenge required team members to triage and treatseven disaster patients secondary to a lightning storm. A thirty-question test on wilderness medicine had teammates debatingquestions on hypothermia, poisonous animals, and identifying theflora in an alligator’s mouth. A significant time penalty was givenfor incorrect answers to the quiz questions and if improper triagingwas done, the team was sent on a diversionary route.

The physical portion of the challenge was varied. Running wasa staple of the race. Other activities included canoeing and water

crossing, rope climbing, and then there was more running. Teams were required to complete 5 legs in the race. Geologiccoordinates were given, requiring the use of orienteering skills. The challenge was designed to run into the night, necessitatingthe use of headlamps and sharp night vision to complete the course.

The Emergency Medicine residents Shaun Adams, MD, Stephanie Gammons, MD, Roger Merk, MD and Daryl Steen, MDfrom the Saginaw Cooperative Hospitals Michigan State University Program crossed the finish line first in 6 hours and 8 minutes.The second place team from Maryland completed the race in 7 hours 3 minutes. However, the first place team’s lead increasedsignificantly when penalties were included for errors in the medical challenges. The Saginaw Cooperative Hospitals, Inc. teamlooks forward to defending their championship title next year and challenges more residency teams to join them.

First Annual Regional SAEM Research Meeting — Rochester, New YorkMarch 12-13, 2001

Sandra Schneider, MDUniversity of Rochester

In one corner sat two scientists discussing their latestideas regarding apoptosis and skin healing and inanother, two clinicians planned a study on the effects ofovercrowding. These encounters and many like them arethe real reasons that regional research meetings,sponsored by SAEM, have been successful around thecountry.

Rochester was host to the first annual New York StateRegional SAEM Research Meeting. New York Stateboasts 17 residencies and over 400 residents. This wealthof talent made possible the highly successful researchmeeting. There were over 90 participants from 14 differentinstitutions attending the conference. There were 47 ab-stracts presented, 6 of these in the oral form.

The highlight of the conference was our keynotespeakers. Dr. Brian Zink, President of SAEM, spoke onthe future of research and education in emergencymedicine. He was followed by Dr. Marcus Martin, Presi-dent Elect of SAEM, who spoke on the value of diversityand cultural confidence in academic emergency medicine.

On the second day Dr. Robert Schafermeyer, Presidentof the American College of Emergency Physicians spokeabout the next five years of emergency medicine practice.

On the afternoon of the second day, attendees chosefrom 3 different workshops.

Dr. Sharon Humiston led the research on How to Writean Abstract. In the first half of the workshop individualsworked in groups to create an abstract from a samplestandardized study. In the second part of the abstract,they scored each others work with a standardized abstractreviewer sheet.

Dr. Frank Zwemer taught a mini-business course inanother workshop introducing the attendees to the princi-ples of business as they relate to Emergency Medicine.

Finally, Dr. Linda Spillane led a workshop utilizing theMeti Patient Simulator. Participants were able to run acomplicated patient whose course terminated in cardiacarrest and then view their work on videotape. Dr. RobertSchafermeyer led one team, and we are pleased to reportthat he is up-to-date on his ACLS protocols.

The dates of the Regional Meeting corresponded to theopening of the brand new Emergency Department atStrong Memorial Hospital. Participants were able to tourthe Emergency Department twenty-four hours prior to itsopening hopefully getting ideas for their own departmentrenovations.

All of the participants felt that the first Annual New YorkState Regional SAEM Meeting was a huge success. Pro-ceeds from this meeting will be transferred to New YorkUniversity, who will host the second Annual Meeting nextSpring. We wish to thank SAEM for its support of ourendeavors to make the New York State Regional Meetinga success.

11

Academic Career ProfileThis is part 3 of a series of interviews of experienced and accomplished researchers that focus on issues of interest to theyoung investigator. On behalf of the SAEM Research Committee, Dr. Craig Newgard interviewed Dr. Roger Lewis who shareshow he began in research and advice for the young investigator.

What do you consider to be yourhighest research accomplishment?How long did it take from the timeyou first had this goal, to the timeyou reached it?

Three accomplishments stand out inmy mind. The first is a work in pro-gress—creating a supportive environ-ment for research fellows in our de-partment. Regarding the length of timerequired to create this environment,we’re still working on it. Second, I amproud of my collaborative work with Dr.Marianne Gausche-Hill on her study ofout-of-hospital bag-valve-mask ventila-tion versus intubation in critically illchildren. Given the setting of the study,this undertaking presented major ob-stacles and required creative ideas,organization and tremendous effort tocomplete the study while maintaining arigorous methodologic design. Thestudy took approximately eight yearsfrom conception to completion. I shouldalso point out that my role was quitesmall when compared to the principalinvestigator, Dr. Gausche-Hill. Last, Iam proud of my role as Chair of theData Monitoring Committee for an out-of-hospital trial of a hemoglobin-basedvolume replacement product for adultpatients with post-traumatic hemorrha-gic shock. The trial was stopped prior tothe first planned interim analysis whena higher than expected death rate in thetreatment group could not be adequate-ly explained by patient characteristics.Although this decision led to the termin-ation of development of this product bythe sponsor, I believe these actionshelped limit the risk to the critically-illstudy subjects. The data monitoringcommittee made the recommendationto suspend enrollment only 24 daysafter the first evidence of a mortality im-balance was detected. This study wasalso the first large multicenter studyconducted under the FDA’s waiver ofconsent regulations (21 CFR §50.24).

How would you rank these issues inorder of importance for reachingyour research goal: mentoring, seedmoney, protected time, collaborativesupport, personality, fellowship train-ing, writing skills, luck, intelligence?

I would put them in the followingorder, starting with the most important:mentoring, protected time, writing skills,intelligence, fellowship training, per-sonality, collaborative support, seedmoney, and luck.

Is there another more important fac-tor that allowed you to reach youraccomplishment? Can you elaborateon what you feel was the single most

important factor in your success?I believe the most important single

factor was training that allowed me tothink “like a scientist.” I believe my doc-toral training in biophysics and my re-search mentors assisted me, not onlyby helping me refine the skills neces-sary to excel in research, but alsohelped me gain the ability to explainscientific ideas clearly in both writtenand verbal formats.

How did you identify your mentorand what advice would you give ayoung researcher looking for a men-tor? How important was mentoringto your accomplishment?

I approached my first mentor, Dr.Philip Hanawalt in the biology depart-ment at Stanford University, while ajunior in college. I had absolutely no re-search experience but Dr. Hanawalt waswilling to take a chance on me. Despitemy lack of experience, this opportunityhelped nurture a love of research and re-sulted in my first paper being published.A second instrumental person in mycareer was Dr. Robert Pecora, a physicalchemist with whom I performed my doc-toral research while in medical school.Dr. Pecora was always available, andprovided me tremendous latitude toselect and answer difficult scientific ques-tions. He helped me to think rigorously. Ibelieve the most important characteris-tics in a mentor are available time, a will-ingness to mentor, research resourcesand environment, strong research experi-ence, the ability to help steer a mentee inthe right direction while still fostering asense of autonomy, providing the free-dom to choose approaches to researchproblems, and the willingness to takerisks on young mentees.

Has fellowship training become anecessity for a young researcher tobecome successful in EM research?

While it is possible for some investi-gators to achieve significant successwithout formal research training, suchas that provided in a fellowship, I be-lieve that the focused time dedicated tolearning research fundamentals andcareer development will increase thelong term productivity, likelihood of ob-taining extramural funding, and careersuccess of any investigator. Where do you think the majority offunding for young investigators in-volved in EM research will comefrom in 10 years? Foundations, In-dustry, or Federal?

All three of these funding sources willprovide important sources of EM re-search funding, even for young investi-gators. I believe that foundations, such

as the Emergency Medicine Foundation,provide and will continue to provide animportant source of funding to supportyoung investigators in EM. SAEM isalso beginning to put programs togetherthat provide substantial support forresearch training. Furthermore, as theNIH and other federal funding sourcesincreasingly emphasize the importanceof clinical research, and especiallyclinical research training, these fundingsources will become increasinglyimportant. The percentage of NIH andAHRQ fellowship training grants that arefunded is very high, often close to 50%.

Where have you derived most ofyour research funding?

My research funding has comelargely as a result of collaborative pro-jects with other researchers, from federalsources, foundations, and to a lesserextent from industry. By focusing on thedesign and analysis of clinical studies, Ihave built many partnerships with otherresearchers and have served as a co-investigator on many funded projects.What is the biggest challenge to theEM researcher to obtaining funding,compared to researchers in otherfields? How did you deal with thischallenge?

One of the biggest challenges to theEM researcher is overcoming the ten-dency to believe that residency aloneprovides adequate preparation for a re-search career. It is clear that mentorship,formal research training, and establishinga track record in undertaking and com-pleting projects are all critical in obtainingfunding. In addition, EM investigatorsmust avoid the idea that being a general-ist, as in clinical practice, also works wellin research. A clear research focus anddemonstrated productivity in a specificarea are also necessary to become acompetitive candidate for funding.If you had a time machine, what deci-sion would you change, or whatwould you have done differentlyabout your research career?

While completing my PhD in biophy-sics I took a number of courses in theoret-ical physics. I now wish that I would havetaken additional courses in mathemat-ical statistics and epidemiology instead.What should SAEM be doing to helpyoung researchers?

I believe SAEM should: increase fund-ing available for fellowship training andensure that these fellowships provide asufficient duration and depth of training;and ensure that the research of young in-vestigators has an appropriate venue forpresentation and publication through ourAnnual Meeting and the Society’s journal.

12

Filming of Patients in Academic Emergency Departments

Catherine A. Marco, MD and GregoryL. Larkin, MD, MSPH, for the SAEMEthics CommitteeConsultation from the SAEM EthicsCommittee

Questions:1. When is filming of ED patients in

academic emergency departmentsappropriate?

2. What conditions should be met toenable commercial ventures involv-ing the filming of ED patients?

Use of Recorded Images for MedicalRecordsA longstanding tradition exists of pro-ducing and maintaining medical recordsand documentation of medical care de-livered to patients, in all medical set-tings, including the emergency depart-ment. In recent years, the paper docu-mentation of medical records has ex-panded to, in some settings, includephotographs and videos. There is littledebate that these venues are appro-priate when used for documentation inthe confidential medical record, asthese services are clearly provided forthe best interest of the patient.

Recorded Images for EducationalPurposesDebate arises when other uses are pro-posed for various additional uses of themedical record (including photographsand video). Use of patient photographsand video for educational purposes israpidly expanding.1,2,3 Although consentis not always obtained prior to takingthe photos, standard practice is to ob-tain consent from the patient, or surro-gate, prior to the dissemination of thesemodalities. There are several logicaljustifications for the use of filming of pa-tient encounters for educationalpurposes:

1. There is a benefit to the medicalcommunity, and to society, by im-proving the quality of care. There isa clear educational benefit of multi-media educational presentations4-8

and of retrospective video qualityanalysis.2,3

2. The proposed audience includeshealth care professionals, who rou-tinely encounter such settings.

3. Film records are not publiclyavailable.

Recorded Images for CommercialPurposesFilming of patients for commercialpurposes (such as television programsor movies) clearly presents uniquemoral questions. Although some argue

that there is educational value to soci-ety,9 the primary motivations for suchfilming are public education, entertain-ment, and financial benefit to proprie-tors. The clear alternative to filming ofpatients is the simulation of events,which can be based on true incidents.

Numerous ethical arguments againstthe use of recorded images of ED pa-tients for commercial purposes exist,including:1. Many patients are unable to consent

prior to recording, due to medicalcondition.

2. Patients who are technically able toconsent may feel coercion whetherovert or camouflaged, in part due tothe inherent vulnerability of theirposition as a patient.10 Rawlsianconceptions of justice mandate thatthe most vulnerable should accurebenefits first when societal burdensand benefits are apportioned.11

3. Confidentiality and privacy of pa-tients and health care providers areseverely invaded.

4. Film crews may interfere with patientcare, both physically and sublim-inally. The presence of commercial,nonmedical staff in the ED may posea significant distraction, and conflictof interest for already overburdenedand stressed health care providers.

5. Both the Code of Conduct forSAEM12 and the Code of Ethics forACEP13 put the interests of patientsabove all else. Filming patients with-out any tangible patient-centeredbenefit clearly violates both theletter and the spirit of these Codes.

There may conceivably, be some cir-cumstance in which the the commercialuse of recorded images of ED patientscould be justified in limited circum-stances. To be justifiable, these cir-cumstances arise rarely, but could oc-cur when benefit to patients is clearlydemonstrated. Review by a multidisci-plinary ethics committee or an institu-tional review board may be of value toascertain that such condit ions ofpatient-centered benefit are in force.When the appropriate use of imagesare deemed to be helpful, significantcommunity and patient advocate repre-sentation should be invoked prior toproject initiation. Although not directlyapplicable to this question, the FDAWaiver of Consent guidelines for emer-gency research14 may provide a usefulmodel. Although these guidelines werespecifically designed to facilitate theconducting of emergency research insituations where obtaining traditional

written informed consent is not feasible,they provide a model for obtaining pro-active input from the institution andcommunity prior to initiation of a projectin which informed consent is not feasi-ble. The feasibility of obtaining agree-ment from an overwhelming majoritydepends in large measure on the word-ing of the question. (For example, “Youwouldn’t mind if we took a few pictures,would you?” versus “Would it be okaywith you if the television crew were tovideotape you after a car accident, asyou l ie unconscious, naked, andbloody, on a stretcher, surrounded bystrangers in the ER?”).

Summary1. Filming of ED patients for medical

records is acceptable, provided rou-tine confidentiality of records ismaintained.

2. Filming of ED patients for peer re-view and professional educationalpurposes is acceptable, provided in-formed consent is obtained whenpossible, and patient confidentialityis maintained.

3. The SAEM Ethics Committee dis-courages the commercial use ofimages of ED patients in academicemergency departments.

4. Commercial filming should only beconsidered in rare cases, wherebenefit to patients and society can beclearly demonstrated, and whereoverwhelming support of the Emer-gency Department staff, the institutionand the community is demonstrated.

5. If permitted, fastidious attentionshould be paid to patient confiden-tiality and voluntary informed con-sent, and strict limitations should beenforced to prevent adverse effectson patient care.

References1. Brooks AJ, Phipson M, Potgieter A et

al: Education of the trauma team: videoevaluation of compliance with universalbarrier precautions in resuscitation. EurJ Surg 1999; 165:1125-8.

2. Ellis DG, Lerner EB, Jehle DV et al: Amulti-state survey of videotaping prac-tices for major trauma resuscitations. JEmerg Med 1999; 17:597-604.

3. Olsen JC, Gurr DE and Hughes M:Video analysis of emergency medicineresidents performing rapid-sequenceintubations. J Emerg Med 2000;18:469-72.

4. Herxhaumer A, McPherson A, Miller Ret al: Database of patients’ experiences(DIPEx): a multimedia approach tosharing experiences and information.Lancet 2000; 355:1540-3.


The following report is the result of the first SAEM Ethics Consultation request. Due to the general interest of the topic, and withthe permission of the individual who requested the consult, the consultation report is published below for the benefit of themembership. Please contact SAEM with any consultation requests.

13

Filming of Patients in AcademicEmergency Departments(Continued)

5. Hovenga EJ: Using multimedia to en-hance a flexible learning program:lessons learned. Proc AMIA Symp1999; 530-4.

6. Xie ZZ, Chen JJ, Scamell RW et al; Aninteractive multimedia training systemfor advanced cardiac l ife support.Comput Methods Programs Biomed1999; 60:117-31.

7. Clark LJ, Watson J, Cobbe SM et al:CPR 98: a practical multimediacomputer-based guide tocardiopulmonary resuscitation for medi-cal students. Resuscitation 2000;44:109-17.

8. McGee JB, Neill J, Goldman L et al:Using multimedia virtual patients toenhance the clinical curriculum formedical students. Medinfo 1998; 9 Pt 2:732-5.

9. Iserson KV: Film: exposing the emer-gency department. Ann Emerg Med2001; 37:220-221.

10. Geiderman JM: Fame, Rights, andVideotape. Ann Emerg Med 2001;37:217-19.

11. Rawls J: A Theory of Justice: RevisedEdition. Belknap Publishers, 1999.

12. Larkin GL: A Code of Conduct forAcademic Emergency Medicine. AcadEmerg Med 6:45, 1999.

13. American College of EmergencyPhysicians: Code of ethics foremergency physicians. Ann EmergMed 30:365-72, 1997.

14. 21 CFR 50.24 and 45 CFR 46.101(i).

Report on Western Regional MeetingMarch 17-18, 2110

A. Antoine Kazzi, MD University of California, IrvineProgram Chair, 4th Annual SAEMWestern Regional Research Forum

“This was a terrific meeting.” “Theopportunities for young faculty develop-ment and for networking were great!”These were the kind of words that sum-marize the feedback we received fol-lowing the Fourth Annual SAEM Wes-tern Regional Research Forum that washeld on March 17-18, 2001, at the HyattNewporter, in Newport Beach.

Co-sponsored by the EM program atthe University of California, the 2001meeting brought together nearly 40panelists, speakers and moderators, aswell as 137 participants. Perhaps themost remarkable achievement this yearfor the Western SAEM Regional Plan-ning Committee was that it succeededin involving and representing all 19Emergency Medicine residency pro-grams in the Western USA. For the firsttime in 4 years, they were all there!

Four separate sessions of abstractpresentations (oral and poster) wereheld. Young faculty, residents and stu-dents presented over 60 abstracts totheir peers, learning the skills necessaryin that process. Moderators includedDrs. Deirdre Anglin, Amiram Shneider-man, Sean Henderson, Deana Baudon-net, Jerris Hedges, Jeffrey Succhard,Judith Brillman, John Sakles, RobertBuckley. Deborah Diercks, Greg Guld-ner, Stephen Hayden, Tareg Bey, CarinOlson, Mitesh Patel, Rob Rodriguez,Michael J. Lambert, and Chris Lipinski.

The didactic sessions related tojunior faculty and resident development,and to the skills needed to pursue aca-demic careers. The topics included:

● The Evolution from EM Residency toSubspecialty Fellowship Training:Impact on Academic EM (Dr. V.Markovchick)

● From Data Collection to Publication:Issues in Authorship and Peer Re-view (Dr. D. Schriger)

● Faculty Development and ProtectedTime: Rules of the Road (Drs. D.Gus and M. Langdorf)

● Introduction to Statistics: How tomake it stick! (Dr. R. Lewis, ourSAEM president-elect)

● Joining a Multi-Center Trial: What’sin It for Me? (Dr. J. Hoffman, G.Hendey and J. Krawczyk)

● Authorship: Issues of Credit, Owner-ship and Intellectual Integrity (Drs. J.Hedges and T. Schmidt)

● Ultrasound Credentialing in EM: anOverview (M. Lambert and C. Fox)

An outstanding turnout was noted forthe “SAEM Western Regional Medical

Perhaps the most unusual sessionwas “Medical Jeopardy — With a Re-search Twist,” which concluded the 2-day meeting. Moderated by Drs. LisaChan and Bill Mallon, teams from NewMexico, the Navy program in San Diegoand UC Irvine competed ferociously.The Navy program valiantly won andtook no prisoners. Actually the humor,competitive collegiality and teamworkwere an outstanding way to end themeeting, which we hope will be repeated.

I wish to take this opportunity tothank SAEM for leading us in this direc-tion, and giving us financial and humanresources, insight and regional oppor-tunity to invest time and effort in devel-oping our residents and young faculty.In particular, I must acknowledge Dr.Deirdre Anglin, Dr. Jerris Hedges andmy partner Dr. Mark Langdorf for theiroutstanding guidance and support. Lastbut not least, I wish to thank all ourspeakers and the moderators for theirtime and commitment, which was thebasic ingredient that allowed thismeeting to be a success. Thank you.

Student Forum.” Over 50 students at-tended the exceptional 3-hour sessionthat was moderated by Dr. WendyCoates and Dr. Barbara Blasko. Thiswas an opportunity for medical studentsinterested in EM as a career to listen tosuperb presentations by renownededucators such as Drs. Gus Garmel,Lori Weichenthal, Wendy Coates andStephen McLaughlin.

One student commented: “First, theSAEM conference in Newport Beachwas a very educational opportunity tolearn more about the current issues sur-rounding academic Emergency Medicineand was a chance to see some intriguingpresentations of research in the field. OnSunday, the Medical Student Forum hadan amazing collection of speakers whocovered all the aspects of the residencyapplication process, which will help all at-tendees approach this future period witha structured plan. The turnout of medicalstudents was quite impressive, and thiswas probably the best 5 hours of presen-tations and Q & A that any medicalstudent could have asked for.”

Recipients of VisualDiagnosis Contest

AnnouncedDuring the 2001 Annual Meeting inAtlanta a Visual Diagnosis Contestwas open to all residents and medi-cal students in attendance. The fol-lowing winners are to be congratu-lated on their excellent diagnosticskills:

Medical Student Winners: Cory J.Pitre, LSU/Charity Hospital and WameWaggenspack, LSU/New Orleans

Resident Winner: Chris Fee, MD,Highland Hospital

The medical student winners will re-ceive a free Annual Meeting registra-tion to the 2002 Annual Meeting. Theresident winner will receive a textbookand a free Annual Meeting reg-istration to the 2002 Annual Meeting.

The Program Committee is alreadymaking plans for next year’s contestand members are encouraged tosubmit potential cases and photos.Please refer to the Call for Photo-graphs that will be published in thenext issue of the SAEM Newsletter.

14

SAEM Response to the GAO About EMTALA

Jim Hoekstra, MDChair, SAEM National Affairs TaskForceOhio State University

The General Accounting Office(GAO) has initiated a study of the im-pact of EMTALA on the practice ofemergency medicine. The following arethe SAEM responses to the GAO Studyquestions. SAEM represents over 5000academic emergency physicians work-ing in the nation’s teaching hospitals.EMTALA’s effects are felt more inacademic emergency departments thananywhere else. These hospitals providethe majority of the uncompensatedemergency care in this country. Assuch, they represent the true medicalsafety net. Academic emergency de-partments are also the teaching centersthat train our health-care providers ofthe future. As such, any negative ef-fects of EMTALA on teaching hospitalEDs will have negative repercussionsthroughout the health-care industry.

EMTALA was initially passed byCongress as part of the 1985 federalbudget and became effective August 1,1986. Its purpose was to protect un-insured patients presenting to a hospi-tal’s emergency department (ED) frombeing “dumped”, i.e. transferred toanother, generally public, facility withoutevaluation and stabilization because ofinability to pay. This law is commonlyreferred to as EMTALA, for the Emer-gency Medical Treatment and LaborAct. SAEM endorses the concepts ofEMTALA as it was originally written. Itis important that all patients presentingto the ED for care are examined andtreated without bias toward ability topay. It is also important that patientsare not transferred from one hospitalED to another based on their inability topay.

Unquestionably the greatest expan-sion of the scope of EMTALA occurredin 1998, which extended EMTALA obli-gations to any individual who “comes tothe ED”, which now also includes hos-pital owned and operated ambulances,even if the ambulance is not on hospitalgrounds. The 1998 guidelines alsomake it clear that anyone who “arrivesat a hospital . . . and requests emer-gency care” is entitled to a MedicalScreening Exam (MSE) even if they arenot technically in the hospital. Hospitalpremises also include the “parking lot,sidewalk and driveway of the hospital”.The 1998 guidelines also state thatEMTALA applies to “a hospital-ownedfacility which is non-contiguous or off-campus, and operates under the hospi-

tal’s Medicare provider number.” Thiswas the first indication that HCFA in-tended to apply EMTALA requirementsto hospital facilities, such as urgentcare centers or satellite clinics, that arenon-contiguous with that hospital’s ED.According to current HCFA regulations,therefore, if a patient “requesting emer-gency care” comes to a satellite centerof a hospital, the facility must “screenand stabilize the patient to the best of itsability or execute an appropriate trans-fer, if necessary.” Compliance withEMTALA therefore requires these facili-ties either to develop a method of identi-fying any patient requesting “emergencycare” among their clientele (as opposedto those needing only “walk in,” “urgent”or “fast track” care), or to medicallyscreen all patients who present. Thenew legal liabilities, and their associatedadministrative and clinical costs, createdby this section of the EMTALA guide-lines may not have been anticipated byHCFA but are clearly being felt byhospitals all around the country.

1. In your opinion, how, if at all, hasthe scope of EMTALA expandedsince its enactment?

The definitions that were provided inthe original EMTALA legislation haveexpanded significantly. Unfortunately,the expansion has increased costs ofED care as well as the liability to EDphysicians and hospitals.

The concept of “comes to the hos-pital ” has expanded significantly thedifficulties faced in the ED with identifi-cation of patients in need of care. It hasexpanded to the ED lobby, wherenurses and techs are now expected toidentify and screen patients for criticalillness. It has expanded to the localarea around an ED entrance, and it hasexpanded to EMS services. How can adiverted ambulance be considered acase that “came to the hospital?” Howcan an ED provide EMS to an area 250yards (let alone 250 feet) beyond theconfines of the hospital? There are nomechanisms to provide such care, andno way that EDs can police theseareas. We are, however, liable for inci-dents that occur within these confines.

The review of all transfers and theL&D practices of a hospital by the localMedicare/Medicaid provider becauseone service or one practitioner ischarged with an EMTALA violation is un-necessarily punitive and expensive.These inquisitions and paper work mara-thons have taken countless nurses andphysicians away from what they shouldbe doing - i.e., providing patient care.

The EMTALA law has provided trial

lawyers to sue outside of the tradi-t ional malpractice environment .Rather than having to prove harm, dutyto serve, negligence and cause/effect,the trial lawyer must only show failureto follow someone’s interpretation of theEMTALA regulation. It has also allowedlawyers to circumvent state tort reformlaws, abrogating the state’s right toprotect its hospitals and physicians andsave money for actually providing medi-cal services to its citizens rather thanspending that money on defense ofsuits or indemnity payments. This is ahuge problem, especially given thevagueness of EMTALA legislation.

2. What impact has EMTALA had onhospitals and emergency depart-ments? What impact has EM-TALA had on physicians servingemergency departments?

Emergency physicians have a moralobligation to take care of any patientthat presents to our ED for care. Unfor-tunately, private physician’s clinics andstate and county agencies know this,and often send their patients to the EDfor their health care needs, regardlessas to whether or not there is a medicalemergency. Emergency departments(especially teaching hospital emergencydepartments) provide a very highpercentage of uncompensated care dueto EMTALA mandates. Patients withtrue medical emergencies are oftenforced to wait for their care due to theovercrowding of EDs with misplaceduncompensated primary care.

The concept of providing a screeningexam and stabilization to all patientswho present to the ED is essentially anunfunded mandate. Unfortunately, onlyEDs are under this mandate. Any office-based physician can screen his/herpatients for ability to pay. EDs cannot.

3. What impact has EMTALA had onthe delivery of emergency ser-vices? How, if at all, has the de-l ivery of emergency serviceschanged since enactment ofEMTALA?

While hospitals and practitioners aremore cautious about transferringpatients, they are also somewhatconcerned about doing all that mightconceivably be considered necessary(after the fact) in a medical work upbecause of the additional liability threatproduced by EMTALA. It has madegetting a specialty consultation, orarranging a transport of a critically illpatient more difficult.


The following is the text of a letter sent to the General Accounting Office on February 28, 2001, in response to the GAO Studyquestions. This text is also posted on the SAEM web site at www.saem.org.

15

Response to EMTALA (Continued)

4. What, if any, administrative prob-lems have physicians servingemergency departments encoun-tered in complying with EMTALA?

See all of above items. In addition tothe average practicing physician havingto fill out transfer forms and providemore “stabilization” testing than beforeEMTALA, most hospitals have dedi-cated staff to police EMTALA compli-ance and reduce a given hospital’sliability to EMTALA reviews or fines.Educational programs regarding EM-TALA, paperwork, transfer forms, rout-ing and investigation of complaints, etc,all cost nurses, administrators, andphysicians time and money.

5. What, if any, financial problemshave physicians serving emer-gency departments encounteredin complying with EMTALA?

The most significant financial prob-lem due to EMTALA has to do with in-creased uncompensated care, which iselaborated above in question 2. Thishas resulted in the reduction of ser-vices available in the ED, reduction ofstaffing in the ED, and inability of EDsto keep up with increased patient vol-ume demands. ED physicians are ex-pected to provide medical screeningexams to all patients without screeningfor ability to pay. As such, EMTALA hassubjected emergency physicians, whooften bill separately from the hospital,to a very high percentage of uncom-pensated care, with no mechanism torecoup their financial losses.

Meeting regulatory requirements(especially in conjunction with the puni-tive review process) takes the practi-tioner and her/his nursing staff awayfrom patient care. The result is in-creased administrative time, whichcosts money.

Patients are unhappy with the addi-tional charges brought about by the de-fensive practices resulting from EM-TALA aversion, although many of themare hidden costs.

6. What are some reasons for theshortage of on-call physiciansavailable to hospital emergencyrooms?

Fear of litigation from EMTALA, fearof monetary penalties up to $50,000outside of malpractice coverage, andpotential exclusion from Medicare andMedicaid is a major concern of on-callphysicians. As such, it is becomingmore and more difficult to recruit andretain on-call physicians. The ED phy-sician often becomes the safety net,and more often than not, transfer of pa-tients to tertiary care hospitals occurs,adding to the costs of medical care.

7. Has managed care affected theprovision of care in emergencydepartments? If yes, how?

Managed care clinics have told theirpatients to come to the ED when theyare understaffed or when a problemoccurs after hours. The managed careclinics then retrospectively decide whatservices to pay for. The EMTALA lawleaves plenty of room for the managedcare clinic to decide what represents anemergency after the fact. Managedcare has not been successful in keep-ing patients out of EDs. On the con-trary, patients cannot see their primarycare providers as soon as they prefer inmost managed care plans, so theycome to the ED for their episodic or ur-gent care needs. Managed care planshave only been successful in limitingpayments to ED physicians, who aremandated by EMTALA to providescreening exams and stabilization priorto discharge. In addition, non-paymentof on-call physicians for after-hours oremergency care of managed care pa-tients by managed care entities is oneof the big reasons physicians decline toparticipate in on-call systems.

8. Has EMTALA affected the utiliza-tion of the emergency room? Ifyes, in what way?

EMTALA has had an increase onthe use of the ED. The patient whocannot pay often comes or is sent tothe ED preferentially because theyknow the ED must provide service,without regard to payment. In addition,what must be done when the patient isseen in the ED has been raised to ahigher level by the EMTALA legalthreat. The lack of primary care in mostcommunities when patients need it(e.g., after hours so that the employeecan maintain her/his job) is also in-creasing the use of the ED.

9. Have any state laws complicatedhospitals’ or physicians’ compli-ance with EMTALA? Examples .

While a good concept, the prudentlayperson law of many states does notprohibit abuse of the ED by managedcare clinics. It is the unavailability ofprimary care (including outright refer-rals from the managed care clinics tothe ED) that drives patients to the ED.The managed care organizations donot really want to stop this practice (infact their clinics encourage it), they justdon’t want to pay the premium for after-

hours care. Hence the managed careorganizations will argue that the EDvisit was unnecessary after the fact andrefuse to pay for all but the retrospec-tively documented major case whiletaking none of the liability for sortingout the serious from the mundane.

Mental health organizations and ser-vices are often provided purely on thebasis of the patient’s insurance plan.As such, psychiatric patients are oftentransferred from site to site purely onthe basis of financial reasons. This is a“pseudo-violation” of EMTALA, eventhough it is an almost universal practice.

10. Are you aware of regional differ-ences in enforcement of EM-TALA?

Yes, the recent GAO report sup-ported considerable variance in the dif-ferent Medicare regions. District courtshave decided differently with regard toburden of proof for whether or not carewas denied without bias or whether ornot the patient was appropriately stabil-ized prior to discharge. This adds to theEMTALA confusion, and the ED fearsof liability.

11. Recommendations for regions,states, and/or hospitals to con-sider in our fieldwork?

a). Some of the definitions providedby EMTALA need to be seriously re-considered. The original purpose ofEMTALA was to assure appropriatetransfers to assure that they were notbased on financial status. The expan-sion of EMTALA beyond its originalpurpose, as outlined above, should bereconsidered.

b). Review of Managed Care Organ-ization policies and actual practices.The MCOs should be taken to taskdemonstrate that their patients haveaccess to emergency care without ret-rospective review, and that they shouldprovide reasonable after-hours primarycare access.

c). If the federal government is goingto mandate ED care for all patients,and expose ED physicians to increasedliability, paperwork, and reviews, itshould COMPENSATE emergencyphysicians for it. The increased costs ofED care due to EMTALA are real, andshould be considered in reimbursementschemes. These costs include on-callcosts, standby costs, paperwork costs,and the cost of increasingly complexevaluations that EMTALA mandates.

16

ACADEMIC RESIDENTNews and Information for Residents Interested in Academic Emergency Medicine

Edited by the SAEM GME Committee

THE ACGME CORE COMPETENCIES:IMPLICATIONS FOR EMERGENCY MEDICINE TRAINING

The next two, interpersonal skills and professionalism,also have direct application to Emergency Medicine. Infact, it has been suggested since 1910, and perhapsbefore, that they apply to all fields of medical study. Inhis report, Abraham Flexner noted that among the moresubtle skills are insight and sympathy, particularly inmulti-cultural encounters.

In Emergency Medicine we see patients from a widespectrum of socioeconomic and cultural environments.This requires the emergency physician to develop broadlistening skills as well as sensitivity to ethnic, cultural,and gender issues in the creation of therapeuticrelationships. The training of an emergency physicianmust therefore incorporate these competencies.Suggested instruments of testing include OSCE,standardized patients, portfolios, and global evaluations.

The fifth competency, practice-based learning, is thecareer long process of self-assessment and quality im-provement. The skills needed to accomplish this pursuitof extended knowledge must be taught early in medicaleducation and reinforced during residency. The skills forthis can be roughly imagined as the utilization of peerreview, introspection, emerging technologies, and othermodalities to recognize one’s own limitations of knowl-edge and proficiency. Residencies may use chart andliterature review, project portfolios, and procedure logs.

Systems-based practice may well be the newest conceptin medical education. Today’s physician must have astrong understanding of the economic, political, andsocial pressures of the modern practice of medicine. Thephysician must demonstrate the practice of EmergencyMedicine within the larger health care system and beable to apply this knowledge to deliver cost-effectivecare while maintaining advocacy for the emergencydepartment patient. Educators can use OSCE, a globalratings scale, project portfolios, and chart stimulationrecall to assess progress in this modern arena.

Encompassing all of emergency medicine within six corecompetencies is an enormous task. To some the assump-tion of increased paperwork is an ominous sign for ourefforts to effectively manage our schedules and keep aproper balance between educating and grading. Certainly,just as these competencies encourage lifelong learning,so should the learner encounter these assessment instru-ments throughout the entirety of medical education. Whenincorporated as such, one can visualize how the testingmodalities overlap and how their use will allow for theteacher attestations to truly signify a standard ofproficiency and competence in emergency medicine.

Gary Katz, MD, RRC-EMMike Beeson, MD, MBA, from the SAEM GME Committee

In February of 1999 the ACGME endorsed the conceptthat professional development be evaluated in com-petency rather than strict exposure to a defined cur-riculum. There are six competencies that are consideredto encompass the practice of medicine. These are:1. Patient care2. Medical knowledge3. Interpersonal skills and communication4. Professionalism5. Practice-based learning and improvement6. Systems-based practice

Since then, there has been extensive debate as to howmedical educators can attest to competency and whichinstruments should be used to assess them.

Our professional organizations have examined this con-cept with varying levels of success. Currently, theACGME and American Board of Medical Specialties(ABMS) are sponsoring a joint endeavor, with leadersfrom ABEM, RRC-EM, CORD, and EMRA, to define howthese competencies apply to Emergency Medicine.Furthermore, they will outline suggested tools that willallow for standard and reliable evaluation of residencytraining and maintenance of certification. It is expectedthat this project will accomplish its goals over the courseof this next year.

In the meantime, in what capacity might we considerthese competencies? What is the application toEmergency Medicine? What tools currently exist thatmight become essential assets in assessing the pres-ence of ability rather than the absence of problems?

The applications of the first two competencies are ratherobvious. No one would argue that a strong fund ofknowledge and the practice of patient care do not belongin Emergency Medicine. Essential skills associated withthese competencies include obtaining complaint relevantH & P’s, counseling patients and families, multi-taskingand team management, and selection of diagnosticstudies and therapeutic interventions. For some time edu-cators have been using assessment tools including stan-dardized patients, objective structured clinical evaluation(OSCE), patient satisfaction queries, and live recordingsto evaluate caring and respectful behavior that leads to athorough and successful patient examination. Tests ofmedical knowledge often use similar modalities and,often, incorporate chart stimulated recall or oral examina-tion, chart review, and model simulation for procedures.

17

MOONLIGHTING AND THE EMERGENCY MEDICINE RESIDENTCarey D Chisholm, MD, University of Indiana

EM residents are eligible to gain full unrestricted licen-sure in their state after 1 or 2 years of postgraduatetraining. With this comes the ability to engage in extra-curricular activities for financial gain (“moonlighting”).While the pressures to engage in moonlighting activitiesmay be great, and the immediate financial rewards large,the EM resident should consider several of the down-sides and consequences of moonlighting prior to jump-ing into this activity.

Moonlighting places ED patients at potential risk .This is particularly true if you choose to work in a settinginvolving autonomous practice. In such a situation, thereis no one available to offer a second opinion or assistyou with a difficult intubation or interpretation of aimaging study. Your may not feel empowered to fullyadvocate for your patient when a private attendingrecommends a course that may not be optimal for thatpatient. Finally, there is no “safety net” for that patient insituations in which you lack experience with a disease orinjury and do not realize this (how often do you gothrough an entire ED shift and have NO changes in yourapproach to patient care?). Are you ready to care for a 3day old in shock? Perform a delivery and care for bothmother and infant for 30 minutes? Serve as the onlyprovider for 4 MVA victims who arrive simultaneously inyour ED? Do you understand EMTALA and how it ap-plies to medical staff responsibilities and patient trans-fer? As a professional, placing patient interest aboveyour own is required. Engaging in the independent prac-tice of EM before you are fully trained could be viewedas placing your own interests above those of yourpatients.

Moonlighting places the EM resident at risk . The ad-ditional commuting involved has resulted in automobileaccidents for the resident (fatigue and distance = risk).Experience in California has demonstrated that practi-tioners with under 3 years of postgraduate experienceare disproportionately represented in adverse medical li-censing actions. With the creation of the National Practi-tioners Data Bank {http://www.npdb-hipdb.com/} mal-practice judgments must be reported. This has the po-tential to prolong or complicate your future applicationsfor medical privileges. Unfamiliarity with EMTALA andthe need to transfer the patient to tertiary facilities mayplace you at risk for civil penalties for violations (theseare not covered by your malpractice insurance). Whatarrangements have been made for your malpractice in-surance coverage? Will you be responsible for purchas-ing tail coverage for a claims-made policy? Have youmade appropriate arrangements for tax withholding orwill you be subject to an unforeseen payment come taxtime? Are you being taken advantage of financially inthis employment (while it is unrealistic to expect thesame salary as established members of the group, howmuch “overhead” is being removed)? Finally, inexperi-ence also may mean that your conflict resolution skillsare relatively underdeveloped, increasing the chance ofa violent encounter with a patient or family member.

Moonlighting places our specialty at risk . If we trulybelieve that EM is a unique specialty requiring a cogni-tive and technical skill set obtained through completionof an accredited postgraduate training program, it be-comes difficult to rationalize how one can engage in thispractice without having developed those cognitive andtechnical skill sets. By engaging in the independentpractice of EM before training is completed perpetuatesthe myth that “anyone can work in the ED”.

Moonlighting violates the intent of ACGME man-dates limiting resident work hours. Those of us in theacademic community have applauded efforts by theACGME and the RRC-EM to limit the number of hoursresidents can be required to work in their programs.These were instituted to firstly and most importantlyprotect our patients from mistakes made through mentaland physical fatigue. They are also part of the cor-nerstone of resident wellness. This time was developedto promote quality personal and family interactions, allowa more balanced life to include non-medical interests,and to increase the opportunity for the resident to ex-plore non-clinical components of their residency trainingenvironment. Spending these hours engaged in theclinical practice of EM may lessen personal and familygrowth, and limit potential contributions you make toyour training program.

Moonlighting Position Statement Links :SAEM: http://www.saem.org/newsltr/1999/position.htmCORD: http://www.cordem.org/moonlig.htmAAEM: http://www.aaem.org/ (see position statementsection)

AAMC debt management strategies & financialplanning : http://www.aamc.org/about/gsa/md2/phase2/start.htmhttp://www.aamc.org/stuapps/finaid/layman/strat3qs.htmhttp://www.aamc.org/about/gsa/md2/md2_sec_iv.htm http://www.aamc.org/about/gsa/md2/phase3/md2_sec_iiib

htmArticles of interest : 1. Hedges JR, Chisholm CD: Building a Profession.

Academic Emergency Med 2001 8: 386-388. 2. Kazzi AA and the SAEM-CORD-AAEM Writing Group:

AAEM, CORD, and SAEM Reach a Landmark Position:Consensus Recommendations to the Federation ofState Medical Boards (FSMB) for Revisions to theFSMB May 1998 Policy Statement on Physician Li-censure. Academic Emergency Med 2001 8: 393-394.

3. Keim S, Chisholm C: Moonlighting and EmergencyMedicine: Raising the Standard. Academic Emer-gency Med. 7(8):927-8, 2000 Aug

4. Chisholm CD. The moonlighting paradox. AmericanJournal of Emergency Medicine. 18(2):224-6, 2000 Mar.

5. Berlin L. Liability of the moonlighting resident. AmericanJournal of Roentgenology. 171(3):565-7, 1998 Sep.

6. Kellermann AL. Moonlighting. Annals of EmergencyMedicine. 26(1):83-4, 1995 Jul.

7. Frumkin K. “What’s in a name?,” “Moonlighting for funand profit”: reflections on the state of emergency med-icine—a goal for 2000 and beyond. Annals of Emer-gency Medicine. 21(7):862-4, 1992 Jul.

18

Council of Academic Societies Spring MeetingDavid Sklar, MDSAEM Rep to AAMC/CASUniversity of New Mexico

The Council of Academic Societiesheld its spring meeting in San Antonio,Texas, March 22-25, 2001. The Councilincludes ninety-one member societies -fifteen basic science societies, seventy-two clinical societies and four interdisci-plinary societies. The purpose of themeeting is to bring issues of importancefrom medical faculty to the attention ofthe leadership of the Association ofAmerican Medical Colleges and to fos-ter collaboration and information ex-change between the member societies.The theme of this meeting was informa-tion technology and how it could be in-corporated into clinical, education andresearch activities of academic medicalfaculty. Of particular relevance to emer-gency medicine is the development ofvirtual reality programs and simulatorsto provide experience in proceduralperformance and care of critically illsimulated patients. In an environmentof increasing scrutiny concerning medi-cal error, simulators and virtual realitymay be able to offer necessary experi-

ence to students who may not get asmuch opportunity to learn by doing asin previous years.

The meeting also offered an oppor-tunity to discuss issues of concern tothe members. The issue of overcrowd-ing of emergency departments, divertingof ambulances and nursing shortagesreceived long and emotional requestsfor prioritization as an area of criticalimportance. Not only did emergencymedicine representatives address thisissue, but surgeons, internists andpediatricians also described concernsand the need for concerted effort.

The recent resident match resultswere discussed informally and the pop-ularity of emergency medicine as com-pared with family medicine remarkedupon. Although I hesitate to draw anyconclusion from the match, I can saythat it was watched closely and influ-ences the perception of the leaders of

ABEM Philosophy of Combined Training Programsand Review Process

At the SAEM Annual Meeting, the ABEM report included a discussion of combinedtraining programs in Emergency Medicine and other primary specialties. This infor-mation came out of the ABEM Board meeting on February 2, 2001. Currently, theBoard has approved Emergency Medicine combined training programs with Pedi-atrics, Internal Medicine, and Internal Medicine/Critical Care Medicine. It clarifiedthat proposals for new combined training options should support an establishedcareer path that a significant number of individuals have already pursued, ratherthan seek to establish a new career path to attract individuals. The Board identifiedseveral areas of information that are important to have in place when considering aproposed combined training program. Institutions interested in starting a combinedtraining program should contact ABEM.

INFORMATION REQUIRED FOR PROPOSED COMBINED TRAINING PROGRAMS1. What is the name of the specialty to be combined with EM training?2. What is the origin of the request to consider a combined training program?3. What are the basic objectives of a combined training program in EM and the

other specialty?4. How would a combined training option in EM and the other specialty improve

patient care?5. How many institutions have accredited programs in both specialties?6. Include a written commitment from at least six training programs that support

the proposed combined program.7. What is the anticipated career path of graduates of such a combined program?

In addition, would there be a reasonable demand for the graduates of such aprogram?

8. How many practicing physicians are currently dual-boarded in EM and the otherspecialty?

9. Include statements from physicians who have pursued this career path.10. Include a template of a proposed curriculum clearly showing and describing the

overlap that is possible between the two specialties.11. How would the combined program be funded?12. How would diplomates certified through the combined program recertify or

maintain certification in both specialty areas?13. Include a letter of endorsement from the director or other appropriate individual

of the residency program of the specialty with which the combined programwould be developed.

14. Has there been contact with the other specialty board? If so, what was theresponse?

the AAMC about the specialties. Theviolent oscillations of Anesthesiologyover the past five years based uponwork force projections and income pro-jections is an example of how outsideforces can cause major changes in themedical students’ sentiments concern-ing the desirability of a specialty. Ihope the present ED overcrowding anddivert crisis does not adversely affectstudent sentiment in a similar manner.

Finally, there were several discus-sions concerning non-physician healthproviders, particularly in anesthesia andpsychiatry. However, physician assis-tants and nurse practitioners are in-creasingly appearing in emergency de-partments sometimes practicing inde-pendently. From the discussions, I wouldsuggest that emergency medicine beginto define the role of nurse practitionersand physician assistants in the EDbefore someone else does it for us.

Keep YourMembership

Mailings Coming!

Be sure to keep theSAEM office informed

of changes in youraddress, phone or fax

numbers, andexpecially your e-mailaddress. SAEM sendsinfrequent e-mails toSAEM members, butonly regarding SAEMissues or activities.

SAEM does not sell orrelease its mailing listor e-mail addresses tooutside organizations.

Send updatedinformation to

[email protected]

19

Many thanks are in order to MaryAnn, Patty and the SAEM family staff“supreme team” (Jennifer, Sonya,Sylvia and Jean). Also, thanks to MaryAnn’s husband, Frank, for all the un-compensated work he does for SAEM.Thanks to the SAEM Board of Directorsfor their vote of confidence in me. I es-pecially thank the Program Committeefor putting together another great An-nual Meeting. I thank all committee,task force and interest groups and Ithank each and every member of theSAEM family for your support anddiligent work.

The pre-meeting day of activitiessuch as the CPC, Chief ResidentForum, committee, task force and inter-est group orientation dinner, academicchairs retreat, the opening plenarypaper session and the banquet in itsnew format on the first day, (attended bywell over 400 people) to the poster ses-sions, paper presentations, didactics,the keynote speech, committee andtask force and interest group meetings,and the President’s reception/banquetheld at the Jimmy Carter PresidentialCenter (hosted by the Emory UniversityDepartment of Emergency Medicine),and many other affiliated activities wereall first rate. The last day of the meetingcontinued with outstanding presenta-tions. There was also a very informativeAcademic Emergency Medicine con-sensus conference on the unraveling ofthe safety net held on the last day.Those who attended the AnnualMeeting recognized that the traditionalslide trays that have in the past fueledthe Imago Obscura award are nowbecoming extinct. Technical support forcomputer presentations went well.

During my term as SAEM president-elect, I was responsible for appointingthe chairs and members of the varioustask forces and committees. I also wasresponsible (with the Board’s approval)for putting together the objectives. Thecommittees and task forces have gottenoff to a great start. The committee andtask force objectives are printed in thisissue of the Newsletter.

The SAEM family obviously has a lotof work to do this year. In this message,I will not mention all but I will mentionsome of the chores. We will evaluatethe new election process, which ap-pears quite successful. We will provideconsults to requesting emergencymedicine divisions and departmentsbased on requests. There has beenrenewed, although cautious, interests inemergency care center categorization.Twenty academic departments haveexpressed interest and many havemade recommendations for membersof their departments to participate in theECC categorization committee. The

President’s Message (Continued)

ECC committee is charged withreviewing the ECC application forpossible streamlining. There was muchdebate during the meeting on thequestion of “why do it and what are therewards?” Although there has beeninertia in the past year regarding theECC, some departments haveexpressed interest and somedepartments have indicated that theyare in the process of applying.

We will develop a teaching modulefor residents interested in academiccareers and we will develop a fellow-ship catalogue similar to the residencycatalogue. We wil l also develop ateaching module for emergency medi-cine residency programs on ethics andprofessionalism. The Faculty Develop-ment Academic Handbook has manychapters already completed but wehave identified more chapters that needto be written. It is our goal to have thehandbook completed within the nextyear. We will develop the mission andgoals and a business plan and mechan-ism for fund raising for the SAEM Re-search Fund. This research fund wasformerly called FAEM. Grant applica-tions for the multiple SAEM grants willbe reviewed and we will assess theneed and development for future newgrants. We will monitor HCFA regula-tions, GME funding and the EMTALAregulations. We will organize an emer-gency medicine program at the AAMCannual meeting. We will solicit and re-view nominations for the elected posi-tions of our organization, the Young In-vestigator Awards and the AcademicExcellence and Leadership Awards.We will develop a teaching module onpatient safety and develop a report thatdiscusses the issues of how to study,monitor, analyze, report and act on ad-verse events, near misses and errors.We will develop a teaching module forresidents explaining the healthy people2010 objectives.

SAEM has not before had a specificpublic relations plan. This year we in-tend to lay the groundwork for public re-lations plans. Our public relations ef-forts will highlight SAEM’s research andeducation activities and also will serveas the watchdog for national activitiesrelated to research and education thatmay affect emergency medicine. Wewill publish a series of articles that high-light the various NIH Institutes, grantprograms and training programs appli-cable to emergency medicine. We willmentor junior researchers by providingquick reviews and comments on federalgrants prior to submission. We will im-plement the 2001-2002 salary surveyand we will continue to develop and re-vise the virtual advisor project for un-dergraduates. A plan will be developed

to implement the standardized emer-gency medicine undergraduate curric-ulum and we will continue to assess thepotential for an emergency medicineshelf examination for undergraduates.

This past year, SAEM issued a posi-tion statement on diversity. The follow-up to that position statement has beenthe development of the Under Repre-sented Member Research/MentoringTask Force. The goal of this task force isto provide mentoring to under repre-sented members of SAEM and to ad-dress cultural competency issuesthrough the development of teachingcases (training modules), monographsand various forms of research. Overtime,we hope to obtain a significant organiza-tional grant. A major question to beanswered is “can cultural competencyhelp to reduce health care disparities”?

The SAEM board has a new initiativefor this year — “projecting SAEM for theyear 2010”. We will obtain informationfrom other academic organizations andvarious sources and we will developstrategies and plans for 2010 goals.We will look at the SAEM finances,staff, the SAEM office building, com-munication modalities, fund raisingplans and staffing needs necessary toimplement PR and national affairstracking. We have a lot of work aheadof us and I look forward to leading theorganization and having some funalong the way. It is my pleasure towork with the SAEM family now andhopefully for years to come.

After the meeting was over, I washappy to get back home to family; wifeand children (two who had just finishedtheir college exams), and my 2 dogsand 2 cats; who were all very glad tosee me and I was very happy to seethem. Just as my kids are relieved tohave completed their college exams forthis year, I was relieved having com-pleted the Annual Meeting. Collegegrades don’t arrive until later in thesummer. As far as the Annual Meeting,I give the Program Committee and allwho contributed an A+.

Future SAEM AnnualMeetings

May 19-22, 2002Adam’s Mark Hotel

St. Louis, MO

May 29-June 1, 2003Marriott Copley Place

Boston, MA

20

Annual Meeting Highlights

2001-2002 SAEM Board ofDirectors: (L-R in back) RogerLewis, MD, PhD, Brian Zink, MD,Donald Yealy, MD, Jim Adams, MD,and Glenn Hamilton, MD. (L-R infront) Susan Stern, MD, JuddHollander, MD, Carey Chisholm, MD,Marcus Martin, MD, and DebraHoury, MD.

Emanuel Rivers, MD, the recipient of the 2001 SAEMAcademic Excellence Award is congratulated by Brian Zinkand Marcus Martin. (L-R) Dr. Zink, Dr. Rivers, and Dr. Martin.

Brian Zink (R) ispictured with Dr. Louis

Binder, the recipientof the 2001 SAEMLeadership Award.

(L-R) Robert O. Wright, MD, MPH, Terry Vanden Hoek,MD, and David Wright, MD, the 2001 recipients of theYoung Investigator Award were presented with theirawards at the Annual Meeting Business Meeting in Atlanta.

The recipients of the 2000 Annual Meeting Best Presentationsawards were recognized during the Annual Business Meeting.(L-R in back) Xin-liang Ma, MD, PhD, D Matthew Sullivan, MD,Suzanne Schuh, MD, and Emanuel Rivers, MD. (L-R in front)Valerie De Maio, David Wright, MD, and Laurence Katz, MD.Not pictured: Geoffrey Jackman, MD, Brigitte Baumann, MD,and Joshua Rucker.

Jerris Hedges, MD, MS, was the speaker atthe Annual Meeting Banquet. Dr. Hedgesshared his personal, historical perspective onbuilding a research career ala “ForrestGump.” He spoke on the question, “Do wehave a destiny or do we just float around on abreeze?” Dr. Hedges (L) is pictured withBrian Zink.

21

Dr. Brian Gibler, AACEM outgoing Presi-dent (R) is presented with a plaque in ap-preciation of his services to AACEM by Dr.John Gallagher, AACEM incomingPresident.

Dr. William Foege, the Annual Meeting Keynote Speaker is pictured with(L-R) Art Kellermann, MD, Ellen Weber, MD, Dr. Foege, Brian Zink, MD,and Marcus Martin, MD.

Dr. Terry Kowalenko, theNational Coordinator for the

Semi-Final CPC Competition ispictured with the winners of the

Competition and the Coor-dinators: (L-R in back) Frank

McGeorge, MD, RobertBaevsky, MD, Marc Roy, MD,

Darren Braude, MD, SteveBaxter, MD, Annie Sadosty,MD, Victoria Palmer-Smith,

MD, Doug McGee, DO. (L-R infront) Dr. Kowalenko, Shawna

Perry, MD, Michael Gisondi,MD, Randy Goldstein, MD,

Mary Ryan, MD, TriciaVillanueva, MD, Elaine Sapiro,MD, and Kevin Rodgers, MD.

2001-2002 AACEM Executive Committee (L-R) Jerris Hedges,MD, John Gallagher, MD, Brian Gibler, MD, and FrankCounselman, MD.

Dr. Brian Zink(R) presentsthe ResidentResearchYear Grantaward to oneof therecipients,RolandMerchant,MD.

Dr. Zink (L) is pictured with Gina Wilson-Rameriz, MD,the 2001-2002 Medtronic Physio Control EMS Fellowand Robert Niskanen from the Medtronic PhysioControl Corporation.

22

SAEM 2001-2002 Committee/Task Force ObjectivesConstitution and Bylaws CommitteeChair: Kate Heilpern, MD, Emory UniversityEmail: [email protected]. Review the Constitution and Bylaws to ensure accuracy

in regards to the Society’s activities and propose neededamendments to the Board for approval.

2. Evaluate the new election process and provide a report tothe Board and membership.

Consultation Service Task ForceChair: Louis Binder, MD, MetroHealth Medical CenterEmail: [email protected]. Provide consultation services as requested by institutions.2. Collect data from the survey of academic chairs and re-

cipients of consults from the past three years anddevelop a report to the Board.

Emergency Care Center Categorization CommitteeChair: Andrew Sama, MD, North Shore University Hospital Email: [email protected]. Promote Emergency Care Center Categorization through

advertisements, Newsletter articles, and letters toinstitutions and chairs.

2. Coordinate the review and approval of ECC categoriza-tion applications.

3. Review the ECC application and process and recom-mend proposed changes to the Board.

Ethics CommitteeChair: Catherine Marco, MD, St. Vincent Mercy MedicalCenterEmail: [email protected]. Develop 3 articles on ethical issues or in response to

questions submitted by SAEM members for publication inthe SAEM Newsletter.

2. Develop 2-3 ethical case studies for submission toAcademic Emergency Medicine.

3. Continue educational efforts for ethics related subjects,including didactic session proposals for consideration atthe Annual Meeting, regional meetings, and other forums.

4. Promote and coordinate the Ethics Consulting Service.5. Develop a teaching module for emergency medicine

residency programs on ethics and professionalism andsubmit to the Board for approval.

6. Develop guidelines for filming of ED patients in academicemergency departments.

Faculty Development CommitteeChair: John Gallagher, MD, Montefiore Medical CenterEmail: [email protected]. Complete the Academic Handbook.2. Develop educational didactic proposals and submit to the

Program Committee for consideration of presentation atthe Annual Meeting.

3. Continue to develop and update the Faculty Developmentsection of the SAEM web site.

4. Develop a Newsletter article on examples of whatconstitutes excellence and scholarship for promotion andtenure for clinician educators.

Financial Development CommitteeChair: Scott Syverud, MD, University of VirginiaEmail: [email protected]. Establish Research/Academic Development mission and

goals with a business plan to include estate planning andother means of endowment.

2. Develop a mechanism for fund-raising efforts directedtowards corporate and private support and endowment,including the development of policies for applying forcorporate and private contributions.

3. Provide continued oversight of SAEM investments.

Graduate Medical Education CommitteeChair: Michael Beeson, MD, Akron City HospitalEmail: [email protected]. Complete the development of a teaching module for a

rotation for residents interested in an academic career. 2. Develop a “Fellowship Catalog” which provides ex-

panded, structured information on fellowships and otherpostgraduate opportunities (MPH, MBA, PhD) and in-clude articles on topics such as the potential benefit, cur-riculum requirements, why it is important to obtain post-graduate training, and likely career impact.

3. Maintain and update the Resident Section of the web site.

Grants CommitteeChair: Jim V. Quinn, MD, University of California, SanFranciscoEmail: [email protected]. Coordinate the grant application reviews (working with

expert reviewers from committees, task forces andinterest groups) and recommend recipients to the Boardfor the following grants:a. Medical Student Interest Groupb. Scholarly Sabbaticalc. Research Training d. Institutional Research Traininge. EMF/SAEM Innovations in Emergency Medicine

Educationf. EMS Research Fellowshipg. EMF/SAEM Medical Studenth. Neuroscience Fellowship

2. Assess the need and development of future new grantsincluding Bridge Grants and an MD/PhD Grant.

3. Develop a database to track grant recipients for possiblefollow-up, possibly using the NRSA appraoch to assesscareer trajectories.

National Affairs CommitteeChair: James Hoekstra, MD, Ohio State UniversityEmail: [email protected]. Represent SAEM at the AAMC and AMA and submit

periodic reports, positions papers and articles of the or-ganizations’ activities and meetings to the Board and forpublication in the SAEM Newsletter.

2. Monitor HCFA regulations, GME funding, EMTALA regu-lations and other issues pertinent to academic emer-gency medicine and develop Newsletter articles and posi-tion statements as needed for submission to the Board.

3. Develop a proposal and organize an emergency medi-cine program at the AAMC Annual Meeting for submis-sion to the Board.

4. Continue a liaison relationship with the other nationalemergency medicine organizations to work together oncommon issues.

5. Encourage involvement of academic emergency physi-cians in the political process.

6. Develop a didactic proposal to inform SAEM members of thegovernmental affairs positions and initiatives of interest toacademic emergency physicians for submission to theProgram Committee for consideration at the Annual Meeting.

Nominating CommitteeChair: Roger Lewis, MD, PhDEmail: [email protected] 1. Develop a slate of nominees for the elected positions on

the Board of Directors, Nominating Committee, andConstitution and Bylaws Committee and submit to theBoard for approval.

2. Solicit and review nominations for the Young InvestigatorAward and recommend recipients to the Board.


23

Committee/Task Force Objectives (Continued)

3. Solicit and review nominations for the Academic Excel-lence and Leadership Awards and recommend recipientsto the Board.

4. Continue efforts to increase membership involvementand diversity within SAEM.

5. Develop criteria for a possible SAEM Humanitarian Award.

Patient Safety Task ForceChair: Robert Wears, MD, University of Florida, JacksonvilleEmail: [email protected]. Continue the development of a teaching module on

patient safety.2. Develop an Annual Meeting didactic proposal for submis-

sion to the Program Committee for consideration at theAnnual Meeting.

3. Prepare a Newsletter article on research opportunities re-lated to patient safety.

4. Develop a report that discusses the issues of how tostudy, monitor, analyze, report, and act on adverseevents, near misses, and errors.

5. Collaborate with other professional societies and disci-plines on patient safety as needed.

Program CommitteeChair: Ellen Weber, MD, University of California, SanFranciscoEmail: [email protected]. Develop and coordinate 2002 Annual Meeting including a

work plan, timeline, budget, and publicity. 2. Provide continuous review of the Annual Meeting goals and

objectives as they relate to the Society’s long range planand mission and make recommendations to the Board.

3. Publicize the Annual Meeting to other national organiza-tions and meetings to encourage the cross-disciplinaryexchange of science.

Public Health Task ForceChair: Carlos Camargo, MD, Massachusetts GeneralHospitalEmail: [email protected]. Develop a teaching module directed towards residents to

explain HP2010 and its objectives.2. Develop an action plan to address four HP2010 objec-

tives (observational research, interventions, networkingwith other medical specialties/public health departments,grants) and present to the Board for approval.

3. Continue to participate in HP2010 national meetings anddisseminate information to the SAEM membershipthrough Newsletter articles.

Public Relations CommitteeChair: Marcus Martin, MD, University of VirginiaEmail: [email protected]. Develop and implement public relations plans for SAEM.

Research CommitteeChair: Mark Angelos, MD, Ohio State UniversityEmail: [email protected]. Develop research didactic proposals, including sessions

focusing on the NIH and other sources of federal funding,for submission to the Program Committee for considera-tion of presentation at the Annual Meeting.

2. Publish articles in the SAEM Newsletter highlighting EMresearchers receiving NIH and other large grants.

3. Publish a series of SAEM Newsletter articles thathighlight various NIH institutes, grant programs, andtraining programs applicable to emergency medicine.

4. Develop a program by which the Research Committee canprovide mentorship for junior researchers by providing quickreview and comments on federal grants prior to submission.

5. Continue to develop Researcher Career Profiles for publica-tion in the Newsletter with the goal of publishing 2-3 articles.

6. Identify organizations that SAEM should interact with inregards to exchanging information about the organiza-tions’ and SAEM’s Annual Meetings.

Salary Survey Task ForceChair: Steve Kristal, MD, Henry Ford HospitalEmail: [email protected]. Develop survey instrument for 2001-2002 Salary Survey

of faculty at emergency medicine residency programsand submit to the Board for approval.

2. Implement the 2001-2002 Salary Survey, collate andanalyze the results, and submit the resultant manuscriptto the Board for approval, and publication in AcademicEmergency Medicine.

Undergraduate CommitteeCo-Chair: Stephen Thomas, MD, Massachusetts GeneralHospitalEmail: [email protected] Co-Chair: Wendy Coates, MD, Harbor-UCLA MedicalCenterEmail: [email protected]. Review, revise and update the Medical Student Section

of the SAEM web site and develop strategies to ensurethat SAEM is more identifiable to medical students.

2. Solicit and review articles and announcements of interestto medical students interested in a career in emergencymedicine, with an emphasis on academic emergencymedicine, for publication on the Medical Student Sectionof the web site.

3. Continue development and revision of the Virtual Advisorproject.

4. Work with the Medical Student Educators Interest Groupto develop a Medical Student Educators’ Section on theSAEM web site, including resources such as medicalstudent rotation information, emergency medicine interestgroups, affiliated residencies, departmental status, etc.

5. Develop an implementation plan of the standardizedemergency medicine undergraduate curriculum pre-viously developed by SAEM.

6. Continue to assess the potential for an emergencymedicine shelf exam.

Under Represented Member Research Mentoring TaskForceChair: Glenn Hamilton, MD, Wright State UniversityEmail: [email protected] task force will provide mentoring to under-representedmembers of SAEM and will address cultural competencyissues, including whether cultural competency reduces racialand ethnic health disparities.1. Provide research mentoring predominantly, but not exclu-

sively, to under represented minority emergency medi-cine residents as defined by the AAMC (African Ameri-can, Mainland Puerto Rican, Native American, and Mexi-can American):a. Develop a teaching module on cultural competencyb. Develop and implement research proposals regardingcultural competency

2. Develop a monograph to encourage under representedminority medical students to consider emergency medi-cine as a specialty.

3. Suggest research proposal for future mentoring initiativesfor submission to the Board.

Board Initiative-Projecting SAEM in 2010The Board of Directors plans to survey other medical organi-zations to compare with SAEM and develop goals for SAEMin 2010.

24

So, I think we did well in our focusareas in the past year. And for thosecommittee and task force chairs andmembers who were not in the “focusareas”, I appreciate the fact that you didnot whine about it, but did some incred-ibly good work. Just to cite a couple ofthese, Felix Ankel chaired the Under-graduate Education Committee, whichhas done a great job over the past fewyears. One of the innovative projectsfrom this Committee is a web-basedVirtual Advisor program for medical stu-dents. You can check this out at the In-novations in Emergency Medicine Edu-cation Exhibit, along with the new Fac-ulty Development Website. The VirtualAdvisor program should be especiallyvaluable to medical students who are atmedical schools without strong EM pro-grams. I encourage faculty members tosign up to be Virtual Advisors.

Another success story has been thePatient Safety Task Force, chaired byBob Wear, which was formed last springin response to the national attention dir-ected at patient safety and medicalerror. The Task Force got off to a greatstart with the Consensus Conferencethat was sponsored by AEM and SAEMlast spring. The proceedings from thatconference were published in the No-vember 2000 edition of AEM, and arebeing highly referenced and mentionedin national discussions on patient safety.Bob and his task force have beentraveling extensively in the past year,representing SAEM at national patientsafety meetings and forums.

I would also like to acknowledge thesignificant systems changes that oc-curred in our organization as a result ofthe C&B amendments that were devel-oped by Sue Fish and the Constitutionand Bylaws (C&B) Committee. As youknow, the amendments were put to themembers for vote in February, and weoverwhelmingly voted to change ourelections to a mail ballot, and to allowresident members to vote for the res-ident member of the Board of Directors.The results of our first mail ballot elec-tion have just been announced, and weare pleased that 5 t imes as manySAEM members voted in the electionthis year as compared with our previousmethod that limiting voting to thosepresent at the business meeting. Aspart of the C&B amendment changes,resident members were able to vote forthe first time this year for the residentmember of the Board of Directors.

Finally in our review, the most ob-vious evidence of our success is allaround us these 5 days in the proceed-ings of a fantastic Annual Meeting that isthe result of the tireless work of EllenWeber and the Program Committee.Well, that’s a long review of systems,and if I were presenting this case to the

State of the Society (Continued)average academic emergency attend-ing physician, he or she would havethat glazed over look in the eyes, andbe thinking about a ski trip to Vail lastJanuary. So, let’s move on:

Family and Social History: In ourcase, this is far from “noncontributory.”SAEM interacts with lots of otherorganizations that begin with “A”. Weattempt to foster productive, harmoni-ous relationships with ACEP, AAEM,AACEM, ABEM, AAMC, and AMA. Wealso collaborate with CORD, EMRA,and the RRC in areas that relate toresident education and research.

Physical Exam: SAEM vital signs arenot only stable, in fact they are increas-ing. SAEM has 5,500 members, 2,150who are active members, 2,751 resi-dent and medical student members,and 360 associate members. Financesare in the black.

Head(quarters): The SAEM Headquar-ters are in Lansing, MI, in a beautiful oldgray house that has wonderful wood-working, high ceilings, and boasts theoldest bathroom in Lansing. Many mem-bers are surprised to learn that the Exec-utive Director, Assistant Director, and afull time staff of 3 other people run, out ofthis old house — SAEM, the journalAEM, CORD, and AACEM. In all, this isan amazing enterprise — efficient, lean,but also innovative, responsive, andvery attentive to members’ needs.

Heart: The heart of the Society is itsmembers, and while there are bouts oftachycardia, especially around abstractsubmission time, and an occasionalmurmur of discontent, the heartbeat isstrong, and regular and not failing.

Neurological: The neurological circui-try of SAEM has become its website.This site is one of the finest availablefor an academic organization, and hasdeveloped considerably in the pastyear. Almost all of the important SAEMfunctions are now web-based, includingmembership registration, abstract sub-mission, and meeting registration. Thesite is also a major repository of infor-mation on EM research opportunities,career development, and medicalstudent and resident information.

Assessment and Plan: In summary,this is a 12-year-old academic medicalorganization. In somewhat of a medicalparadox, the basic elements of theSociety, the members, are somewhatinfirm, but the Society as a whole ishealthy. This makes one a bit nervousthat the problems that are endemic toacademic medicine will eventually af-fect SAEM. The Society is ready tomake a leap to becoming a significantsource of funding for EM research

training, but this will require a largeincrease in our research endowmentand formal development efforts. Weare ready to increase our presence innational affairs and advocacy, but thismay require additional resources andtime. We are determined to offer moresupport to EM faculty to develop theircareers. We want to continue to lead inmedical student and resident education.But to keep to this plan will requiremore, rather than less of our members.

The pressures of clinical workload,departmental finances, and increasedscrutiny of our medical practices areeroding some of things that we have re-garded as fundamental. On the medicalschool side this is manifested as a de-crease in the time and attention thatfaculty devote to medical student edu-cation. Presumably, the reason that weare in academic medicine, and em-ployed by or affiliated with medicalschools, is that we value educating thenext generation of physicians. But be-cause medical student teaching activityis not usually rewarded monetarily, andbecause other crises may be treated asa higher priority, this fundamental partof our mission as academic physiciansis threatened.

The same thing is happening in ouremergency medicine residency pro-grams. Burgeoning patient volumes, re-duced clinical resources, and burden-some federal regulations create a blackhole with a mighty gravitational fieldthat pulls our educational and researchmissions out of our normal orbits. I’mpretty sure that our residents nowadaysdo not have the same depth of facultyinteraction, even in the form of basicconversations, that I enjoyed as a resi-dent. All of that discretionary timeseems to be sucked up by the blackhole. The thing that disturbs me mostabout this is that the way in which weuse our voluntary or discretionary timeindicates where our values lie, and thissends a message to our trainees. Howcan we impart the values and show therewards of teaching, and scientificinquiry to those people who will followus if we seem to ignore or give pooreffort in those areas? How will we at-tract bright, and talented people toacademic emergency medicine if theadjective used to describe EM faculty is“frenzied” rather than “fun”? It seemsunconscionable to ask, but at this time,when the demands on us individuallyand as departments is greatest, wemust rededicate ourselves to ourcentral and fundamental values asacademicians. We must find the timeto teach and investigate, and feel andshow the joy that comes from theseendeavors. Churchill said, “I like a man


25

State of the Society (Continued)who grins when he fights.” I hope thatcan be our approach.

What strategies can we use to fightwhat Kenneth Ludmerer calls “thesecond revolution” of American healthcare? This revolution places marketstrategies and cost containment in ahigher plane than the training of ourmedical students and residents, and thecare of the poor and underserved in so-ciety. Our initial response in academicmedicine was a corporate one — tocompete with each other for patientsand health care markets — to improveour efficiency and bottom line. It can beargued that this approach has beenunsuccessful, especially as it relates tomedical education. We may now have ahealth care system that is leaner anddoesn’t spend at quite the rate as pre-viously, but as we all have seen, dis-content is rampant in our patients, med-ical personnel, faculty, medical studentsand resident physicians. Seeing this,perhaps the best strategy at thismoment, as we combat the industryand government forces that havewounded academic medicine, need notbe too aggressive. As Napoleon noted,you should “never interrupt your enemywhen he is making a mistake.”

I have written in the past year on ad-vocacy, and reiterate now, that ourposition in Emergency Medicine is veryfamiliar to most of the American public.People pay attention when we speak.Our words can be simple: that highquality emergency care must be avail-able to all people, that the training ofquality physicians to provide emer-gency care cannot be further comprom-ised, and that the scientific explorationthat will lead to improved care for futureemergency patients must be supported.Note that our most effective and in-fluential position is to advocate for ourpatients, our residents, and our stu-dents, and not for ourselves. Althoughwe work hard and have lots of stres-sors, this hardly makes us unique in theAmerican workforce, and with our gen-erous incomes, we will not evoke muchsympathy if our advocacy is only foremergency physicians. Jordan Cohen,the President of AAMC said in anaddress last June: “the key to valuingthe profession is to profess its values.”We can feel secure that the basicvalues of teaching, scientific investiga-tion, and providing care to all who needit, whenever they need it, are beyondreproach, and resonate with the Ameri-can public. We do not all need to havea mastery of complex political and leg-islative processes to be effective ad-vocates — we merely need to be ableto illustrate and share our values.

I am very hopeful that a few yearsfrom now we may be translating thelessons we have learned from our

hardships into improved, more efficientemergency patient care, and innovativeteaching and research. Perhaps mymiddle name is Pollyanna, but I hopeyou will all be there with me, grinning,and fighting.

As would be expected, the problemsthat academic emergency physiciansare encountering in their individual situ-ations are transferred to some extent toour academic society. The erosion ofdiscretionary time means that fewerpeople are able to commit to SAEMprojects or work that take significanteffort. So, even though our membershipnumbers are going up, I believe thenumber of people who are doing thework of the Society is decreasing.There are a number of problems withthis. First, as a national and interna-tional society, we want to representideas and activity from members of adiverse and varied background. If one ortwo people do all the work on a partic-ular project we risk having a productthat is not representative of our Societyas a whole. Another concerning thing isthat if SAEM work becomes the domainof a few energetic, well-meaning truebelievers, who will keep advancing ourmission when these individuals (somemay call us zealots) grow old, or weary,or retire? I am concerned that many ofour junior members are not able to findthe time to have meaningful participa-tion in the Society. This is our loss, andalso their loss. And we have the sameproblem at the other end of the experi-ence spectrum. It never seemed possi-ble, but now we have senior memberswho have wisdom and insights to sharewith SAEM, but who find little time to do

so. I would challenge these members tobring your skills and leadership backinto SAEM so that we have some eldersto mentor us and keep us on course.

Why give your precious time andeffort to SAEM? That is a question thateach of us has to answer individually.For me, it may sound corny, but it hasalways been the simplicity of the organ-ization. I find myself refreshed and re-stored again and again by the basicbeauty of our mission. And like manyof you, I find a very nice fit between myvalues and the SAEM mission: to im-prove patient care by advancing re-search and education in emergencymedicine. There are not a lot of thingsin professional life that remain pure, butthe SAEM mission, and the way itsmembers and staff have pursued thatmission over the past 12 years is asabout as pure as it gets.

In closing, I would like to say thankyou to the Society for the outstandingexperience it has been for me to serveas your President in the past year.Many people ask me if I am tired, andready for a break, and to some extent Iam. But after spending a year travelingand interacting with SAEM faculty,residents, medical students, and ourSAEM staff, I am left with such a posi-tive feel for the future of academicemergency medicine, that I leave morerejuvenated than tired. And on that note,I would like to present to you our newSAEM President, Dr. Marcus Martin.

*From the 2001 SAEM President’sAddress presented at the SAEMAnnual Meeting, May 7th, 2001,Atlanta, GA.

11th Annual Midwest RegionalSAEM Research Forum

September 15, 2001St. Louis, Missouri

Hyatt Regency HotelUnion Station

Keynote Speaker:Jerris R. Hedges, MD, MS

“Ten Things You Should Do in 2001”

The Program Committee is now accepting abstracts for oral and poster presentation atthe 11th Annual Midwest Regional Research Forum to be held in St. Louis on Septem-ber 15, 2001. The deadline for abstract submission is Saturday, June 30, 2001.

For meeting information and hotel reservations, contact Linda Barth or Michael Mullins,MD, at the Division of Emergency Medicine, Washington University, Campus Box8072, 660 S. Euclid Ave, St. Louis, MO 63110-8072. Phone: 314-362-8971. Fax: 314-362-0478. E-mail: [email protected] or [email protected].

26

SAEM 2001-2002 Committees and Task ForcesConsultation Service Task ForceChair: Louis S. Binder, MD, MetroHealth Medical Center Wallace Carter, MD, NYU/Bellevue Hospital CenterJames Holliman, MD, Penn State Geisinger Health SystemLiudvikas Jagminas, MD, Rhode Island HospitalKathleen Ann Neacy, MD, Regions HospitalDan Pallin, MD, Mount Sinai School of MedicineRobert Shesser, MD, MPH, George Washington UniversityAllan B. Wolfson, MD, University of Pittsburgh

Ethics CommitteeJean T. Abbott, MD, University of ColoradoEric N. Bryant, MDMichelle Grant Ervin, MD, MHPE, Howard UniversityNeal Flomenbaum, MD, New York HospitalJoel M. Geiderman, MD, Cedars-Sinai Medical CenterGregory Luke Larkin, MD, University of PittsburghChair: Catherine A. Marco, MD, St. Vincent Mercy

Medical CenterMary Patricia McKay, MD, Allegheny General HospitalPatricia P. Nouhan, MD, St. John Hospital and Medical

CenterPhilip N. Salen, MD, St. Luke’s HospitalStacy N. Weisberg, MD, State Univ. of New York, Syracuse

Faculty Development CommitteeWilliam G. Barsan, MD, University of MichiganHoward A. Blumstein, MD, Wake Forest UniversityKathleen Brown, MD, State University of New York, SyracuseGregory P. Conners, MD, University of RochesterDeborah B. Diercks, MD, University of California, Davis David Esses, MD, Montefiore Medical CenterJohn T. Finnell, MD, Regions HospitalChair: E. John Gallagher, MD, Montefiore Medical CenterJ. Lee Garvey, MD, Carolinas Medical CenterKristin E. Harkin, MD, Jacobi Medical CenterSean O. Henderson, MD, University of Southern CaliforniaJennifer Krawczyk, MD, University of California, IrvineGloria Kuhn, DO, PhD, Medical College of VirginiaDouglas W. Lowery, III MD, Emory UniversityMichael S. Lyons, MD, University of CincinnatiDebra G. Perina, MD, University of VirginiaS. Scott Polsky, MD, Summa Health SystemGeorges Ramalanjaona, MD DSc, Newark Beth IsraelGail S. Rudnitsky, MD, MCP Hahnemann UniversityLatha Ganti Stead, MD, Jacobi/Montefiore

Financial Development CommitteeSteven C. Dronen, MD, University of MichiganJudd E. Hollander, MD, University of PennsylvaniaRoger J. Lewis, MD PhD, Harbor-UCLA Medical CenterJoseph A. Salomone, III MD, Truman Medical CenterArthur B. Sanders, MD, University of ArizonaChair: Scott A. Syverud, MD, University of Virginia Jill D. Teplensky, PhD, Thomas Jefferson UniversityBrian J. Zink, MD, University of MichiganFrank L. Zwemer, Jr, MD, University of Rochester

Graduate Medical Education CommitteeJoel M. Bartfield, MD, Albany Medical CenterChair: Michael S. Beeson, MD, Akron City HospitalSteven H. Bowman, MD, Cook County HospitalCharles K. Brown, MD, The Brody School of MedicineDouglas Brunette, MD, Hennepin County Medical CenterMike Burg, MD, University Medical CenterMark W. Fourre, MD, Maine Medical CenterSheryl L. Heron, MD, MPH, Emory UniversityDavid S. Howes, MD, University of Chicago

Steven A. McLaughlin, MD, University of New MexicoUsamah Mossallam, MD, Henry Ford HospitalN. Heramba Prasad, MD, State University of New YorkSandra Sallustio, MD, PhD, Mount Sinai Medical CenterJames Scott, MD, George Washington UniversityPatricia Dighton Short, MD, Indiana UniversityMalini Kishen Singh, MD Rebecca Smith-Coggins, MD, Stanford UniversityJoseph Adrian Tyndall, MD, Brooklyn Hospital CenterAnthony J. Weekes, MD, St. Luke’s-Roosevelt HospitalBeth Whelchel, University of VirginiaKeith Wilkinson, MD, William Beaumont HospitalWendie Williams, MD, Howard University HospitalBradley N. Younggren, MD

Grants CommitteeCharles B. Cairns, MD, University of ColoradoTheodore R. Delbridge, MD, MPH, University of PittsburghJohn Eric Duldner, Jr, MD, Akron General Medical CenterJason Scott Haukoos, MD, Harbor-UCLAJoseph LaMantia, MD, North Shore University HospitalChair: Jim Quinn, MD, University of California, San DiegoMarc S. Rosenthal, PhD, DO, Regions HospitalArthur B. Sanders, MD, University of ArizonaFederico E. Vaca, MD, University of California, IrvineJohn G. Younger, MS, MD, University of Michigan

National Affairs Task ForceJill Grant, University of VirginiaAzita Hamedani, MD, Brigham and Women’s HospitalJ. Brian Hancock, MD, Timberline Emergency Physicians, P.C.Mark C. Henry, MD, State Univ. of New York, Stony BrookChair: James W. Hoekstra, MD, Ohio State UniversityKenneth V. Iserson, MD, MBA, University of ArizonaAmin Antoine Kazzi, MD, University of California, IrvineJohn A. Marx, MD, Carolinas Medical CenterWilliam Frank Peacock, IV, MD, Cleveland ClinicDavid P. Sklar, MD, University of New MexicoVincent P. Verdile, MD, Albany Medical CollegePeter Viccellio, MD, State Univ. of New York, Stony Brook

Patient Safety Task ForceScott D. Berns, MD, Rhode Island HospitalRobert A. Bitterman, MD, JD, Carolinas Medical CenterKaren Cosby, MD Patrick G Croskerry, MD, PhD, Dartmouth General HospitalCliff Erickson, MD, Albany Medical CenterJonathan Fisher, MD, Brigham and Women’s HospitalRichard J. Hamilton, MD, MCP, Hahnemann UniversityStephen Hargarten, MD, MPH, Medical College of WisconsinGregory D. Jay, MD, PhD, Rhode Island HospitalIngrid T. Labat, MD, Howard UniversityNadine R. Levick, MD, Johns Hopkins UniversityWilliam D. O’Riordan, MDShawna Perry, MD, University of FloridaHoward L. Peters, Jr, MD, Howard UniversityStephen Schenkel, MD, University of MichiganMarc J. Shapiro, MD, Rhode Island HospitalJohn Dennis Vinen, MD, Royal North Shore HospitalChair: Robert L. Wears, MD, MS, University of Florida

Health Science Center


27

Committees and Task Forces (Continued)

Program CommitteeChris Barton, MD, San Francisco General HospitalWilliam J. Brady, MD, University of VirginiaDane M. Chapman, MD, PhD, Washington UniversityNorman C. Christopher, MD, Children’s Hospital Medical

Center/AkronCathy Custalow, MD, PhD, University of VirginaBrian Euerle, MD, University of MarylandJohn J. Flaherty, MD, Evanston HospitalLeonard R. Friedland, MD, Temple UniversityDiane Gorgas, MD, Ohio State UniversityDavid A. Guss, MD, University of California, San DiegoSheldon Jacobson, MD, Mount Sinai Medical CenterJames B. Jones, MD, PharmD, Methodist Hospital of IndianaJohn J. Kelly, DO, Albert Einstein Medical CenterTodd M. Larabee, MD, Washington Hospital CenterDavid C. Lee, MD, North Shore University HospitalJohn S. Leung, MD, Northwestern UniversityBernard L. Lopez, MD, Thomas Jefferson UniversityWilliam J. Meggs, MD, PhD, East Carolina UniversityLewis Nelson, MDEmanuel P. Rivers, MD, MPH, Henry Ford HospitalAdam J. Singer, MD, State Univ. of New York, Stony BrookTerry L. Vanden Hoek, MD, University of ChicagoGary M. Vilke, MD, University of California, San DiegoMary Jo Wagner, MD, Saginaw Cooperative HospitalsChair: Ellen J. Weber, MD, University of California, San

Francisco

Public Health Task ForceBrent R. Asplin, MD, Regions HospitalBruce Becker, MD, MPH, Rhode Island HospitalDominic A. Borgialli, DO, MPH, Michigan State UniversityChair: Carlos A. Camargo, Jr, MD, DrPH, Massachusetts

General HospitalMeta Carroll, MD, Children’s Memorial HospitalLinda C. Degutis, DrPH, Yale UniversityLowell W. Gerson, PhD, Northeastern Ohio UniversitiesPeggy E. Goodman, MD, East Carolina UniversityKyle Gunnerson, MD, Henry Ford HospitalDave A. Holson, MD, Harlem Hospital CenterCharlene Babcock Irvin, MD, St. John Hospital and

Medical CenterTerry Kowalenko, MD, Sinai-Grace HospitalMichael H. LeWitt, MD, MPH Robert A. Lowe, MD, MPH, Oregon Health Sciences

UniversityDaniel A. Pollock, MD, Centers for Disease Control and

Prevention Lynne D. Richardson, MD, Mt. Sinai Medical CenterPeter Wyer, MD, New York Presbyterian Medical Center

Research CommitteeChair: Mark G. Angelos, MD, Ohio State UniversityRobert N. Bilkovski, MD, Christ Hospital and Medical CenterGerard X. Brogan, Jr, MD, North Shore University HospitalClifton Callaway, MD, PhD, University of PittsburghRobert T. Gerhardt, MD, MPH, Brooke Army Medical CenterGary B. Green, MD, MPH, Johns Hopkins HospitalWalter L. Green, MDCharles J. Havel, Jr, MD, Medical College of WisconsinAlan E. Jones, MD, Carolinas Medical CenterJeffrey A. Kline, MD, Carolinas Medical CenterPeter L. Lane, MD, Albert Einstein Medical CenterFrank Lovecchio, DO, Good Samaritan Regional Poison

Center

Roland Clayton Merchant, MD, Mt. Sinai Medical CenterDavid P. Milzman, MD, Providence HospitalJames R. Miner, MD, Hennepin County Medical CenterCraig D. Newgard, Harbor-UCLA Medical CenterJames E. Olson, PhD, Wright State UniversityRichard Eric Rothman, MD, PhD, Johns Hopkins HospitalIan Gilmour Stiell, MD, MSc, Ottawa Civic HospitalAnne Tintinalli, MD, State University of New York, BrooklynT. Paul Tran, MDKevin R. Ward, MD, Medical College of VirginiaRobert O. Wright, MD, MPH, Rhode Island Hospital

Undergraduate CommitteeWinifred Agard, MD, University of RochesterAdrienne Birnbaum, MD, Jacobi Medical CenterKerry B. Broderick, MD, Denver Health Medical CenterJudy Jean Chapman, RN, EMT, Vanderbilt UniversityCo-Chair: Wendy C. Coates, MD, Harbor-UCLAJamie Collings, MD, Northwestern Memorial HospitalAdam D. Corrado, Chicago Medical SchoolGus Garmel, MD, Kaiser Permanente Medical CenterCherri Hobgood, MD, University of North CarolinaHeather N. Hollowell, University of PittsburghTamara Howard, MD, Howard UniversityJennifer L. Isenhour, MD, Vanderbilt UniversityDonald J. Kosiak, Jr, University of North DakotaRobert R. Leschke, MD, Froedtert Hospital EastLisa R. Maercks, MD, Christiana Care Health SystemDavid Edwin Manthey, MD, Wake Forest UniversityMoss H. Mendelson, MD, Eastern Virginia Medical SchoolTamas R. Peredy, MD, Maine Medical CenterCory J. Pitre, Louisiana State UniversityAnnie Tewel Sadosty, MD, Mayo ClinicLawrence R. Schwartz, MD, Wayne State UniversityKevin Terrell, Wishard Memorial HospitalRaffi Terzian, MD, MPH, University of PennsylvaniaCo-Chair: Stephen H. Thomas, MD, Massachusetts

General HospitalMichael C. Wadman, MD, University of Nebraska

Under-Represented Member Research Mentoring TaskForceKumar Alagappan, MD, Long Island Jewish Medical CenterLouis S. Binder, MD, MetroHealth Medical CenterMichelle H. Biros, MS, MD, Hennepin County Medical CenterMichelle Grant Ervin, MD, MHPE, Howard UniversityMiguel C. Fernandez, MD, University of TexasJuan A. Gonzalez-Sanchez, MD, Universidad de Puerto RicoChair: Glenn C. Hamilton, MD, Wright State UniversityFred P. Harchelroad, Jr, MD, Allegheny General HospitalJerris R. Hedges, MD, MS, Oregon Health Sciences

UniversityThea James, MD, Boston Medical CenterNorm Kalbfleisch, MD, Oregon Health Sciences UniversityGabor D. Kelen, MD, FRCP(C), Johns Hopkins UniversityArthur L. Kellermann, MD, MPH, Emory UniversityLouis J. Ling, MD, Hennepin County Medical CenterJames Niemann, MD, Harbor-UCLA Medical CenterShawna Perry, MD, University of FloridaLynne D. Richardson, MD, Mt. Sinai Medical CenterEmanuel P. Rivers, MD, MPH, Henry Ford HospitalArthur B. Sanders, MD, University of ArizonaSandra M. Schneider, MD, University of RochesterDavid P. Sklar, MD, University of New MexicoDavid O. Wright, MD, St. Mary’s Hospital

28

Head, Department of EmergencyMedicine

The College of Medicine at the University of Arizona seeks a Headof Emergency Medicine to lead the unitÕs patient care, research,and educational programs. Emergency Medicine, currently adivision in the Department of Surgery, will become anindependent academic department in the College of Medicine July1, 2001. Candidates must be board certified in emergency medicineand have experience in resident/medical student teaching,documented research productivity, and proven administrativeskills. Clinical and teaching site is at University Medical Center inTucson, which is a regional referral center and level-I traumacenter caring for over 60,000 patients a year. Academic qualifica-tions are full professor or academic credentials commensurate withfull professor.

Send personal statement, CV, and contactinformation for 3 references to:

William A. Grana, M.D.Chair, Emergency Medicine Dept Head Search CommitteeProfessor and Head, Department of Orthopaedic Surgery

P.O. Box 245064Tucson, AZ 85724-5064

fax: (520) 626-2668email: [email protected]

FACULTY POSITIONSILLINOIS, Chicago: Cook County Hospital seeks an energetic BC/BPresidency trained emergency physician for a full-time academic position.Attendings enjoy protected time and limited nights/WE in order to pursueresearch and academic pursuits. Our faculty development program allowsattendings to gain depth in clinical areas of interest. The ED sees 120,000adult patients per year and is staffed by 26 full time attendings and 54emergency medicine residents. We have active emergency ultrasound pro-gram. A new state of the art Cook County Hospital will open in August2002 with a greatly expanded ED, trauma unit and OBS unit. For more in-formation contact: Jeffrey Schaider, MD, Associate Chairman, Departmentof Emergency Medicine, 1900 West Polk St, Chicago, IL 60612; telephone312-633-5451; FAX 312-633-8189; e-mail [email protected]

MARYLAND: New emergency medicine opportunity available forsummer 2001 at growing community hospital in suburban Marylandfacility. BC/BP emergency medicine specialists interested in full-timeopportunity with small democratic group with excellent benefits andcompensation can forward C.V. to Medical Matrix at Fax (301) 498-6576or e-mail to [email protected].

MICHIGAN – Ann Arbor: Academic EM position available in Ann Arborat 78,000 annual visit trauma center: ED, Adult and Pediatric ambulatorycare centers, on site helicopter ambulance service, chest pain observationunit. Approved EM Residency sponsored by St. Joseph Mercy Hospitaland the University of Michigan. BC/BE EM physicians with two yearsclinical experience. Excellent remuneration plus faculty stipend, paidmalpractice insurance, relocation allowance, profit sharing, cafeteria-stylebenefits package, 401(k), long term disability, flexible scheduling, referralbonuses, and more. To learn more, contact Nancy Ely at 800-466-3764,ext.337, via e-mail - [email protected], or visit us at www.epmgpc.com.

OHIO STATE UNIVERSITY: Assistant/Associate or Full Professor. Estab-lished residency training program. Level 1 Trauma center. Nationallyrecognized research program. Clinical opportunities at OSU MedicalCenter and affiliated hospitals. Send curriculum vitae to: Douglas A.Rund, MD, Professor and Chairman, Department of Emergency Medi-cine, The Ohio State University, 016 health Sciences Library, 376 W.10th Avenue, Columbus, OH 43210 or call (614) 293-8176. AffirmativeAction/Equal Opportunity Employer.

OREGON: The Oregon Health Sciences University Department of Emer-gency Medicine is conducting an ongoing recruitment of talented entry-level clinical faculty members at the assistant professor level. Preferenceis given to those with fellowship training, experience in collaborativeclinical research, and writing skills. Please submit a letter of interest, CV,and the names and phone numbers of three references to: Jerris Hedges,MD, MS, Professor & Chair, OHSU Department of Emergency Medicine,3181 SW Sam. Jackson Park Road, UHN-52, Portland OR 97201-3098.

UNIVERSITY OF ARIZONA: Department of Emergency Medicine is seek-ing candidates for a full-time faculty position. Candidates may be at theAssistant, Associate or Professor level of Clinical Emergency Medicineand committed to excellence in clinical care, teaching and research. Thesuccessful candidate will be an attending in the University Medical Cen-ter Emergency Department, which is a regional referral center caring forover 60,000 sick and injured children and adults. Interested individualsshould send their CV’s and letter of intent to: Samuel M. Keim, MD,Faculty Search Committee Chair, PO Box 245057, Emergency Medicine,University of Arizona College of Medicine, Tucson, AZ 85724-5057.

UNIVERSITY OF CALIFORNIA, SAN FRANCISCO: Academic: Facultyposition available for residency-trained, board eligible or certified emer-gency physician with previous teaching experience and commitment toacademic career. Mix of clinical, research, educational and administra-tive responsibilities available. High acuity university ED with EM resi-dents and diverse mix of community and tertiary care patients, servingone of the top-rated medical centers in the U.S. Please send your CVand description of interests to Michael Callaham, MD; Box 0208, Uni-versity of California, San Francisco CA 94143-0208 (email [email protected]). The University of California is an equal opportunity employer.

VANDERBILT UNIVERSITY: The Department of Emergency Medicinehas an unexpected opening for a clinician-educator at the Instructor orAssistant Professor level. Please consider joining our successfuldepartment. We have 1st and 4th year student rotations, a Level 1Trauma center, contiguous Pediatric and Adult ED’s and have all theother components of a well established program. Great benefits, greatcity. Please reply to Corey M. Slovis, MD, Chairman, Department ofEmergency Medicine, Vanderbilt University, 703 Oxford House,Nashville, TN 37232-4700. Email: [email protected]

29

The Division of Emergency Medicine at Michigan State Uni-versity (MSU) in cooperation with the MSU EmergencyMedicine Residency Program in Lansing, Michigan and InghamRegional Medical Center invites applications for an immediateopening for a tenure-track faculty position in cardiovascularhealth service research. We are seeking a faculty member toassist the residency faculty in establishing a successfulcardiovascular theme of emergency medicine research. The suc-cessful candidate will provide leadership in the development of aresearch program involving Emergency Medicine residents andfaculty in the cardiovascular disease area. Duties will includefacilitating collaborative research efforts between the specialty ofemergency medicine and other medical specialties, directing andadministering studies, grant preparation, and mentoring ofclinical faculty in research.

Specific requirements for the position are: 1) PhD degree inepidemiology or related discipline with formal training incardiovascular health services research, 2) minimum of fiveyears’ experience in scientific medical research, 3) demonstratedability to publish in peer-reviewed journals, 4) demonstratedability to obtain peer-reviewed, external grant funding.

Salary depends on faculty rank and experience. Michigan StateUniversity is an affirmative action equal opportunity employer.Applicants should submit a letter of interest and curriculum vitaeto: Earl J. Reisdorff, MD, Chairperson - Search Committee,Director of Medical Education Office, Ingham Regional MedicalCenter, 401 W. Greenlawn Avenue, Lansing, MI 48910.

APPLICATION DUE DATE: JULY 1, 2001

Chairman, EmergencyMedicine

Southeastern PennsylvaniaChairman, Department of Emergency Medicine is sought for a480-bed, not-for-profit, teaching hospital in an attractivesuburb of Philadelphia. Serving a regional population of600,000, the medical center’s programs include a burntreatment center and the county’s only adult Level II traumacenter. Over 600 medical students rotate through the medicalcenter from one of the area’s leading medical colleges. Themedical center also supports several highly respectedresidency programs. The Chairman of the Department ofEmergency Medicine will be responsible for all administrativeand clinical aspects of this busy department which manages47,000 visits, including 1,300 trauma patients, a year. He/shewill develop initiatives which will provide the organizationwith a sustained strategic advantage in the delivery of thehighest quality emergency care services to the community. Thesuccessful candidate for this position will be Board Certifiedand residency trained in Emergency Medicine, possess a trackrecord of successful leadership in a complex environment, andbe a demonstrated builder of both programs and collaborativerelationships. For additional information, please contact:

Esther Collet, Vice President & Senior AssociateThe Diversified Search Companies

2005 Market Street, Suite 3300,Philadelphia, PA 19103.

Telephone: 215-656-3579 or Email:[email protected].

RESIDENCY DIRECTORBELLEVUE HOSPITAL

NEW YORK UNIVERSITYMEDICAL CENTERNEW YORK, NEW YORK

We are seeking an inspired, creative leader with demonstrated adminis-trative experience to enhance the growth and development of our resi-dency training program.

The residency program is based at Bellevue Hospital Center, New YorkUniversity Medical Center, and New York University School of Medicine.The active emergency departments at both sites offer a broad exposureto all aspects of Emergency Medicine.

The residency consists of 14 residents per year in a four-year program.Qualified candidates must have completed Emergency Medicine Resi-

dency Training with extensive experience in an academic training pro-gram. The successful candidate will join a large faculty committed toeducation, research and exceptional care at America’s oldest public hos-pital and one of America’s oldest medical schools.

The academic and administrative support will permit the candidate toprosper in a demanding and stimulating environment.

Inquiries should be accompanied by a Curriculum Vitae and addressed to:Lewis Goldfrank, MD, Director Emergency Medicine

Bellevue Hospital Center27th Street and First AvenueNew York, New York 10016

Tel: (212) 562-3346 Fax: (212) 562-3001e-mail: [email protected]

VANDERBILT UNIVERSITY: Research Position — The Department ofEmergency Medicine at Vanderbilt University is seeking a research-oriented faculty member for a tenure track position. This position will becustomized to meet a junior or senior level faculty member’s trainingand experience. This exciting position is based in the Department ofEmergency Medicine in collaboration with The Vanderbilt Center forHealth Services Research. The individual to be recruited will havecompleted training in an Emergency Medicine Residency Program. Heor she should have a strong interest, or record, in an academic careerand a desire to focus on outcomes research. If appropriate, the selectedinvestigator will be allowed sufficient non-clinical time to complete theVanderbilt MPH program during his or her two years. This position willhave up to 80% protected time and start-up funding. Secretarial,research nurse, and statistical support will be provided, along with apremium discretionary research package. Appointments will becommensurate with the individuals level of achievement. Excellentsalary and benefits in a great community. Please reply to Corey M.Slovis, MD, Chairman, Department of Emergency Medicine, VanderbiltUniversity, Room 703, Oxford House, Nashville, TN 37232-4700, E-mail: [email protected]

30

FACULTY POSITION

The Division of Emergency Medicine atDuke University Medical Center is working

to develop an Emergency MedicineResidency Program. We are currently seekingfull-time academic faculty members. Thesepositions offer a variety of opportunities for

clinical practice, teaching, and research.Residency training and BC in EM required.Duke University Medical Center EmergencyDepartment is a Level I Trauma Center inDurham, North Carolina, with an annual

volume of 65,000 patient visits. Competitivesalary and benefits. Faculty at all academic

levels are invited to apply.

Please contact:Kathleen J. Clem, MD, FACEP

Chief, Division of Emergency MedicineDUMC 3096, Durham, NC 27710

email: [email protected]

Faculty Development FellowshipThe Wright State University School of Medicine, Department of Emergency

Medicine is pleased to offer a newly developed Faculty Development Fellowshipbeginning July 1, 2001. Starting dates are flexible. Although we recognize that it islate in the recruitment season, we hope you will contact us if you have an interest inpursuing careers in academic emergency medicine.

We have been working on developing this one-year fellowship for several yearsand are pleased that we have secured all of the support elements.

The Fellowship consists of an 18-20 hour per week clinical commitment at oneof our several practice sites (ranging from 27,000 to 100,000 patient visits). Thereare planned instructional sessions in organizing one’s faculty development,curriculum design, research project planning, grantsmanship, writing andpublishing in the medical literature, use of media, international emergencymedicine and several other topics. Each of these is tied to the expertise of a specificfaculty member and written materials.

Additionally, there is a portion of the program which can be tailored to suit theneeds of the candidate relative to their own faculty development.

Stipend is $50,000 plus generous benefits and travel support. We are currentlyaccepting applications which would include a CV, letter of interest and two letters ofreference until the two available positions are filled.

If you have an interest in academic emergency medicine and believe a year offocused training in the skills necessary to succeed in the profession would benefityour career, then please contact:

Glenn C. Hamilton, MD, MSMDepartment of Emergency Medicine

3525 Southern Blvd. • Kettering, OH 45429Phone: (937) 296-7839 • Fax: (937) 296-4287

email: [email protected]

CALL FOR ABSTRACTS2002 Annual Meeting

May 19-22 — St. Louis, Missouri

The Program Committee is accepting abstracts for review for oral and poster presentation at the 2002 SAEM AnnualMeeting. Authors are invited to submit original research in all aspects of Emergency Medicine including, but not limited to:abdominal/gastrointestinal/genitourinary pathology, administrative/health care policy, airway/anesthesia/analgesia, CPR,cardiovascular (non-CPR), clinical decision guidelines, computer technologies, diagnostic technologies/radiology,disease/injury prevention, education/professional development, EMS/out-of-hospital, ethics, geriatrics, infectious disease,IEME exhibit, ischemia/reperfusion, neurology, obstetrics/gynecology, pediatrics, psychiatry/social issues, researchdesign/methodology/statistics, respiratory/ENT disorders, shock/critical care, toxicology/environmental injury, trauma, andwounds/burns/orthopedics.

The deadline for submission of abstracts is Tuesday, January 8, 2002 at 3:00 pm Eastern Time and will be strictlyenforced. Only electronic submissions via the SAEM online abstract submission form will be accepted. Theabstract submission form and instructions will be available on the SAEM web site at www.saem.org in November. For furtherinformation or questions, contact SAEM at [email protected] or 517-485-5484 or via fax at 517-485-0801.

Only reports of original research may be submitted. The data must not have been published in manuscript or abstract formor presented at a national medical scientific meeting prior to the 2002 SAEM Annual Meeting. Original abstracts presentedat other national meetings within 30 days prior to the 2002 Annual Meeting will be considered.

Abstracts accepted for presentation will be published in the May issue of Academic Emergency Medicine, the official journalof the Society for Academic Emergency Medicine. SAEM strongly encourages authors to submit their manuscripts to AEM.AEM will notify authors of a decision regarding publication within 60 days of receipt of a manuscript.

Society for Academic Emergency Medicine • 901 North Washington Avenue • Lansing, MI 48906

31

The following is a summary of the research grants that will be funded by SAEM in academic year 2002.Further information and application materials can be obtained via the SAEM website at www.saem.org .

SAEM Research Training Grant (formerly known as the Resident Research Year Award)This grant provides financial support of $75,000 per year for two years of formal, full-time research trainingfor emergency medicine fellows, resident physicians, or junior faculty. The trainee must have a

concentrated, mentored program in specific research methods and concepts, and complete a research project. Deadlinefor applications is November 1, 2001 .

SAEM Institutional Research Training GrantThis grant is currently under development, but SAEM expects to call for applications in the summer of 2001 for a start dateof July 2002. The grant will provide financial support of $75,000 per year for two years for an academic emergencymedicine program to train a research fellow. The sponsoring program must demonstrate an excellent research trainingenvironment with a qualified mentor and specific area of research emphasis. The training for the fellow may include aformal research education program or advanced degree. It is expected that the fellow who is selected by the applyingprogram will dedicate full time effort to research, and will complete a research project. The ultimate goal of this grant is tohelp establish a departmental culture in emergency medicine programs that will continue to support advanced researchtraining for emergency medicine residency graduates. Tentative deadline is November 1, 2001 .

SAEM Scholarly Sabbatical GrantThis grant provides funding of $10,000 per month for a maximum of six months to help emergency medicine faculty at thelevel of assistant professor or higher obtain release time to develop skills that will advance their academic careers. Theultimate goal of the grant is to increase the number of independent career researchers who may further advance researchand education in emergency medicine. The grant may be used to learn unique research or educational methods orprocedures which require day-to day, in-depth training under the direct supervision of a knowledgeable mentor, or todevelop a knowledge base that can be shared with the faculty member’s department to further research and education.Deadline for applications is November 1, 2001 .

SAEM Emergency Medical Services Research FellowshipThis grant is sponsored by Medtronic Physio-Control. It provides $50,000 for a one year fellowship for emergency medi-cine residency graduates in EMS at an approved fellowship training site. The fellow must have an in-depth training ex-perience in EMS with an emphasis on research concepts and methods. The grant process involves a review and approvalof emergency medicine training sites as well as individual applications from potential fellows. Deadline for applications isNovember 1, 2001 .

SAEM Neuroscience Research FellowshipThis grant is sponsored by AstraZeneca. It provides one year of funding at $50,000 for an emergency medicine resident,graduate, or junior faculty member to obtain a mentored research training experience in cerebrovascular emergencies. Theresearch training may be in basic science research, clinical research, or a combination of both, and the mentor need notbe an emergency medicine faculty member. Completion of a research project is required, but the emphasis of thefellowship is on the acquisition of research skills. Deadline for applications is November 1, 2001 .

EMF/SAEM Medical Student Research GrantsThis grant is co-sponsored by the Emergency Medicine Foundation and SAEM. It provides up to $2400 over 3 months fora medical student or resident to encourage research in emergency medicine. More than one grant is awarded each year.The trainee must have a qualified research mentor and a specific research project proposal. The final deadline for the2002 grants has not been announced, but will likely be in January 2002 .

EMF/SAEM Innovations in Medical Education GrantThis grant is co-sponsored by the Emergency Medicine Foundation and SAEM. It provides up to $5,000 to support projectsthat use novel techniques, programs, or products to improve emergency medicine education. The final deadline for the2002 grants has not been announced, but will likely be in January 2002 .

SAEM Medical Student Interest Group GrantsThese grants provide funding of $500 each to help support the educational or research activities of emergency medicinemedical student organizations at U.S. medical schools. Established or developing interest groups, clubs, or other medicalstudent organizations are eligible to apply. It is not necessary for the medical school to have an emergency medicinetraining program for the student group to apply. The application deadline is September 1, 2001 .

The above descriptions may be subject to modification by the Board of Directors and Grants Committee. Please check theSAEM website, or call the SAEM office at (517) 485-5484 for grant instructions, application materials, and confirmation ofdeadlines.

Final grant applications and announcements are expected to be posted on the SAEM web siteby July 1, 2001.

SAEM Research Grants for 2002

NEWSLETTERNEWSLETTERNewsletter of The Society For Academic Emergency Medicine

Board of DirectorsMarcus Martin, MDPresidentRoger Lewis, MD, PhDPresident-ElectDonald Yealy, MDSecretary-TreasurerBrian Zink, MDPast PresidentJames Adams, MDCarey Chisholm, MDGlenn Hamilton, MDJudd Hollander, MDDebra Houry, MD, MPHSusan Stern, MD

EditorDavid Cone, [email protected]

Executive Director/Managing EditorMary Ann [email protected]

Advertising CoordinatorJennifer [email protected]

Society for AcademicEmergency Medicine901 N. Washington AvenueLansing, MI 48906-5137

The SAEM newsletter is published bimonthly by the Society for Academic EmergencyMedicine. The opinions expressed in this publication are those of the authors and donot necessarily reflect those of SAEM.

Presorted

Standard

U.S. Postage

P A I D

Lansing, MI

Permit No. 485

“to improve patient care byadvancing research andeducation in emergencymedicine”

CALL FOR DIDACTIC PROPOSALS2002 Annual Meeting

May 19-22, 2002 — St. Louis, Missouri

The Program Committee is soliciting proposals for didactic sessions for the 2002 Annual Meeting. Didacticsessions should emphasize issues of research, education, clinical advances in Emergency Medicine, andfaculty development. Didactics may be aimed at medical students, residents, junior faculty and/or senior faculty.The format may be a lecture, panel discussion, or workshop. The Program Committee will also review proposals forpre- or post-day workshops, or multiple sessions during the Annual Meeting aimed at in-depth instruction in aspecific discipline. Didactic proposals should support the mission of SAEM and should fall into one of the followingcategories:

• Education (education methodology, improving the quality of education, enhancing teaching skills)• Research (research methodology, improving the quality of research)• Career Development • State-of-the-Art (presentation of cutting-edge basic science or clinical research that has important implications for

further investigation or the future practice of emergency medicine)• Health Care Policy and National Affairs

Note that State of the Art sessions are not a review of the literature of a summary of clinical practice. All submittersare asked to briefly explain how the session meets the SAEM mission.

The deadline for submission is August 30, 2001.

To submit a proposal, complete a Didactic Submission Form, which will be posted on the SAEM web site atwww.saem.org. All proposals must be submitted electronically. For additional questions or information, contact theProgram Committee/Didactic Subcommittee through the SAEM office at [email protected] or 517-485-5484.

Documents

May-June 2001