January/February 2011 by Society for Academic Emergency Medicine

2340 S. River Road, Suite 200 • Des Plaines, IL 60018 • 847-813-9823 • saem@saem.org • www.saem.org

JANUARY/FEBRUARY 2011

DOUGLAS ANDER, MD

SAEM

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VOLUME XXVI NUMBER 1

SAEM M em bership

SAEM STAFF Executive Director James R. Tarrant, CAE Ext. 212, jtarrant@saem.org Executive Director – CORD Barbara A. Mulder bmulder@saem.org Executive Assistant Sandy Rummel Ext. 213, srummel@saem.org Bookkeeper Janet Bentley Ext. 202, jbentley@saem.org Customer Service Coordinator Michelle Iniguez Ext. 201, miniguez@saem.org Education Coordinator Kirsten Nadler Ext. 207, knadler@saem.org Grants Coordinator Melissa McMillian Ext. 207, mmcmillian@saem.org Help Desk Specialist Neal Hardin Ext. 204, nhardin@saem.org IT/Communications David Kretz Ext. 205, dkretz@saem.org

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SAEM Is Going Green! We have heard the request for SAEM to go “green” and we are listening. Beginning January 2011, SAEM will be taking a step forward in the green movement by delivering the SAEM Newsletter electronically to your email. The electronic newsletter can be downloaded from our website to your laptop, net book, or iPad to be read wherever you are. Whether on an airplane or sitting at the kitchen counter, members will still have easy access to the newsletter. Also, if you have missed an issue, don’t forget all newsletters are archived on our website at www.saem.org under Publications. The newsletter contains valuable information and we don’t want you to be left out! Make sure you review your profile to ensure SAEM has your email on file.

President’s Message

Saem Member Highlights

Future Funding and Research

Program Committee Update

Academic Announcements

Ethics in Action

Fellowship Fair

Spadafora Scholarship

Calls And Meeting Announcements

President’s M essage SOCIETY FOR ACADEMIC EMERGENCY MEDICINE Jeffrey A. Kline, MD

Expertise, part III

Arbitrary Awesomeness Scale (AAS score)

Let’s talk about you. More specifically, how awesome you are. This moment, as you idle at a stoplight or on the toilet, is no time to be modest. Being an expert in many things, I will assist by providing a graphical illustration of your relative awesomeness using my soon to be trademarked Arbitrary Awesomeness Scale score (AAS). I do plan on commercializing and marketing my AAS score as a serious competitor to the impact factor. You will soon be reporting Jeffrey A. Kline, MD the Kline AAS score on your CV. Figure 1 shows some typical results of the self-assessed AAS score. The data clearly show a zero probability of the null hypothesis, which, if viable, would state that someone else could actually compare to you. 120 100 80 60 40 20 0

You

Everybody else

Figure 1. Plot of how awesome each of us is relative to everyone else.

Academic medicine has a way of creating insular beasts. Otherwise unselfish and giving people, placed into the competitive environment of promotion and tenure, wRVU goals, and the utter nonsense of peer review, can be silently transformed from a nice person into a brat. Not a metamorphosis into a creature of splendid colors, but more of a Kafka-like metamorphosis — an involution into the grey zone of one’s own anxiety and rueful thoughts. The way to reverse this transformation of a butterfly into a worm is through the strength and bonding of your academic community. Put another way, connectivity helps us grow outward. In my previous two essays, I discussed the importance of choice and competence in developing expertise. Connectivity with peers provides a vital third component to developing healthy expertise. Connectivity creates friendships, and trust, and a network of knowledge that makes researchers stronger by creating a comfort zone of smart people to share ideas and criticisms without concern of embarrassment, or the need to show one’s AAS. SAEM allows a time and place to form these bonds. Observe the physical nexus that can be seen at each break at each Annual Meeting, as young investigators meet persons who last week were names on a paper. The ability to know a fellow researcher’s voice and stance; to grow your connection and learn about their workplace, their system of promotion and tenure, and, soon, their families, their fears and their hopes, creates true awesomeness of life in academia. And

by awesome, I mean the unbreakable bonds of friendship and dedication that cross distances every day, last a lifetime, and will sometimes rescue you from your own self-doubt. The future of knowledge discovery — and the creation of topic experts — in emergency care lies with each of us in our ability to organize teams of researchers. In 2007, Wuchty et al. examined 19.9 million peer-reviewed papers encompassing a wide range of disciplines, with the objective of determining the primary predictors of high-impact research.1 They found that over the past 45 years, the number of authors of each paper has more than doubled. Importantly, publications of research done by teams were cited 1.7 times more frequently than research done by individual scientists. I should note that Wuchty et al. had some serious limitations in their analysis because they used a measurement they called the Relative Team Index (RTI) to assess impact, instead of using the Kline AAS score. I have emailed the authors to ask them to reanalyze their data using the new gold standard. I am anxiously awaiting their reply. The work by Wuchty et al. underscores an important point. And that point is that most of our research and education will soon be done by Facebook and Twitter. We will share data in real time, with photos of surprised patients being enrolled in clinical trials, and we will Tweet important notes to each other such as “OMG, just figured out that I can use the PROC/RAND command in SAS to generate a random sequence. LOL.” Inasmuch as the future of connectivity lies with new media, SAEM has created a Social Media Committee, comprised mostly of guys with those cool beards on the lower lips and a few teenagers we asked to help. To learn more about the future of social networking in research, I performed a structured interview of a randomly-selected teenager to learn more about how our future researchers will rely on social media to communicate information. In particular, I found a random teenager who is taking her SAT in December. In compliance with the Privacy Rule, I have carefully concealed her identity. In the interest of space, I will present the abbreviated version of this scintillating interview. Me: “As a random teenager who is all hip, can you tell the SAEM audience how you use Facebook to share knowledge?” Random teenager: “Dad, please, I am trying to study for the SAT.” Me: “But you are looking at Facebook.” Random teenager: “Sigh (with eye roll) I am studying.” Me: “Studying what? That stupid hat that guy is wearing?” Random teenager: “No, Dad, I am getting the answers to the practice SAT questions.” Me: “That guy’s hat is stupid-looking.” Random teenager: “Don’t be such an AAS.” (Note: the guy wearing the hat is actually the random teenager’s boyfriend.) This interview clearly supports the hypothesis that connectivity is the future of scientific advancement. And, of course, that you are awesome. Reference 1Wuchty S, Jones BF, Uzzi B. The increasing dominance of teams in production of knowledge. Science, 316:1036-1039, 2007.

Executive director’s M essage New Year’s Resolution: Advocacy is Critical In 2008 I commented on the pending Presidential election and the change which would result. Since then, Health Care reform was passed, the economy has been improving, if ever so slowly, while the sentiment of Americans appears to be less hopeful. Over the past two years, the media have been reporting on the public’s dissatisfaction with the direction of the country, which may have influenced the change in the balance of power in James Tarrant, CAE Congress. With the 112th Congress convening in January 2011, there will be many new faces on Capitol Hill. Our elected representatives are not experts in all fields in which they will be making decisions. They depend on legislative aides’ research, agency reports, interest groups, associations, etc. for information. You can be a source of accurate information concerning healthcare. If legislators are not receiving input from physicians, how can they make informed decisions regarding healthcare policy? Who knows patient care better than physicians? How many patients would be in the hospital without a physician signing the orders? You are in the driver’s seat for patient care. Physicians too often wish to defer the “political stuff” to others. They do not want to enter what they perceive as the political swamp. I recommend becoming an advocate for your patients in the political process through education. Educate your representatives on the impact their decisions have on your patients. It is critical for physicians to engage in the political process. Over the years, I have repeatedly heard representatives say they do not hear from physicians. They have heard from other groups, such as trial attorneys on medical liability, and executives on health insurance and prescription drugs. You have the best voice to share stories of patients and the effects of overcrowding, lack of insurance, and shortage of primary care physicians. Start by writing a brief letter with your concern for patient care and a request for support to fix it. Please share your advocacy experience with SAEM. Before you make a trek to Washington, DC, start at home. Most representatives are in their districts Friday through Monday. Make an appointment to speak with them. Do not ask them to fix the

world in one visit. Select the most important issue affecting your ability to care for patients. Be prepared and have data on the issue (an important article, statistics from your department). Before you leave, let the representative know you would be pleased to share your expertise on healthcare issues in the future, and ask them if they would be interested in visiting your institution for a meeting with faculty and residents to hear from your peers. Encourage faculty members and residents to write to representatives. Each academic center contacting one representative and two senators will reach nearly half of all Congressional members. An additional letter to your individual Congress member will further increase exposure of representatives to academic emergency medicine issues and advance opportunities to share your expertise on future issues. Previously, I suggested that SAEM faculty and resident members host separate legislative breakfast meetings with your local representatives from the state legislature and members of Congress. Begin a dialogue with the representative, and end with an invitation to spend part of a day in the department, and again be available to provide expertise on healthcare issues. As the new Congress begins with promises of repealing some of the Healthcare Reform Act, it is a perfect time for you to become engaged in the advocacy process. Representatives, particularly new members, need your expertise and insight to improve access, quality of care and the need for funding of residency programs. There will be no better time to discuss emergency medicine issues with decision makers. As background, Jeffrey Kline, MD, and Jennifer Walthall, MD have prepared an analysis of the Health Care Reform legislation, outlining its impact on academic emergency medicine and highlighting a number of positive outcomes for EM research (find it at http://www.saem.org/SAEMDNN/Portals/0/ News/Summary-and-Review-of-the-Healthcare-Reform-Act.pdf). What does this mean to you? By taking these initial steps, you are now engaging in advocacy. You are not a lobbyist; you do not have to be a major donor to the representative’s campaign, although modest support of a local event never hurts. What you will do is put a face to academic emergency medicine and expose Congressional members to educated decision-making. While you are very busy, can you afford not to advocate for your patients and your profession?

SAEM M em ber highlight Douglas Ander, MD Someone forgot to tell Douglas Ander that the “triple threat” academician is an anachronism. While we are proud to have created a triple threat department at Emory, Douglas insists on being able to do it all himself! Many in the SAEM community are aware of his leadership and innovations in education. Douglas was among the first wave of professional medical student clerkship directors to revolutionize the students’ clinical experience and turn it into a comprehensive curriculum. One of the founding members of the Academy of Clerkship Directors of Emergency Medicine (CDEM), Douglas now serves as the current CDEM President. He is also an ACEP National Faculty Teaching Award recipient, founder and director of Emory’s simulation center, Assistant Dean in the School of Medicine, clinician par excellence, and perennial favorite teacher in three different and demanding academic emergency departments. His SAEM colleagues may be less aware of his considerable research accomplishments. Douglas is an expert in the evaluation and management of CHF. He is a funded researcher in the noninvasive measurement of central venous impedance, and has served in leadership roles for the Society of Chest Pain Centers. He has also been instrumental in the development of the new Society of Chest Pain Centers CHF guidelines. His colleagues at Emory know him for his endless generosity. There is no limit to the time he will spend, shifts he will cover, and wise counsel he will provide to residents and faculty members. He has also devoted hundreds of hours counseling individual medical students at both the Emory and the Morehouse Schools of Medicine, and he’s burned midnight oil ‘scrambling’ students even long after they’ve given up on themselves. He believes in people and will bend over backwards to both promote their potential and celebrate their successes. And then there is the Douglas his family knows. Devoted husband and father, he is regularly on carpool duty, accompanying field trips, or out camping with his girls. Additionally, he is an amateur photographer of note, and an avid fly fisherman. Oh, and he ran his first full marathon in New York City last year. We’re beginning to wonder if there’s anything he can’t do… Douglas Ander M.D., Associate Professor in Emergency Medicine, and Assistant Dean for Medical Education, Director of the Emory Center for Experiential Learning, and Director of Undergraduate Education for Emergency Medicine, Emory University School of Medicine – he’s a natural leader and role model, a wonderful colleague, and someone you should take the time to meet. Respectfully submitted: Katherine Heilpern, MD Philip Shayne, MD Emory University

Future Funding And Research Opportunities In Emergency Medicine: Building On Successes — What Does The Future Hold? Part II Of A Series On Unmet Needs And Future Funding Opportunities For Emergency Care Researchers For this report focusing on clinical research, we interviewed Nathan Kuppermann, MD, MPH, Chair of the Department of Emergency Medicine at U.C. Davis and Professor of Emergency Medicine (EM) and Pediatrics. Dr. Kuppermann has been involved in multicenter research in Pediatric EM for nearly two decades. He served as the Chair of the Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics from 1996-2000 and as the Chair of the Steering Committee of the Pediatric Emergency Care Applied Research Network (PECARN) from its inception in 2001 until late in 2008. He is currently the PI for the Academic Centers Research Node (ACORN) of PECARN. This is one of the 4 nodes in this consortium of 22 research institutions conducting multi-institutional research for the management and prevention of acute illness and injury in children. PECARN is the first and only federally-funded pediatric EM research network in the United States and is supported by the Health Resources and Services Administration / Maternal and Child Health Bureau (HRSA/MCHB), Division of Research, Education and Training and the Emergency Medical Services for Children (EMSC) Program. Last year, Dr. Kuppermann participated in NIH roundtable discussion panels addressing with NIH leadership the unmet needs in emergency research. These discussions included the formulation of strategies for emergency researchers to be able to increase their competitiveness in the federal grant arena. “The bottom line is that we must align our research strategies and agendas with the NIH funding framework and priorities.” This will maximize the competitiveness of junior EM investigators in obtaining career development, or K grants, which can lead to subsequent R grants. Furthermore, he emphasized that “we must work closely with our federal partners within the existing NIH institutes because there is no foreseeable National Institute for EM being planned.” Dr. Kuppermann feels that there are several approaches to research and grant success, including providing improved research training and expertise within EM through additional dedicated research fellowship programs, and/or by improving formal research requirements and training within existing programs. He noted, for example, that “EM fellowships such as ultrasound are typically one year long. These short clinical fellowships are great for developing clinical expertise, but do not provide ample time for research training and development. Improved training in research methodology and interdisciplinary and multidisciplinary collaborations are a must for those seeking a career in research. Seed grants are important, as they lead to career development awards, and subsequent larger sources of funding.” Dr. Kuppermann added that “seed grants and internal training grants within EM academic departments and institutions are extremely important investments that will enable EM candidates

to test their hypotheses and generate preliminary data from small funded pilot studies – small steps that may lead to obtaining larger grants (including career development awards). Ultimately, many clinical research topics will require multi-center study to determine precise outcomes which are widely generalizable. These networks are also necessary to test methods of implementation of findings and knowledge translation.” How can we improve multi-center studies and gather better data for improving clinical care in EM? Dr. Kuppermann noted that although general EM has outstanding disease-focused research networks, such as the Neurological Emergency Treatment Trials Network (NETT), the Resuscitation Outcomes Consortium (ROC) and the US Critical Illness and Injuries Trial Group, there is the room and the need for non-differentiated research networks. Examples include EMNet and the recently-created CTSA Western Consortium that includes several western and inter-mountain institutions. This allows for pooling of local resources for multicenter research, finding common research interests among researchers affiliated with CTSAs, and ultimately the testing of hypotheses and implementation of best practices. Starting small with regional networks is one way to get started, with face-to-face meetings at national or regional meetings. From these seeds of collaboration, ideas are generated, and bigger projects can be developed.

For further information on grant funding opportunities, please see the following web links: http://www.saem.org/saemdnn/GrantsAwards/Grants/ ResearchTrainingGrant/tabid/95/Default.aspx http://www.pecarn.org http://grants.nih.gov/training/K-Awards_Across_ICs.xls http://www.grants.gov/applicants/find_grant_opportunities.jsp http://www.emfoundation.org/EMF.aspx?id=108 http://grantsnet.org/search/pgm_info.cfm?pgm_id=7336

On behalf of efforts from the SAEM Research Committee -- Jonathan Valente, Larissa May, Erik Kulstad, Hillary Cohen, and Mark Courtney

Program Comm ittee Update Annual Meeting, June 1-5, 2011, Boston, MA Author: Andra L. Blomkalns, MD, University of Cincinnati Every year SAEM strives to improve its Annual Meeting based on your feedback. We are excited to announce several new features for our next exhibition and gathering. Take a look! I. So much material, not enough time. Meeting length expanded one day: The dates for the 2011 Annual Meeting are June 1-5, 2011. Events such as the Grants Workshop, CPC competition, and AEM Consensus Conference will occur on Day 1 or June 1, 2011. Plenary abstracts and other didactics will begin on June 2, 2011. The meeting ends on Andra L. Blomkalns, MD Sunday, June 5, 2011 at noon. II. The annual Leadership Forum includes a special two-day event titled “Leadership Bootcamp,” taking place on May 31, 2011 (pre-day) and June 1, 2011 (Day 1 of the Annual Meeting). III. New keynote lecture series titled “Emergency Medicine Past, Present, and Future.“ A number of you wanted to see the return of a Keynote Speaker. You want it, you got it! This year will be the inaugural keynote lecture series titled “Emergency Medicine: Yesterday, Today, and Tomorrow,” in which a luminary in Emergency Medicine will provide their thoughts on this topic. IV. So many options - New Itinerary Builder: The use of the new and very improved OASIS abstract submission platform will allow you to generate a custom itinerary based on your dates of attendance and topics of interest. No more slogging through the entire abstract book and on-site program to find what sessions you wish to attend. You will be able to download this itinerary to your PDA or smart phone, so please check the website before you depart for the meeting and plan your itinerary. V. Can’t make it to both meetings? Best of Council of Emergency Medicine Residency Directors (CORD) Academic Assembly. Four didactic hours will highlight the most interesting and valuable information from CORD and CDEM tracks at the spring Academic Assembly meeting. Don’t miss it! VI. Who are those people? Medical Student Ambassadors: In 2010, the Program Committee recruited 12 outstanding medical students who facilitated the flow of the meeting and gathered real-time feedback. These outstanding individuals collected over 40 single-spaced 10-pt.-font pages of comments and suggestions. Whew! VII. Fellowships, It’s Not Fair not to have a Fair - First Annual Fellowship Fair. The 2011 SAEM annual meeting will have its first Fellowship Fair. Fellowship directors should contact Maryanne Greketis, mgreketis@saem.org at SAEM if interested in having a booth. VIII. Don’t just stand there! Interactive Poster Sessions: Last year’s pilot initiative of the “lightning oral presentation” allowed more presenters, who otherwise might have been assigned to traditional standing posters, to present their research in front of an audience. We hope to expand this and other opportunities that increase the quality of the presenter and attendee experience. IX. Everyone could use few more “friends”! - Social Media: Thanks to the Website and Social Media task force, get updated SAEM news and announcements by following SAEM on Twitter and Facebook. Post your thoughts and musings; you may even get a reply! X. Plans and bids are in process for several events, including the Opening Reception, Fun Run, Dodge Ball competition, Sports Bar Baseball Game Social, Pub Crawl, and Wine and Cheese Poster Session. So please start talking it up, block your calendars, gather your group, book your sleeping room reservations early, look for meeting registration announcements, and please plan to attend this meeting. On behalf of the Program Committee, we hope you decide to spend your valuable time and CME dollars in Boston!

Program Committee Roster • Chandra Aubin, Washington University • Steven Bird, University of Massachusetts Medical Center • Andra Blomkalns, University of Cincinnati College of Medicine, Chair, Program Committee • Jennifer Carey, Brown University, Co-chair, Medical Student Ambassadors • Leigh Evans, Yale University School of Medicine • Kevin Ferguson, University of Florida, Gainesville • Susan Fuchs, Children’s Memorial Hospital • Maria Glenn, Carolinas Medical Center • Autumn Graham, Georgetown/Washington Medical Center, Co-chair, Events • Eric Gross, Hennepin County Medical Center • Jonathan Heidt, Washington University in St. Louis • Carolyn Holland, Cincinnati Children’s Hospital Medical Center/ University of Cincinnati College of Medicine • Michael Hochberg, Saint Peter’s University Hospital, Chair, Program Committee 2012 • Robert Hoffman, Beth Israel Medical Center • Jason Hoppe, University of Colorado/Denver Health Sciences Center • Bill Knight, University of Cincinnati College of Medicine/ Cincinnati Children’s Hospital Medical Center • Terry Kowalenko, University of Michigan, Chair, Speaker Search, Chair, Medical Student Symposium • Hollynn Larrabee, West Virginia University, Chair, Onsite Program • JoAnna Leuck, Carolinas Medical Center, Chair, IEME • John Marshall, Maimonides Medical Center • Henderson McGinnis, Wake Forest University • Dave Milzman, Georgetown University, Co-chair, Events • James Olson, Wright State University, Chair, Awards • Tiffany Osborn, University of Virginia • Ali Raja, Brigham and Women’s Hospital, Chair, Social Media/Press • Megan Ranney, Brown University/Rhode Island Hospital, Chair, Didactics • Kevin Rodgers, Indiana University, Chair, Chief Resident Forum • Sarah Ronan, University of Cincinnati College of Medicine • Christopher Ross, Cook County Hospital • Lorraine Thibodeau, Albany Medical Center, Co-chair, IEME • R. Jason Thurman, Vanderbilt University Medical Center, Chair, Photos • Taher Vohra, Henry Ford Hospital, Chair, Poster Tours • Joshua Wallenstein, Emory University, Co-chair, Medical Student Symposium • Robert Woolard, Texas Tech El Paso • Chris Zammit, University of Cincinnati, Chair, Medical Student Ambassadors

Riddle: These Boston ducklings just returned from a visit with their cousins for the holidays. What sort of souvenirs might they have brought back for Mom and why? Please e-mail your answers to Andra Blomkalns at andra.blomkalns@uc.edu. The first correct answer will receive mention in the next newsletter and a prize! Answer: TBA in the next Program Committee newsletter update.

Academ ic Announcements AHRQ Grant to Help Identify Emergency Department Best Practices to Reduce Healthcare Associated Infections Boston, MA - Jeremiah Schuur, MD, MHS, of the Department of Emergency Medicine at Brigham and Women’s Hospital (BWH), has received a $1 million grant from the Health and Human Services’ Agency for Healthcare Research and Quality, for a three-year research project to identify best practices for Emergency Departments (EDs) to reduce healthcare associated infections. The award is part of a $34 million project focused on funding research to prevent one of the top 10 leading causes of death in the United States – healthcare-associated infections (HAIs). AHRQ hopes this new funding will help improve the quality of care delivered to patients and expand the fight against HAIs in hospitals, ambulatory care settings, end-stage renal disease facilities and long-term care facilities.

produce the first estimate of infection-prevention strategies in emergency departments nationwide. The project will also identify best practices for infection prevention in use in EDs across the U.S., highlighting how the practices were successfully adopted and sustained in the busy ED environment. Preventing HAIs is a national priority, and over the last several years AHRQ has demonstrated a sustained commitment to supporting this priority. From 2007-2009, AHRQ awarded over $27 million for projects on the use of standardized procedures, including a checklist of proven safety practices based on CDC recommendations, staff training and tools for improving teamwork among health care providers. With the additional $34 million in funding, AHRQ is significantly expanding this important work.

In collaboration with Carlos Camargo, MD, DrPH, of the Massachusetts General Hospital and EMNet, the project will

EDs with innovative infection-prevention practices that are interested in sharing their success with the researchers should contact Dr. Schuur at edhaistudy@partners.org.

Amy Kaji, MD, PhD received a 2010 Distinguished

M. Kit Delgado, MD, Clinical Instructor in Emergency

Teaching Award from the University of California at Los Angeles. This university-wide award is given to several individuals each year who are considered to be outstanding educators within their chosen fields. Dr Kaji was the medical school’s nominee for this year’s award. Dr Kaji is an Associate Professor of Clinical Medicine at the David Geffen School of Medicine at UCLA and Director of the Disaster Resource Center at Harbor-UCLA Medical Center.

Dr. Gus Garmel has been promoted to Clinical Professor

at Stanford University School of Medicine. He also received the EMRA Mentorship Award at ACEP Scientific Assembly in Las Vegas, NV on Sept. 29, 2010.

Jeanine Ward MD PhD, a second-year medical

toxicology fellow at the University of Massachusetts, has been awarded a $15,000 award from Johnson & Johnson to identify time-dependent microRNA (“miRNA”) fingerprints following acetaminophen overdose. For this investigator-initiated proposal, Dr. Ward relied upon preliminary data identifying unique patterns of miRNA production in hepatotoxic states.

Medicine, Stanford University School of Medicine was awarded the Lee B. Lusted Prize for Outstanding Research at the Annual Meeting of The Society for Medical Decision Making (SMDM) in Toronto for his presentation, “Helicopter Versus Ground Ambulance Transport for Trauma: The Threshold Mortality Reduction Needed for Cost-Effectiveness.” Dr. Delgado is a Health Care Research and Policy Fellow at Stanford University’s Center for Health Policy/Primary Care and Outcomes Research. The 3-year fellowship is funded by a T32 training grant from the Agency for Healthcare Research and Quality (AHRQ).

Skip Craig, MBA, CMPE, Assistant to the Chair

of the Department of Emergency Medicine at the University of Alabama at Birmingham, retired after more than 27 years at the end of 2010. His replacement will be Chris Chicarello.

Vicken Totten has been promoted to Associate Professor

from Assistant Professor of Emergency Medicine at Case Western Research University School of Medicine, Cleveland, OH.

Zabrina Evens was awarded the 2010 SAEM ‘Medical The following attendings at Summa Health System in Akron, OH have received degrees: Kirk Stiffler, MD, 2010 Masters of Public Health, University of Massachusetts, Amherst

Alison Southern, MD, 2010 Masters in Medical Education and Leadership, University of New England

Sonny (Rudd) Bare, MD, 2010 Masters in Medical Education and Leadership, University of New England

Student Excellence in Emergency Medicine Award’ for the University of Minnesota graduating class of 2010. Dr. Evens won this award based on her commitment to Emergency Medicine and her outstanding performance on her Emergency Medicine clerkships. She is currently an intern at the Regions Hospital Emergency Medicine Residency.

Institute of Medicine Elects 65 New Members, Five Foreign Associates

Congratulations to Nate Kuppermann and Terry Klassen. This was the year for Peds EM.

UC Irvine ICTS is pleased to announce the recipients of the postdoctoral (KL-2) faculty career development program awardees and predoctoral (TL-1) training awards program awardees. KL-2 Career Development Program

The primary goal of the career development program is to increase the quantity and quality of exceptionally gifted investigators who are skilled at leading multidisciplinary research teams focused on distinctive clinical and translational investigation leading to sustained improvements on the health of the public.

TL-1 Training Program

The program is designed to integrate training in clinical research and translational science into the core curriculum of students in medicine, public health, nursing, pharmaceutical sciences, biomedical and social sciences, physical sciences, engineering, and informatics.

Shahram Lotfipour, MD, MPH Emergency

Medicine. Dr. Lotfipour’s research examines the effectiveness of a Computerized Alcohol Screening and Brief Intervention (CASI) in the Emergency Department through the teachable moment as compared to standard of care. CASI’s novel approach can mitigate barriers to proper screening and intervention, including time, availability of trained personnel, patient comfort, and language barriers. CASI is designed to provide the Alcohol Use Disorders Identification Test (AUDIT), a brief intervention, and customized resources for the patient. Mentors: C. Anderson, PhD & Jie Weiss, PhD.

Sarah Choi, PhD, RN, FNP Department of

Nursing Science. Dr. Choi’s program of research focuses on improving diabetes self-management and outcomes among underserved ethnic minority populations through community-based interventions. Dr. Choi is interested in designing a populationspecific community intervention (e.g., family support skills training) to improve diabetes outcome among underserved Asian subgroups (T2 translational research). Her proposed research has high relevance for 1) health disparities in diabetes care; 2) a priority area for comparative effectiveness research as indicated by the Institute of Medicine report (2009) (e.g., community-based multilevel interventions, simple health education, and usual care); and 3) heterogeneity in disease risk and management in Asian Americans (NIH, 2010). Mentors: Sheldon Greenfield, MD; Sherri Kaplan, PhD; & Karen Rook, PhD.

Hirohito Ichii, MD, PhD Department of Surgery. The

results of clinical islet transplantation have greatly improved due to the introduction of more efficient methods for the separation of islets and more effective immunosuppressive strategies. However,

it is still difficult to consistently produce adequate islet numbers for ongoing clinical trials. Nrf2 (nuclear factor erythroid 2-related factor 1)-Keap 1 (Kelch ECH Associating protein 1) signaling pathway plays a significant role in protecting cells from various stresses including environmental agents/drugs, inflammatory stresses, and chronic exposures to cigarette smoke and other carcinogens. The goal of the proposed research is to explore a novel strategy to improve islet isolation through Nrf2-Keap1 pathway in pancreatic beta cell and to investigate a possible usage in clinical islet transplantation. Mentors: N.D Vaziri, MD, MACP & Jonathan Lakey, PhD.

Vanessa Juth, PhD candidate, Psychology and Social

Behavior. Vanessa Juth’s research interests focus broadly on promoting health and psychosocial well-being among individuals coping with the cancer illness experience. She is currently in the doctoral program in Health Psychology in the Department of Psychology and Social Behavior and will be completing a masters degree in Public Health to pursue her interests in translating research into public health policies targeted at healthcare settings. She has begun a multi-method three- phase program of research at Children’s Hospital of Orange County that will examine the interdependent relationships of pediatric cancer patients, their familial caregivers, and healthcare providers. Mentor: Roxane Cohen Silver, PhD.

Melissa

Strong, PhD candidate, Anatomy & Neurobiology. Melissa Strong’s research aims to identify the source of resistance to cell death in a model of Huntington’s disease. The two goals of this research are to characterize induced resistance to excitotoxic cell death and to identify genes that are differentially expressed in mice that develop resistance to excitotoxic cell death. The preliminary evidence that there are genes, or changes in gene expression, that can confer protection against neurodegeneration leads us to pursue molecular mechanisms that can be targeted for therapeutic intervention. Mentors: Oswald Steward, PhD. Bruce Yang, PhD candidate, Biomedical Engineering.

Port wine stain birthmarks are vascular malformations that can greatly impact psychosocial development. Bruce Yang will determine the efficacy of functional optical imaging methods to improve treatment efficacy. The long-term goal is to develop and integrate these methods for use in image-guided surgery, not only for the treatment of port wine stains, but also for a wide range of medical applications. Mentors: Choi, PhD; J. Stuart Nelson, MD, PhD; & Kristen Kelly, MD.

AEM Author Announcements CrossCheck Academic Emergency Medicine now employs a plagiarism detection system. By submitting your manuscript to this journal, you accept that your manuscript may be screened for plagiarism against previously published works.

Academ ic Resident Section On behalf of the SAEM GME Committee, we are pleased to re-introduce the “Academic Resident” section of the SAEM newsletter. Quarterly articles will focus on topics of interest and importance to emergency medicine residents, with topics recurring on a roughly 3-year cycle. It is our hope that you will find these articles to be useful tools in your academic/professional development. We encourage your feedback and suggestions regarding additional content areas that would be of value to residents and recent residency graduates. Feel free to email comments and suggestions to techsupport@saem.org

Jonathan Davis, MD, Georgetown University | Douglas McGee, DO, Albert Einstein | Jacob Ufberg, MD, Temple University

Medical Simulation in Emergency Medicine Authored By: Leah C. Rey, MD, Emergency Medicine Resident, Albany Medical Center & Carolyn K. Holland, MD, MEd, Assistant Professor of Clinical Pediatrics and Emergency Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati Every day in the emergency department, we encounter patients with unique and challenging problems, with high potential for errors and their related consequences.[1] Recent changes in the way healthcare is delivered centers on the prevention of error. Simulation in emergency medicine (EM) can have a key role in achieving this goal of decreasing medical errors. Its use as an educational and training tool allows us to ensure a standardized approach to acquiring the knowledge skills and attitudes necessary to prevent error and be successful. Simulation is used to teach procedural skills to trainees and evaluate clinical knowledge or procedural competence in an individual. Finally, it can be used for the larger goal of analyzing the technical and organizational aspects of an entire department or hospital to discover potential dangers in a system that might otherwise go unnoticed. A comprehensive discussion of the uses of simulation in EM is beyond the scope of this article, so we will focus on the utilization of simulation for EM residency training. All EM residency graduates are expected to be able to perform a vast array of procedures in the care of their patients. These range from peripheral IV placement to pericardiocentesis and everything in between.[2] Traditional methods of teaching these procedural skills rely on the “see one, do one, teach one” method. In an effort to reduce medical errors and thus decrease potential harm to patients, this long-held dogma is falling out of favor. Additionally, some procedures are performed so rarely that it is possible for a physician to graduate from residency training and have never seen, let alone performed, a given procedure.[3] Simulation in medical education for this and other purposes is a relatively new idea. The Institute of Medicine (IOM) proposed simulation as an adjunct to traditional graduate medical education in 1999.[4] By 2003, only 19 EM residency programs had incorporated a significant amount of simulation in their curricula. At the 2004 Academic Emergency Medicine Consensus Conference for Informatics and Technology in Emergency Department Health Care, residency programs were encouraged to “consider the use of high-fidelity patient simulators to enhance the teaching and evaluation of core competencies among trainees.”[3] As of 2008, there were almost 60 programs that provided more than 10 hours of simulation experience per year for each resident.[5] Medicine is finally catching up with what other high-risk fields, such as aviation, nuclear power production, and the military, have long been doing - using simulation to provide trainees an opportunity to work through common and uncommon errors without the potential for causing harm.[6] Historically, physicians have been evaluated and assessed by focusing on the cognitive aspect of knowledge, as measured by

written and oral examinations. These types of evaluation do not evaluate decision making and the application of knowledge, which are both higher-order functions than the knowledge itself, nor are they able to assess teamwork or procedural skills.[7] Simulation provides opportunities to develop scenarios that directly reflect common tasks in medicine and allow definitive measurable outcomes that can be used to assess knowledge, skills or attitudes traditionally found to be difficult to measure. Consider the following question: Is a physician able to successfully run a code? It is difficult to completely answer this question with written or oral test questions alone, as there are far too many parameters than can be individually measured. Simulation can be used as a tool to identify specific knowledge and tasks in a given experience and then break it down to define a limited number of precise questions that need to be answered about one’s skills. In a simulated code, many of the ACGME core competencies can be critiqued in one setting: medical knowledge and procedural skill; interpersonal communications skills and teamwork; professionalism and compassionate patient care; and even systems-based practice when looking at the larger health care system of the emergency department and hospital.[8] Questions about the fund of knowledge of the physician, such as, do they recognize and treat cardiac tamponade as the cause of PEA? can be answered at the same time that their skill in performing a pericardiocentesis is evaluated. Finally, communication skills, team dynamics and attitudes can be evaluated by examining whether the physician addresses others in the room using eye contact and specific instructions. Simulation allows us to measure these qualities equally and fairly by defining measurable outcomes and allowing for specific and immediate feedback.[9] There is a broad spectrum of simulation equipment and resources available to residency programs. The highest level of fidelity in simulation is actors working as standardized patients.[10] While standardized patients are commonly used in teaching clinical exam skills to medical students, they have also been used in EM training to help medical students transition to residency, as well as to evaluate professionalism and communication skills.[1113] High-fidelity mechanical simulators are the next step down in the fidelity continuum. They are generally life-sized models that have mechanisms allowing breathing, response to surrounding environment and the ability to mimic human complications, such as an edematous airway. High-fidelity simulators can be very realistic, Medical Simulation in Emergency Medicine Continued on Page 11

Medical Simulation in Emergency Medicine Continued from Page 10 allowing for rich experience during the instruction by giving the trainee a chance to actually interact with the patient, the medical team and the surrounding environment. This realism comes with expenses in terms of money, as well as of time and energy for set- up and facilitation of sessions for trainees; however, the advantage of being able to emulate the real experience is priceless. With high-fidelity simulation, a trauma scenario can assess the ability of the team leader to effectively delegate responsibility, while also evaluating a trainee’s technical skills in performing RSI using the appropriate tools and medications. A high-fidelity simulator allows for a situation in which a trainee is unaware of what exactly is being tested, making it more congruent to real life. It can allow participants and observers to identify predictable problems and patterns of sub-optimal performance in order to learn how to prevent them. Luckily, high-fidelity simulators aren’t the only resources available to simulation devotees. Less expensive lowfidelity simulators can be used with success in many situations. A prime example of the most basic form of low-fidelity simulation is the oral board preparation being done in every residency. Another form of low-fidelity simulation is the use of “task trainers.”[10] Task trainers are good for use in teaching specific skills such as central line insertion, intubation or CPR. A minor disadvantage noted by some is that simulated experiences may make it easier for a trainee to identify what is being evaluated. This gives them the opportunity to focus in on the obvious task being assessed while making the assessment of their potential performance in a realworld situation less realistic.[14] Similar to the variety of different types of simulation tools available to educators, there are a variety of education and evaluative uses for simulation. Barriers to patient care can be found with simulation by identifying team hierarchy and leadership issues, communication barriers, and equipment malfunctions. Simulation can identify holes in safety nets, such as lack of systematic emergency procedures, differences in organizational norms amongst team members, and lack of clear role delineation within teams. It can also work to improve shared application of and appreciation for the process of patient care through simulation participation, and improvement in resource awareness via simulations.[15] Even with the expansion of simulation in EM residency training, the philosophical questions continue to arise: how closely does simulation evaluate the ability of one to apply knowledge, skills, and attitudes in similar real-life situations? There is no doubt that a patient overdosing on barbiturates will teach us more than a mannequin with the same situation. While technology in highfidelity simulators is constantly advancing, there are barriers to having an obviously fake patient with a cold plastic body. Subtle but key clinical findings, such as diaphoresis, are still lacking in current models. Simulation can never completely replace the hands-on medicine and bedside teaching that are core to an EM residency, but having the exposure to any given situation even once prior to having to address it in an actual patient is worthwhile, and will make the real-life situation run more smoothly. We believe that actively working through clinical questions by going through the physical and mental tasks is far superior to merely thinking about what one would do in any given situation. There are geographic limitations to some disease processes (hypothermia in Hawaii, toxic marine animals in Colorado) which can present a disadvantage to trainees in those programs where they may

not gain direct exposure to certain clinical scenarios. Simulation can provide these residents with real opportunities to develop the knowledge and experience necessary to care for patients around the country and the globe. Additionally, there are many universally rare situations that are of high morbidity where simulation can allow us to review the knowledge and practice the skills required to provide lifesaving care when the need finally arises. As previously mentioned, simulation in EM residency programs is expanding. While some residencies have merely incorporated simulation experiences into the standard curriculum, others have redesigned their entire educational experiences around simulation. In 2004, Brigham and Women’s Hospital opened a comprehensive medical simulation center, and the initial feedback indicated that residents prefer experiential simulation-based learning to traditional methods of teaching.[7] Several other hospitals around the country have opened centers and integrated simulation experiences into their curricula. However, there are still some residency programs that have not yet expanded their educational experiences to include simulation. Reasons cited for this lack of integration include lack of faculty time and training, costs of equipment, lack of support staff, and inadequate access to trainees.[5] In the past 10 years, the cost of acquiring a high-fidelity simulator has dropped from over $200,000 to around $40,000 per simulator.[5] There is an ever-expanding array of resources to help faculty expand their own simulation knowledge, such as Medical Simulation in Emergency Medicine Continued on Page 12

JACOBI MEDICAL CENTER

Affiliated with the Albert Einstein College of Medicine

Emergency Medicine Fellowship in Clinical Research The Department of Emergency Medicine of the Albert Einstein College of Medicine at Jacobi Medical Center is seeking applications for its EM Fellowship in Clinical Research. The fellow will be part of an established research program with a track record of NIH funding. This two year research fellowship combines a didactic curriculum leading to a Master of Science degree in clinical research methods with a mentored experience in clinical research. Applicants must successfully complete an Emergency Medicine Residency prior to beginning the fellowship. Applications for training to begin in July 2011 must be received by February 1, 2011. Contact: Adrienne Birnbaum, MD, MS Department of Emergency Medicine Room 1B25 - Jacobi Building 6 1400 Pelham Parkway South Bronx, NY 10461 Phone: 718-918-5815 E-mail: adrienne.birnbaum@nbhn.net

Medical Simulation in Emergency Medicine Continued from Page 11 those from the online resource www.emedu.org.[5] While these and other unnamed barriers may seem insurmountable, program directors and residents need to remember that simulation-based training can even result in improved outcomes on traditional multiple choice exams, and to utilize this fact to leverage time and money to implement or expand simulation training in EM residency education.[16] Simulation places the knowledge, skills, and attitudes needed to become an effective emergency physician at our fingertips, offering an expansion of traditional teaching methods favored by current residency trainees.[16] Every year, as students graduate from medical school and enter residency training, they take some form of the Hippocratic Oath at graduation. One key tenet of all of these oaths is primum non nocere – first, do no harm – and utilizing simulation in EM residency education is one way to uphold that oath. We have a technology that engages and educates without placing patients in harm’s way. As it continues to become less expensive, we expect to see a continued expansion of simulation throughout all residency training, not just EM. For those programs that have yet to take the opportunity to expand their curricula to include simulation modalities, we challenge residents or faculty who are interested to start small and think big. It is your education – make the most of it. Go to www.emedu.org and www.medsim.org to get involved.

References 1. Xiao, Y., et al., Task complexity in emergency medical care and its implications for team coordination. LOTAS Group. Level One Trauma Anesthesia Simulation. Hum Factors, 1996. 38(4): p. 636-45. 2. ACGME, A.C.f.G.M.E. Emergency Medicine Guidelines - Guidelines for procedures and resuscitations. 2010 [cited 2010 11/29/2010]; Available from: http://www.acgme.org/acWebsite/RRC_110/110_guidelines.asp. 3. Vozenilek, J., et al., See one, do one, teach one: advanced technology in medical education. Acad Emerg Med, 2004. 11(11): p. 1149-54. 4. Gordon, J.A., Vozenilek, J. A., On Behalf of the SAEM Simulation Task Force and Interest Group, and the Technology in Medical and E. Committee, The science of simulation in healthcare: defining and developing clinical expertise. . Acad Emerg Med, 2008. 15(11): p. 971-977. 5. Okuda, Y., et al., National growth in simulation training within emergency medicine residency programs, 20032008. Acad Emerg Med, 2008. 15(11): p. 1113-6. 6. Gaba, D.M., The future vision of simulation in health care. Qual Saf Health Care, 2004. 13 Suppl 1: p. i2-10. 7. Binstadt, E.S., et al., A comprehensive medical simulation education curriculum for emergency medicine residents. Ann Emerg Med, 2007. 49(4): p. 495-504, 504 e1-11. 8. Rosen, M.A., et al., A measurement tool for simulation-based training in emergency medicine: the simulation module for assessment of resident targeted event responses (SMARTER) approach. Simul Healthc, 2008. 3(3): p. 170-9. 9. Rosen, M.A., et al., Promoting teamwork: an event-based approach to simulation-based teamwork training for emergency medicine residents. Acad Emerg Med, 2008. 15(11): p. 1190-8. 10. Maran, N.J. and R.J. Glavin, Low- to high-fidelity simulation - a continuum of medical education? Med Educ, 2003. 37 Suppl 1: p. 22-8. 11. McGraw, R.C. and H.M. O’Connor, Standardized patients in the early acquisition of clinical skills. Med Educ, 1999. 33(8): p. 572-8. 12. Zabar, S., et al., Can unannounced standardized patients assess professionalism and communication skills in the emergency department? Acad Emerg Med, 2009. 16(9): p. 915-8. 13. Laack, T.A., et al., A 1-week simulated internship course helps prepare medical students for transition to residency. Simul Healthc, 2010. 5(3): p. 127-32. 14. Havighurst LC, F.L., Fields CL, High versus low fidelity simulations: does the type of format affect candidates performance or perceptions?, in 27th Annual IPMA-HR Assessment Council Conference on Personnel Assessment. 2003, Fields Consulting Group: Baltimore, Maryland. 15. Shilkofski, N., Hunt, E. Use of In Situ Simulations to Identify Barriers to Patient Care for Ad Hoc Multicultural and Multidisciplinary Teams in Developing Countries. 2010 [cited 2010 11/29/2010]; Available from: http:// www.hopkinsmedicine.org/simulation_center/downloads/Nics%20abstract. 16. Ten Eyck, R.P., M. Tews, and J.M. Ballester, Improved medical student satisfaction and test performance with a simulation-based emergency medicine curriculum: a randomized controlled trial. Ann Emerg Med, 2009. 54(5): p. 684-91.

Is Being Selected as Chief Resident a Detriment to a Career in Academics? Gabrielle Jacquet MD, Michael Barra MD, Ilona Barash MD, Mathieu De Clerck MD, Josh Flanagan MD, Eric Katz MD, John Nicolet MD, Jordan Sax MD, Jeff Soderman MD, Michael Ward MD, Jeff Druck MD Abstract: In the United States alone, there are 149 Emergency Medicine residency programs, most of which have Chief Residents chosen to lead the residents in their final year. After graduation, EM-trained physicians can work in a variety of clinical settings, ranging from community hospitals to academic institutions. There are some who believe that the Chief position is of value for developing academicians, while others believe being appointed Chief is a detriment to development of an academic career. Objective: This study was conducted to determine whether being a Chief Resident is associated with an increased likelihood of entering a career in academics as compared with non-Chief Residents. Methods: In this retrospective study, the career choices of graduates from a convenience sample of 10 nationally-accredited Emergency Medicine residencies selected over a 5-year period were collected. The data were then analyzed with respect to Chief status during residency. The data were then further analyzed in subgroups with respect to time since graduation, and with respect to 3- vs. 4-year residency program. Further statistical analysis was performed using SPSS (IBM, Armonk, NY) to derive confidence intervals and assess the absence of differences in program duration. Results: A total of 557 graduate career choices were assessed, of which 153 were Chief Residents. Overall, 34% of graduates pursued a career in academics. Of former Chief Residents, 52% pursued a career in academics. Of the graduates who were not Chief Residents, 27% pursued a career in academics (Figure 1). This resulted in an Odds Ratio of 2.853 with 95% confidence intervals from 2.80-

2.91. Conclusion: Chief Residents in our convenience sample were almost three times as likely to pursue a career in academics as non-Chiefs. Introduction: Little is known about the Chief Resident role in Emergency Medicine. A recent article surveyed Chief Residents and program directors as to the roles and responsibilities of a Chief Resident, with the career plans of Chief Residents predicted to be either a mixed community/academic practice (approx. 33%), community medicine (approx. 29%) or academic practice (approx. 19%). However, these results were from a prospective study. Other disciplines have shown that being chosen as a Chief Resident affects career choice, with Chief Residents feeling that being selected for the position influenced them to preferentially choose an academic career, but this preference has not been shown in Emergency Medicine. Some postulate that the Chief Resident role, with an increased administrative duty, serves as an introduction to academic medicine; others posit that this introduction may serve as a detriment to future involvement in academic medicine. Often, the Chief Resident role is poorly defined, and one study in family medicine found a significant discrepancy in expectations for the position. It is not currently known if Chief Residents in emergency medicine go into academic positions more frequently than their non-Chief counterparts. Career in Academics Continued on Page 13

Career in Academics Continued from Page 12 Methods: After IRB approval of this multicentered study, 10 nationally-recognized Emergency Medicine programs were selected by the investigators as a general representative sample of programs, ranging from large academic to community-based programs. Each program was tasked with documenting where each of their graduates had gone to practice over the previous five years. Location of practice was divided between academic vs community; graduates with more than one clinical site of practice were placed in the category where the graduate spent a majority of their time. Fellowships currently engaged in were classified as academic, while fellowship graduates were classified as to their most common site of practice. Results were collected and then de-identified, after which they were entered into a SPSS database and examined for statistical results. Results: 557 residency graduates from 10 different ACGMEaccredited programs were followed for post-graduation practice type. No graduates were lost to follow-up. Of the total graduates, 153 were Chief Residents. Overall, 34% of graduates pursued a career in academics. Of former Chief Residents, 52% pursued a career in academics. Of the graduates who were not Chief Residents, 27% pursued a career in academics (Figure 1). This resulted in an Odds Ratio of 2.853 with 95% confidence intervals from 2.80-2.91. Figure 1:

The results were analyzed with respect to length of time since graduation from residency (Figure 2). Figure 2:

Figure 3:

Discussion: Chief Residents were almost three times as likely to pursue a career in academics as non-Chiefs. However, it is uncertain if this result is a cause or an effect scenario. It is possible that academic interest is a factor that went into selecting Chief Residents, but our study did not examine how Chiefs were selected at the 10 programs. It is even possible that a higher percent of Chiefs would have gone into academics, but that the Chief experience was a negative re-enforcer. Specifically, future evaluation with pre-Chief surveys as to career inclination would be helpful; evaluation of the method and criteria for Chief selection would also assist in verifying the extent of selection bias. The lack of a difference in academic interest in 3-year versus 4-year programs is difficult to assess as our program sample size was small (10 total), and the number of 4-year programs was even smaller from a statistical vantage. In addition, there was not a statistical difference with respect to length of time since graduation. Lastly, the fact that there was no statistical difference in length of time from graduation is surprising. It would be expected that with fellowships included in the academic realm, there would be an initial increased academic preference; this may be outweighed by a majority of fellowship graduates going into academics. Further evaluation would clarify if this is a change in trend of resident preference for academics or if fellowship graduates are more likely to enter academics. Conclusion: In conclusion, Chief Residents in our convenience sample were almost three times as likely to pursue a career in academics as non-Chiefs. There are a number of confounding variables that most likely affect this distribution, primarily the selection of a resident as Chief Resident; however, further study needs to be done to assess if acting as Chief improves the odds of going into academics or if the difference is all based on selection bias.

Hafner, John W. Jr., MD, MPH, Gardner, Joanna C MD, Boston, William S, Aldag, Jean C The Chief Resident Role in Emergency Medicine Residency Programs. Western Journal of Emergency Medicine (1936-9018) 11:2, 2010 Jagsi R, Buck DA, Singh AK et al. Results of the 2003 Association of Residents in Radiation Oncology (ARRO) Surveys of Residents and Chief Residents in the United States. Int. J. Radiation Oncology Biol Phys,(642-648) 61:3, 2005

When analyzed with respect to 3- vs. 4-year programs, the following results were obtained: 56% of Chief residents in 3-year programs went into academics vs. 49% of Chief residents in 4year programs. 26% of non-Chiefs in 3-year programs went into academics vs. 27% of non-Chiefs in 4-year programs (Figure 3).

Warner CH, Rachal J, Brietbach J, et al. Current Perspectives on Chief Residents in Psychiatry. Academic Psychiatry, (270-276) 31:4, July-August 2007. Lim RF, Schwartz E, Servis M, etr al. The Chief Resident in Psychiatry: Roles and Responsibilities. Academic Psychiatry (56-59) 33:1 Jan-Feb 2009. Norris T, Susman J, Gilbert C. Do the Program Directors and their Chief Residents View the Role of Chief Resident Similarly? Fam Med (343-5) 28:5 May 1996.

Ethics in Action Mark A. Clark, M.D. St. Luke’s/Roosevelt Hospital Center Case: A 21-year-old female is brought to the emergency department after collapsing in the waiting room of the Ob/Gyn clinic. She did not lose consciousness, but complained of chest pain and shortness of breath. The patient had been seen in the ED several days prior for nausea and vomiting. At the initial ED visit, her LMP was 6 weeks prior and urine Hcg was positive. She was hydrated, given anti-emetics and discharged after tolerating PO fluids. She expressed that this was an unwanted pregnancy. She was discharged and referred for an official obstetrical ultrasound and Ob follow up. She never had abdominal pain or vaginal bleeding. In the interval before her follow up she had continued to have intermittent nausea and vomiting. On the 2nd ED visit vitals were significant for tachycardia to 115 with a normal BP. She was agitated, and appeared weak. She was able to communicate that she had been experiencing severe nausea, vomiting and episodes of shortness of breath and that she felt the problem to be the pregnancy. She refused any further evaluation unless it would include steps to terminate the pregnancy. She repeatedly stated that if a termination was not performed, she would “go home and do it herself because she couldn’t take it anymore.” All initial attempts to reason with her and coax her to consent to ED assessment and workup were refused, including blood draw, ecg, IV access and physical exam. This case illustrates the complex challenges ED physicians face involving refusal of care and decision-making capacity. This patient requires immediate thorough assessment of the cause of her collapse. The differential ranges from benign causes such as vomiting of pregnancy with dehydration, to life-threatening causes like ruptured ectopic pregnancy or pulmonary embolism. The patient refuses assessment and voices an intention which would certainly lead to self-harm. Does the threat of self-aborting amount to a high risk of self-harm? Should she be evaluated against her will or should she be allowed to leave? Does she have the capacity to refuse a workup? The Ethics of Decision-Making Capacity (DMC): A guiding ethical principle for all interactions with patients is protection of individual autonomy whenever possible. Autonomy is compromised by conditions which impair an individual’s ability to act in their own interest. These conditions may include acute medical illness or injury, intoxication, fear, severe mental or emotional anguish, coercion by others or by medical staff, impaired cognitive functioning and mental illness. Patients are always assumed to have DMC unless their choices are dangerous, erratic or irrational, or unless there is an evident medical reason

to assume otherwise, such as dementia. The ED physician is obligated to make the best possible determination of the patient’s DCM and to find the balance between preservation of autonomy and protection from harm. Key Elements of Assessing Decision-Making Capacity: Assessment of DMC is the role of the treating physician, and while a psychiatry consult may be helpful, it is not required. DMC pertains to the specific situation and question of the moment and is not applicable to future situations or generalized to global assessments of competence. Future situations will require a new assessment, and each situation may require repeated assessments as DCM is frequently fluid. For example, if the severely agitated patient is calmed or intoxication resolves, the patient may regain sufficient ability to understand their condition and the consequences of their choices. Evidence of lack of DMC does not eliminate the physician’s duty to attempt to engage and negotiate with the patient, and patients may ultimately respond to that effort by acquiescing to treatment. In the determination of DCM, ED physicians largely rely on concrete criteria. The patient must be alert and calm enough to attend to the information at hand and have sufficient cognitive ability to communicate an understanding of the possible alternatives and their consequences. The patient must be able to indicate their choice, and that choice should be consistent with their values. Lack of agreement with the values of the physician or others is not in itself a criterion of lack of decision making capacity. It is helpful if the preference of the patient is stable over time; however, this is often impossible to determine in the ED. When the stakes are high and loss of life or limb is a possibility, it is prudent and ethical to act to protect the patient when the decisional capacity of the patient is unclear. The physician must restore full autonomy to the patient as soon as possible. Resolution of the Case: In this case the patient was unable to communicate an understanding of the risks of refusal to be evaluated. She was agitated and could not engage in any meaningful conversation about her situation. The presentation was concerning for a possible life-threat. The ED physician determined that she lacked capacity to refuse treatment. An IV was started and a workup was begun. The patient was found to be profoundly dehydrated and IVF resuscitation was initiated. Psychiatry was consulted and agreed with the initial determination of lack of decisional capacity to refuse treatment. The patient’s tachycardia and symptoms resolved with treatment for hyperemesis, and she was admitted to the hospital for further management.

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Academy of Geriatric Emergency M edicine Undoubtedly, older patients pose diagnostic and treatment challenges for the emergency physician. There also is no doubt the growing proportion of older Americans is having an effect on the delivery of emergency care, and this effect will continue to become even more profound as the aging population disproportionately increases. The Academy of Geriatric Emergency Medicine was formed in 2009 as one element to address and improve the quality of care for older patients. **THE FOLLOWING ARTICLE CONTAINS INFORMATION THAT WOULD NORMALLY BE RESTRICTED TO AGEM MEMBERS.

AGEM MISSION STATEMENT: The Academy of Geriatric Emergency Medicine (AGEM) provides a forum for the collaborative exchange of ideas among emergency medicine researchers, educators, trainees and clinicians. Our mission is to improve the quality of emergency care received by older patients through advancing research, education and faculty development. Our specific goals are: 1. To serve as a unified voice for geriatric emergency medicine researchers, educators, trainees and clinicians. 2. To provide a forum for individuals committed to geriatric emergency medicine to communicate, share ideas, and generate solutions to common problems. 3. To foster research that improves the care and quality of life of older patients. 4. To advance resident and continuing education and professional development to improve clinical outcomes as they pertain to issues of aging. 5. To foster relationships with other organizations to promote geriatric emergency medicine. MEMBERSHIP: Annual AGEM membership fees were due at the end of December 2010, concurrent with SAEM membership dues. Membership provides exclusive access and use of AGEM resources available on the website that include educational, clinical, and research support. Join or renew NOW and don’t miss another day of AGEM access. AGEM membership fees are: $100 for attending-level individuals; $25 for residents, fellows, non-EM or emeritus SAEM members (Please contact Ula Hwang at ula.hwang@mountsinai.org if you think you may qualify for reduced membership fees) You can sign up for AGEM the following ways: 1. Log in to your SAEM users account (www.saem.org upper left corner) and electronically join AGEM by clicking on “Pay for dues, donations and interest groups” (to do this, you will need your SAEM account logon and password) 2. For additional questions or assistance with your membership please contact membership@saem.org or call the SAEM main office at 847-813-9823 and ask to speak to a membership services representative: Holly Gouin at hgouin@saem.org Perks of being an AGEM member include: - Access the network of other SAEM AGEM members interested in improving the quality of emergency care received by older

patients through advancing research, education, and faculty development - Access to the AGEM forums webpage that at present includes topics in research, education, advocacy, and general discussion for hot Geriatric-EM focused topics. A sample of some information includes: • Federal and private grant announcements, training opportunities, and tips focused on Geriatric-EM programs • Development of a Geriatric-EM research network • Discussion of and access to Geriatric-EM educational lectures and presentations • Development of a web-based Geriatric-EM educational module • Access to past and future links for educational Geriatric-EM electronic media - ***Most importantly, a voice in what you would like AGEM to do to support your needs and interests with regards to geriatric emergency care. A survey will be distributed to AGEM members in JANUARY 2011 to determine what your individual needs are so that AGEM can help its members succeed and accomplish its mission. SAEM 2011 ANNUAL MEETING: The AGEM-sponsored didactic session “Opportunities for Basic and Translational Research in Aging” is scheduled for Saturday June 4 from 9:00-10:30am. Featured panelists include Basil Eldadah, MD, PhD, NIA Program Officer, Charles Cairns, MD, Chair of Emergency Medicine at the University of North Carolina, and Scott Wilber, MD, MPH, Chair of the Academy of Geriatric Emergency Medicine. An improved understanding of the basic mechanisms of how acute illness affects the aging patient is crucial in improving quality of care and developing new therapies. However, most research on the emergency care of the older patient has been clinical or programmatic. The NIH sponsored a Roundtable on Medical and Surgical Emergencies in 2009, and the National Institute of Aging (NIA) was a major sponsor. At this roundtable, a number of mechanistic and translational research opportunities were identified. In addition, the NIA has recently announced the GEMMSTAR career development grant targeted at surgical specialists such as Emergency Medicine. To take advantage of these opportunities and optimize the care of the acutely ill aging patient, emergency physicians must develop the skills and knowledge necessary to conduct basic and translational research in this population. This session is intended for clinical geriatric researchers who want to expand their focus, basic and translational researchers who want to extend their research to the aging population, and young researchers interested in career development. In an interactive panel discussion, Dr. Eldadah will review the mission of the NIA, their interest in basic and translational research in aging and acute illness, and available grant mechanisms, including the new GEMMSTAR grant. Dr. Wilber will discuss the important Academy of Geriatric Emergency Medicine Continued on Page 16

Academy of Geriatric Emergency Medicine Continued from Page 15 basic and translational opportunities identified at the 2009 NIH Roundtable. Dr. Cairns will then discuss the approach to basic and translational research, with a focus on techniques, interfacing with CTSAs, and career development. Following the didactic panel, a roundtable discussion will continue at the annual AGEM meeting with featured panelists, and will also include Drs. Nate Shapiro and John Younger, both NIH-funded translational researchers. The date, time and location of the AGEM meeting is pending. EDUCATION: An abdominal pain care web-based CME module is scheduled for debut in 2011. An announcement will be made when this is available. WEBINARS: Starting in 2011, AGEM members will be invited to webinars that will discuss a variety of topics of interest to geriatric emergency medicine educators and researchers. Currently planned topics include career development awards, getting published, multicenter networks, and geriatric emergency medicine core competencies. RESEARCH TRAINING OPPORTUNITIES: Applications are now open to participate in the National Institute on Aging Summer Institute, which will be held July 915, 2011 in Queenstown, MD. The NIA Aging Summer Institute

is targeted for junior investigators (pre-K or K-awardees) seeking to take the next step towards becoming independently-funded investigators. You will have the opportunity to meet face-to-face with study section members for days at a time while reviewing your summary statements and ideas with them. You will also be able to to participate in a mock study section as study section members/leaders â&#x20AC;&#x201C; with the real study section leaders looking over your shoulders. The setting is a picturesque farmhouse in rural Maryland. Applications can be obtained from Andrea Griffin-Mann via e-mail (griffinmanna@nia.nih.gov) and are due March 4, 2011. The application consists of a brief research proposal and several letters of recommendation, along with a personal statement. All meals and travel expenses are covered for those selected to participate. OTHER: Emergency Physician Monthlyâ&#x20AC;&#x2122;s November 2010 issue featured geriatric emergency care as its primary theme. Links to noted articles include: A Model Geriatric ED: http://www.epmonthly.com/features/current-features/the-geriatric-emergency-department/

Detecting Delirium: http://www.epmonthly.com/cme/current-issue/detecting-delirium-in-the-ed/

Geriatric Driver Assessment in the Busy ED: http://www.epmonthly.com/features/current-features/should-emergency-physicians-take-away-grandpas-keys/

Prehospital Medicine Faculty & Fellowship Positions The Department of Emergency Medicine, Division of Prehospital Medicine is recruiting for Faculty and Fellowship positions at the University of Rochester. The Division has an extensive portfolio of research, education and medical oversight in a multicounty region. The Rochester area has a diverse mix of prehospital delivery services and will afford the Faculty and Fellow unparalleled leadership opportunities. Members enjoy superb benefits and a dynamic work environment and the Rochester area provides an excellent standard of living and many opportunities. Faculty: Faculty candidates at all levels (Assistant, Associate, and Professor) are sought. Positions exist for candidates with specific interest in research, education, and operations. Leadership positions exist for those with appropriate experience. Fellowship: The two-year Fellowship seeks qualified applicants who wish to develop themselves into EMS Physicians who will actively participate in prehospital systems and become leaders in prehospital care. Experienced mentors will guide the Fellow and advanced degree training is available. Candidates must be residency trained in Emergency Medicine. For more information please contact: Manish N. Shah, MD MPH Jeremy T. Cushman, MD, MS, EMT-P Chief, Division of Prehospital Medicine Prehospital Medicine Fellowship Director Manish.Shah@rochester.edu Jeremy_Cushman@urmc.rochester.edu Department of Emergency Medicine 601 Elmwood Avenue, Box 655 Rochester, NY 14642 585.463.2900

2011/2012 SAEM Grant and Scholarship Information

E R S I TY O

SAEM is pleased to offer a variety of grants available for competitive application. The grant below has an upcoming deadline: SAEM / EMPSF Patient Safety Research Grant ($75,000/yr for 1 year) – Application deadline: January 31, 2011 This grant is intended to enhance the development of an emergency medicine patient safety researcher. Additionally, funds are provided for the recipient to participate in the AHA Quality Forum. Additional upcoming SAEM grants include: SAEM/ACMT Michael P. Spadafora Toxicology Scholarship Application Deadline: May 2, 2011 Scholarship fund to encourage Emergency Medicine residents to pursue Medical Toxicology fellowship training. One recipient is chosen each year to receive funds to allow them to attend the North American Congress of Clinical Toxicology (NACCT) conference, which is held in different locations every fall. For more details as well as detailed application instructions, please go to the SAEM website (www.saem.org) and click on “Grants” under the “Grants & Awards” tab.

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University of Pittsburgh

Emergency Medicine Faculty Positions The University of Pittsburgh Medical Center (UPMC) in collaboration with the University of Pittsburgh, is seeking talented candidates for full-time emergency medicine faculty positions at the Instructor through Professor Level. We offer a variety of career opportunities including: academic clinicians, clinician-investigators, and clinician-educators. Individuals with ultrasound or investigative interests that complement our current excellence are highly desired. Our diverse faculty is widely recognized in research, teaching, and clinical care. Our three clinical sites provide tertiary and Level I Trauma care to approximately 150,000 ED patients collectively each year, while training residents, fellows, and students. We also house toxicology and hyperbaric medicine treatment programs and multiple fellowships in our department. Salary is commensurate with experience and duties. For further information write to: Donald M. Yealy, MD, Chair, Department of Emergency Medicine, University of Pittsburgh Physicians, 3600 Meyran Avenue, Suite 10028, Pittsburgh, PA 15260.

EOE

SAVE THE DATE MAY 31 AND JUNE 1, 2011 Boston, MA SAEM 2011 Leadership Forum The Business of Academic Medicine Boot Camp This exciting two-day course is designed for junior faculty leaders in Academic Emergency Medicine seeking a fundamental understanding of the business issues related to leading an Academic Department of Emergency Medicine. The presentations are designed to be interactive and will be presented by experts in Academic Emergency Medicine. The course will cover topics such as: strategic planning, revenue generation, finances of graduate medical education and research, developing a business plan, human resource management (and many more).

PROGRAM COM M ITTEE DEADLINES All Program Committee set deadlines are at 5PM EST. • Call for IEME - Deadline Tuesday, January 25, 2011 • Call for Photos - Deadline Tuesday, February 8, 2011 • Call for Medical Student Ambassadors – Deadline Tuesday, February 15, 2011 • Call for Manuscripts - AEM Consensus Conference – Monday, March 28, 2011

UNIVERSITY OF COLORADO SCHOOL OF MEDICINE DEPARTMENT OF EMERGENCY MEDICINE The University of Colorado at the Anschutz Medical Campus in Aurora, Colorado is the only completely new academic medical center to be built in more than a generation. When completed, the campus will house the University of Colorado Hospital, the Children’s Hospital, the VA Medical Center, the University of Colorado Denver Schools of Medicine, Dentistry, Nursing and Pharmacy plus two new biomedical research towers. Applications are now being accepted for a full-time emergency medicine faculty member to join our dynamic and growing department. Responsibilities include clinical practice, administrative responsibilities, teaching of emergency medicine and other housestaff as well as scholarship. Faculty applicants must be residency trained in emergency medicine and be board certified or board eligible. Applicants with administrative or fellowship experience are preferred. Compensation is competitive. The University of Colorado Denver offers a full benefits package. Information on University benefits programs, including eligibility, is located at http://www.cu.edu/pbs/.

Call for Proposals 2013 AEM Consensus Conference Submission deadline: April 15, 2011 The editors of Academic Emergency Medicine are now accepting proposals for the 14th annual AEM Consensus Conference, to be held on May 15, 2013, the day before the SAEM Annual Meeting in Atlanta. Proposals must advance a topic relevant to emergency medicine that is conducive to the development of a research agenda, and be spearheaded by thought leaders from within the specialty. Consensus conference goals are to heighten awareness related to the topic, discuss the current state of knowledge about the topic, identify knowledge gaps, propose needed research, and issue a call to action to allow future progress. Importantly, the consensus conference is not a “state of the art” session, but is intended primarily to create the research agenda that is needed to advance our knowledge of the topic area. Previous topics have included and will include (2011): • 2000: Errors in emergency medicine • 2001: The unraveling safety net • 2002: Quality and best practices in emergency care • 2003: Disparities in emergency care • 2004: Information technology in emergency medicine • 2005: Emergency research without informed consent • 2006: The science of surge • 2007: Knowledge translation • 2008: Simulation in emergency medicine • 2009: Public health in the emergency department: surveillance, screening, and intervention • 2010: Beyond regionalization: integrated networks of emergency care • 2011: Interventions to assure quality in the crowded emergency department Well-developed proposals will be reviewed on a competitive basis by a sub-committee of the AEM editorial board. The 2012 AEM Consensus Conference topic was announced at the SAEM Annual Business Meeting during the 2010 annual

meeting in Phoenix: Education Research in Emergency Medicine: Opportunities, Challenges and Strategies for Success, Nicole M. DeIorio, MD, Joseph LaMantia, MD, and Lalena Yarris, MD. Proceedings of the meeting and original contributions related to the topic will be published exclusively by AEM in its special topic issue in December 2012. Submitters are strongly advised to review proceedings of previous consensus conferences, which can be found in the past November issues of AEM, to guide the development of their proposals. All prior consensus conference issues are available free of charge online. Submitters are also welcome to contact the journal’s editors or leaders of prior consensus conferences with any questions. Proposals must include the following: 1. Introduction of the topic • brief statement of relevance • justification for this topic choice 2. Proposed conference chairs, and sponsoring SAEM interest groups or committees (if any) 3. Proposed conference agenda and proposed presenters • plenary lectures • panels • breakout topics and questions for discussion and consensus-building 4. Anticipated audience • stakeholder groups/organizations • federal regulators • national researchers and educators • others 5. Anticipated budget, to include such items as: • travel costs • audiovisual equipment and other materials • publishing costs (brochures, syllabus, journal) • meals 6. Potential funding sources and strategies for securing conference funding. How to submit your proposal. Proposals must be submitted electronically to aem@saem.org no later than 5PM Eastern Daylight Time on April 15, 2011. Late submissions will not be considered. The review sub-committee may query submitters for additional information prior to making the final selection. Questions may be directed to aem@saem.org or to the editor-in-chief at editor@saem.org.

Academic Emergency Medicine on the Wiley Online Library Platform Make sure you keep checking the journal’s home page on the recently implemented platform, Wiley Online Library (WOL) - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1553-2712. Many new features appear in the form of “modules” and will be updated on a regular basis. The new platform is more robust and easier to navigate, with enhanced online functionality. Visit often and stay tuned for updates!

SAEM Annual M eeting Launches First Fellowship Fair First-Ever Fellowship Fair! Friday June 3, 2011 – 4:45pm to 6:30pm, following Chief Residents’ Forum Fellowship directors are invited to participate in the SAEM Annual Meeting Fellowship Fair in Boston this June. The Fellowship Fair provides fellowship programs an opportunity to introduce their programs to residents and fellow candidates. Each participating institution will receive one table (6 feet long and 24 inches wide) for small displays, brochures and modest giveaways. Participating fellowship programs will be announced on the Annual Meeting website. Space limitations (50 tables) apply and programs will be selected to participate on a first come, first served basis; multiple fellowships from one institution can be represented at a single table. Registration fees are $100/table until March 1st, $150/

table until May 2nd, and $175/table after May 2nd. Applications are available from Maryanne Greketis by email to mgreketis@ saem.org. or on the SAEM website: http://www.saem.org/saemdnn/LinkClick.aspx?fileticket=H9LLB 7WnM4Y%3d&tabid=1457 The Society for Academic Emergency Medicine values the active participation of its fellowship program leaders and their fellows. Program directors are encouraged to update their fellowship information on the SAEM website. Please email questions regarding the Fellowship Fair to Stacy Reynolds, Fellowship Fair Steering Committee, at stacy.reynolds@carolinas.org.

Academic Emergency Medicine Now Offers CME Credit ACADEMIC EMERGENCY MEDICINE is now offering continuing medical education (CME) credits for reading select articles in the journal and successfully completing a test on the content. Physicians interested in completing the exam should log on to www.wileyblackwellcme.com. Upon successfully finishing the activity, physicians will receive an electronic certificate of completion, which can be printed and saved online under the user’s profile. The program is free to subscribers of the journal. Stay tuned for updates!

Boyer’s four areas of scholarship The scholarship of discovery

The scholarship of integration

The scholarship of application

The scholarship of teaching Emergency Medicine is about making a difference. Sometimes through treating. Always through caring. Eternally through teaching. Make your donations today at www.saem.org or to SAEM Foundation, 2340 S. River Rd., #200, Des Plaines, IL 60018 Contact hgouin@saem.org with any questions regarding donations **** Please note that all donations are for Education.

Spadafora Scholarship – follow-up essay Shana Kusin, MD For a budding toxicologist with minimal experience, having the opportunity to attend the 2010 NACCT meeting in Denver as a Spadafora scholar was an exceptional opportunity. Much like when I snuck into Stephen King’s Pet Sematary at the age of 13, making it past the registration table without being turned away felt like I’d gotten away with something huge. Even better, and unlike my great horror movie caper, boasting about my exploits won’t get me grounded for a month. Quite the opposite is true, as I now have the opportunity to share my experiences with the members of SAEM. The conference represented an opportunity to take a bird’s-eye view of my future field of study. Educational tidbits abounded, and I found myself furiously taking notes on a wide array of subjects in the margins of my schedule book. In Christopher DeWitt’s talk, for example, I learned about the amusingly-named amatoxin antidote, Silibinin, which is derived from milk thistle and blocks hepatocyte uptake of toxin. Jenny Lu led a comprehensive review of literature concerning intubation in severe salicylate poisonings, a topic I was quite keen to hear about, having recently caused my first fake patient code by making this mistake in simulation lab. I learned from Dr. Mortensen that smokers have significantly higher cadmium levels because the element concentrates in tobacco leaves, an esoteric but useful additional piece of information to put in my anti-smoking arsenal. Horst Thiermann presented an informative review of nerve gas agents and their different chemical properties, as well as a play-by-play of the timing and emergency department challenges following the Tokyo sarin gas subway attack. There were a few big topics that, based on attendance, were clearly crowd favorites. Glen Millner’s talk about the health implications of the Gulf oil spill presented a summary of decontamination techniques and monitoring data for exposure levels of workers on the ground and on the water, an aspect of the catastrophe that has not received much attention in the lay press. The Toxicological History Society evening presented the unique opportunity to see Steven Seifert sporting an 18th-century gown and powdered wig. One of my favorite presentations was

Guy Weinberg’s discussion of the synchronicity involved in his discovery of intralipid’s properties as a reversal agent – down to his initial research thesis that intralipid would make symptoms of lidocaine toxicity worse – a talk which was both inspiring and intimidating with respect to my own future research endeavors. A few presentations describing unusual cases or personal experience were the biggest standouts for me. During the Radiation and Occupational/Environmental Joint Symposium, Edward Cetaruk’s description of the aftermath surrounding a laboratory plutonium accident – from the irony of a reference vial cracking in a lab whose mission was to develop better nuclear detection techniques, to the unique challenges of controlling panic in a highly educated but non-medically-trained group of patients – was both engaging and alarming. Rizwan Riyaz’s presentation of a case of intentional thallium ingestion with a prolonged, critical, and ultimately terminal hospital course provoked a riveting management discussion among the expert panel, including topics such as early lavage in lethal ingestions and the dangers of fluid shifts with prolonged resuscitations. Patrick Whiteley’s hydrofluoric acid ingestion patient, who, against all odds and conventional teaching, lived to see hospital discharge, was exciting to hear about. Raido Paasma’s presentation of a methanol poisoning epidemic in Estonia – where the number of patients requiring dialysis outstripped the region’s resources, a disquieting number of patients died before they received medical care, and the infrastructure simply didn’t exist to spread the word into rural areas that people shouldn’t drink this particular patch of black-market alcohol – was a humbling reminder of the resources we have at our disposal here in the US. Attending the NACCT 2010 meeting as a Spadafora scholar was an inspiring and educational experience that will always stand apart in my memory when I attend future meetings as a toxicologist. My gratitude to the Spadafora selection committee for giving me this opportunity is profound. I look forward to becoming a part of this close-knit, friendly, and intimidatingly intelligent community of physicians when I begin toxicology fellowship in 2011.

VIRTUAL ISSUES “Virtual issues” will be a key feature of the journal’s new home page on our publisher’s recently-implemented platform, Wiley Online Library. A virtual issue is basically just a collection of articles on a given topic - so the EMS virtual issue, for example, will be a running compilation of all EMS articles that we publish. The idea is that a reader will go there to look for a particular article, but then will see our other offerings on that topic as well - increasing our full-text download numbers and helping ensure the broadest dissemination of our authors’ work. See the “Clinical Reviews in Asthma” virtual issue on the web site of Clinical & Experimental Allergy here, for an example of how this works and what it looks like: http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-222 (Note: you must be logged into your member profile on the SAEM website to access this link.) Stay tuned for updates!

Academ ic Informatics Interest Group It’s been a busy period for the SAEM Academic Informatics Interest Group. First up, the informatics survey. If you’re a physician at an emergency department with an EM residency, involved with informatics or IT decision-making, have we got a survey for you! EM informatics and work related to ED information technology have become increasingly important to the practice of emergency medicine, and yet little is known about those of us working in this field. The Society for Academic Emergency Medicine’s Informatics Group has designed this survey to help determine the characteristics and environment in which academic emergency department informatics and IT personnel find themselves in 2011. Check it out at http://informaticssurvey.org This is primarily for a research study; your responses will remain completely anonymous. However, you’ll have the option to share contact information and certain details of your department’s systems with other survey participants if you wish -- these optional responses will be made part of an EM Informatics Directory that SAEM is putting together.

The SAEM Social M edia Comm ittee has had a productive and busy fall season We met in Las Vegas to review the ongoing social media guidelines project. We also discussed new ideas for the SAEMonline Twitter and Facebook accounts, which have been growing strong and together number close to 900 subscribers as of this writing. In additional to faithful news updates and reminders regarding SAEM funding and deadlines, our followers and fans can expect more collaborative opportunities, such as a “slide swap” of useful figures and images for academic use, and a list of online EM journal clubs. Also, as we get closer to the Annual Meeting, look for “behind the scenes” reports from the Program Committee and previews of some notable presentations and research. Several members of our committee will be participating in a didactic session, led by Dr. James Miner, at the Annual Meeting in Boston this June. It’s called “SAEM Online: Advancing Education and Research Collaboration in Cyberspace.” The session will cover the use of new electronic communication tools, including social media like Twitter and Facebook, for academic emergency medicine. AEM’s online offerings, as well as the SAEM.org website itself, will also be covered. Watch for it in Boston! As always, we welcome your input and comments. Please feel free to subscribe to our Facebook presence and drop a note on our Wall -- http://facebook.com/SAEMonline. You can also follow us on Twitter at http://twitter.com/SAEMonline.

Thank you for agreeing to fill out this important survey about our growing subspecialty. Feel free to contact the SAEM informatics group secretary, Nicholas Genes, at nicholas.genes@gmail.com with any questions or concerns. Next item: Many AIIG members participated in the recent AEM consensus conference, “Beyond Regionalization: Integrated Networks of Emergency Care”, which was held on June 2 in Phoenix, AZ. Out of our technology breakout group grew a paper, called “Electronic Collaboration: Using Technology to Solve Old Problems of Quality Care,” which provides an overview of the past, present and future of technology in aiding regionalization. The paper specifically focuses on the potential for telemetry, electronic medical records, prehospital data, personal health records, and social media and collaborative tools to improve regional networks of emergency care. Look for our paper in the December 2010 issue of Academic Emergency Medicine.

Social Media Committee SAEM’s Social Media committee met at ACEP in Las Vegas. The group is hard at work developing guidelines for the Board regarding official (and personal) use of social media. We’re also developing plans to bring our fans and followers unprecedented access and background materials for the upcoming Annual Meeting in Boston. And, as always, we’re updating the Facebook account and Twitter feed with timely and important academic emergency medicine news, reminders, and interesting links. Be sure to follow us at: http://Facebook.com/SAEMonline and http://Twitter.com/SAEMonline. Committee Members: Nick Genes, Michelle Lin, Graham Walker, Jim Miner, Mark Hauswald, Matt Sullivan, Rob Rodgers

SAEM Annual Meeting Residency Fair Saturday, June 4, 2011 4:30 pm – 6:30 pm All Emergency Medicine Residency Programs, Allopathic and Osteopathic, are invited to participate. Each participating program will receive one table, 6 ft long x 18 in. wide. The registration fee for the Residency Fair is only $100 per program until February 28, 2011. After February 28 the fee is $150. The registration fee after March 28, 2011, including on-site registrations on June 4, is $175. Book your space now!

CHAIR UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE CHATTANOOGA DEPARTMENT OF EMERGENCY MEDICINE The University of Tennessee College of Medicine Chattanooga is seeking applicants for the position of Chairman of the Department of Emergency Medicine with faculty rank commensurate with experience. Qualified individuals must hold the M.D. degree or its equivalent and board certification by the American Board of Emergency Medicine; must have documented and proven experience as a faculty member with experience in academics and currently hold the rank of Associate Professor or above; and must have evidence of scholarly activity. Previous administrative experience is required. The Department of Emergency Medicine has an approved residency program. The goal of our residency is to educate and train excellent practitioners so that they are prepared to enter community practice or subspecialty training. The UT College of Medicine is affiliated with Erlanger Health System, one of the busiest Level One Trauma Centers in the U.S. Approximately 165 residents are appointed currently in nine disciplines. Visit our website at www.utcomchatt.org. The University of Tennessee is an Equal Opportunity/Affirmative Action/Title VI/TitleIX/Section504/ADA/ADEA Employer. Please submit CV and references to:

For more information contact Michelle Iniguez at 847 813-9823 or e-mail miniguez@saem.org .

Chair, Emergency Medicine Search Advisory Committee. University of Tennessee College of Medicine, Chattanooga 960 East Third St. Suite 100 Chattanooga, TN 37403

Mark your calendars for the 2011 CORD Academic Assembly in San Diego, California. CORD’s annual conference will once again provide a spectrum of expert panel discussions, didactic sessions, interactive small group breakouts and consensus working groups, all specifically designed by and for educators in emergency medicine to address the needs of our unique teaching environment. The theme of this year’s conference is “Residency 2.0: Integrating Technology Into Training.” Speakers will address such topics as the effect of social networking sites, the use of onͲline modalities in EM training, and the implications of teaching physicians in the information age. Academic Assembly features several different curricular tracks tailored to the interests of Program Directors, Program Coordinators, Clerkship Directors, Junior Faculty, and EM Residents. A special session will discuss the impact of the revised ACGME Resident Duty Hours going into effect in 2011. Other panels will explore the development of cultural competency and international medicine curricula in emergency medicine programs. A robust peerͲreviewed Research Forum allows participants to showcase their research and educational innovations. CORD Academic Assembly 2011 will provide a unique opportunity for scholarship, faculty development and networking among colleagues and education experts from around the country in a beautiful setting. We look forward to seeing you in San Diego this March.

2011 CORD Academic Assembly March 3-5, 2011 Marriott Mission Valley

San Diego, California

Patrick Brunett and Elise Lovell Academic Assembly 2011 CoͲChairs

From AWAEM to a Brigadier General to CIMER, this yearʼs Midwest Regional Meeting had something for all... Meeting Organizers: James Brown, MD, Corey Heitz, MD, James Olson, PhD, Stacey Poznanski, DO With over 70 people in attendance at Wright State University (WSU) in Dayton, OH on November 8, 2010, the 20th Annual Midwest Regional SAEM Meeting was a great success! The event kicked off on the evening of November 7, with a reception and tour of our Center for Immersive Medical Education and Research (CIMER). It made for an excellent backdrop to the evening, and prompted a great deal of energetic discussion on the current and upcoming roles of simulation in Emergency Medicine. The Regional Meeting began the next morning with an engaging discussion on Advancing the Academic Career by a representative from the Academy for Women in Academic Emergency Medicine (AWAEM), Dr. Linda Druelinger. She was joined by a distinguished panel of Academicians, Drs. John Younger, Mary Jo Wagner, and Glenn Hamilton, who served as enlightening resources for those wishing to begin or continue their academic endeavors. As our Keynote Speaker, we were honored to have Brigadier General Hersack, Command Surgeon, Air Force Materiel Command, Wright-Patterson Air Force Base, Ohio, present a thorough, highly insightful look into the collaboration between civilian and military medicine, and the recent technological advances in the care of the injured soldier. In addition, participants joined both a discussion group and an oral presentation track. Discussion groups included Disaster and Tactical Medicine, Simulation, and a Q/A with Program and Clerkship Directors, while the two oral presentation tracks were Education and Clinical Research. With a total of twelve presenters, we had a diverse group of medical students, residents, and faculty, making the presentations interesting and educational. Finally, with 46 posters on display, we covered a wide array Photograph courtesy of Cassandra Browning, WSU EM of current research topics, ranging from cell biology, to trauma, to airway control, and even one on finger length ratios as a predictor of career choice! Although the decision was difficult, we were pleased to provide awards for both oral and poster presentations. See the complete list of awards and their winners below. As evidenced this November and at each previous event, the SAEM Regional Meetings serve as an excellent venue for academicians to come together and discuss both progress and new direction. We are all looking forward to the next Midwest Regional in 2011, to be held at Mercy St. Vincent Medical Center in Toledo, Ohio! ★Best Oral Presentation: Dylan Cooper, Indiana University "Residents as Teachers: Emergency Medicine Residents are as Effective as Faculty in Medical Student Simulation Debriefing." ★Best Poster Presentation: Sheila Steer, SUMMA Health Systems "Prevalence of Strangulation in Victims of Sexual Assault vs Intimate Partner Violence." ★Best Resident Presentation: Thomas Charlton, Synergy Medical Education Alliance "The Effect of Commonly Available Breath Sprays on Commercial Breath Alcohol Analyzers." ★Best Medical Student Presentation: Nicole Dubosh, The Ohio State University "Clinical Teaching Site Does Not Affect Examination Performance in an Emergency Medicine Clerkship."

New EM Residency Program in California Seeking CORE FACULTY Opportunity: Our CEP America Kaweah Delta ED, in collaboration with the Kaweah Delta Medical Center, is establishing a new EM Residency Program scheduled to start in 2013. Details: We are looking for Core Faculty especially with fellowship training or experience in Ultrasound, Research, EMS, Peds EM, Toxicology, Critical Care, including new grads, will be strongly considered. Site: Kaweah Delta Medical Center is one of the largest regional referral centers for an array of services in California's Central Valley. The ED is a Level III trauma facility that sees more than 74,000 patients annually. Who we are: CEP America is the largest truly democratic EM partnership in the U.S. We are a stable partnership offering highly satisfying, long-term emergency career opportunities for EM Providers for 35 years.

Imagine being part of a team that makes a discovery. Emergency Room Faculty UMDNJ-Robert Wood Johnson Medical School is searching for faculty physicians for its Department of Emergency Medicine on the New Brunswick campus. Candidates should be residency trained board certified/eligible in Emergency Medicine (ABEM, ABOEM). Clinical responsibilities include direct patient care and attending supervision of residents and medical students in the Robert Wood Johnson University Hospital Emergency Department. The department has a residency program in Emergency Medicine and has an established EMS fellowship, is developing a research program and increasing Emergency Medicine education within the medical school. Academic responsibility includes contribution to all aspects of the Department’s growth. Robert Wood Johnson University Hospital serves as the medical school’s primary teaching affiliate. Robert Wood Johnson is a 580 bed Level One trauma center with an annual ED census of greater than 65,000 adult visits. A separate pediatric Emergency Department sees approximately 20,000 patients per year. RWJUH has an active EMS system. Qualified candidates should send a letter of intent and curriculum vitae to: Robert Eisenstein, MD Associate Professor & Vice Chairman, Department of Emergency Medicine, Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, MEB 104, New Brunswick, New Jersey, 08903. Email: eisensrm@umdnj.edu Call: 732-235-8717, or Fax: 732-235-7379. Academic appointment is commensurate with experience. UMDNJ is and Affirmative Action/Equal Opportunity Employer.

To learn more contact: Patti Egan @ 510.350.2789 or careers@cepamerica.com

University of Alabama at Birmingham Department of Emergency Medicine

The Department of Emergency Medicine At Beth Israel Deaconess Medical Center Is seeking qualified physicians to join its faculty The Department of Emergency Medicine at the Beth Israel Deaconess Medical Center, Harvard Medical School is seeking an emergency physician with a serious interest in academics. The candidate must be an excellent clinician and teacher and have completed at least 3 years of post-graduate experience and show evidence of academic pursuits. The successful candidate will be mentored in, and expected to pursue an academic career as evidenced by submissions of scholarly work for publication in professional journals and application for grant funding in their specific area of expertise. Candidates may be considered for faculty appointments at Harvard Medical School. Candidates will work clinically both at Beth Israel Deaconess Medical Center (a tertiary medical center with a level 1 trauma center and an annual volume of 55,000 patients) as well as at one of our community emergency departments. Salaries are competitive, incentive-based with generous benefits and funded CME. Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center (HMFP) is an equal opportunity employer and does not discriminate on the basis of race, color, religion, or gender. Women and minority applicants are encouraged to apply.

Send a cover letter and CV to: Richard E. Wolfe, M.D., Chief of Emergency Medicine c/o mblicker@bidmc.harvard.edu For more information go to www.bidmc.org/emergency

The Department of Emergency Medicine at the University of Alabama School of Medicine is seeking talented Emergency Medicine clinicianscientists at the rank of Professor, Associate Professor or Assistant SAEM NEWSLETTER Professor to join its NIH-funded research program.

03/01/2011, 05/01/2011 University of Alabama at Birmingham (UAB) is a major academic 6150977-NYPC45767 research medical center with over $440 million in NIH and other extramural funding. The Department of Emergency Medicine is a site UMDNJX for the NIH-funded Resuscitation Outcomes Consortium (ROC) and the 3.5” x 4.75” Protocolized Care of Early Sepsis Shock trial (ProCESS). The Department Gilrain also coordinates Colleen v.2activities of the multidisciplinary Center for Emerging Infections and Emergency Preparedness. The Department has been highly successful in developing extramural research support in this warmly PAGE 2 collaborative institution. The UAB Hospital is a 930-bed teaching hospital. The ED treats over 60,000 patients annually and is the only Level I Trauma Center in Alabama. The Department is the site of a PGY 1-3 Residency Program. Significant protected time, start-up funds and tenure-stream pathways will be available to qualified applicants. A highly competitive salary is offered. Applicants must be EM board eligible or certified. UAB is an Affirmative Action/Equal Opportunity Employer. Women and minorities are encouraged to apply. Please send your curriculum vitae to: Janyce Sanford, M.D., Associate Professor & Chair of Emergency Medicine, University of Alabama at Birmingham; Department of Emergency Medicine; 619 South 19th Street; OHB 251; Birmingham, AL 35249-7013

¸ Clinician-Educator ¸ Clinical Researcher ¸ ¸ Clinical Toxicologist ¸ The Department of Emergency Medicine at the Brody School of Medicine at East Carolina University is expanding its faculty. We are seeking BC/BP emergency physicians for tenure or clinical track positions at the rank of assistant professor or above, depending on qualifications. Our current faculty possesses diverse interests and expertise leading to extensive state and national-level involvement. Through this expansion we hope to increase our depth and further develop programs in clinical toxicology and clinical research, and our cadre of clinicianeducators. The emergency medicine residency is well-established and includes 12 EM and 2 EM/IM residents per year. We treat more than 90,000 patients per year in a state-of-the-art ED at Pitt County Memorial Hospital. PCMH is a rapidly growing level I trauma, cardiac and regional stroke center. Our tertiary care catchment area includes more than 1.5 million people in eastern North Carolina, many of whom arrive via our integrated mobile critical care and air medical service. Greenville, NC is a livable, family-oriented university community located ninety minutes from the Crystal Coast. Cultural and recreational opportunities are abundant. Compensation is competitive and commensurate with qualifications; excellent fringe benefits are provided. Successful applicants will possess outstanding clinical and teaching skills and qualify for appropriate privileges from ECU Physicians and PCMH. Screening begins July 1 and will remain open until filled. Confidential inquiry may be made to Theodore Delbridge, MD, MPH, Chair, Department of Emergency Medicine (delbridget@ecu.edu). Must apply online by using ECU OneStop on the main ECU page: www.ecu.edu. ECU is an EEO/AA employer and accommodates individuals with disabilities. Applicants must comply with the Immigration Reform and Control Act. Proper documentation of identity and employability required at the time of employment. Current references must be provided upon request.

www.ecu.edu/med

www.uhseast.com

The Department of Emergency Medicine At Beth Israel Deaconess Medical Center Is seeking a Senior Academic Faculty with expertise in Educational Informatics The Department of Emergency Medicine at the Beth Israel Deaconess Medical Center, Harvard Medical School is seeking an emergency physician with at least 15 years of clinical experience and proven excellence in the field of educational informatics. The ideal candidate will be an actively practicing emergency physician who is a nationally recognized leader in the area of clinical decision support. Leadership would be manifested by a record of progressively increasing levels of responsibility in drug and disease information, patient safety, and tools for the electronic delivery of CDS. Senior-level administrative experience and proven thought leadership at a state and national level are desired. Candidates may be considered for faculty appointments at Harvard Medical School and will work clinically both at Beth Israel Deaconess Medical Center (a tertiary medical center with a level 1 trauma center and an annual volume of 55,000 patients) as well as at one of our community emergency departments. Salaries are competitive, incentive-based with generous benefits and funded CME. Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center (HMFP) is an equal opportunity employer and does not discriminate on the basis of race, color, religion, or gender. Women and minority applicants are encouraged to apply.

Send a cover letter indicating your interest and CV to:

Richard E. Wolfe, M.D., Chief of Emergency Medicine c/o mblicker@bidmc.harvard.edu For more information go to www.bidmc.org/emergency

Department of Emergency Medicine Yale University School of Medicine Advancing the Science and Practice of Emergency Medicine Emergency Medicine recently became the 28th Department at the Yale University School of Medicine! Thus, we are expanding our faculty, seeking emergency physicians at all academic ranks. The successful candidate will be committed to enhancing our mission of clinical, teaching and scholarly excellence. The DEM provides an environment fostering faculty development with strong mentorship. We have an outstanding track record of federal and foundation funding, as well as a mature research infrastructure supported by a faculty Director of Research Development, a staff of research associates, administrative assistance, and contract and grant pre-/post-award support. Eligible candidates must be residency-trained and board-prepared in emergency medicine. Rank, protected time and salary will be commensurate with education, training and experience. Yale University is a world class institution providing a wide array of benefits and research opportunities. To apply, please forward your CV and cover letter to Gail D’Onofrio, MD, Chair, via email: jamie.petrone@yale.edu, or mail: Yale University School of Medicine, Department of Emergency Medicine, 464 Congress Ave, P.O. Box 208062, New Haven, CT 06519-1315. Yale University is an affirmative action, equal opportunity employer. Women and members of minority groups are encouraged to apply.

CALLS AND M EETING ANNOUNCEM ENTS For details and submission information on the items below, see www.saem.org and look for the Newsletter links on the home page or links within the Meetings section of the web site.

Call for Papers – AEM

2011 Academic Emergency Medicine Consensus Conference “Interventions to Assure Quality in the Crowded Emergency Department” will be held on June 1, 2011, immediately preceding the SAEM Annual Meeting in Boston, Massachusetts. Original papers on the conference topic, if accepted, will be published together with the conference proceedings in the December 2011 issue of Academic Emergency Medicine. Deadline for Abstracts: Monday, March 28, 2011.

SAEM Annual Meeting

June 1-5, 2011 is the SAEM Annual Meeting at the Boston Marriott Copley Place in Boston, MA. Also consider attending the AEM Consensus Conference on June 1, 2011. Topic: “Interventions to Assure Quality in the Crowded Emergency Department”.

E R S I TY O

SAEM is looking for 15 energetic, self-starting, responsible, and enthusiastic medical students to work with the SAEM Program Committee at the Annual Meeting in Boston on June 1-5, 2011. Interested medical students should submit their brief statement of interest (<150 words) as well as an updated electronic copy of their CV to Michelle Iniguez at miniguez@saem.org. Deadline: February 1, 2011. Recipients will be notified by February 21, 2011.

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Submitters are invited to complete an application describing an innovative new educational methodology that they have designed, or an innovative educational application of an existing product. Visit www.saem.org to learn more. Deadline: Tuesday, February 15, 2011 at 5 pm EST.

Call for Photographs

Original photographs of patients, pathology specimens, gram stains, EKGs and radiographic studies of other visual data are invited for presentation at the 2011 SAEM Annual Meeting. Deadline: Tuesday, February 8, 2011 at 5 pm EST. Submit to miniguez@saem.org

Regional Meetings

Check the www.saem.org Meetings >SAEM Regional Meetings link for updates.

Call for Medical Student Ambassadors

Innovations in Emergency Medicine Education Exhibits (IEME)

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Western Regional Meeting February 24-26, 2011Keystone, Colorado New England Regional Meeting April 6, 2011 – Hartford, Connecticut For more information on these regional meetings please visit us at www.saem.org.

University of Pittsburgh

University of Pittsburgh Department of Emergency Medicine The University of Pittsburgh in partnership with the University of Pittsburgh Medical Center (UPMC), is offering fellowships in the following areas: • Toxicology • Emergency Medical Services • Research • Education These fellowships provide intensive training and interaction with the nationally-known experts in each domain among the faculty in the Department of Emergency Medicine. Multidisciplinary collaboration with other departments on campus is encouraged. We provide experience in basic or clinical research. Teaching opportunities exist with medical students, residents, and other health care providers. Fellows enroll in one of several available Master’s level degree programs as a part of formal training. Fellowships include clinical responsibilities with limited hours as attending physicians in the Emergency Department at UPMC and affiliated institutions. The University of Pittsburgh and UPMC are Equal Opportunity Employers, and we welcome candidates from diverse backgrounds. Each applicant should have an MD/DO background or equivalent degree and be board certified/prepared in emergency medicine. Applicants with similar experience will be considered. To discuss your future, contact Clifton W. Callaway, MD, PhD, University of Pittsburgh, Department of Emergency Medicine, Iroquois Building, Suite 400A, 3600 Forbes Avenue, Pittsburgh, PA 15261 or e-mail callawaycw@upmc.edu.

EOE

CHAIR DEPARTMENT OF EMERGENCY MEDICINE KECK SCHOOL OF MEDICINE UNIVERSITY OF SOUTHERN CALIFORNIA The Keck School of Medicine would like to formally announce the commencement of a search for a nationally recognized academic emergency medicine physician to serve as the Chair of the Department of Emergency Medicine at the Keck School of Medicine of the University of Southern California. This department is one of the oldest academic departments of Emergency Medicine in the country and, in its partnership with the Los Angeles County Medical Center, one of the busiest emergency departments and trauma centers in the United States --serving upwards of 500 ill and injured adult and pediatric patients who arrive at LAC+USC every day. The new chair would lead a world-class faculty and a superb residency program at one of the largest acute care teaching hospitals in the nation, at the largest of three main hospitals in the Los Angeles County Medical System. The successful applicant should have a sustained record of academic achievement in emergency medicine education and research, administrative experience within an academic medical center, and the ability. This individual should be board certified in Emergency Medicine, and should possess or be eligible for medical Licensure in the State of California. We expect this individual to demonstrate skill in managing a complex program, expertise in managing resources and resolving conflicts, strength in forging strong relationships with the top levels of administration of the medical school and county hospital, and a commitment to ensuring regulatory compliance. Individuals who wish to apply for this position should submit a letter of intent, a curriculum vitae, and names of 3 references to the address below by January 31, 2011, and a detailed confidential position description will be provided in return. Philip Lumb, M.D., Chair, Emergency Medicine Search Committee c/o Judy Garner, Ph.D., Vice Dean for Faculty Affairs Keck School of Medicine of USC 1975 Zonal Avenue KAM 110 Los Angeles, CA 90089 Or electronically, please submit letters and support documents to fadean@usc.edu .

USC values diversity and is committed to equal opportunity in employment. Women and men, and members of all racial and ethnic groups are encouraged to apply.

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SAEM, 2340 S. River Rd, Suite 200 Des Plaines, IL 60018. email: membership@saem.org You may also join at member.saem.org Rev. Date 10/13/2010

Society for Academic Emergency Medicine 2340 S. River Road, Suite 200 • Des Plaines, IL 60018 • 847-813-9823 • saem@saem.org • www.saem.org

Board of Directors Jeffrey A. Kline, MD President Debra E. Houry, MD, MPH President-Elect Adam J. Singer, MD Secretary-Treasurer Jill M. Baren, MD, MBE Past President Brigitte M. Baumann, MD, MSCE Deborah B. Diercks, MD, MSc Cherri D. Hobgood, MD Robert S. Hockberger, MD Alan E. Jones, MD O. John Ma, MD Jody A. Vogel, MD Executive Director James R. Tarrant, CAE Send Articles to: newsletter@saem.org

FUTURE SAEM ANNUAL M EETINGS 2011 June 1-5 Marriott Copley Place, Boston, MA 2012 May 9-13 Sheraton Hotel and Towers, Chicago, IL 2013 May 15-19 The Westin Peachtree Plaza, Atlanta, GA 2014 May 14-18 Sheraton Hotel, Dallas, TX 2015 May 13-17 Sheraton Hotel and Marina, San Diego, CA

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2011 CORD ANNUAL ACADEMIC ASSEMBLY March 2-5, 2011 Marriott Mission Valley, San Diego, CA

The SAEM Newsletter is published bimonthly by The Society for Academic Emergency Medicine. The opinions expressed in this publication are those of the authors and do not necessarily reflect those of SAEM.

AEM Consensus Conference June 1, 2011 Topic: “Interventions to Assure Quality in the Crowded Emergency Department”.

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