SAEM November-December 2014 Newsletter

Celebrating Our 25th Anniversary

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

NOVEMBER-DECEMBER 2014

VOLUME XXIX NUMBER 6

EDWARD BOYER, MD NIH Faculty Mentoring Award Comes to Emergency Medicine

ETHICS IN ACTION A Duty to Warn

SAEM ABSTRACTS SCORING SYSTEM Submission Guidelines

SAEM SOCIAL MEDIA Five FOAM Favorites

CAREER IN GLOBAL HEALTH Words of Wisdom from Seasoned Experts

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

SAEM STAFF Chief Executive Officer Ronald S. Moen Ext. 212, rmoen@saem.org Director of Information Services & Administration James Pearson Ext. 225, jpearson@saem.org Accounting Manager Mai Luu, MSA Ext. 208, mluu@saem.org Accountant Dipesh Patel, CFE, MSA Ext. 207, dpatel@saem.org Communications Manager/Newsletter Editor Karen Freund Ext. 202, kfreund@saem.org Education Manager LaTanya Morris Ext. 214, lmorris@saem.org Grants & Foundation Manager Melissa McMillian, CNP Ext. 203, mmcmillian@saem.org Marketing & Membership Manager Holly Byrd-Duncan, MBA Ext. 210, hbyrdduncan@saem.org Meeting Planner Maryanne Greketis, CMP Ext. 209, mgreketis@saem.org Membership Coordinator George Greaves Ext. 211, ggreaves@saem.org Systems Administrator/Database Analyst Michael Reed Ext. 205, mreed@saem.org SAEM & Foundation Administrative Assistant Sarah Buchanan Ext. 201, sbuchanan@saem.org Education Administrative Assistant Elizabeth Oshinson Ext. 204, eoshinson@saem.org

AEM STAFF Editor in Chief David C. Cone, MD david.cone@yale.edu Journal Editor Kathleen Seal kseal@saem.org Journal Manager Sandi Arjona sandrak.arjona@gmail.com

2014-2015 BOARD OF DIRECTORS Robert S. Hockberger, MD President Harbor-UCLA Medical Center Deborah B. Diercks, MD, MSc President-Elect University of Texas Southwestern Andra L. Blomkalns, MD Secretary-Treasurer University of Cincinnati College of Medicine Alan E. Jones, MD Past President University of Mississippi Medical Center Steven B. Bird, MD University of Massachusetts Medical School Kathleen J. Clem, MD, FACEP Loma Linda University School of Medicine D. Mark Courtney, MD Northwestern University Feinberg School of Medicine James F. Holmes, Jr., MD, MPH University of California, Davis, Health System Lauren Hudak, MD Resident Board Member Emory University School of Med Amy H. Kaji, MD, PhD Harbor-UCLA Medical Center Ian B.K. Martin, MD University of North Carolina School of Medicine The SAEM Newsletter is published bimonthly by the Society for Academic Emergency Medicine. The opinions expressed in this publication are those of the authors and do not necessarily reflect those of SAEM. For Newsletter archives visit http://www.saem.org/publications/newsletters Š 2014 Society for Academic Emergency Medicine. All rights reserved. No part of this publication may be reproduced, stored, or transmitted in any form or by any means without prior permission in writing from the copyright holder.

HIGHLIGHTS NEWSLETTER GUIDELINES N EWSLETTER G UIDELINES SAEM invites its members to submit materials to be SAEM invites considered for submissions publication to in the theNewsletter, Newsletter,published which is bimonthly six times a year in identical and online paper published bimonthly six times a year inonline identical editions, academictoemergency in and paperpertaining editions, to pertaining academicmedicine emergency medicine in areas including: areas including:     

Clinical practice Education of EM residents, off-service residents, medical students, and fellows Faculty development, CME Politics and economics as they pertain to the academic environment General announcements and notices

Submit materials for consideration for publication at newsletter@saem.org. Please include the names and affiliations of authors and a means of contact.

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Calls and Meeting Announcements

PRESIDENT’S M ESSAGE Robert S. Hockberger, MD

David Geffen School of Medicine at UCLA Harbor-UCLA Medical Center

THE 80/20 RULE In preparation for serving as SAEM president, I attended a conference for CEOs and elected officers of volunteer organizations sponsored by the American Society of Association Executives (ASAE) to learn about current trends and challenges facing organizations like ours. When it comes to member involvement, things that have changed in recent times include (1) people are busier in their primary jobs and Robert S. Hockberger, MD have less time for volunteer work, and (2) the competition for that time has increased as the number of organizations continues to expand. Things that have not changed include (1) many people only get involved when asked, (2) people still appreciate face-to-face interactions, and (3) personal and professional recognition are highly valued.

but also within our hospitals and medical schools. Extramurally, we should strive to be among the 20% of top contributors to an organization we believe will contribute to the continued growth of our academic discipline and to our own professional growth and development. There are many worthwhile organizations within emergency medicine in addition to SAEM. Each has an important mission and will provide active members with the opportunity to do good, to be mentored by senior people, to collaborate with colleagues from around the country (sometimes the world), to gain credit in extramural service for academic advancement, and to receive the heartfelt appreciation and recognition of one’s peers for their efforts. No organization is innately more important than any other. They are distinguished only by their core missions.

SAEM’s mission is to lead the advancement of emergency care through education and research, advocacy, and professional development in academic emergency medicine.

Italian economist Vilfredo Pareto once observed that 80% of the income in Italy was received by only 20% of the population.

Later, management guru Joseph Juran coined the term Pareto Principle, also termed the 80/20 Rule, to refer to an oftenobserved occurrence in the world of business where most of the results in any situation are determined by a small number of causes. The ASAE teaches leaders of volunteer organizations that 20% of their members will produce 80% of the organization’s work product, and recommends they spend 80% of their time and energy supporting and mentoring those individuals, since it is they who will advance the society’s core mission (bettering the lives of the other 80%), and future leaders of the organization will inevitably come from that group.

SAEM is currently looking for individuals to serve on its committees and task forces for the 2015-16 academic year.

Application information is available in this newsletter. If you are not already serving on a committee, I invite you to join SAEM’s 20% by doing so next year. If you are currently on a committee, please consider volunteering to chair a subcommittee next year.

If you are currently chairing a subcommittee… well, you get my point. Both intramurally and extramurally, the higher your level of involvement within any organization, the greater the opportunities become for doing good, for collaborating with colleagues, for both receiving and providing mentorship and, ultimately, for experiencing personal and professional growth and realizing leadership potential. If you have questions regarding the value of involvement in EM organizations to your academic career, or about which organization to choose at this point in time, please talk to your department chair or mentor. If they aren’t available, give me a call.

If there is a lesson to be learned from the Pareto Principle, from the standpoint of faculty development, I believe it is that, intramurally, we should strive to be among the top 20% of the faculty at our home institutions within our primary areas of interest (research, teaching or service), not just within our own departments

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CHIEF EXECUTIVE’S M ESSAGE PRESIDENTIAL FASCINATION As speculation abounds about who may run for president of the United States in 2016, it may help to reflect on why we become so fascinated about these individuals, and how often their terms in that office differ from the campaigns and the speculation about those campaigns, or about how they will serve our country in times of war, peace, turmoil, prosperity, depression. Some of you may have seen Ronald S. Moen the recent public television series on the Roosevelts. I found the series fascinating primarily in the difference in their personalities, and in how they dealt with personal tragedy in moving forward with their lives. Regardless of your political persuasion, I believe there are lessons to be learned from how both Roosevelt presidents dealt with tragedy, and how, as they struggled to deal with those tragedies, it molded their personality and sharpened their commitment to provide leadership in the years that they served. The same can be said for other presidents. As EM physicians, especially in medical schools and other training institutions, you have a unique role to play in helping individuals who are sometimes facing serious tragic situations and life-threatening conditions.

How you help those individuals deal with tragedy can have a profound influence on not only how they cope in the immediate situation, but also how they will move on with their lives. One has to look no further than the recent deaths from Ebola and how caregivers are dealing with their own personal concerns as they deal with this virus. We can also recall how caregivers dealt with HIV and AIDS in those early years, when no one knew what was happening. Or go back a bit further, but still in what we would refer to modern-day medicine, when polio struck with such ferocity. In all of these situations, we are drawn to our leaders, examining every word, every inflection, and all presidential staff for clues on what is happening. We often forget that the president is just like us, and that many of the same experiences that have molded his personality are molding ours. We too have the opportunity to learn from tragedy and move on to bigger and better things.

BUT WHAT ABOUT THE PRESIDENTS OF SAEM? Now that I have been with SAEM for a few years, I continue to be fascinated by conversations with past presidents. They are quick to share what the issues were when they were president, what they felt were their accomplishments, and how friendships developed before, during and after their terms. One of the truly fun parts of my job is attending the Past Presidents’ Breakfast at the SAEM Annual Meeting. I never cease to be amazed at their level of energy, how well versed they are in emergency medicine, and how committed they are to their students, faculty and the

profession, even after they have retired. Now in most instances, they do not have a world stage on which to perform their duties, although many do operate on a global level. However, most have also struggled with some tragedy that has given them new perspectives on their work and personal lives. If you have the opportunity, I encourage you to get to know the past presidents of SAEM. You will be amazed at what you can learn and how willing they are to share with you.

WHY BRING THIS MATTER UP NOW? We are now soliciting nominations for candidates for the Board of Directors, and for secretary-treasurer and presidentelect of SAEM. In addition to those offices, each of the academies is soliciting nominations for their own leadership positions, and in 2015 you will have the opportunity to vote to select those individuals to whom you entrust the future of this great association. What qualities do you seek in nominating a candidate for one of these offices? Is it someone who can look beyond her own personal positions and ideas to work with others to bring out the best in their colleagues? Is it someone who only seems to be padding his resume for a promotion to another position? Can this person work well with others? Does that person represent a specific interest and expertise that is needed to round out a group of leaders in an academy or on the Board of Directors? No one person can provide all of the answers, and an effective approach to the problems of the day is to take multiple viewpoints into account. Another US president, Abraham Lincoln, chose men who had competed for his job to be part of his cabinet. He had a unique ability to surround himself with very strong individuals with varying points of view, and to mold them into a strong and unified cabinet during one of the most difficult periods in US history.

We don’t have the same fascination about SAEM presidents or other SAEM leaders that we may have for national elected officials. However, their position as president of SAEM gives them a significant leadership role in academic emergency medicine, and one that demands a lot of their time, dedication and expertise to work with all manner of members and other leaders. SAEM and its members can be very proud of the individuals who have served as SAEM president, and of what has been accomplished so far, and of what will be accomplished in the future.

It is a privilege to have gotten to know many of these exceptional leaders and to work with some of them, and I hope you will be able to say the same. Make a choice to participate in the creation of the next generation of leaders of SAEM: It will be a rewarding experience that will bring you great benefits as you move through your career in emergency medicine.

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M EM BER HIGHLIGHT EDWARD BOYER, MD Professor of Emergency Medicine Chief, Division of Medical Toxicology - University of Massachusetts Medical School Lecturer in Pediatrics - Harvard Medical School

“The evolving capacity of mobile technology to change the way we act has driven my research career.”

NIH FACULTY MENTORING AWARD COMES TO EMERGENCY MEDICINE My son’s failed attempt to photobomb the picture on the left got me thinking. Because smartphone cameras enable lots of images to be captured and immediately deleted, the person who sneaks into another’s picture is no longer a churl. The now-painless act of deleting an image has made photobombers’ antics innocent fun rather than an expensive waste of film. Photobombing is a new, broad-based behavior, but it is just one of several new phenomena the emergence of which is driven by use of a new mobile technology.

The evolving capacity of mobile technology to change the way we act has driven my research career. Beginning in 2001, NIH funded a series of three grants through which I investigated the impact of technology on drug abuse, HIV transmission risk, and opioid addiction, respectively. In 2009 I received a Challenge grant, followed by two R01s (the research awards with big deliverables) to investigate mHealth approaches to medication adherence and the use of mobile biosensors to identify drug abuse in real time. Most recently, NIH awarded me a grant under a K24 mechanism to support my efforts in mentoring junior faculty in mHealth research. While the award of any NIH grant is uplifting, the K24 is particularly meaningful because it is emblematic of many things that remain important, particularly in the modern academic medical center.

First, the K24 is about cultivation rather than prestige.

R01s may be the major research grants leading to major scientific advances with their fame and fortune, but a K24 is designed to grow new crops of clinician-scientists.

The principal investigator of a K24 transitions from a researcher to being, at least in part, a gardener of clinicianscientists. While many academic emergency physicians serve as mentors, the K24 provides a solid infrastructure for an academician’s efforts to bring junior faculty to that cutting edge where successful academic careers begin.

My mentees can participate in ongoing R01 research projects while they develop innovative new studies of their own. Then, with seed money drawn from my K24 budget, mentees begin pilot research to generate preliminary data

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for larger grant submissions. As mentees obtain their own grants, they complete the transition from trainee to funded investigator pursuing hypothesis-driven original research investigations. The K24 augments those individual characteristics that herald success in a research career: an ability to think creatively, to write beautifully, and to look at the world around us and wonder, “What if?”

My “what if” moment came during a night shift when I treated two adolescents who presented with abrupt onset of coma. These kids had purchased GHB precursors on the Internet, synthesized GHB according to Internet instructions, dosed the drug using online doses… and promptly overdosed exactly like the web said they could. Because the Internet at that time wasn’t recognized as a source of knowledge about drugs of abuse, much less a location to purchase the drugs themselves, we published this as a case report. During my toxicology fellowship I asked my mentor, Patricia Hibberd, about the possibility of studying how technology changed behavior. She showed me how to convert this question into a research study worthy of NIH funding, but she also helped me reinterpret how I looked at the literature. I came to understand that well-constructed case reports fit cleanly into the scientific method; they function as the observations that spawn hypotheses which, in turn, demand testing. Some hypotheses, with enough care and mentoring, are worthy of NIH funding.

Pat taught me the method, but Michael Shannon, another mentor at Boston Children’s, provided the context. “Nobody seeks medical care at Children’s because cardiology generates great billing,” he would say. “They come because we are worldwide leaders in new treatments derived from research.” That attitude is what makes NIH funding desirable, but it also explains why NIH support is the great equalizer in academic medicine. Those who don’t have NIH funding want it; those who have it know how much work it takes. At the institutional level, NIH funding means instant respect. The academic capital of the modern medical center is research, but its currency is NIH funding.

NIH research funding matters, but despite significant advances, emergency medicine lags behind other medical specialties.

I compared my former residency program (located at what then was arguably the most academic of emergency departments) with my wife’s residency program at a children’s hospital in Philadelphia. Over a three-year period, around 60% of pediatric graduates from her residency pursued training in an ACGMEapproved subspecialty program, compared with 15% from our EM program in the sister hospital. Within three years of training, about 40% of her classmates had some NIH funding, while a leading academic emergency department had produced but one. The career trajectory of a major academic EM residency’s graduates was as shallow as the disparity was striking. To close this training gap, the field of emergency medicine will require academic departments to produce NIH-capable graduates at a faster rate.

Even if they do this, so many obstacles confront trainees and junior faculty. Clinical workloads, administrative drudgery, the lack of expert mentorship, and low standards for research and scholarship sap academic vigor. At the same time, business sorts pruriently poke physicians to improve productivity and exceed metrics; accreditation agencies demand “e-learning” exercises.

We all recognize the great potential for biomedical research, but the prevalent mentality of getting and spending robs many academicians of the pure satisfaction drawn from expanding the body of knowledge.

A K24, then, is more than establishing a pipeline of new researchers; it does more than complete the academic circle of clinical observation triggering biomedical research that leads to improvements in patient care. A K24 helps restore a department’s grounding in academics. That simple ability may be the best reason for other NIH-funded, midcareer emergency physicians to seek support under this mechanism. I look forward to new mentoring opportunities, and I want to help mid-career faculty navigate the path toward K24s of their own. And if my mentees and I are able to develop some novel behavioral interventions that resonate across broad populations, perhaps we can stop my son’s photobombing proclivity.

2015 SAEM ANNUAL MEETING MAY 12 – 15, 2015 SAVE THE DATES

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ETHICS IN ACTION A DUTY TO WARN Natalie Kreitzer, MD

Neurocritical Care Fellow, University of Cincinnati Department of Emergency Medicine

A well-appearing middle-aged female patient presents to your emergency department following a suicide attempt. The Poison Control Center recommends that the patient be observed for 4-6 hours to monitor for any further deterioration, and a 72-hour psychiatric hold is placed on her. Her toxicological workup is negative for acetaminophen and salicylates, and she remains alert and well appearing, and has no lab abnormalities during her observation period. The patient’s husband arrives at the emergency department and remains present at the patient’s bedside.

Your emergency department has psychiatric social workers who help facilitate the disposition of patients from the ED into a psychiatric facility, and you consult them to evaluate this patient, as you anticipate she can safely be discharged within a few hours to psychiatry. At the same time, several of the nurses change shifts, and a new nurse assumes care of the patient.

The patient’s oncoming nurse and the psychiatric social worker both recognize the patient’s husband immediately. He was seen in the emergency department within the last week, and is known by many of the staff. They also know that he is HIV-positive. Both the nurse and the social worker come to you with concerns that the patient likely does not know this information, because she did not endorse this as part of her past medical history. They are unsure how to proceed. What should you do?

Obviously, before contemplating any intervention in a case like this, one must be sure the person in question actually is HIV-positive. In this scenario, the patient was well known to the emergency department staff and there was little concern that this was not the case; however, this should be the first priority.

As a physician, what is your responsibility to your patient? Are you allowed to notify your patient that she has a risk of being HIVpositive? This is commonly referred to as “a duty to warn.” Should patient-doctor confidentiality be maintained if it is potentially putting someone else at an immediate risk of danger?

The answers to these questions are largely state-dependent, as each state has its own laws regarding how to proceed in this scenario. For instance, the Ohio Revised Code states that “the results of an HIV test or the identity of an individual on whom an HIV test is performed or who is diagnosed as having AIDS or an AIDS-related condition may be disclosed only to the following: the

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individual who was tested or the individual’s legal guardian, and the individual’s spouse or any sexual partner.” Note that the law reads that the results may be disclosed. It does not state that the results must be disclosed. Some states and cities have partner notification laws that mandate that if someone tests positive for HIV, they or their health care provider must tell sex or needlesharing partners. Some health departments also require providers to report the names of partners as well, even if the patient refuses to report the information on their own.

Regardless of the specifics of the local laws, most states require that all HIV-positive results be sent to the state’s health department, and this has many beneficial public health consequences. The health department will then send along this information, de-identified, to the CDC for the purposes of monitoring trends. The state health department can be involved in tracking down sexual contacts for notification purposes. The Ryan White HIV/AIDS Program requires that any health department receiving money from their program show “good faith” efforts to notify marriage partners of a patient with HIV/AIDS. A further question that arises is whether or not an HIV-positive person who knowingly exposes another person to HIV is engaging in criminal behavior. Most states have passed laws that criminalize the exposure of a partner to HIV. Between 1986 and 2001, 316 people were prosecuted for exposing others to HIV, according to the Criminal Law and Policy Project. Many of these laws were developed prior to HAART therapy, which significantly diminishes the transmission of HIV. Some HIV advocacy groups, as well as the Obama administration’s National AIDS Strategy, released in July 2010, have recommended that these laws are outdated, and that they “may make people less willing to disclose their status by making people feel at even greater risk of discrimination.”

What of the initial question? What are we permitted or obligated to tell our patient? In states that require or, alternatively, do not permit, revealing results to partners, the answer is straightforward.

Where the decision is up to the provider, that is, where he or she may, but need not, inform partners, matters are more difficult.

This decision is difficult, and several patient factors may play a role in it. For instance, a patient who is no longer sexually active with the infected partner may conceivably be at lower risk of contracting HIV in the future compared to one who is still with their partner. In a patient who has limited access to follow-up care, telling them in the emergency department may help facilitate follow-up appointments with infectious disease specialists. Some

emergency departments, including ours, have an infrastructure in place to help counsel and arrange follow-up for patients who test positive for HIV, such that a provider on a busy shift could still assure timely care for these complicated patients.

If the decision is made to tell the patient of their exposure, the provider should also be prepared to test the patient for HIV. If an individual tests positive for HIV, providers should be comfortable explaining the positive test result and the nature of HIV, and should be able to provide resources for medical treatment, social services, and possibly counseling. Patients who test positive for HIV should be informed on the importance of preventing transmission to others as part of their post-test counseling.

In the case at hand, the ED staff first attempted to encourage the patient’s husband to disclose his HIV status to the patient. When he did not oblige, the legal and ethics team on call were consulted, and recommended notifying the patient of her husband’s status.

An HIV test was performed on the patient following notification, and was negative.

REFERENCES FOR INDIVIDUAL STATE LAWS: http://www.hivdent.org/_uspublicpolicy_/USPP_SCSOHT_2005.htm http://www.cdc.gov/hiv/policies/law/states/exposure.html Acknowledgments: Caitlin Schaninger provided assistance with this article.

DIVERSITY AND INCLUSION ADIEM/SAEM MEMBERS WELL REPRESENTED AT THE AAMC HEALTHCARE EXECUTIVE DIVERSITY AND INCLUSION CERTIFICATE PROGRAM Bernie Lopez, MD, MS, CPE, FACEP, FAAEM

President–Elect, ADIEM Professor and Vice Chair of Emergency Medicine at Thomas Jefferson University Hospital and Associate Dean for Diversity and Community Engagement at the Sidney Kimmel Medical School of Thomas Jefferson University

The SAEM Academy for Diversity and Inclusion in Emergency Medicine (ADIEM) continues to engage in leadership opportunities addressing diversity and inclusion in the United States. We know that, although the US population continues to become more diverse, the medical workforce has not kept pace. We also know that the benefits of a diverse and inclusive health care environment have been well described, and contribute to reducing the health inequities seen across the country. While efforts are being made at most academic institutions to enhance the focus on diversity and inclusion, it requires a significant investment in the education and training of leaders to drive the process.

Nineteen diversity leaders in a variety of medical specialties from across the country participated in the American Association of Medical College (AAMC) Healthcare Executive Certificate Program in Diversity and Inclusion from January to June of this year. This is a six-month intensive academic program of diversity education specifically designed to develop the competencies leaders need to drive diversity as a core component of excellence in health care. The program consisted of a formal curriculum that combined distance-learning through series of webinars and interactive projects and three weeks of in-residence study with a focus on acquired knowledge and applied skills.

Of the nineteen participants, the predominant specialty was emergency medicine, as four SAEM members completed the program: Yolanda Haywood, MD, associate professor of emergency medicine and associate dean for student affairs and diversity and inclusion at George Washington University School of Medicine; Marquita Hicks, MD, associate professor of emergency medicine and director of community engagement in the Office of Diversity

(from left to right): Marquita Hicks, MD, Yolanda Haywood, MD, Bernie Lopez, MD, MS, and Ava Pierce, MD.

and Inclusion at the University of Alabama at Birmingham School of Medicine; Ava Pierce, MD, associate professor of emergency medicine and faculty liaison for Housestaff Emerging Academy of Leaders (HEAL) at the University of Texas Southwestern Medical School; and Bernie Lopez, MD, MS, professor and vice chair of emergency medicine at Thomas Jefferson University Hospital and associate dean for diversity and community engagement at the Sidney Kimmel Medical School of Thomas Jefferson University.

Three of the participants − Drs. Hicks (Awards Committee), Pierce (Development), and Lopez (president-elect) − serve as executive board members for ADIEM. This accomplishment serves as further evidence of the dedication of ADIEM members in promoting diverse and inclusive environments not only in emergency medicine, but in the house of medicine in general. This further promotes health equity and the provision of optimal health care to all that we serve. As we continue to move the needle on diversity and disparities in EM, we encourage you to join us. We continue to do important work and welcome your engagement.

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SAEM SOCIAL M EDIA COM M ITTEE FIVE FOAM FAVORITES IN RESEARCH INNOVATION Lauren Westafer, DO, MPH Baystate Medical Center Resident Social Media Scholar SAEM Social Media Committee

Social media and free open-access medical education (FOAM) aren’t merely trendy, superficial exercises in popularity. These platforms allow for dissemination of research findings and facilitate meaningful discourse. This may mitigate the gap in knowledge translation, often cited at ten or more years[1]. FOAM sources such as Twitter, podcasts, and blogs are creating dialogue with researchers in an attempt to improve patient outcomes through research.

“Are a Third of Research Conclusions Wrong?”

- Dr. Ryan Radecki, Emergency Medicine Literature of Note Dr. Radecki discusses a JAMA study showing that 35% of reanalyses of previous randomized control trials, most by the same research group, had different conclusions than the original trial[2].

These results provoke worry that subtle statistical manipulation can change the conclusions. Thus Dr. Radecki calls for increased transparency of research data. We should also have a better handle on statistics; after all, if the same authors can’t agree on the conclusions of the same data, what are we to do as clinicians?

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“The Adventure in the Valley of Fear” - Dr. Rory Spiegel, EM Nerd As indicated by the blog tagline, “Nihilism, Medicine and the Art of Doing Nothing,” Dr. Spiegel often finds that we rapidly invest hope, money, and the lives of our patients in therapies without evidence that these interventions improve patient-centered metrics. In this post, he reviews the evidence on procalcitonin.

Pushed by the industry, touting “antibiotic-free days,” this expensive biomarker fails to demonstrate a benefit to the patient in any measurable way (mortality, ICU length of stay, etc.).

“Can social media bridge the gap between research and practice?”

- Young PJ, Nickson CP, Gantner DC. Can social media bridge the gap between research and practice? Crit Care Resusc. 2013;15(4):257–9.

The FOAM world also involves researchers in this quest to improve the quality of research. In this FOAM article, Young and colleagues call for researchers to harness social media to disseminate their findings and participate in discussions. The authors submit this plea with the hope that this will improve the knowledge-translation chasm. They hope that discussion of research findings through social media will increase the impact

in context, and provides intellectual voyeurism into the minds of top researchers and educators. This insight is available to anyone with an interest and internet access.

“The Dark Side of Research” - Dr. Simon Finfer, Intensive Care Network podcast.

The movement for honesty and transparency in research is, in fact, championed by researchers. Dr. Simon Finfer, an academic intensivist, confronted major concerns in research, including subversive conflicts of interest, industry influence, and peer review. Cynical but not nihilistic, he cautions clinicians to think carefully about trials that produce dramatic benefit, as these often fade over time. Dr. Finfer places the responsibility on researchers to reduce the many sources of bias in the trial and publication process. and reach those in remote locations or non-academic institutions more quickly.

“Lung US Journal Club Part 1 with @nobleultrasound and @aliteplo. #foamed.

Lancet article discussed with first author, Christian Laursen.” - Ultrasound Podcast.

REFERENCES 1. Davis D, Evans M, Jadad A, et al. The case for knowledge translation: shortening the journey from evidence to effect. BMJ. 2003;327(7405):33–5. doi:10.1136/ bmj.327.7405.33.

2. Ebrahim S, Sohani ZN, Montoya L, et al. Reanalyses of Randomized Clinical Trial Data. Jama. 2014;312(10):1024. doi:10.1001/jama.2014.9646.

This podcast, hosted by Drs. Matt Dawson and Mike Malin, exemplified researcher engagement in FOAM when they reviewed a recent debated trial on point-of-care ultrasound. Novelly, they included the lead author, Dr. Christian Laursen. In addition to discussing the paper, ostensibly about ultrasound and dyspnea, they also discussed the realistic goals of research in point-of-care ultrasound and emergency medicine. This virtual journal club allows clarification of the research findings, places the findings

CDC’S NEW INJURY CENTER DIRECTOR: DEBRA HOURY, MD, MPH The National Center for Injury Prevention and Control (NCIPC) announced on September 18, 2014, the selection of SAEM past president Debra Houry, MD, MPH, as its new director.

Dr. Houry joins the CDC from the Emory University School of Medicine (EUSOM), where she was an associate professor in the Department of Emergency Medicine and an attending physician at Emory University Hospital and Grady Memorial Hospital. Dr. Houry has served as the director of the Emory Center for Injury Control at EUSOM/Rollins School of Public Health.

SAEM congratulates Dr. Houry on her appointment, which will begin on October 6, 2014.

Debra Houry, MD, MPH

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SAEM PUBLISHES SCORING SYSTEM FOR ANNUAL MEETING SCIENTIFIC ABSTRACTS Danny Pallin, MD, MPH

Brigham and Women’s Hospital Harvard Medical School Co-Chair, Scientific Subcommittee SAEM Program Committee

The Program Committee is responsible for planning SAEM’s Annual Meeting. The Program Committee’s Scientific Subcommittee is responsible for selecting research Danny Pallin, MD abstracts to be presented at the meeting, as either oral or poster presentations. We are pleased to announce that, as of

the 2015 Annual Meeting, our scoring system is publicly available. We’re delighted to share the full criteria with you in this issue of the SAEM Newsletter – please see the next two pages.

Anyone interested in getting more involved is welcome to join us as an abstract reviewer! To be eligible, you must have first-authored at least two peer-reviewed original research articles that have been published. Alternatively, if you have an additional health care research-related degree like an MPH or PhD, you are eligible (clinical degrees do not count).

If you would like to join us as a reviewer, please reach out to LaTanya Morris, SAEM’s education manager, at LMorris@saem.org.

SUBMITTING YOUR ABSTRACT TO THE SAEM ANNUAL MEETING SCIENTIFIC ABSTRACT SCORING SYSTEM

SUBMISSION GUIDELINES In choosing abstracts for our annual meeting, SAEM’s goals are logic, fairness, and transparency. Abstracts are scored according to their scientific quality, medical importance, and publication readiness. We do not believe one form of research is inherently better than another (e.g., clinical trials vs. health services research vs. qualitative studies).

We are pleased to announce that, as of 2015, we will publish our abstract scoring criteria. We think this will help new researchers produce better abstracts, and we think junior and senior researchers alike will appreciate the transparency. The publication readiness score is an important new addition. Every accepted abstract is published in Academic Emergency Medicine (and indexed in PubMed), and well-written abstracts make better publications in the journal.

We use a two-stage process for scoring abstracts. First, a primary reviewer evaluates each abstract, and may send it back to the author if something is missing, or may triage the abstract for no further review, if major problems are identified. If the abstract passes this initial review, it moves on to full review. Each fully reviewed abstract is scored by at least three qualified reviewers.

Effective 2015, SAEM will require that all reviewers have firstauthored two or more peer-reviewed original research articles or have an MPH, PhD, or equivalent non-clinical health care degree.

Remember, scoring is a judgment call. You are welcome to use the criteria to score your own abstract, but this won’t change how the reviewers call the play at game-time.

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The SAEM Annual Meeting is your meeting!

We hope you find it helpful to understand the selection process as you prepare your abstract, and we hope this helps new researchers grow.

Here are some tips to help you save on word count, and to get your abstract ready for publication in Academic Emergency Medicine: General • Make sure your name, degrees, and affiliations are quoted consistently on every abstract that lists you as an author.

Double check.

• If one research project is split into two or more abstracts, they may be rejected for “data splitting.”

• Have a colleague critique and proofread the abstract each time you revise it, especially if you do not usually write in English.

• You do not have to mention IRB or animal committee approval in your abstract, because you will attest to that during submission.

• Do not include bibliographic references in your submitted abstract. (You may do so in your poster or presentation.)

• Do not use fonts smaller than 10 point.

Figures and Tables • Be sure your figure or table has uploaded correctly to the system before you hit the submit button. Double check!

• Figures can use color. Figure/table width is limited to 8.6 cm.

Include the author’s name in the title (e.g., “Jones Figure 1”).

• Be sure there is a “callout” for each figure/table in the text of the abstract (e.g., “(see Jones Figure 1)”).

Statistics and Analytical Software • Use this format for confidence intervals: (95%CI 2.0-2.7).

Use “to” if there is a negative number, as in (95%CI –2.0 to 2.7).

• You do not have to say what statistical software you used.

Save that for the manuscript.

• Mention your statistical alpha only if it is something other than 0.05.

Grammar and Style • The following standard abbreviations will be shown for all abstracts, so you can use them without defining them: 95% CI, AAAEM, AAEM, ACEP, AEUS, AGEM, AWAEM, ACGME, ADIEM, AIDS, ASA, AUC, BP, bpm, CBC, CDEM, CORD, CPR, CT, CXR, dBP, ECG, ED, EM, EMS, FDA, GEMA, HIV, INR, IQR, IV, mmHg, MRI, NIH, PGY, ROC, SAEM, sBP, SIM, SD (when used as standard deviation after a mean), tPA, U/S. • Do not use other new or uncommon abbreviations unless it is unavoidable. Do not define abbreviations/acronyms in the title.

• Never use an abbreviation in place of a single English word: for example, never use “pts” in place of “patients.”

• Only capitalize the first word of each sentence, acronyms, and proper names. It is not necessary to capitalize “emergency medicine.”

• In sentences, do not use symbols instead of words (like “&” instead of “and”). Using symbols in the usual way (25% or $25) is fine.

• There should be a space between a number and its units. For example, 80 mmHg is correct, but 80mmHg is not.

• Use a leading zero for all decimal figures: for example, 0.2.

• Do not use underlined < and > and + symbols. Instead use the “Insert / Symbol” function to show the real ≤ and ≥ and ± symbols. Use the “Insert / Symbol” function for the ° (degree) symbol, rather than a superscript o.

SUBMISSION GUIDELINES — Reviewers, follow criteria literally, and score each domain independently.

CLARITY OF OBJECTIVES—Reviewers prioritize studies with clear objectives (whether descriptive or hypothesis-testing).

CHOICE OF APPROACH—Reviewers prioritize studies that use the right research methods for the scientific question.

2 W ell-thought-out study objectives, or clearly stated and testable hypothesis.

2 C hosen study design was the best feasible method for testing the stated hypothesis/ objectives (i.e., a robust design).

1 C hosen study design was sub-optimal but did test the stated hypothesis/objectives (i.e., an acceptable design).

0 Design did not test stated hypothesis/objectives, or not relevant to emergency medicine.

1 S tated objectives were poorly chosen, or stated hypothesis was difficult to test.

0 No clear objectives or hypothesis, or not relevant to emergency medicine.

VALIDITY—Were the right outcomes measured in the right way? Were potential confounders managed well? Is the story logical?

Specific Examples (abstract not required to fit in one of these specific categories – see general Scoring Criteria at left) Scoring Criteria

Clinical Trial

Observational Study

Survey

Laboratory

Qualitative Research

Meta-analysis

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Well-controlled, wellprotected from bias, and presented very clearly

Appropriately randomized, blinded, and controlled

Excellent control of bias and confounding. Clean data acquisition

Few non-respondents, sampling bias unlikely, clear constructs, robust analysis

Excellent methods, and experimental control, can replicate

Analytic framework, coding, and interview guides clear.

Session notes and recordings.

Exhaustive search and selection criteria, good heterogeneity control

1

Protection against bias, experimental control, and presentation satisfactory

Randomized for main outcome, vulnerable to bias or poor blinding

Bias/confounding controlled with some shortcomings; data acquisition reasonable

Response rate adequate but not impressive, valid constructs, clear analyses

Adequate methods and experimental controls

Analytic framework, coding, or guides not perfect, session notes or recordings

Adequate search and selection criteria, or fair heterogeneity control

0

Poorly controlled and vulnerable to bias, vague, confusing, or illogical

Not randomized for main outcome, or faulty randomization

Unclear methods, vulnerable Flawed logic, low response to bias/confounding, or rate, or respondents may invalid data acquisition differ from non-respondents

Methods invalid, poor experimental control, or cannot replicate

Analytic framework, coding, or guides not specified, or poor session documentation

Unclear search or selection criteria, or inappropriate pooling

STATISTICS—Reviewers prioritize studies that use statistics correctly.

X S kip this question because statistics are not applicable – this is a study type that should not be scored based on inferential statistics (e.g., qualitative study).

2 S tatistical methods and conclusions are correct. The reader has a clear understanding of the possibility of Type I and Type II error.

1 S tatistical methods and conclusions are technically flawed, but the reader is able to understand the possibility of Type I and Type II error. Conclusions are accurate.

0 T he reader is not given a clear understanding of the relative importance of variation targeted for measurement versus random variation (i.e., signal vs. noise).

IMPORTANCE OF TOPIC—Reviewers prioritize topics of major

SCOPE—Reviewers prioritize large multicenter studies over small single-center studies.

X S kip this question because this is a basic science study or another study type for which scope is clearly not relevant.

2 L arge, multicenter study likely to be published in major journal. For example, randomized trial with >5 sites and >200 subjects, or large multicenter educational study.

1 M oderate-sized study. For example, a randomized trial of 100 subjects at 3 EDs, or a process improvement study that includes 5 EDs in different states.

0 S mall N in a study of a common disease. For example, a clinical trial of 50 subjects at one center, or a qualitative study with 8 participants.

importance to large numbers of emergency medicine researchers or clinicians. Reward innovation.

PUBLICATION READINESS—Does this abstract reflect high-

2 T his topic, or its foreseeable progeny, is relevant to every emergency physician, or is highly innovative.

1 T his is an important topic that will lead to information of interest to many or most emergency physicians, including those who do not study this topic.

0 T his topic is only of interest to the small group of people who study it, and is unlikely to result in important knowledge.

2 P erfect grammar, no errors, very clear expression of ideas. Conforms perfectly to our SAEM submission guidelines.

1 G enerally well-written, but leaves room for confusion on some concepts or has one or two errors.

0 P oorly written. Hard to understand, idiosyncratic phrasing, or awkward abbreviations.

quality writing and attention to detail?

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COGNITIVE ERRORS IN THE EMERGENCY DEPARTMENT Benjamin Schnapp, MD Chief Resident

Kaushal Shah, MD

Associate Professor Mount Sinai Emergency Medicine

Decision-making was long thought to be a purely rational process, governed by logic and statistics according to Bayesian principles. Psychologists Daniel Kahneman and Amos Tversky were the first to prove that this was not the case and that “rational” decision-making can easily be led astray. Despite the importance of medical decision-making in the daily life of doctors, the pitfalls are poorly examined as a part of medical training, and important strategies to avoid errors are likely being widely underutilized.

TYPES OF ERRORS

Perhaps the widest-known cognitive error in the house of medicine is premature diagnostic closure. Patients are often judged within seconds of arrival, and additional data is shoehorned into our existing model as it becomes available. An EMS crew

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could, for example, anchor emergency doctors by mentioning that their patient smelled of alcohol. If the patient seizes and has an alcohol level of zero, a physician who fails to make the proper mental adjustment could attribute these symptoms solely to alcohol withdrawal, and fail to consider that the patient could have an intracranial bleed.

Doctors also respond based on information availability. The facts that spring to mind easily tend to be judged as the most salient to the problem at hand, although they may not be most relevant. Many of us know doctors who cite memorable bad outcomes for which they did not obtain initial imaging as justification for ordering unnecessary CTs. Important diagnoses can also be overlooked because they do not come easily to mind, such as carbon monoxide poisoning as a cause of headache in the summer. In “How Doctors Think,” Jerome Groopman describes a physician overwhelmed by a flu epidemic who misses a case of aspirin toxicity by attributing the patient’s rapid breathing and frequent consumption of over-the-counter medications to the more readily available signs of the flu.

Another error is diagnosis momentum, in which a diagnosis that may have been assigned tentatively stays attached to a patient improperly. This error is committed most when patients return multiple times for the same complaint; it is tempting to attribute their continued complaints to noncompliance or secondary gain rather than reconsider their diagnosis completely.

ordering blood tests), the physician erects a mental roadblock, not allowing herself to proceed further until she has reconsidered all the details of the case, including asking the question, “What else could this be?” Simply by engaging the analytical, effortful part of the brain, we can overcome some of the errors introduced by the automatic system that is more prone to bias.

Similarly, when a patient is sent in to be ruled out for a particular condition and has been confirmed as negative, it is easy to assume that the task is complete. However, especially in cases where the patient’s symptoms have not abated, it is important to consider that the original suppositions of the referring doctor may have been in error.

Another effective strategy against cognitive dispositions to respond is to offload some of our cognitive burden onto external decision-making aids, references and clinical practice guidelines.

This frees up our attention to focus on more subtle aspects of the case. Rather than contemplating at length whether a complex set of symptoms is likely to be caused by a pulmonary embolism, simply deduce whether the patient meets the pulmonary embolism rule-out criteria (PERC).

The cognitive dispositions to respond outlined here are just the beginning, however; many additional types of thinking errors have been described.

TAKING SHORTCUTS

Why do errors occur, especially in patterns like those outlined above? The brain is best understood as two distinct systems.

The first system is automatic, effortless, and subconscious. It tells us whether a person is friendly or threatening before we say a word to them. The second system is effortful, conscious, and logical. It helps us do things like long division. While we think of ourselves mainly constituted of the reasonable second system, the reality is that it is the first, automatic, effortless system that is constantly running, making millions of judgments about the world and our patients every second, and our sophisticated systems kick in only when a challenging problem demands it. This subconscious autopilot is most vulnerable to pernicious cognitive dispositions to respond.

Automatic, effort-free thinking does perform one valuable service for us: cognitive unloading. Frequently encountered situations and tasks are relegated to automatic routines.

A pregnant female with lower abdominal pain and vaginal bleeding needs an ultrasound to confirm an intrauterine pregnancy, and threatened-abortion discharge instructions. Active reasoning through every decision of every case such as this would leave a physician mentally exhausted. Fortunately, many cases can be handled with these experience-based routines for problem solving, also known as heuristics. However, danger arises when too much of our reasoning in ambiguous presentations is handled by the automatic system, without the intervention of the more deliberate portion, and, as a result, important features of the case that suggest alternative diagnoses are overlooked.

AVOIDING ERRORS

It is tempting to say that because we are hard-wired to take these cognitive shortcuts, and because they can be beneficial, there is no use in attempting to prevent them. However, there are several effective strategies to reduce potentially harmful cognitive dispositions to respond. The first is to be aware of the cognitive pitfalls that exist. In reading this article, you have already taken the first step in metacognition, or “thinking about thinking.” Unfortunately, due to the pervasiveness of the effects in our automatic processing systems, mere awareness has been shown to be insufficient to reduce biases. What then are more effective strategies?

One of the most powerful and intuitive ways to combat dangerous automatic thinking patterns is cognitive forcing. In this strategy, when a predetermined point is arrived at (e.g., after

Timely, nonjudgmental feedback is also an essential element in avoiding cognitive errors. Even the most prepared, enlightened doctor will inevitably miss diagnoses or mismanage the details of a case. Without knowing about the error, the physician misses the opportunity to identify correctable patterns of mistakes, such as repeatedly missing medical illness in psychiatric patients. A practice of following up mysterious or complex patients and an institutional policy of notifying clinicians of relevant bounce-backs can illuminate blind spots that might otherwise go unnoticed.

Finally, an overlooked factor in error-free decision-making is self-care. In a profession with similar demands on decisionmaking, judges have been found to give significantly less parole before lunch than after, suggesting that we are less rational (and compassionate!) when working on an empty stomach.

An examination of the frailties of our medical reasoning can be extremely uncomfortable given the litigious practice environment in the US and the pervasive myth of the superhuman doctor.

However, advanced training and even years of experience are often not enough to avoid critical errors that can harm patients.

By increasing awareness of the pitfalls that exist and teaching strategies to prevent common mistakes in thinking, we can be better prepared to handle that next tricky patient that comes through the door.

REFERENCES: 1. Gorry GA, Barnet GO. Experience with a model of sequential diagnosis. Comput. Biomedical Res. 1. 1968:490-507.

2. Tversky A, Kahneman D. Judgment under uncertainty. Heuristics Biases Sci. 1974;185:1124-31.

3. Tversky A, Kahneman D. Availability: A heuristic for judging frequency and probability.

Cognitive psychology, 1973;5(2):207-232.

4. Groopman J. How doctors think. New York: Houghton Mifflin Co.; 2007.

5. Croskerry P. The importance of cognitive errors in diagnosis and strategies to minimize them. Acad Med. 2003;78(8):775–780.

6. Kahneman D. Thinking, fast and slow. New York: Farrar, Straus and Giroux; 2011.

7. Croskerry P. A universal model of diagnostic reasoning. Academic Medicine.

2009;84(8):1022.

8. Wilson TD, Houston CE, Etling KM, Brekke N. A new look at anchoring effects: basic anchoring and its antecedents. Journal of Experimental Psychology: General.

1996;125(4):387.

9. Croskerry P. Cognitive forcing strategies in clinical decision making. Annals of Emergency Medicine. 2003:41(1):110-120.

10. Croskerry P. Diagnostic failure: a cognitive and affective approach. Rockville, MD: Agency for Healthcare Research and Quality; 2005.

11. Graber ML, Kissam S, Payne VL, Meyer AN, Sorensen A, Lenfestey N, et al. Cognitive interventions to reduce diagnostic error: a narrative review. BMJ Quality & Safety.

2012;21(7):535-557.

12. Danziger S, Levav J, Avnaim-Pesso L. Extraneous factors in judicial decisions. Proceedings of the National Academy of Sciences. 2011;108:6889–6892.

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LIFE AND A CAREER IN GLOBAL HEALTH: CAN YOU HAVE IT ALL? WORDS OF WISDOM FROM SEASONED EXPERTS IN GLOBAL ACADEMIC EMERGENCY MEDICINE Bhakti Hansoti, MBChB, MPH

Stephanie Kayden, MD, MPH

Gabrielle A. Jacquet, MD, MPH

Adam C. Levine, MD, MPH

Johns Hopkins University School of Medicine

Boston University School of Medicine Boston University Center for Global Health and Development

G. Bobby Kapur, MD, MPH Baylor School of Medicine

Brigham and Women’s Hospital Harvard Medical School Brown University Alpert School of Medicine

University of South Florida

Scott Weiner, MD, MPH

Brigham and Women’s Hospital Harvard Medical School

Ian B.K. Martin, MD

University of North Carolina School of Medicine

Interest in a career in global health among medical students, residents, and fellows has never been higher.1-5 The number of emergency physicians pursuing a career in global health is increasing. Individual medical trainees face many personal challenges when opting for a career in global health. The issues of how to balance clinical training, family, travel, and debt present difficult dilemmas.

In response to this surge, as well as to a growth in interest in career-life balance, including the recent Slaughter article in The Atlantic and the book Lean In6,7, the following information was presented in May 2013 at an educational session at the Annual Meeting of the Society for Academic Emergency Medicine (SAEM) in Atlanta, Georgia. This didactic was co-sponsored by the Global Emergency Medicine Academy (GEMA) and the Academy for Women in Academic Emergency Medicine (AWAEM)8,9. We

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Tracy Sanson, MD

hope that this information will help young physicians who are contemplating or embarking upon a career in global emergency medicine.

PERSONAL AND PROFESSIONAL DEVELOPMENT What are the necessary components of professional development to have a successful academic career in global health?

What does it mean to have it all? The reality is that the definition of “all” is going to be different for each and every one of us. We all have different desires, different ideas of what we want to do with our global health career. In addition, that notion is going to change at different points in our career. What is important? What is the depth of your experience? Is global health something you have just dabbled in? Or do you have something productive to show for your experiences? The reality is that, every step of the way, at

every level, each of our experiences is valuable for developing our foundation and preparing us for what we can do in global health.

How do we put together and frame our experiences? When you are writing a grant for a foundation or for the US government, you need to report who will be working on the grant, and what your budget is. They also want a capacity statement, and they don’t want you to simply say, “We did work in Iraq”: they want to know the depth of what you’ve done. What have you done, what have you accomplished, and how can you quantify that and develop your capacity statement? It’s not just a line item on your CV, but the way you can actually present it coherently and cogently when you have 3-5 minutes to present your global health accomplishments.

This becomes important because, academically, you’ve got to project your interest in global health and you’ve got to validate what you’ve done already, or what you want to do, to the people around you—whether it’s your colleagues, your chair, your dean, or the president of the medical school. You need to be able to convince them that what you’ve done is important, and that what you’re doing is part of your academic portfolio. How will you define your value within your institution? What we’re seeing is that it’s not a passing interest: global health care is a phenomenon. Medical students and residents are looking for substantive programmatic opportunities in the global health arena. We can, through our previous experiences and opportunities, really make ourselves valuable and define our value within our institutions—whether it’s within a global health track, whether it’s by giving lectures within the school, or whether it’s providing mentorship. It’s important to reach out to other individuals, departments, specialties within your institution: pediatrics, internal medicine, surgery; public health, law, public policy, business, nursing, engineering. If you create these networks and establish these contacts, and if you show them what you bring to the table, they will start coming to you for help with their projects, in creating their lectures, in writing their grants. Define your value across the institution.

How do you finance your career?

It’s difficult: we all have to buy down our time. If you can be of value not only within your department, but within your institution as a whole—if you are teaching a course, or are named on a larger grant with another department—there are other opportunities beyond what you are doing in emergency medicine to fund what you want to do and to create time to do it.

The trajectory of a career in global health is not necessarily linear, or stepwise, or vertical. You may do something, then take time away from it, and then maybe go back to it. Global experiences may open up doors and prepare you for other opportunities. For example, after setting up residencies in India, one of us had more experience than our colleagues, and was then asked to set up a US residency. What we are doing internationally can be applied to our own departments and institutions.

Summary: Know academic output, finance career, get grants, buy down time, reach out and collaborate. Do this both at home and abroad.

ROLE WITHIN YOUR FAMILY What are important considerations when trying to balance your family life with a career in global health?

You can have it all, just not all at the same time. When you bring in a partner and/or children, your life will be filled with conflict; be

prepared. There’s no such thing as a perfect life balance—that’s a myth. There’s life. You must try to do the best that you possibly can with the life that you have at that moment.

It’s important to ask the people around you: How are you handling the demands of a family? Does an au pair work? Does it work to have your parents move in? Perfection is not possible, so let that go. You may have heard the saying, “There’s a fine line between chaos and success.” Another myth! There’s no line at all: it’s often both at the same time, and you’re just kind of going along with that.

Choose a partner well: this applies not only to a life partner, but to a work partner as well. Your work partner needs to believe that what you are doing is important. You need partners that understand that this is part of who you are: the unpredictability of your life, the adapting and overcoming, the series of new situations one after the other. While we all care for patients individually, when we work internationally, we impact systems. In every situation that requires compromise between your family life and your work life, perhaps one way to approach it is to think of the two-value consideration: What value do I bring to this situation or relationship? What value will I receive from this situation or relationship? It’s important to balance that every time. You may have a phenomenal opportunity to go away somewhere, but at the same moment your life partner or work partner is not seeing the value of it, or will not get value from it himself. You need to do the work necessary to lay the foundation for your decision. You will have opportunities and possibilities that come and go. And sometimes the value of not missing a soccer game outweighs anything else.

There is no “right time” to do anything. People often ask: Should I do it before I get married, before I have children, before I have a family? If at the moment you’re not married or you’re early in your career, that’s a fantastic time to travel abroad. There may be times later on when your partner or your family situation or your work situation requires you to stay at home. That time spent laying your foundation—by setting up your systems, writing articles, making connections, writing grants—is not lost. When your life has fewer pressing family or work obligations and you can go overseas, that can also be a time to go. There’s no specific right time for when you do it.

Set up your support at work. Let them know about the preparatory work, the work that you are doing once you’re there, and the work that comes afterward.

Set up your support at home. Who’s feeding your dogs? Who’s paying your bills? Who’s making sure that the pipes don’t freeze?

All of those things need to be set up.

If you have children, think about your options. Home-schooling may be the most portable option. Private schools and charter schools will often let you take your children out of school for extended periods if you agree to achieve certain benchmarks while you are gone. In public schools, sometimes if you miss a certain number of days, you can end up in trouble. You may find it easier to wait until the children are older and can make their own decisions about whether or not to go with you. The military is a source of knowledge in this department that you may want to tap: they must always handle the deployment of one or both parents in a family, figure out how to bring in caretakers, how to provide their personnel with the tools to make the necessary arrangements and decisions.

Continued on Page 18

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Continued from Page 17 It’s important to set goals and make plans with your life partner and with your work partner. And then be prepared for every single one of those to fail. This is a phenomenon called resilient fallibility: things will fail, you will be busy, you will be overwhelmed, and you will make mistakes. But everyone makes mistakes. You are teaching your children, your parents, your partner, and your work how make mistakes, and how to get back up and start again. What we do overseas when setting systems up is tragic and triumphant.

It gets messy when you start involving other people. You realize that, and you let them know the magical parts of what we do.

Conclusion: There is no perfect life balance. There’s no right time to do it. Consider: Do I bring value? What value do I receive?

ROLE WITHIN AN ACADEMIC DEPARTMENT How do you negotiate/strengthen your role with an academic emergency medicine department in order to best create a worklife balance and have a successful career in global health?

Global emergency medicine is a field in which we often work a little bit harder and get paid a little bit less than any of our colleagues that do research. You need to consider that it’s hard for your chair to give you extra time off to do your research just because it happens to be international, when he has a lot of other people doing other types of research who don’t get the extra time. When you go into negotiations with your chair, you have to go in knowing that this is often how chairs think, and how they have to think. Whatever they negotiate with you has to be okay with the rest of the department.

When you are first starting out, it is worth talking to your chair in your new job about what you need to do to make it work. It’s worth negotiating some buy-down of your time, at least initially, so that you can get your feet on the ground and get some projects under way and start your research, so that you can then write grants and get funded a bit more. It’s great if you can negotiate several months of protected time, but you need to understand that it’s very likely to be temporary, and that you need to follow up very quickly for grants for your projects. Once you get the grants, you need to publish. It’s important for institutional promotion and tenure, but also to show your chair that you’re being productive and that what you are doing is a legitimate research endeavor.

When thinking about what value you bring to the situation, consider the fact that many departments have medical students and residents that are interested in international work, and they are looking for a ways to satisfy that interest. Taking residents and students with you on international projects, or arranging for them to complete international rotations, is a way you can provide value. Keep in mind that it’s a lot of work to do it and do it well: getting them there and back safely, making sure that they are doing good work in the field, and ensuring that they get evaluated.

It may not be what you had in mind when you signed up for the job, but it adds a lot to the department. Some departments might be interested in developing a global health fellowship for the institution—this is another value you can bring.

Don’t overlook the use of media to bring a little bit of fame to your department. When you do international work, pitch that story both to the internal communications within your hospital (hospital bulletins) and to the local media. If you’ve responded to a disaster or done a really good project, that’s something that everyone will want to know about and that your chair will want everyone to

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know about. If you’re going to talk to the media, make sure you develop relationships and that you know how do to this effectively.

Once you have done all the work to gather these values to bring to your department, make sure that you showcase them to your chair so that he will know what they are getting from your programs. The value that we bring to the department as global health researchers is not necessarily obvious to chairs who have grown up in a purely academic emergency medicine system; show them that what we do is real, worthy research.

You need to be a good clinician, first and foremost. You have to get your charts dictated and signed on time. You don’t want to be the last one to get your credentialing paperwork done. You want to be a good citizen to your department.

Be ready with your 30-second elevator speech, and tell everybody—all the time—what you are doing. Be specific: Do not say, “I’m off to India.” People think we’re all on vacation; they assume we’re sitting on a beach and maybe touring a local hospital on a day off. Say instead, “I’m going to Puducherry to implement a new emergency medical system for a catchment area of 2 million people.” Avoid the slides of a beautiful sunset at the end of your presentations. Show pictures of people you work with, the group photo, the new ambulance. Always reinforce the professionalism of what we do.

Summary: Know your potential, get grants, and use that to buy down time; publish your work, and provide value in your department. Once you know your value, have your 30-second elevator speech polished and ready.

REFERENCES:

1.

Colleges AoAM. 1984 Medical School Graduation Questionnaire: All Schools Report. .

Washington, DC1984.

2.

Colleges. AoAM. 2011 Medical School Graduation Questionnaire: All Schools Report. .

Washington, DC2011.

3. Drain P, Primack A, Hunt D, Fawzi W, Holmes K, Gardner P. Global health in medical education: a call for more training and opportunities. Acad Med 2007;82:226-30.

4. Torjesen K, Mandalakas A, Kahn R, Duncan B. International child health electives for pediatric residents. Arch Pediatr Adolesc Med 1999;153:1297–302.

5. Nelson B, Lee A, Newby P, Chamberlin M, Huang C. Global health training in pediatric residency programs. . Pediatrics 2008;122:28–33.

6. Slaughter A. Why WOmen Still Can’t Have It All. The Atlantic 2012.

7. S andberg S. Lean In: Women, Work, and the Will to Lead. 1 ed: Knopf; 2013.

8. (Accessed May 21, 2013, at http://community.saem.org/Communities/ViewCommunities/Group Details/?CommunityKey=58595efd-f39b-45ac-93b4-398646d11f4f.)

9. (Accessed May 21, 2013, at http://community.saem.org/Communities/ViewCommunities/Group Details/?CommunityKey=f465fb9b-df5d-4809-9810-942d625f963a.)

LIFETIME ACHIEVEMENT AWARD PETER ROSEN, MD, RECEIVES LIFETIME ACHIEVEMENT AWARD FROM ASSOCIATION OF ACADEMIC CHAIRS OF EMERGENCY MEDICINE Brian J. Zink, MD

Past President, AACEM Rhode Island & Miriam Hospitals/The Warren Alpert Medical School of Brown University

Ron M. Walls, MD

Immediate Past President, AACEM Brigham and Women’s Hospital/Harvard Medical School

Wyoming, Rosen, for some reason, believed that it might be less stressful on his heart to take over as director of the emergency department at his alma mater, the University of Chicago, where he had also done his internship. Over the next seven years Rosen, against considerable odds and opposition, was able to start an emergency medicine residency (1973), and begin his tradition of training future leaders in EM. He transformed emergency care in the teaching hospital, and became active in national efforts to build the specialty of emergency medicine.

Rosen’s academic credibility, penchant for battle, and enthusiastic approach to the negotiations over approval of the American Board of Emergency Medicine (ABEM) helped the process along at some crucial points. He was a founding member of the ABEM Board of Directors, and helped to develop the initial ABEM examinations. His “Biology of Emergency Medicine” article from 1979(1) eloquently made the case for the unique role of emergency medicine as a specialty in the house of medicine.

After his successful stint in Chicago, Rosen repeated his efforts in Denver, creating a strong EM residency and academic program at Denver General Hospital, where he again recruited and mentored EM leaders such as the late John Marx, MD. Rosen’s hat trick was completed when he established the EM residency at the University of California, San Diego, where he claimed he relocated to “slow down.”

Rosen made major contributions to scholarship in emergency medicine as the founding editor of the Journal of Emergency Medicine and of Rosen’s Emergency Medicine: Concepts and Clinical Practice, first published in 1983 and now in its 8th edition.

This textbook was the first to be written exclusively by emergency physicians for emergency physicians, and set the standard as the premier emergency medicine textbook.

Peter Rosen, MD receives Lifetime Achievement Award.

Photo Credit: Ed Michelson, MD

The Association of Academic Chairs of Emergency Medicine (AACEM) presented its inaugural Lifetime Achievement Award at the AACEM Annual Retreat in San Diego in April 2014. The first emergency medicine leader to be honored with this award was Peter Rosen, MD. Dr. Rosen is a legendary clinician, educator, and leader in academic emergency medicine whose brilliant career spans four and half decades.

Rosen was originally from Brooklyn, attended the University of Chicago as an undergraduate, and then graduated from medical school at Washington University in St. Louis. He trained as a surgeon at Highland Hospital in Oakland, California. After military service in Germany, Rosen began a general surgery practice in rural Wyoming, where he helped develop ICUs in regional hospitals, and became interested in emergency care.

After suffering two myocardial infarctions at a young age in

Rosen has remained active as a teacher in the later years of his career, splitting his time as a senior faculty member between University of Arizona in Tucson and Beth Israel Deaconess Hospital, a Harvard Medical School affiliate in Boston. He continues to lecture around the country, and to function as a sage mentor for the many physicians who have trained under him. He remains frighteningly up to date with the emergency medicine literature and well informed in the world of academic medicine.

At the session at which Rosen received the AACEM Lifetime Achievement Award, the past-president of AACEM, Brian Zink, MD, interviewed Rosen on aspects of his career, and asked his opinions on the current state of emergency medicine. Rosen, as usual, was not shy with his opinions in many areas. He said that too many physicians do not use the power and authority that their degree and position confer, and that they could use their influence more effectively to solve issues in hospitals and the medical community. He made a plea for physicians to do a better job of explaining to patients what is going on in their emergency care. He also called for emergency physicians to share the responsibility for managing chronic medical conditions such as Continued on Page 21

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AEUS is comprised of emergency physicians who are committed to improving patient care by advancing education and research in ultrasound for the bedside evaluation of emergency medical conditions.

Benefits of Joining AEUS: Networking Research Collaboration Mentorship Network Educational Resources Leadership Opportunities Academic Development â&#x20AC;Śand Much More SonoGamesÂŽ is a competition in which competitors demonstrate their skills and knowledge of point-of-care ultrasound in a lively and educational format.

Visit our website to enjoy pictures from the 2014 competition. http://www.saem.org/annual-meeting/events/sonogames Get your best 3-member ultrasound-savvy teams ready to come compete for the title of SonoChamps 2015 and bring home the SonoCup! Email questions to: SonoGames2014@gmail.com

AEUS is currently seeking nominations for the following positions: President Elect (1-year term, followed by 1-yr president & 1-yr immediate past president) Education Officer (2-year term), Secretary (2-year term) All terms begin at the SAEM Annual Meeting in May 2015 Interested individuals should submit a current CV and personal statement to Kristin Carmody no later than December 8, 2014: kristin@carmodys.net In this issue we illustrate the utility of US guidance in: PERIPHERAL NERVE BLOCKS Case: An 84-year-old female presents with a right hip fracture after a mechanical fall.

Consider the following: 1. What are the advantages of using ultrasound to perform a peripheral nerve block?

2. What is the approximate maximum S.C. dose for the anesthetic you would choose?

3. What diagnosis should be considered with metallic taste, perioral numbness or tinnitus?

4. What is the treatment if the patient rapidly becomes confused and hypotensive?

(Points to consider on following page)

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Continued from Page 19 congestive heart failure. Rosen said he recognized the increasing role of advanced practice providers (PAs and NPs) in emergency care, but expressed concern that they may displace emergency physicians in some EDs. Rosen was presented his award by Ron Walls, MD, AACEM president, who trained in Denver under Rosen. Afterward, the inaugural awardee was surrounded by current chairs, who snapped photographs and expressed their appreciation for his seminal role in fighting the battles that made emergency medicine a specialty. There was also a sense of awe and gratitude for someone who has, through his teaching and mentorship, spawned and launched so many successful careers in emergency medicine. As Rosen noted in 2002, this is what he views as his most important contribution: “I think the thing I am most proud of is my graduates. They’ve been better emergency physicians than I am, and they are good people, and they’ve been excellent leaders and have made the field flourish. They are what it is all about…My life was being part of their life cycle.”(2) (from left to right): Brian Zink, MD, Peter Rosen, MD and Ron Walls, MD. Photo Credit: Ed Michelson, MD

REFERENCES:

1. Rosen, P. The biology of emergency medicine. JACEP. 1979; 8:280-3.

2. Zink, B. Anyone, Anything, Anytime: A History of Emergency Medicine. Philadelphia, PA: Mosby Elsevier, 2006.

Points to Consider (from previous page): 1. Advantages: In the figure to the left, an ultrasound-guided fascia iliaca compartment block was chosen to manage the pain from the hip fracture.

This block, like most PNBs, can be performed using landmark methods; however, US increases the likelihood of success and decreases the complication rate (tissue damage, bleeding, toxic injection).

2. Max doses*: Bupivacaine 2mg/kg, Ropivicaine 3mg/kg, Lidocaine 4.5mg/kg 3. Early signs of local anesthetic systemic toxicity include those listed.

Graduated signs of more severe toxicity include muscle twitching, agitation, seizure, coma, respiratory depression and cardiac arrest.

4. 20% Lipid Emulsion Figures: (Top) Ultrasound image just before injection. Note the needle tip deep to the fascia iliaca.

(Bottom) Image after injection of local anesthetic. Note the anechoic collection of local anesthetic just beneath the plane of the fascia iliaca.

Figures reprinted from J Emerg Med. Vol . 43, No.4. Haines L, Dickman E, Ayvazyan S, Pearl M, et al. Ultrasound-guided fascia iliaca compartment block for hip fractures in the emergency department, pages 692-7, 2012, with permission from Elsevier. *Schwartz DR, Kaufman B. Local Anesthetics. In: Nelson LS. Lewin NA, Howland MA, Hoffman RS, Goldfrank LR,Flomenbaum NE (eds).

Goldfrank’s Manual of Toxicologic Emergencies 9e. New York, NY: McGraw-Hill; 2011.

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Information Technology Solutions Academy for Diversity and Inclusion in Emergency Medicine JOIN THE ACADEMY ...

M ISSIO N

Who? Medical Students, Residents, Fellows, Faculty and Associates interested in promoting the mission and objectives of ADIEM.

To promote equal access to quality healthcare and the elimination of disparities in treatment and outcomes through education and research.

Why? As EM physicians, we have the ability to shape the delivery of culturally competent patient care and encouraging progress in eliminating healthcare disparities.

To enhance the retention and promotion of LGBT and those historically under-represented in medicine to create an inclusive environment for the training of emergency medicine providers; specifically using the AAMC’s guide “to unite expertise, experience and innovation to inform and guide the advancement of diversity and inclusion in emergency medicine”.

Benefits of joining ADIEM? You will be joining a movement to change the face of medicine and addressing how we can effectively treat the diverse population of patients we see everyday. We are building a network of physicians who share a common goal, which ultimately empowers us to continue to unveil health care disparities, heighten awareness, and improve how we practice medicine.

To enhance the professional development of all EM faculty and residents with respect to culturally competent medical care.

O BJ ECTI VES Enhance the recruitment and retention of under-represented and LGBT groups in Emergency Medicine.

Foster academic promotion of URM and LGBT faculty in Emergency Medicine.

Serve as a leader in the professional development of EM faculty, residents and students with respect to culturally competency.

Promote the concepts of access and quality of care for all patients.

Minimize racial, ethnic, gender, sexual orientation, gender identity, and cultural outcome disparities in health care.

Promote diversity of students, residents, staff and faculty in Emergency Medicine.

Foster inclusive environments within the specialty.

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Opportunities for:



Mentorship, Professional Development and Networking



Scholarly projects, Presentations, Didactics, and Abstract Submission



Scholarships to attend SAEM for medical student and resident members

We encourage you to join/renew with ADIEM with your annual SAEM renewals.

In coming decades, the number of older adults in your ED

will more than double...are you ready?

The Academy of Geriatric Emergency Medicine can help!

• Improve your clinical care of older patients

• Use the newly-released Geriatric ED Guidelines (http://www.saem.org/education/geriatric-ed-guidelines) • Result of a collaboration between SAEM, ACEP, ENA, and AGS • Cover resources, staffing, environment, and policies for Geriatric EDs

• Prepare your trainees to care for older patients • Access and download our educational materials: • Geriatric EM Journal Club: Modeled after the highly successful ACP Journal Club, it provides expert review and commentary on articles critical to geriatric EM • Lectures, training curricula, and simulation cases available • Check out the Abdominal pain in the Elder Adult module for CME or asynchronous learning (http://elearning.saem.org/saem_online) • Connect with AGEM members available to give grand rounds talks

• Advance your research agenda

• Connect with AGEM investigators • NIH and foundation-funded, including multiple K23 awards • Receive mentoring and counseling • For junior and mid-career investigator members of AGEM Questions? Please contact us!

Emmy Betz (2014-15 President) – marian.betz@ucdenver.edu Maura Kennedy (2014-15 President-Elect) - mkennedy@bidmc.harvard.edu

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AWAEM was established in 2009 to promote the recruitment, retention, advancement and leadership of women in academic emergency medicine. We provide faculty development and a support network to facilitate mentoring and research collaboration to address the unique needs of women in academic emergency medicine. The success of academic emergency medicine and the ability of the specialty to train future emergency physicians are intrinsically linked with the success of female faculty. Here are just a few reasons to join us this year!

TOP 10 REASONS TO JOIN AWAEM 1. Learn about what choices to make to lay the groundwork for a successful academic career 2. Discover how prominent female academic emergency physicians choose to shape their careers 3. Understand the unique demands in being a female academic emergency physician and how to deal with the challenges 4. Gain insight into key leadership lessons 5. Energize to make a difference on a larger level, for ourselves professionally and as socially accountable physicians and members of society 6. Practice the practical aspects of work-life balance by learning from those who came before us 7. Ensure that we continue to make a difference for our patients, utilizing our role as women in bringing a unique perspective 8. Obtain mentorship from our female role models within emergency medicine 9. Make sure that we take care of ourselves by making self-care and wellness part of our routine 10. Take part in peer-to-peer networking to foster an atmosphere of mutual support and collaboration

RECURRING AWAEM EVENTS

Bimonthly eNewsletter • Regional Meeting Representation Annual Events at SAEM - Didactic Sessions • Academy Block • Networking Luncheon Annual Awards - Resident, Early Career, Research

SIGN UP TODAY! ANY MEMBER OF SAEM IS ELIGIBLE TO JOIN. Sign up on the SAEM website: http://www.member.saem.org

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Clerkship Directors in Emergency Medicine

National representation of EM in UME: • Full voting member of the Alliance for Clinical Education (ACE) along with the other six core specialties • AAMC Resources for Educators: • Designed and published National fourth year, third year and pediatric EM curricula • Clerkship Primer Resources for Students: • www.CDEMcurriculum.org o Self-Study Modules (cases based on National 4th year curriculum) o DIEM cases (interactive timed cases assessing clinical reasoning) Assessment tools: • NBME Exam: Advanced EM “Shelf” exam • CDEM Tests – Standardized validated FREE exams based on NBME Platform Collaborations: • Multiple collaborative projects with CORD, SAEM, EMRA, and ACEP Academic Affairs for Education • Developing relations with International Education Organizations • Collaboration with other SAEM Academies National Meetings: • Three-day CDEM track at CORD Academic Assembly • Enhanced Educator focused material at SAEM Annual Meeting • AAMC

OUR MISSION is to advance the education of medical students in emergency and acute care medicine.

Get Involved Social Media: @CDEMfaculty (For educators) and @CDEMstudents (For students); interested in authoring a tweet?

Contact michael.w.vanmeter@uth.tmc.edu

SAEM Clerkship Directory: We are updating the Clerkship Directory. If you are a new clerkship director and are not on the SAEM website, let us know at CDEM@saem.org

Membership Drive: CDEM wants to strengthen our voice!

We want every UME Educator to be an active member. Contact CDEM President, Nick Kman at Nicholas.kman@osumc.edu for more information.

Redesign of Medical Student Resources: CDEMcurriculum.org is a free, open-access resource for educators and their students used by over 50,000 people from 160 countries. We need your help to improve the modules. If you would like to author a topic, please contact CDEM@saem.org.

Who should join? You! We offer a forum for all EM educators to share ideas, generate solutions, collaborate on research, and develop standardized, peer-reviewed resources for educators and students alike.

@ www.saem.org

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2015 MEMBERSHIP ENROLLMENT NOW OPEN The Global Emergency Medicine Academy, focused on bringing SAEMâ&#x20AC;&#x2122;s mission and attention to academic physicians around the world.

Join us in making a global difference.

e

rgency M e m E g n i c edi n a c v t h d e n W u i d o o r r A l d n A

The Pillars of GEMA

Networking * Mentoring * Collaboration Education * Fellowship community.saem.org/gema

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www.globalem.net

THE AMERICAN BOARD OF EMERGENCY MEDICINE ABEM ELECTS PRESIDENT, PRESIDENT-ELECT FOR 2014-2015 At its July 2014 meeting, the American Board of Emergency Medicine elected the following members to its 2014-2015 Executive Committee: Francis L. Counselman, MD, president; James H. Jones, MD, immediate past president; Barry N. Heller, MD, president-elect; Michael L. Carius, MD, secretary-treasurer; Terry Kowalenko, MD, member-at-large; and Robert W. Strauss, MD, senior member-at-large.

Dr. Counselman has been a member of the Board of Directors since July 2008, and was elected to the Executive Committee in 2011. Since 2003, he has served ABEM in a variety of capacities, including as examination editor, item writer, oral examiner, and member of the Relevance of Examination to Physician Practice (REPP) Task Force Advisory Panel. He currently serves as chair of the Francis L. Counselman, MD Test Development Committee, is a member of the Academic Affairs, Executive, Finance, Research, and Test Administration committees, and is

an editor and chief examiner for the oral certification examination.

Dr. Counselman has also represented ABEM on the EM Model Review Task Force; the Internal Medicine-CCM Task Force; the Surgery-CCM Task Force; the Anesthesia-CCM Task Force; and the Initial Certification Task Force. He has been active in a number of national organizations, including the Accreditation Council for Graduate Medical Education, American Board of Medical Specialties, American College of Emergency Physicians, Association of Academic Chairs of Emergency Medicine, Alpha Omega Alpha Honor Medical Society, Council of Emergency Medicine Residency Directors, and the Society for Academic Emergency Medicine.

Barry N. Heller, MD

Dr. Heller currently practices Emergency Medicine at St. Mary Medical Center in Long Beach, California, and Little Company of Mary Hospital in San Pedro, California. Dr. Heller is an assistant clinical professor of medicine at UCLA School of Medicine. At St. Maryâ&#x20AC;&#x2122;s he has served as chair of the Department of Emergency Medicine, chief of staff, and vice president of medical affairs.

ABOUT ABEM Founded in 1976, the American Board of Emergency Medicine (ABEM) develops and administers the Emergency Medicine certification examination for physicians who have met the ABEM credentialing requirements. ABEM has nearly 30,000 emergency physicians currently certified. ABEM is not a membership organization, but a non-profit, independent evaluation organization. ABEM is one of 24 Member Boards of the American Board of Medical Specialties.

ABEM MISSION The ABEM mission is to ensure the highest standards in the specialty of Emergency Medicine.

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THE AMERICAN BOARD OF EMERGENCY MEDICINE ABEM TO UPDATE INITIAL CERTIFICATION EXAMINATION PASSING SCORES Emergency medicine has evolved over the last 35 years, and the examinations for board certification are evolving as well. Over the last several years, ABEM has been evaluating every aspect of the examination process, including evolving changes in the clinical practice of emergency medicine. ABEM conducted a survey of its diplomates to determine the appropriate test content for certification in emergency medicine. From this, a detailed description was compiled of what a board-certified emergency physician knows and is able to do (knowledge, skills, and abilities statements). The most appropriate method for measuring the information gathered by the diplomate survey was then established. To better reflect the clinical practice of EM, ABEM is optimizing the use of computer technology to develop and administer the examinations.

The next step is to update the certification standards and passing scores for the modified examinations.

Setting the Passing Scores

Updated passing scores will be determined for initial certification examinations beginning with the fall 2014 qualifying examination.

This could have some impact on the overall passing rate. However, the intention of this revision is to create a passing score that accurately reflects the current standards for a cohort of ACGMEaccredited emergency medicine residency graduates in 2014.

The process for setting a passing score is based on several decades of study by specialists in psychometrics (psychometricians). Psychometricians are psychologists who specialize in measuring human abilities, and are specially trained in testing science. The processes used by ABEM follow these core principles, as defined by psychometrics. ABEM has always applied and will continue to apply psychometric best practices in its testing processes.

The Standard-setting Study A representative sample of clinically active ABEM-certified physicians will be selected to recommend a passing score.

This group of physicians will create a description of the candidate who meets ABEM standards. This description represents the line between those who should pass and those who should not pass.

This group of physicians will then evaluate each test question or oral examination case and determine how it believes the candidate who meets the ABEM standards will perform.

The examination will continue to be “criterion referenced.” If you know the subject matter, you will pass. Curves, quotas, or percentage passing will not be used to set the passing score.

Setting the Final Passing Score—Board Action The ABEM Board of Directors will review the results of the standard-setting study to determine the final passing score.

The Board will consider the type of error they wish to minimize (such as passing unqualified candidates, or failing qualified candidates), the impact on the quality of the profession, and the results from the aforementioned group of physicians.

The final passing score will be determined by a formal vote of the Board of Directors, as informed by the standard-setting study.

The Bottom Line

The Qualifying Examination Passing Score Will Change in Fall 2014 Candidates taking the fall 2014 qualifying examination will be scored using an updated passing score. Because the results of the examination are used to inform the new passing score, the new score cannot be determined until after the examination has been given.

The Oral Examination Passing Score Will Change in Spring 2015 (and Thereafter) Three of the seven cases given at the spring 2015 examination will be eOral cases (a video demonstration of the new format is available on the ABEM website). This revised examination format, together with the evolving ABEM standards, established the need to recalibrate the passing score for the examination. Because the eOral cases will be increasingly integrated into the oral examination, the passing score will need to be determined after each oral examination for the next several years.

2014 PQRS MOC ADDED INCENTIVE An updated webinar about the 2014 PQRS MOC Added Incentive Program is now available on the ABEM website. You can register for the incentive on ABEM MOC Online; the deadline is 3:00 pm, February 13, 2015. There is a $25 fee for ABEM to prepare and submit your ABEM MOC activity completion information to the Centers for Medicare and Medicaid Services (CMS). CMS will determine if you are eligible to receive the additional reimbursement and, if so, will send the payment to the same place your Medicare payments are received. Additional information, including FAQs, handout, and the 2014 webinar explaining the program and registration process, are also available on the ABEM website. You can also email questions to pqrs@abem.org, or call 517.332.4800, extension 383.

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ACADEM IC ANNOUNCEM ENTS The Department of Emergency Medicine at Hennepin County Medical Center is proud to announce the 2013 promotion of the following faculty to the rank of professor of emergency medicine at the University of Minnesota Medical School:

Dr. Doug Brunette; Dr. Bill Heegaard; Dr. John Hick; Dr. Jeff Ho; & Dr. Steve Smith.

These distinguished academicians bring the total number of professors in the department to nine of a total academic staff of 20.

Christopher Fee, MD, associate professor of clinical

emergency medicine at the University of California, San Francisco, has been appointed director of the UCSF-SFGH Emergency Medicine Residency Program.

Thomas D. Kirsch, MD, MPH, associate professor in

the Johns Hopkins University Department of Emergency Medicine and director of the Center for Refugee and Disaster Response in the university’s Bloomberg School of Public Health, has received the American Red Cross’s Clara Barton Honor Award for Meritorious Volunteer Leadership, presented to a volunteer for service in a number of leadership positions held over a period of years.

Alex F. Manini, MD, MS, FACMT, associate professor

of emergency medicine at the Icahn School of Medicine at Mount Sinai in New York City, has received a five-year, $3.4 million Research Project Grant (R01) from the NIH. The award involves collaboration among investigators at Dr. Manini’s institution, as well as with co-investigators at NYU School of Medicine and the Toxicology Investigators’ Consortium (ToxIC) run by the American College of Medical Toxicology (ACMT). Clinical studies launched by the R01 will test a broad array of risk prediction instruments, laboratory biomarkers, and genetic markers, with the goal of producing clinical tools for prevention of emergency medical consequences from drug overdose, which is currently the leading cause of injury-related fatality in the United States.

Mark Mycyk, MD, FACMT, has been appointed editor-

in-chief of the Journal of Medical Toxicology. He has served as associate editor of JMT for the past three years; prior to that, he was a peer reviewer and editorial board member. He will continue to serve as associate editor and editorial board member for Academic Emergency Medicine.

CLASSIFIEDS THE VANDERBILT UNIVERSITY DEPARTMENT OF EMERGENCY MEDICINE has an opening for a faculty member at the assistant or associate level. We have 1st- and 4th-year medical student rotations, a Level 1 trauma center, pediatric and adult EDs, a superb residency program and all other components of a well-established program including fellowships in research, US, sports medicine, PEM and EMS. Looking for a highly motivated clinician-educator. Please reply to Corey M. Slovis, MD, chairman, Department of Emergency Medicine, Vanderbilt University Medical Center, 703 Oxford House, Nashville, TN 37232. Email: corey.slovis@vanderbilt.edu. Vanderbilt is an equal opportunity employer.

UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL, DEPARTMENT OF EMERGENCY MEDICINE is currently recruiting for faculty openings for 2015-2016.

Specific areas of interest include Toxicology, Ultrasound, EMS and Medical Direction.

Rank/salary commensurate with experience. Successful fixed-term candidates will be Board Certified/Board Prepared in Emergency Medicine. UNC Hospitals is a 750bed Level I Trauma Center. Interested candidates are encouraged to apply online at: http://unc.peopleadmin.com/postings/50819. Questions, please contact Gail Holzmacher, gholzmac@med.unc.edu. The University of North Carolina at Chapel Hill is an equal opportunity employer that welcomes all to apply, including protected veterans and individuals with disabilities.

F O U N D A T I O N The SAEM Foundation relies on donations from individuals like you to provide grants that make possible the ongoing development of academic emergency medicine. In times like these when government funding is limited, we can ensure our researchers and educators continue to receive the support they need.

DONATE TODAY AT HTTP://WWW.SAEM.ORG/SAEM-FOUNDATION

Henry E. Wang, MD, MS, professor and vice chair for

research in the Department of Emergency Medicine at the University of Alabama School of Medicine, received grant award UH2HL125163 from the National Heart, Lung and Blood Institute for the study “Pragmatic Trial of Airway Management in Out-of-Hospital Cardiac Arrest.” In collaboration with the Resuscitation Outcomes Consortium and the University of Washington Clinical Trials Center, the five-year effort will compare the effect of paramedic intubation and supraglottic airway insertion upon outcomes after out-of-hospital cardiac arrest.

News from the Indiana University School of Medicine Department of Emergency Medicine: Charles Miramonti, MD, was appointed the medical director and Tyler Stepsis, MD, the assistant medical director of the Michael & Susan Smith Emergency Department at Eskenazi Health. This site is one of the main teaching and clinical sites for the IU Department of Emergency Medicine.

Julie Welch, MD, assistant professor of EM, was awarded the 2014 EMRA Mentorship Award. In addition, she was recognized as a 2014 AMA Inspiration Physician Award Honoree. Jeff Kline, MD, received the 2014 Bantz-Petronio Translating Research into Practice Faculty Award from Indiana Unversity-Purdue University at Indianapolis.

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CALLS AND M EETING ANNOUNCEM ENTS INTERACTIVE CME TRAINING: ABDOMINAL PAIN IN THE OLDER ADULT CALLING ALL MEDICAL STUDENTS! Jump-Start a Career in Academic Emergency Medicine

How often do you encounter older patients in the emergency department with abdominal pain? Do you find it difficult to communicate with them? Is treatment challenging?

Learn how to interact, diagnose, and treat older adults more effectively through this interactive online training tool titled “Abdominal Pain in the Older Adult” (http://www.saem.org/ education/continuing-education/saem-online-cme) FREE for non-CME participants; or $95 for 6 AMA PRA Category 1 Credits™.

This program is brought to you by AGEM (an academy of SAEM) and is funded through the generous support of the Retirement Research Foundation.

Accreditation Statement This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of California, Irvine School of Medicine and the Society for Academic Emergency Medicine. The University of California, Irvine School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement The University of California, Irvine School of Medicine designates this enduring material for a maximum of 6 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

California Assembly Bill 1195 This activity is in compliance with California Assembly Bill 1195, which requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. For specific information regarding Bill 1195 and definitions of cultural and linguistic competency, please visit the CME website at http://www.cme.uci.edu.

Disclosure Policy It is the policy of the University of California, Irvine School of Medicine and the University of California CME Consortium to ensure balance, independence, objectivity, and scientific rigor in all CME activities. Full disclosure of conflicts and conflict resolutions will be made prior to the activity.

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SAEM is looking for 25 energetic, self-starting, responsible and enthusiastic medical students to work with the SAEM Program Committee at the Annual Meeting in San Diego, May 12-15, 2015. The Program Committee, comprised of nearly 40 faculty members selected by the president of SAEM from emergency medicine programs all over the country, is responsible for the planning, coordination, and execution of the Annual Meeting.

Benefits for medical student volunteers: • Waiver of your registration fee to the SAEM Annual Meeting and to the Medical Student Symposium* • Be paired with a member of the Program Committee to serve in an advisory capacity for future EM pursuits • Learn about current research and educational activities taking place in the field of emergency medicine • Have the opportunity to form relationships with faculty members from EM programs around the country • A personal letter from the Committee chair will be sent to your dean of student affairs, acknowledging your contributions to the Program Committee Requirements and expectations of medical student volunteers: • Arrive in time to attend orientation and property tour on Monday, May 11 at 3:00 pm and stay through 6:00 pm on Friday, May 15.

• Attend daily Program Committee meetings • See to assigned tasks and responsibilities, which include, but are not limited to: o Approximately six hours of responsibilities per day o Attend research and didactic sessions o Solicit evaluations from meeting participants and enter results into an online database o Assist with AV needs o Facilitate transitions between lectures o Be responsive and flexible to the needs of the Program Committee Interested medical students should submit their name and contact information to Elizabeth Oshinson at eoshinson@saem.org. Please write “Medical Student Ambassadors” in the subject line and attach a CV and a statement of interest indicating your motivations for volunteering with the Program Committee (<150 words).** Deadline is February 1, 2015. Recipients will be notified by February 20, 2015. * Travel and hotel will be the responsibility of the individual student; however. SAEM will provide the emails of other selected students to facilitate consolidating lodging expenses. ** PDF format preferred. Please combine your CV and statement of interest into a single document.

CALLS AND M EETING ANNOUNCEM ENTS - CONT. Call for Papers 2015 Academic Emergency Medicine Consensus Conference Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization The 2015 Academic Emergency Medicine (AEM) consensus conference, Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization, will be held on May 12, 2015, immediately preceding the SAEM Annual Meeting in San Diego, CA. Original papers on this topic, if accepted, will be published together with the conference proceedings in the December 2015 issue of AEM. Diagnostic imaging is integral and beneficial to the practice of emergency medicine. Over the last several decades, emergency department (ED) diagnostic imaging has increased without a commensurate rise in identified pathology or improvement in patient-centered outcomes. Unnecessary imaging results in increased resource use and significant exposure risks. ED diagnostic imaging has become the focus of many stakeholders, including patients and various regulatory agencies.

This multidisciplinary consensus conference represents the first coordinated effort to further our evidence-based knowledge of ED diagnostic imaging. This consensus conference will formulate the research priorities for emergency diagnostic imaging, initiate a collaborative dialogue between stakeholders, and align this research agenda with that of federal funding agencies.

Consensus Goal: The overall mission of the 2015 AEM consensus conference will be to create a prioritized research agenda in emergency diagnostic imaging for the next decade and beyond. The consensus conference will feature expert keynote speakers, panel discussions including nationally recognized experts, and facilitated breakout group sessions to develop consensus on research agendas by topic. Optimizing diagnostic imaging in the ED is a timely topic that is relevant to all who practice emergency medicine. Furthermore, the conference content spans many other specialties (e.g. radiology, pediatrics, cardiology, surgery, internal medicine), all of which will be invited to participate in the conference to optimize the agenda and for future collaboration in order to improve emergency diagnostic imaging use.

Consensus Objectives: 1. Understand the current state of evidence regarding diagnostic imaging utilization in the ED and identify opportunities, limitations, and gaps in knowledge of previous study designs and methodology 2. Develop a consensus statement that emphasizes the priorities and opportunities for research in emergency diagnostic imaging that will result in practice changes, and the most effective methodologic approaches to emergency diagnostic imaging research 3. Explore and improve knowledge of specific funding mechanisms available to perform research in emergency diagnostic imaging

Accepted manuscripts will present original, high-quality research in emergency diagnostic imaging in areas such as clinical decision rules, shared decision making, knowledge translation, comparative effectiveness research, and multidisciplinary collaboration. They may include work in clinical/translational, health systems, policy, or basic sciences research. Papers will be considered for publication in the December 2015 issue of AEM if received by April 17, 2015. All submissions will undergo peer review and publication cannot be guaranteed.

Contact Jennifer R. Marin, MD, MSc (jennifer.marin@chp.edu) or Angela M. Mills, MD (millsa@uphs.upenn.edu), the 2015 consensus conference co-chairs, for queries. Information and updates will be regularly posted in AEM, the SAEM Newsletter, and the journal and SAEM websites.

SAEM Academy Elections Get Involved!

SAEM’s academies are now accepting nominations for service on their executive committees. This is your chance to take a more active part in the academies’ work and direction. Nominations should be submitted to the specific academy’s SAEM staff liaison by Friday, December 8, 2014. Voting is scheduled to open on Monday, February 2, 2015.

Please contact the following staff liaisons for more information: Academy of Administrators in Academic Emergency Medicine SAEM staff liaison Maryanne Greketis, mgreketis@saem.org Academy for Diversity and Inclusion in Emergency Medicine SAEM staff liaison Sarah Buchanan, sbuchanan@saem.org Academy of Emergency Ultrasound SAEM staff liaison Sarah Buchanan, sbuchanan@saem.org Academy of Geriatric Emergency Medicine SAEM staff liaison Melissa McMillian, mmcmillian@saem.org Academy for Women in Academic Emergency Medicine SAEM staff liaison Holly Byrd-Duncan, hbyrdduncan@saem.org

Clerkship Directors in Emergency Medicine

Clerkship Directors in Emergency Medicine SAEM staff liaison Melissa McMillian, mmcmillian@saem.org Global Emergency Medicine Academy SAEM staff liaison Holly Byrd-Duncan, hbyrdduncan@saem.org Simulation Academy SAEM staff liaison Jim Pearson, jpearson@saem.org

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CALLS AND M EETING ANNOUNCEM ENTS - CONT. Call for Photographs for Clinical Images Exhibit 2015 SAEM Annual Meeting Deadline: February 7, 2015 SAEM is now accepting original high-quality clinical images relevant to the practice of emergency medicine for presentation at the 2015 SAEM Annual Meeting in San Diego, CA. Accepted submissions will be displayed at the Clinical Images Exhibit and may be featured in the “Clinical Pearls” session or the “Visual Diagnosis” medical student/resident contest.

GUIDELINES: 1. No more than 3 different images should be submitted for any one case.

2. Submit digital copies only in JPEG or TIF format (resolution of at least 2000x1600 pixels required, higher-resolution images preferred).

3. EKGs, radiographic studies and other visual data are also considered, but photographs are preferred.

4. Photographs must not appear in a refereed journal prior to the Annual Meeting.

5. Photo submissions must be accompanied by a brief case history (250-word limit) written as an “unknown” in the following format: a. 2-page Word document, 14pt font b. Page 1: chief complaint, history of present illness, pertinent physical exam (other than what is depicted in the photo), pertinent laboratory data, one or two questions asking the viewer to identify the diagnosis or pertinent finding(s) c. Page 2: answer(s) and brief discussion of the case, including an explanation of the finding(s) in the photo and 1-3 bulleted take-home points or “pearls”

6. If a patient can be identified in the image, written consent from the patient must be obtained for the image to be displayed, or the patient must be appropriately masked to insure anonymity. An attestation statement to confirm that written consent has been obtained must be included with the photo submission.

Submissions will be selected based on their educational merit, relevance to emergency medicine, image quality, the case history, and appropriateness for public display. Contributors will be acknowledged in the Annual Meeting on-site program, the exhibit itself, and the July/August 2015 SAEM Newsletter. Academic Emergency Medicine (AEM), the official SAEM journal, may invite a limited number of displayed photos to be submitted to AEM for consideration for publication. If the photos are accepted for display, SAEM reserves the right to edit the submitted case history.

SAEM will retain the rights to use submitted photographs in future educational projects, with full credit given for the contribution.

If you have any questions, please contact Elizabeth Oshinson at eoshinson@saem.org or visit our website: www.SAEM.org.

Sign up for the AACEM Chair Development Program!

First session starts January 12, 2015

What is the CDP and why was it created?

Who can participate in the CDP?

The AACEM Chair Development Program (CDP) is a leadership training initiative, now in its 2nd year, designed to enhance the capabilities and effectiveness of new and aspiring academic emergency medicine department chairs through skill development, advising, and mentorship.

By creating more informed and capable chairs, we hope to improve patient care, education, and research in emergency medicine.

Those eligible for the program include current EM chairs who are within 4 years of their start date at the beginning of the program, and vice chairs or associate chairs who wish to advance to become chairs. Other developing EM leaders may also apply.

Selection: Each class of participants will have 12-15 members. Interested candidates must submit an application form (see below). Preference is given to existing chairs.

What type of leadership training does the CDP offer?

The CDP consists of six leadership training sessions averaging 4-8 hours, for a total of 40-50 inperson training hours. Sessions will provide new and aspiring chairs with practical, emergencymedicine-specific leadership training and will be held near the SAEM headquarters in Des Plaines, IL (close to Chicago’s O’Hare Airport), and in conjunction with the AACEM/AAAEM Retreat, the SAEM Annual Meeting, the ACEP Scientific Assembly, and the AAMC Annual Meeting. CDP faculty instructors include experienced EM chairs, deans and administrators, as well as other leadership development experts. We will focus on areas that may not be covered in other leadership courses. Personal advising and mentorship will be provided. Participants are required to attend at least five of the six offered sessions, and to complete readings and assignments for those sessions they cannot attend. All participants must attend the first and last sessions of the CDP. Participants will receive a certificate from AACEM upon completion of the program.

How much does it cost?

Tuition is $3,950 for the course, with travel and lodging expenses paid by the participant.

When does it start?

The first session of the AACEM CDP will begin on January 12, 2015 at SAEM Headquarters in Des Plaines, IL.

Applications are due November 5, 2014.

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

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CALLS AND M EETING ANNOUNCEM ENTS - CONT. Help SAEM Recognize The Best of The Best!

Nominate your peers for the 2015 SAEM Awards SAEM presents awards in recognition of excellence in our field, for contributions improving the health of society, and for academic achievements. The Awards Committee would like to consider as many exceptional candidates as possible, so please nominate your peers for the following awards.

The deadline for all nominations is Monday, January 5, 2015 Young Investigator Awards This award recognizes up to three SAEM members who have demonstrated commitment to and achievement in research during the early stage of their academic careers. The Society’s core mission includes the creation of knowledge, and this award recognizes those who have achieved early success in this sphere.

Hal Jayne Educational Excellence Award Complimentary to the Research Award, this award is presented to a member of SAEM who has made outstanding contributions to emergency medicine through the teaching of others and by improving our knowledge base regarding the teaching of learners.

Excellence in Research Award Complimentary to the Hal Jayne Education Award, this award is presented to a member of SAEM who has made outstanding contributions to emergency medicine through the creation and sharing of new knowledge.

Advancement of Women in Academic Emergency Medicine Award This award recognizes an SAEM member who has made significant contributions to the advancement of women in academic emergency medicine.

John Marx Leadership Award This award honors a SAEM member who has made exceptional contributions to emergency medicine through leadership – locally, regionally, nationally or internationally – with priority given to those with demonstrated leadership within SAEM. For submission information, please visit the SAEM Awards webpage at http://www.saem.org/meetings/saem-awards

Call for Leaders Make a difference!

Help guide SAEM into the future!

Nominations are sought for the SAEM Board of Directors election that will be held in the spring of 2015. The Nominating Committee will select a slate of nominees based on the following criteria: previous

service to SAEM, leadership potential, interpersonal skills, and the ability to advance the broad interests of the membership and academic emergency medicine.

The Nominating Committee wishes to consider as many candidates as possible and whenever possible will select more than one nominee for each position. Nominations may be submitted by the candidate or any SAEM member. The deadline for nominations is Friday, December 5, 2014.

Please visit http://saem.org/about-saem/leadership/positionsnominations-criteria for more information. Get involved!

Get Involved!

Share your talents and experience and help determine the direction of SAEM and of emergency medicine.

Apply now for appointment to SAEM’s committees – your chance to participate and make your mark in defining the future of your Society for Academic Emergency Medicine. Visit the SAEM website at http://saem.org/saem-community/get-involved/join-committeetask-force for more information on the Society’s committees and to submit the interest form.

EMERGENCY MEDICINE FACULTY ◊ Clinician-Educator ◊ Clinician-Researcher ◊ Pediatric Emergency Medicine ◊ Ultrasound ◊

The Department of Emergency Medicine at East Carolina University Brody School of Medicine seeks BC/BP emergency physicians and pediatric emergency physicians for tenure or clinical track positions at the rank of assistant professor or above, depending on qualifications. We are expanding our faculty to increase our cadre of clinician-educators and further develop programs in pediatric EM, ultrasound, and clinical research. Our current faculty members possess diverse interests and expertise leading to extensive state and national-level involvement. The emergency medicine residency is well-established and includes 12 EM and 2 EM/IM residents per year. We treat more than 120,000 patients per year in a state-of-the-art ED at Vidant Medical Center. VMC is a 960+ bed level 1 trauma center and regional 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. Our new children’s ED opened in July 2012, and a new children’s hospital opened in June 2013. Greenville, NC is a fast-growing university community located near beautiful North Carolina beaches. Cultural and recreational opportunities are abundant. Compensation is competitive and commensurate with qualifications; excellent fringe benefits are provided. Successful applicants will be board certified or prepared in Emergency Medicine or Pediatric Emergency Medicine. They will possess outstanding clinical and teaching skills and qualify for appropriate privileges from ECU Physicians and VMC.

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

www.ecu.edu/ecuem/ • 252-744-1418

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Yale University School of Medicine Department of Emergency Medicine Fellowship Programs For specific information including deadlines and requirements, visit: http://medicine.yale.edu/emergencymed/ The Research fellowship is a new 2-3 year program focused on training clinician scholars as independent researchers in Emergency Medicine. Scholars will earn a Master of Health Sciences degree from Yale combining clinical experience with extensive training in research methods, statistics and research design. With the guidance of research content experts and professional coach mentors, the scholar will develop a research program, complete a publishable project and submit a grant application prior to completion of the program. The program is credentialed by the Society for Academic Emergency Medicine. For further information, contact Steven L. Bernstein, MD, steven.bernstein@yale.edu.

The fellowship in Emergency Ultrasound is a 1 or 2 year program that will prepare graduates to lead an academic/ community emergency ultrasound program. The 2-year option includes a Master of Health Sciences with a focus on emergency ultrasound research. This fellowship satisfies recommendations of all major societies for the interpretation of emergency ultrasound as well as RDMS/RDCS/RVT certification, and will include exposure to aspects of program development, quality assurance, properties of coding and billing, and research. The program consists of structured time in the ED performing bedside examinations, examination QA and review, research into new applications, and education in the academic/ community arenas. We have a particular focus on emergency echo and utilize state of the art equipment, as well as wireless image review. For further information, contact Chris Moore, MD, RDMS, RDCS, chris.moore@yale.edu.

The fellowship in EMS is a 1-2 year program that provides training in all aspects of EMS, including academics, administration, medical oversight, research, teaching, and clinical components. The ACGME-accredited program focuses on operational EMS, with the fellow actively participating in the system’s physician response team, and all fellows offered training to the Firefighter I or II level. A 1-year MPH program is available for fellows choosing the 2-year program.

The fellowship graduate will be prepared for a career in academic EMS and/or medical direction of a local or regional EMS system, and for the new ABEM subspecialty examination. For further information, contact David Cone, MD, david.cone@yale.edu.

The Administration fellowship is a new 2-year program that will prepare graduates to assume administrative leadership positions in private or academic practice. By having an active clinical practice in our department, the fellow will acquire experience in all facets of emergency department clinical operations. Fellows will complete the Executive MBA program at the Yale School of Management and a clinical Emergency Medicine Administrative Fellowship. In addition, the candidate will play a leadership role on one or more projects from the offices of the Chair and Vice Chair for Clinical Operations. For further information, contact Steven L. Bernstein, MD, steven.bernstein@yale.edu.

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

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

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

The Wilderness Medicine fellowship is a new 1-year program that provides the core content of medical knowledge and skills in being able to plan for and to provide care in an environment that is limited by resources and geographically separated from definitive medical care in all types of weather and evacuation situations. The fellow can attain certification with the Diploma in Mountain Medicine as well as becoming a leader and an advanced instructor in the growing specialty of wilderness medicine. For further information, contact David Della-Giustina, MD, FAWM at david.della-giustina@ yale.edu.

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

All require the applicant to be BP/BC emergency physicians and offer an appointment as a Clinical Instructor to the faculty of the Department of Emergency Medicine at Yale University School of Medicine. Applications are available at the Yale Emergency Medicine web page http://medicine.yale.edu/emergencymed/ and are due by November 15, 2014.

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

University of Pittsburgh

Fellowship opportunities EMERGENCY MEDICINE PHYSICIAN The Department of Emergency Medicine at Mayo Clinic in Florida is seeking an Emergency Medicine Physician to join our practice. The successful candidate must be an individual with a demonstrated interest in academic emergency medicine as proven by performance in residency or fellowship training or faculty positions. EM residency trained ABEM-certification/preparedness and eligibility for Florida medical license is required.

This position provides the opportunity to join a dynamic faculty with commitment to practice, education and research in a nearly 30,000 visit/year high acuity department.

Jacksonville is a beautiful coastal Florida city featuring an excellent year-round climate, miles of beaches, outstanding outdoor recreational, cultural and family-oriented amenities.

Mayo Clinic has been recognized as the best hospital in the nation for 2014-2015 by U.S. News and World Report. Our multi-disciplinary group practice focuses on providing high quality, compassionate medical care. We are the largest integrated, not-for-profit medical group practice in the world with approximately 3,800 physicians and scientists across all locations working in a unique environment that brings together the best in patient care, groundbreaking research and innovative medical education. We offer a highly competitive compensation package, which includes exceptional benefits, and has been recognized

by FORTUNE magazine as one of the top 100 “Best Companies to Work For.” Interested candidates can apply or learn more about this opportunity online at www.mayoclinic.org/physician-jobs and search 38887BR. Specific questions should be addressed to: Scott Silvers, M.D. Chair, Department of Emergency Medicine Email: silvers.scott@mayo.edu

Scan this code with your smart phone to begin your job search.

My Career: eMergenCy MediCine The University of Pittsburgh and UPMC offer fellowships in Toxicology, Emergency Medical Services, Research, and Education.

We offer intensive training with the nationally-known experts in each domain from among the faculty in the Department of Emergency Medicine and from the University. We encourage strong multidisciplinary collaboration. We provide experience in basic or clinical research and teaching opportunities exist with medical students, residents and other health care providers.

Fellows enroll in one of several available Master’s level degree programs. Fellows also have limited clinical responsibilities in one of our core academic Emergency Departments or an affiliated institution. Each applicant should have an MD/DO or another equivalent degree and be board-certified/eligible in emergency medicine. Other doctoral prepared candidates are candidates for our research fellowship.

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 E-mail: callawaycw@upmc.edu

Heal the sick, advance the science, share the knowledge.

EOE. Minority/Female/Vet/Disabled 72214C HRCS 08/14

©2014 Mayo Foundation for Medical Education and Research. Post offer/pre-employment drug screening is required.

Mayo Clinic is an equal opportunity educator and employer (including veterans and persons with disabilities).

Term Tenure Track Faculty Position Assistant or Associate Professor Oncologic Emergency Medicine Fellowship The University of Texas MD Anderson Cancer Center has established the first academic Department of Emergency Medicine in a comprehensive cancer center and is presently recruiting faculty. MD Anderson is ranked as one of the nation’s top two cancer centers as rated by U.S. News & World Report’s “Best Hospitals” survey. The MD Anderson family includes more than 19,000 members, including 1,600 faculty, each playing a critical role in our mission to eliminate cancer.

Term Tenure Track Faculty Position

Knox H. Todd, M.D., MPH Professor and Chair, Department of Emergency Medicine, Unit 1468 The University of Texas MD Anderson Cancer Center PO Box 301402, Houston, TX 77030-1402 E-mail: khtodd@mdanderson.org

Term tenure track positions are supported by institutional funding to provide as much as 75% dedicated research effort for the initial appointment with future intramural support dependent on adequate progress toward an independent research career. Successful candidates will have advanced training and skills in laboratory, translational, clinical or population-based research. MD Anderson provides extensive opportunities for collaboration and departmental research priorities include pain, palliative care, health services research and epidemiology.

Assistant or Associate Professor

We are also seeking Emergency Medicine board-prepared or board-certified physicians to join our growing faculty. Responsibilities include providing patient care to patients with oncologic emergencies in our 45-bed Emergency Center; educating medical students, residents and fellows; and engaging in academic pursuits to support the development of oncologic emergency medicine as a distinct sub-discipline.

Oncologic Emergency Medicine Fellowship The Oncologic Emergency Medicine fellowship provides 12 months of advanced training in the emergency treatment of cancer patients. Trainees may focus on pain management, palliative care or operations research. Our program is designed to facilitate expertise in the diagnosis and treatment of a wide variety of conditions that are specific to cancer patients presenting to the emergency department, as well as to advance scholarship in the growing sub-discipline of oncologic emergency medicine.

Application process: Eligible candidates should have completed an ACGME-accredited residency program in Emergency Medicine, although candidates with other training backgrounds will be considered on a case-by-case basis. Personal statements, curriculum vitae and three letters of recommendation are required. Competitive candidates will be asked for medical school transcripts and invited for personal interviews.

Refer to the Department of Emergency Medicine Web page for additional information about the department and its programs. Qualified candidates for any of the listed opportunities are invited to send a cover letter, current curriculum vitae and list of three reference to: Knox H. Todd, M.D., MPH Professor and Chair, Department of Emergency Medicine, Unit 1468 The University of Texas MD Anderson Cancer Center PO Box 301402, Houston, TX 77030-1402 E-mail: khtodd@mdanderson.org MD Anderson is an equal opportunity employer and does not discriminate on the basis of race, color, national origin, gender, sexual orientation, age, religion, disability or veteran status except where such distinction is required by law. All positions at The University of Texas MD Anderson Cancer Center are security sensitive and subject to examination of criminal history record information. Smoke-free and drug-free environment.

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Director of Simulation Education The Department of Emergency Medicine at the University Of Alabama School of Medicine is seeking a Medical Toxicologist to join our faculty. The selected candidate will be BC/BE in Emergency Medicine, will have successfully completed an ACGME accredited fellowship in Medical Toxicology, and will be BC/BE for subspecialty certification in Medical Toxicology from the American Board of Emergency Medicine. This position will include service as an Associate Medical Director for the Regional Poison Control Center (RPCC), which handles over 60,000 calls each year from the entire state of Alabama. The Associate Medical Director functions as an integral member of the RPCC team.

In this capacity, the Associate Medical Director will provide telephone medical consultation to health care providers, and will help to facilitate transfers to UAB Medical Center as clinically necessary. This individual will also participate in the planning and provision of educational programs for a wide variety of medical professionals, not only at the UAB campus and the RPCC, but also throughout the region.

Academic rank will be commensurate with experience. The University offers both tenure and non -tenure earning positions. The University of Alabama Hospital is a 1046 bed teaching hospital, with a “state of the art” 44,000 sq. ft. emergency department. The Department of Emergency Medicine provides care to over 90,000 patients annually at its two clinical sites. UAB provides Alabama’s only ACS designated Level I trauma center. The Department of Emergency Medicine hosts the State of Alabama’s sole emergency medicine residency training program, which is now among the most competitive in the Southeast. The Regional Poison Control Center serves the entire state of Alabama (which has a population of over 4.5 million), and participates in numerous public health initiatives.

The University of Alabama at Birmingham (UAB) is a major research center with over $440 million in NIH and other extramural funding. The Department of Emergency Medicine hosts a nationallyrecognized research program and is a site for the NIH- funded Resuscitation Outcomes Consortium (ROC). The Department has been highly successful in developing extramural research support in this warmly collaborative institution.

Birmingham Alabama is a vibrant, diverse, beautiful city located in the foothills of the Appalachian Mountains. The metropolitan area is home to over one million people, who enjoy recreational activities year round because of its mild southern Climate. Birmingham combines big city amenities with Southern charm and hospitality.

Compensation is highly competitive. UAB is an Equal Opportunity/Affirmative Action Employer committed to fostering a diverse, equitable and family-friendly environment in which all faculty and staff can excel and achieve work/life balance irrespective of, race, national origin, age, genetic or family medical history, gender, faith, gender identity and expression as well as sexual orientation. UAB also encourages applications from individuals with disabilities and veterans.

A pre-employment background investigation is performed on candidates selected for employment. In addition, physicians and other clinical faculty candidates, who will be employed by the University of Alabama Health Services Foundation (UAHSF) or other UAB Medicine entities, must successfully complete a pre-employment drug and nicotine screen to be hired.

Please send your curriculum vitae to: Janyce Sanford, M.D., Chair of Emergency Medicine, University of Alabama at Birmingham; Department of Emergency Medicine; 619 South 19th Street; OHB 251; Birmingham, AL 35249-7013

Division of Emergency Medicine The Division of Emergency Medicine at Washington University School of Medicine serves two busy, high-acuity, urban tertiary emergency departments — Barnes-Jewish Hospital and St. Louis Children’s Hospital — as well as a smaller community emergency department.

We offer: • Competitive salary and excellent benefits package • Protected time for simulation education and research • Opportunity to work in up to four simulation labs throughout Washington University Medical Center • Opportunity for in situ simulation using the division’s own mannequin

The Division At A Glance: • Level I Trauma Center • Approximately 160,000 adult and pediatric visits annually • More than 100 pediatric and adult faculty physicians • 48 residents • 7 fellowships • Nationally ranked medical school and academic medical center with a history of innovation and discovery

Learn more at

emed.wustl.edu Brent E. Ruoff, MD Chief and Associate Professor Division of Emergency Medicine Washington University 660 S. Euclid Ave., CB 8072 St. Louis MO 63110

• Ability to credential in both pediatric and adult care

Emergency Medicine Faculty Regions Hospital – St. Paul, Minnesota As a major metropolitan Level 1 adult and pediatric trauma center, Regions Hospital serves emergent patient care needs throughout Minneapolis/St. Paul, Minnesota. With our own well-established three-year Emergency Medicine residency program and state-of-the-art ED with an annual volume of 79,000, our Emergency Medicine Department combines the best in academics and quality emergency care in the Upper Midwest. We are currently recruiting faculty to join our dynamic group in 2015.

Qualified candidates must be EM residency-trained and ABEM certified/eligible with fellowship training in one of the following areas: Research, Ultrasound, Pediatric EM (adult trained), or dual trained in Emergency Medicine/Critical Care Medicine. Protected time is available and we will support a faculty appointment to the Department of Emergency Medicine at the University of Minnesota at the appropriate level.

As part of the multispecialty HealthPartners Medical Group family, our EM physicians receive a highly competitive salary and benefits package, paid malpractice coverage and an exciting, rewarding practice. Please forward your CV and cover letter to Dr. Kurt Isenberger, Department Head, c/o Sandy Lachman at sandy.j.lachman@healthpartners.com or complete our online MD application at healthpartners.com/careers. EOE

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University of Pittsburgh BRIGHAM AND WOMEN’S HOSPITAL/ BRIGHAM AND WOMEN’S FAULKNER HOSPITAL EMERGENCY MEDICINE ATTENDING PHYSICIANS

The Department of Emergency Medicine at Brigham and Women’s Hospital (BWH) is currently seeking emergency medicine attending physicians for our emergency department at the Brigham and Women’s Faulkner Hospital (BWFH), a 150-bed, non-profit community teaching hospital located in the desirable Jamaica Plain community in southwest Boston. This position is eligible for an academic appointment at Harvard Medical School at an academic rank of Instructor or Assistant Professor, commensurate with experience, achievement, recognition, and planned participation in teaching and scholarly activities. The position also offers unparalleled opportunities for professional development, a competitive salary, and an outstanding comprehensive benefit package.

The successful candidate must have successfully completed a four year residency training program in Emergency Medicine or a three year program followed by a fellowship, and also be board prepared or certified in Emergency Medicine. Interest and demonstrated ability in the practice of community based Emergency Medicine is essential.

Interested candidates should send a letter and Curriculum Vitae to Ron M. Walls, MD, Professor and Chair, Department of Emergency Medicine, Brigham and Women’s Hospital. Please apply by confidential email to mdeloge@partners.org.

Faculty MeMbers

(Instructor through Professor Level)

My career: eMergency Medicine The University of Pittsburgh and UPMC have full-time opportunities for emergency medicine residency-trained and board-certified/eligible candidates. UPMC is a national leader in health care and has diverse EM faculty recognized for excellence in research, teaching and clinical care. Our four clinical sites provide tertiary and Level I trauma care to approximately 200,000 ED patients collectively each year while training residents, fellows and students.

The post-cardiac arrest, toxicology and hyperbaric medicine treatment programs are a part of our department, and we have multiple fellowships. Academic clinician, clinicianinvestigator or clinician-educator career opportunities exist.

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

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

EOE. Minority/Female/Vet/Disabled 72215C TACS 08/14

Department of Emergency Medicine Yale University School of Medicine Advancing the Science and Practice of Emergency Medicine The Department of Emergency Medicine at the Yale University School of Medicine has expanded to a total of 3 clinical sites that comprise Yale-New Haven Hospital with a combined ED volume of 180,000 visits per year. We are seeking faculty at all levels with interests in clinical care, education or research to enhance our existing strengths. The successful candidate may be a full time clinician committed to excellence in patient care and emergency medicine education or one that would want to join the academic faculty promoting scholarship to enhance the field of emergency medicine. We offer an extensive faculty development program for junior and more senior faculty. We have a well-established track record of interdisciplinary collaboration with other renowned faculty, obtaining federal and private foundation funding, and a mature research infrastructure supported by a faculty Research Director, a staff of research associates and administrative assistants.

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

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

To apply, please forward your CV and cover letter to Gail D’Onofrio, MD, MS 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.

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The Department of Emergency Medicine at the University of Alabama School of Medicine is seeking talented residency trained Emergency Medicine physicians at all academic ranks to join our faculty. The University offers both tenure and non tenure earning positions.

CHAIR The University of Alabama Hospital is a 903-bed teaching hospital, with UNIVERSITY OF TENNESSEE a state of the art emergency department that occupies an area the size of a CHAIR football field. The Department treats over 75,000 patients annually and houses COLLEGE OF MEDICINE CHATTANOOGA The University of Tennessee College of Medicine Chattanooga is seeking applicants for UNIVERSITY OF TENNESSEE Alabama’s only designated Level I trauma center. The Department’s dynamic, the position of Chair of the Department of Emergency Medicine with faculty rank COLLEGE OF MEDICINE CHATTANOOGA DEPARTMENT OF EMERGENCY MEDICINE challenging emergency medicine residency training program is the only one of commensurate with experience. Qualified individuals must hold the M.D. degree or its DEPARTMENT OF EMERGENCY MEDICINE its kind in the State of Alabama. equivalent and board certification by the American Board of Emergency Medicine must have documented and proven experience as a faculty member with experience in Thefor University of Alabama at Birmingham (UAB) is a major research center University Tennessee Chattanooga seeking applicants for niversity of The Tennessee College Medicine Chattanooga is seeking applicants academics andofcurrently holdCollege the of rankof ofMedicine Associate Professor orisabove; and must have with over $440 million in NIH and other extramural funding. The Department the position Chair ofactivity. the Department Emergency Medicine with faculty rank evidence of of scholarly Previousof administrative experience is required.

The of Emergency Medicine hosts a nationally-recognized research program and sition of Chair of the Department of Emergency Medicine Department of Emergency Medicine is approved for 24 residents. goal of with ouror itsfaculty rank commensurate with experience.

Qualified individuals must hold theThe M.D. degree is a site for the NIH-funded Resuscitation Outcomes Consortium (ROC). The residency is to board educate and train excellent practitioners soofthat they are prepared to equivalent and certification by the American Board Emergency Medicine must ensurate with experience.

Qualified individuals must hold the M.D. degree or its Department has been highly successful in developing extramural research enterdocumented community practice or subspecialty have and proven experiencetraining. as a faculty member with experience in support in this warmly collaborative institution. lent and board certification bythethe Board of Emergency Medicine must academics and currently hold rank American of Associate Professor or above; and must have The UT College of Medicine is Previous affiliated administrative with Erlanger Health System, one of theThe busiest Alabama is a vibrant, diverse, beautiful city located in the of scholarly activity. experience is required. ocumentedevidence andOneproven experience as a faculty member with experience in Birmingham Level Trauma Centers in the U.S. Approximately 170 residents are appointed foothills of the Appalachian Mountains. The metropolitan area is home to Department of Emergency Medicine is approved for 24 residents. The goal of our currently in ten disciplines.

Visit our website at www.utcomchatt.org. mics and currently hold the of Associate or above; and must have over one million people, who enjoy recreational activities year round because residency is to educate andrank train excellent practitioners soProfessor that they are prepared to its mild southern Climate. Birmingham combines big city amenities with enter community or subspecialty training.

The University of practice Tennessee is an Equal Opportunity/Affirmative Action/Title ce of scholarly activity.

Previous administrative experience is required. Theof Southern charm and hospitality.

VI/TitleIX/Section504/ADA/ADEA Employer. ment of Emergency Medicine is approved for 24 residents.

The goal of our The UT College of Medicine is affiliated with Erlanger Health System, one of the busiest A highly competitive salary is offered. Applicants must be EM board eligible Please submit CVtrain and references to: Chair, Emergency Medicine Level One Trauma Centers in the U.S. Approximately 170 residents appointed or certified. UAB is an Equal Opportunity/Affirmative Action Employer ncy is to educate and excellent practitioners so are that they are prepared to Search Advisory Committee. currently in ten disciplines. Visit our website at www.utcomchatt.org. committed to fostering a diverse, equitable and family-friendly environment in University of Tennessee ommunity practice or subspecialty training. which all faculty and staff can excel and achieve work/life balance irrespective College of Medicine, Action/Title Chattanooga The University of Tennessee is an Equal Opportunity/Affirmative of, race, national origin, age, genetic or family medical history, gender, VI/TitleIX/Section504/ADA/ADEA Employer. 960 East Third St. Suite 100 faith, gender identity and expression as well as sexual orientation. UAB also 37403 T College of Medicine is affiliated with Chattanooga, ErlangerTNHealth System, one of the busiest encourages applications from individuals with disabilities and veterans.

Please submit CV and references to: Chair, Emergency Medicine A pre-employment background investigation is performed on candidates One Trauma Centers in the U.S. Approximately 170 residents are appointed Search Advisory Committee. selected for employment. of Tennessee ly in ten disciplines. Visit our website University at www.utcomchatt.org.

In addition, physicians and other clinical faculty candidates, who will be College of Medicine, Chattanooga employed by the University of Alabama Health Services Foundation (UAHSF) 960 East Third St. Suite 100 or other UAB Medicine entities, must successfully complete a pre-employment Chattanooga, TN 37403 niversity of Tennessee is an Equal Opportunity/Affirmative Action/Title drug and nicotine screen to be hired.

CHAIR UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE CHATTANOOGA DEPARTMENT OF EMERGENCY MEDICINE

IX/Section504/ADA/ADEA Employer.

submit CV and references to: Chair, Emergency Medicine Search Advisory Committee.

University of Tennessee College of Medicine, Chattanooga 960 East Third St. Suite 100 Chattanooga, TN 37403 WASHINGTON, DC -The Department of Emergency Medicine of the George Washington University is seeking physicians for our academic practice.

WASHINGTON, DC -The Department of Emergency Medicine of the George Physicians are employed Medical Faculty Associates, a University-affiliated, Washington University is by seeking physicians for our academic practice. not-for-profit physicianFaculty group, Associates, and receive aregular faculty Physicians are multispecialty employed by Medical University-affiliated, appointmentsmultispecialty at the University.

The Department for the not-for-profit physician group, andprovides receive staffing regular faculty Emergency Units George Washington University Hospital, the Walter appointments at theofUniversity.

The Department provides staffing for theReed National Military Medical and theUniversity DC Veterans' Administration Medical Emergency Units of GeorgeCenter Washington Hospital, the Walter Reed Center. The Department a four-year ten FellowshipsMedical and a National Military Medicalsponsors Center and the DC Residency, Veterans' Administration variety The of student programs.

Center.

Department sponsors a four-year Residency, ten Fellowships and a

variety of student programs.

We are seeking physicians who will participate in our clinical and educational programs and contribute to the Department's research and consulting portfolio.

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

Rank salary are commensurate with experience.

Basicand Qualifications: Physicians should be residency-trained in Emergency Medicine.

Basic Qualifications: Physicians should be residency-trained in Emergency Medicine.

Application Procedure: Complete the online faculty application at

http://www.gwu.jobs/postings/22131 and upload a CV and cover letter. Review Application Procedure: Complete faculty at filled. Only of applications will be ongoing, andthe willonline continue untilapplication positions are http://www.gwu.jobs/postings/22131 and upload CV andShesser, cover letter.

Review complete applications will be considered.

Contacta Robert MD, Chair, of applications be ongoing, and will continue positions about are filled.

Department of will Emergency Medicine, directly withuntil any questions the Only complete applications will be considered. Contact Robert Shesser, MD, Chair, position at: rshesser@mfa.gwu.edu.

Department of Emergency Medicine, directly with any questions about the position at: rshesser@mfa.gwu.edu.

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

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

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SAE Nov Dea Qua

Department of Emergency Medicine – Faculty Opportunities Director of Clinical Operations at the Episcopal Site of Temple University Hospital The selected individual will have oversight of clinical emergency services within the Department of Emergency Medicine at the Episcopal Campus. The Director will have a direct report to the Chair and will work closely with the Program Director, the Departmental Administrator, the Director of ED informatics, faculty serving on related hospital committees and hospital administrative and nursing leadership.

The Episcopal site is currently fully staffed with 24/7 double coverage by EM boardcertified Temple faculty physicians and is a rotation site for the EM residents and TU medical students. There is additional clinical coverage with dedicated physician assistants. The Episcopal Campus has a full-service Emergency Department that treats more than 45,000 patients annually.

Physician –Emergency Medicine The BC/BE emergency medicine physician will be join the EM faculty, which covers three distinct clinical sites: Temple University Hospital, a level 1 Trauma Center, the Episcopal Campus, a busy inner city ED and Jeanes Hospital serving more of a private patient mix.

Clinical time distribution will be matched to the candidate’s interest and qualifications. All sites are part of the EM residency program and medical student experience. The position thus requires a strong interest in clinical teaching. Clinical hours vary depending on the expected role within the Department. Candidates with expertise in EMS or Toxicology are especially encouraged to apply as we have openings in these subspecialty areas.

Emergency Medicine enjoys strong support at Temple University with a nationally recognized EM residency and a faculty that provides leadership within the medical school, hospital and the greater EM community.

Interested candidates should submit a current curriculum vita to: Robert McNamara, MD, FAAEM, Professor and Chairperson, Department of Emergency Medicine, Chief Medical Officer, Temple University Physicians, C/O Julie Brissett, Sr. Physician Recruiter, Temple University School of Medicine, 3420 N. Broad Street, MRB 101, Philadelphia, PA, 19140, Email: julie.brissett@tuhs.temple.edu Ph: 215-707-5665.

Temple University School of Medicine is an Affirmative Action/Equal Opportunity Employer.

Associate Emergency Medicine Residency Program Director (Staff Physician) Charleston Area Medical Center is seeking an Associate Emergency Medicine Residency Program Director for an established emergency medicine residency program. The Associate Residency Program Director will be a part of an overall team of physicians engaged in emergency services at one of the nation’s busiest Level 1 Trauma Centers with 85,000 emergency room visits and 3,000 major traumas annually.

Job Requirements are: • MD or DO degree from an accredited program • Board Certification by the American Board of Emergency Medicine or the American Osteopathic Board of Emergency Medicine • Minimum of 5 years current experience as an active faculty member in an accredited emergency medicine residency program • Three years experience as an Associate Program Director or other graduate medical education administrative experience is preferred • Ability to combine administrative, educational and clinical teaching responsibilities • Willingness to participate in appropriate academic, clinical research or other scholarly activity as may be required of clinical faculty • Familiarity with GME program requirements and policy

Benefits include: • Excellent benefits package • Salary commensurate with qualifications and experience • Vibrant community • Superb family environment • Unsurpassed recreational activities • Outstanding school systems The search will remain open until a suitable candidate is identified.

For consideration, please send CV to carol.wamsley@camc.org.

ACADEMIC EMERGENCY MEDICINE PHYSICIANS The Department of Emergency Medicine, Mayo Clinic College of Medicine (Rochester, MN), is expanding and has openings for an Academic Emergency Physician and an Academic Pediatric Emergency Physician.

Among other things, these opportunities include: • clinical practice in a busy (75,000 total annual visits with 15,000 pediatric visits), high acuity academic ED and Level I Adult and Pediatric Trauma Center • an expanded and renovated state of the art ED and Pediatric ED (opening in 2015) • teaching in outstanding Emergency Medicine and Pediatric residency programs, the Mayo School of Graduate Medical Education, and Mayo Medical School • collaboration within an integrated network of 21 other Emergency Departments in the upper Midwest and with colleagues in Florida and Arizona • a world-class multidisciplinary simulation center • collaboration with systems engineers and analysts, programmers, and designers from the Center for the Science of Healthcare Delivery to study and optimize ED Operations • numerous opportunities for collaborative research, with administrative support and intramural funding available • accomplished colleagues with an unwavering commitment to high value patient care, education, and research To apply online, please attach your CV and cover letter at www.mayoclinic.org/physician-jobs and reference job posting #36268BR or #36267BR. For further information, please contact: Annie T. Sadosty, M.D., Chair, Department of Emergency Medicine at sadosty.annie@mayo.edu.

Heal the sick, advance the science, share the knowledge. ©2014 Mayo Foundation for Medical Education and Research. Post offer/pre-employment drug screening is required. Mayo Clinic is an equal opportunity educator and employer (including veterans and persons with disabilities).

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Society for Academic Emergency Medicine 2340 S. River Road, Suite 208 Des Plaines, IL 60018

NON PROFIT ORGANIZATION U.S. POSTAGE PAID SAEM

FUTURE FUTURE SAEM SAEM ANNUAL ANNUAL MEETINGS MEETINGS 2013

SAEM Leadership Forum May 14-15, 2013 SAEM Annual Meeting2015 Topics: May 14-18 SAEM Annual Meeting “Leadership” The Westin Peachtree Plaza, Atlanta, MayGA 12-15 “Developing and Sustaining a Vision” Sheraton Hotel and Marina, San Diego, CA “Strategic Planning” AEM Consensus Conference “Building a Team” May 15, 2013 “Conflict Resolution” 2016 Topic: “Global Health and Emergency Care: “How to Run a Meeting” SAEM Annual Meeting

A Research Agenda” “ED Operations Overview” MayMPH 10-14 Co-Chairs: Stephan Hargarten, MD, Management” Hotel, New Orleans, LA Mark Hauswald, MD Sheraton New Orleans“Change “Negotiating for Your Dept./Faculty” Jon Mark Hirshon, MD, MPH “Overview of Dept. Finances” Ian B.K. Martin, MD 2017 “Communication Skills” SAEM Annual Meeting May 16-20 Hyatt Regency Orlando, Orlando, FL 2014 2015 SAEM Annual Meeting May 14-17 Sheraton Hotel, Dallas, TX

SAEM Annual Meeting May 13-16 Sheraton Hotel and Marina, San Diego, CA