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Emergency MedicineEmergency Medicine
Training in the USATraining in the USA
Gloria Kuhn, DO, Ph.DGloria Kuhn, DO, Ph.D
NeedNeed
Patch work of carePatch work of care
– KnowledgeKnowledge
– TrainingTraining
– ExperienceExperience
NeedNeed
Needs of PatientsNeeds of Patients
– Unique body of knowledgeUnique body of knowledge
– TrainingTraining
– ExperienceExperience
CurrentCurrent
StandardizationStandardization
– Trained in EMTrained in EM
– Equivalent trainingEquivalent training
CurrentCurrent
Certified by the American Board of Certified by the American Board of
Emergency Medicine (ABEM)Emergency Medicine (ABEM)
– Written examWritten exam
– Oral examOral exam
– Continuing certificationContinuing certification
Structure of TrainingStructure of Training
Total NumberTotal Number 127 127
Three year Three year 9595
four year programsfour year programs– 2-42-4 1616– 1-41-4 1616
ABEM ExamABEM Exam
FellowshipsFellowships
– ToxicologyToxicology
– Sports medicineSports medicine
– Pediatric EMPediatric EM
– Undersea and Hyperbaric Undersea and Hyperbaric
No ExamNo Exam
FellowshipsFellowships
– ResearchResearch– AdministrativeAdministrative– EducationEducation
Training CertificationTraining Certification
Accreditation Council for Graduate Accreditation Council for Graduate
Medical Education (ACGME)Medical Education (ACGME)
– General EssentialsGeneral Essentials
– Residency Review CommitteeResidency Review Committee
Training CertificationTraining Certification
Residency Review CommitteeResidency Review Committee
– Special RequirementsSpecial Requirements
– Determines concepts of trainingDetermines concepts of training
– Evaluates program, personnel, institutionEvaluates program, personnel, institution
ABEMABEM
Administers board exam and certificationAdministers board exam and certification– Competency to practiceCompetency to practice
ImplicationsImplications
PracticePractice
– Hospital credentialsHospital credentials
– Academic credentialsAcademic credentials
FinancialFinancial
– ReimbursementReimbursement
RecertificationRecertification
Road to Current StatusRoad to Current Status
PoliticalPolitical– American College of Emergency Physicians American College of Emergency Physicians
(ACEP)(ACEP)
Training Training – Liaison Residency Endorsement Committee Liaison Residency Endorsement Committee
(LREC)(LREC)
CertificationCertification– ABEMABEM
15 Years of Negotiation15 Years of Negotiation
American Medical Association (AMA)American Medical Association (AMA)
American Board of Medical Specialties (ABMS)American Board of Medical Specialties (ABMS)
– ABEMABEM
ACGMEACGME
– RRCRRC
Conjoint BoardConjoint Board
Co-sponsorsCo-sponsors
Shared responsibilitiesShared responsibilities
Shared powersShared powers
Conjoint BoardConjoint Board
Family PracticeFamily Practice
Internal MedicineInternal Medicine
Obstetrics and GynecologyObstetrics and Gynecology
OtolaryngologyOtolaryngology
PediatricsPediatrics
Psychiatry and NeurologyPsychiatry and Neurology
SurgerySurgery
Challenges to ExistenceChallenges to Existence
Recognition of unique body of Recognition of unique body of
– InformationInformation
– SkillsSkills
– ExperienceExperience
Financial ChallengesFinancial Challenges
Definition of emergencyDefinition of emergency
FinancialFinancial– Right to practiceRight to practice– ReimbursementReimbursement
Control of careControl of care
Training ChallengesTraining Challenges
Equal statusEqual status (Mutual needs)(Mutual needs)
– SupervisionSupervision
– AutonomyAutonomy
– Access to patientsAccess to patients
FutureFuture
Continuing NegotiationsContinuing Negotiations
Recognition of specialtyRecognition of specialty
Political issuesPolitical issues
Financial Financial
TrainingTraining