PRESIDENT’S MESSAGE

The Physician asScientist:

Thoughts from aSkeptic

(and a Believer)Our academic practice environ-

ment has grown increasingly chal-lenging from a cognitive, affectiveand physical standpoint. At a timewhen we seem to need to be all

things to all people—being empathetic physicians practicingcustomer friendly care to all comers at all times and frugallyusing resources at a zero-error tolerance rate while super-vising and teaching residents and students—why would Iadvocate that we remember our role as scientists as well?Because our specialty's future depends on your efforts with-in the academic community. It is here that the science of dis-covery (without which we cannot progress), the science ofapplication (without which new discoveries are meaninglessto society) and the science of education (without which wehave no future) are practiced.

Looking back over my relatively brief 24 year career inEmergency Medicine, there are numerous examples of howeach of these "sciences" have profoundly changed the waywe practice Emergency Medicine as a specialty. Examplesare easy to find.

● Nasotracheal intubation has been replaced by RSItechniques.

● "Brutane"and “bite the bulletol” have been replaced byprocedural sedation and analgesia.

● Sensitive bedside pregnancy testing and ultrasonag-raphy have taken much of the guesswork away fromdiagnosing ectopic pregnancies. (Does anyoneremember the culdocentesis?)

Medicine can be characterized as the art of caring lay-ered on the foundation of science. It cannot exist withoutattention to both. Neither caring nor science is alone suc-cessful in healthcare when practiced in isolation. In CarlSagan's book, The Demon-Haunted World: Science as aCandle in the Dark, he writes about the unique combinationof a globalized society dependent upon science and tech-nology existing within systems that increasingly do notunderstand basic scientific principles. He notes this to be a"prescription for disaster".

In the chapter "The fine art of baloney detection," Sagandescribes the need for us to be skeptics (as opposed to cyn-ics, who have predetermined and negative beliefs unde-terred by further data) in our role as scientists. The scientif-

Carey Chisholm, MD

(continued on page 23) (continued on page 2)

SAEM

Newsletter of the Society for Academic Emergency MedicineNovember/December 2004 Volume XVI, Number 6

901 N. Washington Ave.Lansing, MI 48906-5137

(517) 485-5484saem@saem.orgwww.saem.org

“to improve patient care by advancing research and education in emergency medicine”

The SAEM Research Fund – Helping toBuild Academic Careers

Brian J. Zink, MDUniversity of MichiganChair, SAEM Development Committee

In the few short years since it was founded, the SAEMResearch Fund has had a remarkably positive impact on the aca-demic careers of scores of young emergency physicians. Thesephysicians are working hard in research and education towardthe end result that all of us strive for – improved care for ouremergency patients. The comments of our SAEM grant recipi-ents provide the best testimony to the success of the ResearchFund.

Samuel Yang from the Johns Hopkins School of Medicinewrote, “As a recent recipient of the SAEM Research TrainingGrant, I would like to say that the grant has been instrumental injump-starting my career in academic emergency medicine. It hasafforded me the ‘protected’ time to develop essential researchskills and grantsmanship in order to pursue my research inquiryfurther and become competitive for additional intra- and extramu-ral funding.”

Daniel Davis of the University of California, San Diego notes,“The SAEM Scholarly Sabbatical Grant was pivotal in allowingme to explore both basic science and clinical research andreceive mentorship from two world-class scientists from my insti-tution. It was directly responsible for my successful acquisition ofboth an R01 in experimental models of ischemia and a U01 aspart of a resuscitation consortium.”

At the special reception held at the Annual Meeting in May2004, donors to the Research Fund discussed their motivationsand reasons for contributing. For some it was to give a chanceto young physicians that they never had. For others it was theadvancement of original research in emergency medicine. For afew, the cycle was being completed - they had benefited fromreceiving training grants early in their careers, now were acknowl-edging the importance of this by contributing back to the cause.

The Research Fund now sits at over three million dollars, andmany SAEM members have contributed to the Fund. However,the largest donor remains our parent organization. In the pasttwo years SAEM has donated $0.5 million of its reserves to theResearch Fund. This is a great example of a putting our moneywhere our mouth is. However, we cannot count on this level ofdonation from SAEM each year, and in order to increase the sizeof the Research Fund we must have a higher contribution fromSAEM members. One of the most disappointing activities forSAEM each year is when the Grants Committee must chooseonly one recipient for the Research Training Grant, InstitutionalResearch Training Grant, and Scholarly Sabbatical Grant, andhighly qualified applicants are turned down. Our goal is that theResearch Fund will function as a sustainable endowment thatcan provide many more grants than we are currently able to fund.

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Call for NominationsDeadline: February 4, 2005

Nominations are sought for the Hal Jayne Academic Excellence Award and the Leadership Award. These awards will bepresented during the SAEM Annual Business Meeting in New York City. Nominations for honorary membership for thosewho have made exceptional contributions to emergency medicine are also sought. The Nominating Committee wishes toconsider as many exceptional candidates as possible. Nominations may be submitted by the candidate or any SAEM mem-ber. Nominations should include a copy of the candidate's CV and a cover letter describing his/her qualifications. Nomi-nations must be sent electronically to saem@saem.org. The awards and criteria are described below:Academic Excellence AwardThe Hal Jayne Academic Excellence Award is presented to an individual who has made outstanding contributions to emer-gency medicine through research, education, and scholarly accomplishments. Candidates will be evaluated on theiraccomplishments in emergency medicine, including:1. Teaching

A. Didactic/BedsideB. Development of new techniques of instruction or instructional materialsC. Scholarly worksD. PresentationsE. Recognition or awards by students, residents, or peers

2. Research and Scholarly AccomplishmentsA. Original research in peer-reviewed journalsB. Other research publications (e.g., review articles, book chapters, editorials)C. Research support generated through grants and contractsD. Peer-reviewed research presentationsE. Honors and awards

Previous recipients of this award are: Tom Aufderheide, MD, William Barsan, MD, Charles Brown, MD, Steven Dronen, MD,Richard Edlich, MD, PhD, Lewis Goldfrank, MD, Glenn Hamilton, MD, Jerris Hedges, MD, MS, Judd Hollander, MD, GaborKelen, MD, Arthur Kellermann, MD, MPH, John Marx, MD, James Niemann, MD, Emanuel Rivers, MD, James Roberts, MD,Ernest Ruiz, MD, Arthur Sanders, MD, Corey Slovis, MD, Ian Stiell, MD, and Blaine White, MD.

Leadership AwardThe Leadership Award is presented to an individual who has demonstrated exceptional leadership in academic emergencymedicine. Candidates will be evaluated on their leadership contributions including:1. Emergency medicine organizations and publications.2. Emergency medicine academic productivity.3. Growth of academic emergency medicine.

Previous recipients of this award are: Louis Binder, MD, E. John Gallagher, MD, Lewis Goldfrank, MD, Glenn Hamilton,MD, Jerris Hedges, MD, MS, Robert Knopp, MD, Ronald Krome, MD, Richard Levy, MD, Louis Ling, MD, James Niemann,MD, Peter Rosen, MD, Arthur Sanders, MD, David Sklar, MD, William Spivey, MD, Judith Tintinalli, MD, Joseph Waecker-le, MD, and David Wagner, MD.

The SAEM Research Fund…(continued from page 1)The Development Committee will beembarking on a new initiative toincrease contributions from our individ-ual members. If the membership cancontribute at a higher rate and at a high-er amount, we can potentially providemore young emergency physicians withthe academic boost of a training grant.As much as we seek and hope for majorsupport from industry and philanthropicorganizations, the type of unrestricteddonation needed to provide general

research training grants is best raisedfrom our own ranks. If we don’t believein ourselves, we will never convince oth-ers to contribute to our cause.

Please consider donating to theSAEM Research Fund as an investmentin the future of our field. A donationenvelope is enclosed in this Newsletter,and a letter and brochure will be sent toSAEM members in the next month. Youcan also make a donation on-line atwww.saem.org.

SAEM Membership as of 10-11-04

Active - 2329Associate - 259Resident - 2264

Fellow - 55Medical Student - 303

Emeritus - 22Honorary - 7

TOTAL: 5,239

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Two New Residency Programs Approved by the RRC-EMDuring the September meeting of the Residency Review Committee for Emergency Medicine (RRC-EM) two new EmergencyMedicine residency programs were approved. Because of the timing of the approval, neither program will participate in ERASthis year, but will participate in the Match in 2005. Congratulations to these institutions and their faculty.

University of Medicine and Dentistry of New Jersey - NewJersey Medical School

The University of Medicine and Dentistry of New Jersey(UMDNJ)/New Jersey Medical School Center EmergencyMedicine Residency Program will be located at the UniversityHospital in New Jersey, a large city hospital that is a majortrauma center and referral center, as well as a large researchcenter. The program will be a four year program, and wasapproved for 32 residents. Currently the program will berecruiting for 6 residents. The Chief of the Division of Emer-gency Medicine is Ronald B. Low, MD. The program directoris Joseph Rella, MD, and the assistant program director is Tiffany Murano, MD.

University of Utah

The University of Utah Affiliated Residency in EmergencyMedicine is based at the 430 bed University Hospital, a Level1 Trauma Center. The Universitiy of Utah School of Medicinehas three other campuses including the 500 bed LDS Hospitaland residents will also rotate through the ED and PICU at Pri-mary Children’s Medical Center. A fourth campus, the 102 bedSalt Lake City Veterans Medical Center, will provide medicalintensive care. The program was approved as a 1-3 programand this year will be recruiting 7 residents. The Chief of theDivision of Emergency Medicine is Erik Barton, MD, MS, andthe Program Director is Stephen C. Hartsell, MD. The Associ-ate Program Director is Susan Stroud, MD, and the AssistantDirector at LDS Hospital is Todd Allen, MD.

SAEM 2005 Research GrantsResearch Training Grant This grant provides financial support of $75,000 per year for two years of formal, full-time research training foremergency medicine fellows, resident physicians, or junior faculty. The trainee must have a concentrated, men-tored program in specific research methods and concepts, and complete a research project. Deadline: November4, 2004.

Institutional Research Training GrantThis grant provides financial support of $75,000 per year for two years for an academic emergency medicine pro-gram to train a research fellow. The sponsoring program must demonstrate an excellent research training envi-ronment with a qualified mentor and specific area of research emphasis. The training for the fellow may include aformal research education program or advanced degree. It is expected that the fellow who is selected by the apply-ing program will dedicate full time effort to research, and will complete a research project. The goal of this grant isto help establish a departmental culture in emergency medicine programs that will continue to support advancedresearch training for emergency medicine residency graduates. Deadline: November 4, 2004.

Scholarly Sabbatical Grant This grant provides funding of $10,000 per month for a maximum of six months to help emergency medicine fac-ulty at the level of assistant professor or higher obtain release time to develop skills that will advance their aca-demic careers. The goal of the grant is to increase the number of independent career researchers who may fur-ther advance research and education in emergency medicine. The grant may be used to learn unique research oreducational methods or procedures which require day-to-day, in-depth training under the direct supervision of aknowledgeable mentor, or to develop a knowledge base that can be shared with the faculty member’s departmentto further research and education. Deadline: November 4, 2004.

Emergency Medical Services Research FellowshipThis grant is sponsored by Medtronic Physio-Control. It provides $60,000 for a one year EMS fellowship for emer-gency medicine residency graduates at an SAEM approved fellowship training site. The fellow must have an in-depth training experience in EMS with an emphasis on research concepts and methods. The grant processinvolves a review and approval of emergency medicine training sites as well as individual applications from poten-tial fellows. Deadline: November 4, 2004.

Further information and application materials can be obtained via the SAEM website at www.saem.org.

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Call For NominationsYoung Investigator Award

Deadline: December 17, 2004

In May 2005, SAEM will recognize a few young investigators who have demonstrated promise and distinction in theiremergency medicine research careers. The purpose of the award is to recognize and encourage emergency physicians/sci-entists of junior academic rank who have a demonstrated commitment to research as evidenced by academic achievementand qualifications. The criteria for the award includes:1. Specialty training and certification in emergency medicine or pediatric emergency medicine.2. Evidence of significant research collaboration with a senior clinical investigator/scientist. This may be in the setting of a

collaborative research effort or a formal mentor-trainee relationship. 3. Academic accomplishments which may include:

a. postgraduate training/education: research fellowship, master’s program, doctoral program, etc.b. publications: abstracts, papers, review articles, chapters, case reports, etc.c. research grant awardsd. presentations at national research meetingse. research awards/recognition

The candidate must have training and board certification in emergency medicine or pediatric emergency medicine. Criteriataken into consideration in determining the award recipient include prior research grant awards, publications, presentation, andother awards. Research grant awards are most highly weighted, especially if from federal or major foundation sources. Researchpublications will be weighted based on their quality and number. Publication in high impact or moderate impact journals will beweighted higher than publications in low impact journals. Research presentations at national meetings and non-monetaryawards will be given relatively less weight in the overall evaluation.

The deadline for the submission of nominations is December 17, 2004, and nominations should be submitted electronicallyto saem@saem.org. Nominations should include the candidate’s CV and a cover letter summarizing why the candidate meritsconsideration for this award. Candidates may nominate themselves or any SAEM member may nominate a deserving young in-vestigator. Candidates may not be senior faculty (associate or full professor) and must not have graduated from their residencyprogram prior to June 30, 1998.

The core mission of SAEM is to advance teaching and research in our specialty. This recognition may assist the careeradvancement of the successful nominees. We also hope the successful candidates will serve as role models and inspira-tions to us all. Your efforts to identify and nominate deserving candidates will help advance the mission of our Society.

Call for PhotographsDeadline: February 18, 2005

Original photographs of patients, pathology specimens, gram stains, EKG’s, and radiographic studies or other visual dataare invited for presentation at the 2005 SAEM Annual Meeting in New York City. Submissions should depict findings that arepathognomonic for a particular diagnosis relevant to the practice of emergency medicine or findings of unusual interest thathave educational value. Accepted submissions will be mounted by SAEM and presented in the “Clinical Pearls” sessionand/or the “Visual Diagnosis” medical student/resident contest.No more than three different photos should be submitted for any one case. Submit one glossy photo (5 x 7, 8 x 10, 11 x 14,or 16 x 20) and a digital copy in JPEG or TIFF format on a disk or by email attachment (resolution of at least 640 x 48).Radiographs and EKGs should also be submitted in hard copy and digital format. Do not send X-rays. The back of eachphoto should contain the contributor’s name, address, hospital or program, and an arrow indicating the top. Submissionsshould be shipped in an envelope with cardboard, but should not be mounted.Photo submissions must be accompanied by a brief case history written as an “unknown” in the following format: 1) chiefcomplaint, 2) history of present illness, 3) pertinent physical exam (other than what is depicted in the photo), 4) pertinent lab-oratory data, 5) one or two questions asking the viewer to identify the diagnosis or pertinent finding, 6) answer(s) and briefdiscussion of the case, including an explanation of the findings in the photo, and 7) one to three bulleted take home pointsor “pearls.”The case history must be submitted on the template posted on the SAEM website at www.saem.org and must be submittedelectronically. The case history is limited to no more than 250 words. If accepted for display SAEM reserves the right to editthe submitted case history. Submissions will be selected based on their educational merit, relevance to emergency medi-cine, quality of the photograph, the case history and appropriateness for public display. Contributors will be acknowledgedand photos will be returned after the Annual Meeting. Academic Emergency Medicine (AEM), the official SAEM journal, mayinvite a limited number of displayed photos to be submitted to AEM for consideration of publication. SAEM will retain therights to use submitted photographs in future educational projects, with full credit given for the contribution.Photographs must not appear in a refereed journal prior to the Annual Meeting. Patients should be appropriately masked.Submitters must attest that written consent and release of responsibility have been obtained for all photos EXCEPT for iso-lated diagnostic studies such as EKGs, radiographs, gram stains, etc.

5

Committee and Task Force Selection Process BeginsGlenn C. Hamilton, MDWright State UniversitySAEM President-elect

Most of our annual planning for the 2005-2006 SAEM year,which begins each May, occurs during the winter months. Animportant component of this is the development of realisticobjectives for our committees and assignment of specialneeds projects to task forces.

The committees have an essential role in determining howwell SAEM progresses in our mission each year. The workeach year focuses on a number of specific objectives.Although ultimately assigned by the President-elect, theseobjectives are developed by soliciting ideas from the entiremembership, as well as current and prior committee chairsand members. The Board of Directors reviews these assign-ments, to assure coordination and resource allocation appro-priate to each task.

Task Forces (TF) are unique entities developed by thePresident-elect in cooperation with the Board of Directors toaddress a specific focused issue in a timely manner. SAEMrelies on task forces to deliver recommendations to the Boardor produce a time sensitive product for the organization. Atask force usually accomplishes its objectives within one to twoyears from inception.Why Should You Become a Committee or Task ForceMember?

● You believe in SAEM’s mission statement: “to improvepatient care by advancing research and education inemergency medicine”.

● You wish to assist in defining the future practice of yourspecialty. The academic mission is a special andunique pursuit, critical to the future of our specialty andthe patients we serve. We are responsible for trainingthe next generation of EM clinicians and academicians.We define the future practice of our specialty throughthe work of our members, both with SAEM activities andat our academic institutions. You have special knowl-edge/skills or interests in a committee/TF work area.Sometimes more junior members in the Society areafraid to volunteer because they “lack expertise” in anarea. However, if you have the time, are willing to do

the work, and have a passion for that area, you repre-sent exactly what a committee/TF really needs.

How Do I Get Assigned to a Committee/TF?● First, assess your ability to offer a realistic time commit-

ment. ● Second, review the current committee and task force

objectives. Where do your interests and experienceslie? What abilities or perspectives might you con-tribute?

● Third, everyone who desires appointment MUST com-plete the Committee/TF Interest Form available onlineat www.saem.org. This includes currently assignedmembers as well! Remember committee compositionrotates regularly, with approximately one-third of themembers turning over each year. This assures that allSAEM members who desire to participate can do so.While invariably disappointing to some members whoare not reassigned, this practice has served SAEM verywell over the years and is a critical component of indi-vidual member development. Reassignment also isinfluenced by the chair’s evaluation of an individual’sproductivity, timeliness, responsivity and overall contri-butions.

● Finally, when submitting your interest form, please makea brief statement supporting your committee choice.SAEM is a large organization, and I unfortunately do notknow every member’s skills and talents. While per-formance record goes a long way for those currentlyserving, the interest form will be a major factor inappointment decisions for all members.

SAEM’s mission has never been more critical for the livesof our patient population. We are charged with defining thefuture practice of EM, both clinical practice and academics.The Committees and Task Forces are central to the missionand goals of the Society. We look forward to your volunteeringthis year. Please address specific questions about this processto the central office at saem@saem.org.

Call for SubmissionsInnovations in Emergency Medicine Education Exhibits

Deadline: February 22, 2005The Program Committee is accepting Innovations in Emergency Medicine Education (IEME) Exhibits for consideration of

presentation at the 2005 SAEM Annual Meeting, May 22-25, 2005 in New York City. Submitters are invited to complete anapplication describing an innovative new educational methodology that they have designed, or an innovative educationalapplication of an existing product. The exhibit should not be used to display a commercial product that is already availableand being used in its intended application. Exhibits will be selected based on utility, originality, and applicability to the teach-ing setting. Commercial support of innovations is permitted but must be disclosed. IEME exhibits will be published in a sum-mer 2005 issue of Academic Emergency Medicine, as well as in the Annual Meeting on-site program. However, if submit-ters have conducted a research project on or using the innovation, the project may be written up as a scientific abstract andsubmitted for scientific review in the appropriate subject category by the January 6 deadline.

The deadline for submission of IEME Exhibit applications is Tuesday, February 22, 2005 at 5:00 pm Eastern DaylightTime. Only online submissions using the form on the SAEM website at www.saem.org will be accepted. For further infor-mation or questions, contact SAEM at saem@saem.org or 517-485-5484 or via fax at 517-485-0801.

Academic AnnouncementsSAEM members are encouraged to submit Academic Announcements on promotions, research funding, and other items of inter-est to the SAEM membership. Submissions must be sent to saem@saem.org by December 1 to be included in theJanuary/February issue.

Robert A. Barish, MD, Professor ofSurgery and Medicine, has been pro-moted from Associate to Senior Associ-ate Dean for Clinical Affairs in theDean’s Office at the University of Mary-land School of Medicine.

Roger Barkin, MD, has been named asthe recipient of the James D. Mills Out-standing Contribution to EmergencyMedicine Award by the American Col-lege of Emergency Physicians (ACEP).

Steven L. Bernstein, MD, has beenpromoted to Associate Professor ofClinical Emergency Medicine at theAlbert Einstein College of Medicine.

Laura Bontempo, MD, will become theResidency Director at the Yale Universi-ty Emergency Medicine Residency Pro-gram on October 27. She previouslyserved as the Associate ResidencyDirector at the Brigham andWomen's/Massachusetts GeneralHospital Harvard Affiliated EmergencyMedicine Program.

Jane Brice, MD, MPH, has been pro-moted to Associate Professor withTenure at the University of North Caroli-na at Chapel Hill.

Gregory Connors, MD, MPH, MBA,Associate Professor of EmergencyMedicine and Pediatrics at the Universi-ty of Rochester School of Medicine &Dentistry, has been appointed chief ofthe Division of Pediatric EmergencyMedicine. He also remains Vice Chairof Emergency Medicine for AcademicAffairs.

Marc Dorfman, MD, has been namedthe Program Director of the EmergencyMedicine Residency Program at Resur-rection Medical Center.

Howard A. Freed, MD, has been pro-moted to Clinical Professor of Emer-gency Medicine at Georgetown Univer-sity and Clinical Professor of Medicineat Howard University. In addition, Dr.Freed and his son, Max, became thefirst father/son duo to present separatepapers at the same SAEM meeting. Atthe 2004 Mid-Atlantic Regional MeetingDr. Freed presented "KnowledgeAmong Washington DC's EmergencyPhysicians About the Initial Presenta-tion of Smallpox." His son presented,

"Impact of Depression on ED Recidi-vism: A New Approach to the FrequentFlyer."

Jerris R. Hedges, MD, is the principalinvestigator at Oregon Health & ScienceUniversity's Center for Policy andResearch in Emergency Medicine of theResuscitation Outcomes Consortium.This national consortium, which will pro-vide 30 million dollars over five years atten sites, is being funded by the nation-al Heart, Lung, and Blood Institute.

Cherri Hobgood, MD, Assistant Profes-sor, at the University of North Carolinaat Chapel Hill has been appointed Asso-ciate Dean for Curriculum and Educa-tional Development. Dr. Hobgood hasalso been selected as the North Caroli-na Emergency Physician of the Year.

Gregory D. Jay, MD, PhD, AssociateProfessor of Emergency Medicine andEngineering at Brown University, pre-sented an oral presentation entitled,“Lubrication and Mechanisms of Articu-lar Cartilage at the Bioengineering andMusculoskeletal Biology meeting of theGordon Research Conferences”. Dr.Jay has also been awarded a two-yearR41 (STTR) entitled, Pulsus PardoxusMonitor, by the National Heart Lung andBlood Institute. This award will supportefforts to embed pulsus paradoxusmonitoring capabilities in pulse oximetryand determine the clinical impact ofmeasuring pulsus paradoxus routinelyamong dyspneic ED patients.

Jeffrey A. Kline, MD, is the principalinvestigator of a 1.12 million dollarSmall Business Technology Transfergrant from the National Heart Lung andBlood Institute. The title of the grant is"Pretest Probability Assessment for Pul-monary Embolism" and the major goalsof the study are to measure the preva-lence of pulmonary embolism in EDpatients and to develop a large data-base to use as the basis of a novelmethod to estimate the pretest probabil-ity of ED patients with possible pul-monary embolism.

John B. McCabe, MD, has assumedthe presidency of the American Board ofEmergency Medicine. He has been amember of the ABEM Board of Directorssince 1996 and has served as the chair

of the Academic Affairs Committee, theEmergency Medicine Continuous Certi-fication Task Force, and the NominatingCommittee. Dr. McCabe is the Profes-sor and Chair of Emergency Medicine atthe State University of New York,Upstate Medical University.

Roland C. Merchant, MD, MPH, hasreceived a one-year $120,000 grantfrom the Centers of Disease Controland Prevention to support his research,“Evaluation of Video-based Rapid HIVTest Counseling in the EmergencyDepartment.” Dr. Merchant is an Assis-tant Professor at Brown Medical School.

James Scott, MD, has been namedDean of the School of Medicine atHealth Sciences at the George Wash-ington University. Dr. Scott served asthe interim dean since 2003 and theassociate dean since 2000. He wasnamed Professor of EmergencyMedicine in 1998. Previously he servedas residency director, assistant dean forGraduate Medical Education, and assis-tant dean for Student Affairs. Dr. Scottis the fourth emergency physician toserve as Dean of a U.S. medical school,joining John Prescott, MD, at the WestVirginia University, Paul Roth, MD, atthe University of New Mexico, andVince Verdile, MD, at the Albany Medi-cal Center.

Joshua Stillman, MD, MPH, a facultymember of the New York PresbyterianEmergency Medicine Residency Pro-gram, as a co-principal investigator withthe Department of Neurology, has beenawarded a SOTRIAS grant (SpecializedProgram of Translational Research inAcute Stroke) from the National Instituteof Neurological Disorders and Stroke.The five-year grant, worth 12 million dol-lars, will accelerate the process of tak-ing bench research to human applica-tions in the acute care of patients withstroke.

David Townes, MD, Assistant Profes-sor of Medicine, Division of EmergencyMedicine at the University of Washing-ton has assumed the role of AssociateResidency Director of the MadiganMedical Center/University of Washing-

(continued on next page)

6

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ton Emergency Medicine ResidencyProgram.

Jacob Ufberg, MD, has become theResidency Director of the EmergencyMedicine Residency Program at TempleUniversity Hospital. Dr. Ufberg previ-ously served as the Assistant ProgramDirector.

Robert H. Woolard, MD, has been

named Chair of the newly establishedDepartment of Emergency Medicine atBrown Medical School.

Brian S. Zachariah, MD, AssociateProfessor and Chief of the Division ofEmergency Medicine at the Universityof Texas Medical Branch in Galvestonhas been named the innaugural holderof the Elaine Mantooth Fleming, MD,Professorship of Emergency Medicine.

Brian Zink, MD, has been named asthe Associate Dean for Student Pro-grams at the University of MichiganMedical School. Dr. Zink will provideleadership for all medical school pro-grams that support medical students,including advising and counseling,admissions, financial aid, special eventsand government, and medical studentresearch.

The SAEM Research Fund…(continued from page 6)

In Memoriam: Two Leaders in Emergency MedicineThe EMS community was

saddened by the death of JamesO. Page, JD, on September 4.Page was known throughout theEMS and fire service world asthe founder and publisher ofJEMS magazine and as one ofthe most influential fire/EMSleaders in the nation.

Page began his public safetycareer in 1957 with the LosAngeles County Fire Depart-ment. In 1971, he was assigned

the task of developing a countywide paramedic rescue pro-gram. In 1973, he retired as a Battalion Chief and acceptedthe newly created position of state EMS director in NorthCarolina. He founded JEMS in 1979, and returned to the fireservice in 1984, retiring five years later from the position ofchief of the fire department in the City of Monterey Park. Hethen returned full time to JEMS Communications as its pres-ident.

A prolific writer and speaker, Page authored six text-books and over 400 articles. At the time of his death, he wascontinuing to serve as publisher emeritus of both EMS andFireRescue Magazine.

Throughout his career, Page promoted EMS within thefire service, and probably did more to bring these two fieldstogether than anybody else. NAEMSP honored him last Jan-uary with its Ronald D. Stewart Award, which is awardedannually to a person who has made a lasting, major contri-bution to EMS. Dr. Page was also selected to receive the2004 ACEP Award for Outstanding Contribution in EMS.

David Cone, MDYale University

It is with deep regret that thedeath of Daniel L. Storer, MD, onSeptember 21 is announced.Dan was very well known tomany in emergency medicine,prehospital care, and ACLS train-ing for over 30 years. He wasone of the four founding academ-ic faculty for the emergency med-icine program at the University ofCincinnati, and founded the AirCare helicopter program at theUniversity of Cincinnati Hospital

in 1984. He educated countless residents, medical students,and paramedics over the last three decades. He also servednationally as a paramedic educator and site surveyor for theJoint Review Committee on Educational Programs for theEMT-Paramedic, a liaison representative to the NationalRegistry of EMTs, and as a Medical Assistance Team (MAT)Medical Commander for the American Red Cross DisasterServices. In the greater Cincinnati area, Dan was the headof every prehospital care organization and truly a legendamong prehospital providers. Dan was the President ofOhio ACEP in 1987, and was awarded the ACEP EMSAward in 1987 and the Dr. Peter J. Safar-American HeartAssociation Award of the American Heart Association for theOhio Region ECC Committee in 2003. The above serves asonly a partial listing of Dan's major career accomplishmentsand awards. He will be sorely missed by all of us here at theUniversity of Cincinnati, as well as by our field of EmergencyMedicine.

Brian Gibler, MDUniversity of Cincinnati

Cochrane Prehospital and Emergency Health FieldOn August 23, the Cochrane Collab-

oration formally approved the registra-tion of the Cochrane Prehospital andEmergency Health Field. The CochranePrehospital and Emergency HealthField seeks to represent the uniqueneeds and concerns of prehospital careand emergency health clinicians,researchers, managers and educators.

The Field’s primary role will be to pro-mote the production and use of system-atic reviews of the effectiveness of pre-hospital care and emergency healthinterventions. At the request of theCochrane leadership, the Field wasexpanded from a prehospital focus toinclude care in the emergency depart-ment. Michael Sayre, MD, serves on

the Advisory Board for the Field. Con-tact him at Sayre.84@osu.edu if youhave questions or would like additionalinformation. You can sign up to receiveadditional information and keep up todate on the Field activities on the web-site at: www.cochranepehf.org.

8

2004 SAEM New York RegionalMeeting Research Award Recipi-ents: (L-R) Stephen J. Leech, MD,Christiana Care Health System,Christine Ortiz, MD, St. Luke's-Roosevelt/Columbia University, Kendra Dolan, MD, York Hospital,Melanie O'Neil, MD, St. Luke's-Roosevelt/ Columbia University,and Rafael Torres, MD, New YorkMethodist Hospital. Not pictured: William Chang, MD,Bellevue/NYU, and Shari Platt,MD, New York Presbyterian-WeillCornell Medical Center.

New York State SAEM 2004 Regional MeetingTheodore C. Bania, MD, MSSt. Luke’s-Roosevelt / Columbia UniversityChair, 2004 SAEM New York State Regional Meeting

St. Luke’s-Roosevelt Hospital /Columbia University was honored tohost the 4th Annual New York StateRegional Meeting on March 31, 2004 atLerner Hall on Columbia UniversityMorningside Campus. This conferencewas the largest of any regional meetingsto date with 492 registered participants.The conference attracted participantsfrom 25 Emergency Medicine Residen-cy Program in the New York/NewJersey/Pennsylvania area, as well asprograms from Massachusetts, RhodeIsland, Delaware, Washington DC, Flori-da, North Carolina and Michigan. A totalof 150 abstracts were presented (8 oralpresentations, 16 moderated posterpresentations, and 126 poster presenta-tions).

Dan Wiener, MD, chair of the Depart-ment of Emergency Medicine at St.Luke’s-Roosevelt/Columbia Universityprovided opening remarks. Highlights ofthe meeting were the keynote addressgiven by Dr. Glenn Hamilton, Professorand Chair of Emergency Medicine atWright State University and a lecturegiven by Dr. Roger Lewis, Director ofResearch, Department of EmergencyMedicine, Harbor-UCLA Medical Center.Dr. Hamilton spoke on “Updates in

Cerebral Resuscitation” and Dr. Lewisspoke on “Myths in EmergencyMedicine Research.”

The afternoon sessions includeddidactic sessions titled “Debunking ofEM Myths using Evidence BasedMedicine” by David Newman, MD, and“Emergency Medicine and Toxicology inthe Philippines” by Ginno Blancaflor,MD, Ramona Sunderwirth, MD, MPHand In-Hei Hahn, MD. An AdvancedEmergency Medicine UltrasoundCourse was given after the meeting bythe St. Luke’s-Roosevelt UltrasoundDivision. In addition, the ResearchDirectors of New York (RDNY) held theirfirst meeting. Best Oral Research PresentationWilliam Chang, MD, Bellevue/NYU“Headache and Hypertension – Is Therean Association?” Shari Platt, MD, New York Presbyterian– Weill Cornell Medical Center “Predictor of Pneumonia in YoungFebrile Infants Objective: To IdentifyPredictor of Pneumonia in YoungFebrile Infants” Best Oral Research Presentation by aResidentChristine Ortiz, MD, St. Luke’s-Roo-

sevelt/Columbia University “Rate of Outcomes of UnrecognizedEsophageal Placement of EndotrachealTubes by Paramedics in an UrbanEmergency Department” Best Moderated Poster PresentationsKendra Dolan, MD, York Hospital “Beta-Blocker Use in Elderly EDPatients with AMI” Rafael Torres, MD, New York MethodistHospital “Need for Training in Informed Consentamong Emergency Medicine Residents”Stephen J. Leech, MD, Christiana CareHealth System, Delaware “Emergency Physician Performed Ultra-sound Accurately Identifies UpperExtremity Deep Venous Thrombosis” Melanie O’Neil, MD, St. Luke’s-Roo-sevelt/Columbia University “Optimal Dosing Regimen to ProduceGamma-hydroxybutyrate (GHB) With-drawal in an Animal Model”

Next year’s meeting will be spon-sored by the State University of NewYork, Downstate Medical Center, KingsCounty Hospital on April 3, 2005. Forinformation about next year's meeting,please contact Dr. Richard Sinert atnephron1@bellatlantic.net.

9

Becoming a Leader in the Medical School Dean’s OfficeYvette Calderon, MDJacobi Medical CenterSAEM Faculty Development Committee

Multiple faculty development semi-nars were held at the 2004 SAEM Annu-al Meeting. The seminar on "Becominga Leader in the Medical School Dean’sOffice" included five Deans who areleaders in academic EmergencyMedicine: Brian J. Zink, MD, AssistantDean for Medical Student Career Devel-opment, University of Michigan MedicalSchool; Vincent Verdile, MD, Dean,Albany Medical College, John E.Prescott, MD, Dean, West VirginiaUniversity School of Medicine; DavidSklar, MD, Senior Associate Dean forClinical Affairs, University of New Mexi-co School of Medicine; and KatherineHeilpern, MD, Assistant Dean for Medi-cal Education and Student Affairs,Emory University School of Medicine.Each presenter discussed his/her viewsin the following areas: 1) the character-istics and qualifications needed tobecome a Dean; 2) a day in the life of aDean; 3) the challenges and rewards ofbeing a Dean; and 4) the struggles of aDean serving in two worlds - the medicalschool and Emergency Medicine.

The Dean of a medical school pos-sesses the highest authority in academ-ic medicine. Leadership skills areessential for the Dean to meet the com-plex demands of the institution. To meetthese demands, the Dean must have aclear vision for his/her medical schooland inspire and direct collaborationamong the faculty, administrators andstudents1. “What the dean does as anindividual is not nearly as important aswhat a dean enables others to do1.”Therefore, the most important responsi-bility of a medical school dean is to cre-ate an environment where individualand institutional goals, which comple-ment each other, are nurtured and sup-ported.

The average Dean tenure is veryshort. However, there are multiple qual-ities that define a successful Dean andmay expand the tenure. The Dean mustbe able to multi-task. There are multipleissues that need to be addressed everyday, and the pace is rapid. The ability tobe diplomatic, and to relate and suc-cessfully communicate with others is avital skill. Extraordinary interpersonalskills are crucial. It is important that theDean be familiar with federal and statepolicies that will have an impact on themedical school and its mission2.Whether the Dean’s background is aca-

demic, clinical or administrative is not asimportant as having impressive mana-gerial skills. Most Deans have previous-ly been Department Chairs or served ina major management role in an aca-demic medical center. The Dean mustbalance the tension between adminis-trative, academic, and professionalleaders3. It is less important to have hadexperience as an Assistant or AssociateDean.

The daily responsibilities of a Deanstart with protecting and championingthe educational mission of the medicalschool1,2,4. The Dean must advocateand negotiate the support needed toinsure the “development of an educa-tional strategic plan, critically evaluatethe educational process, determine thedesired outcomes, and hold the facultyand academic administration account-able for the medical school’s mission”2.It is equally important that the Deanhave a savvy business sense. Thefinancial success of the medical schoolhas a direct impact on the realization ofits educational and research missions.The funding that medical schoolsreceive for research can be a large partof the financial success of the medicalschool2. Therefore, the Dean must beable to direct the faculty to researchareas that are currently a priority for theNIH and other funding sources so theinstitution successfully competes forresearch dollars. Equally important inthe daily responsibilities of the Dean isfund raising. The Dean dedicates signif-icant time to securing the financial via-bility of the school through fundraisingand philanthropy2. Lastly, a critical ele-ment to ensure ongoing success is thedevelopment of leaders in other depart-ments who can work with the Dean.These can be chairs, section chiefs,associate deans or committee chairs.The reality is that there is a constantstate of flux in these leadership roles. Itis critical that the Dean continuallyrecruit, develop and retain leaders withwhom he/she can work to make certainthe mission of the medical school isaccomplished.

The qualities that make emergencyphysicians successful are shared withindividuals who are successful Deans.When caring for patients, the stellaremergency physician has a mastery ofinterpersonal skills, is multitasking, haspatience and flexibility, and possesses

sound managerial skills. These charac-teristics and skills are relevant in bothcareer paths1. Some Deans with emer-gency medicine backgrounds have cho-sen to wear both hats. The advantagesto keeping leadership roles in both theDean’s office and the Department ofEmergency Medicine are: having theability to be more powerful than in eithersingle role; using resources from onerole to solve problems in another; andhaving pre-established working relation-ships with other clinical leaders5. Thedisadvantages are: you can not advo-cate for your own department as well;you may be seen as too powerful orthreatening by other chairs or associatedeans; and you must remain impartialwhen there is a conflict of interest5.

A strong and enduring Dean musthave good knowledge and backgroundof medicine and business while pos-sessing excellent managerial, diplomat-ic and interpersonal skills. The stabilityand long-term survival of medicalschools are directly related to the lead-ership from the Dean’s office. The Deanrepresents the values, commitment andvision of a medical school. Emergencyphysicians can and should aspire tobecome a Dean. It is clear that the fun-damental skills of a Dean are demon-strated as part of the daily routine of anemergency physician. When consider-ing senior leadership roles in emer-gency medicine, a position in the Dean’soffice can be an achievable goal for theacademic emergency physician.

References1. Daugherty RM, Jr. Leading among

leaders: the Dean in today's MedicalSchool. Acad Med. 1998; 73: 649-53

2. Verdile V. Becoming a Dean. 2004SAEM Annual Meeting, Orlando, Fla;May 2004. Website address:http://www.saem.org/facdev/fac_dev_handbook/4-8_on_becoming_the_dean1.

3. Lee A, Hoyle E. Who would become aSuccessful Dean of Faculty ofMedicine: Academic or Clinician orAdministrator? Med.Teach. 2002; 24:637-41.

4. Chapman JE. Reflections on theMedical Deanship. Acad Med. 1998;73: 654-6.

5. Sklar, D. Serving Two Masters. 2004SAEM Annual Meeting, Orlando, Fla;May 2004.

10

2004 SAEM Mid-Atlantic Regional Research ConferenceDavid Milzman, MDProvidence HospitalChair, 2004 SAEM Mid-Atlantic Regional Meeting

The 2004 Mid-Atlantic Regional Meeting was hosted by theWashington Hospital Center and Georgetown University Med-ical Center’s Department of Emergency Medicine at theGeorgetown University Conference Center on October 1. MarkSmith, MD Chair of the host program welcomed Glenn Hamil-ton, MD, President-Elect of SAEM and Chair and Professor ofEM at Wright State University. Dr. Hamilton, who literallydrove to D.C., highlighted the meeting with an importantkeynote address seeking additional input from the regionalresearchers on how the Society can better assist researchdevelopment. He gave a superb lecture on future directionson the Society. In addition, John Younger, MD, gave theResearch lecture on the intricacies of writing one’s first grant.Break-out lectures on International Medicine Opportunitieswere given by Dr. Jim Holliman and Dr. Terry Mulligan. Dr. JeffLove led an overflowing room of medical students through a‘How to’ EM Residency application process.

The meeting once again used an all oral format for thepresentation of six plenary papers by Dr. Jim Manning, Dr.George Shaw, Dr. Robert Freishtat, Dr. Michael Witting, Dr.Jesse Pines and Dr. Howard Freed. The 44 briefer presenta-tions were given in 5 minutes and allowed for outstanding dis-cussions usually not afforded in the standard poster presenta-tions. The outstanding presentations were awarded to the fol-lowing: George Shaw, MD, the former Georgetown alumnusand current University of Cincinnati attending: Best Overallwith: “Microscopic Imaging of Recombinant TPA Thrombolysis

with 120 kHz Ultrasound in an In-Vivo Human Clot Model.”Best Resident: Jason Gukhool MD, precepted by PaulSierzenski MD, Christiana Care Health Systems, “EP Ultra-sound Decreases Time to Diagnosis, Time to CT Scan andTime to Operative Repair in Patients with Ruptured AAA.” BestStudent: Johnny Parvani: “Why Call 911 for Pre-Hospital Car-diac Arrest: Analysis of an Urban Experience and Post-ArrestSurvey of Pre-Arrest Life Quality” and Tom Rozwadowski:“Poor Predictive Value of Vital Signs in Predicting Need forAdmission on ED Presentation and Value of Bio-markers.”Both students were from the University Georgetown and pre-cepted by Dave Milzman, MD.

Once again, Dr Charlene Irvin was acknowledged forlargest travel group of presenting residents, representing theED from St. John Hospital in Michigan. Dr Reeder also wasacknowledged for having three presenting residents from theprogram at East Carolina. The meeting included over 20 med-ical student presentations. Letters of Accommodation wereprepared for all of the student presenters by the meeting’s pro-gram committee for their outstanding presentations.

The meeting once again allowed a great deal of researchinteraction and exchange of ideas. Future meetings were dis-cussed and the fall may likely become the usual time for thisregional event. Dave Milzman served as Chair for the meet-ing and was assisted, most ably by Karen Jones of the Wash-ington Hospital Center.

Dave Milzman, MD, Meeting Chair awards the Best Student presentation awardto Georgetown University students: Johnny Parvani and Tom Rozwadowski.

NewsletterSubmissionsWelcomed

SAEM invites submissions to theNewsletter pertaining to academicemergency medicine in the followingareas: 1) clinical practice; 2) educationof EM residents, off-service residents,medical students, and fellows; 3) fac-ulty development; 4) politics and eco-nomics as they pertain to the academ-ic environment; 5) general announce-ments and notices; and 6) other perti-nent topics. Materials should be sub-mitted by e-mail to saem@saem.org.Be sure to include the names and affil-iations of authors and a means of con-tact. All submissions are subject toreview and editing. Queries can besent to the SAEM office or directly tothe Editor at david.cone@yale.edu.

11

Highlights of the North American Congress of Clinical Toxicology 2004 Research Symposium

Brad Weir, MDIndiana University Emergency Medicine Residency2004 Spadafora Scholarship Recipient

Seattle, the “Emerald City,” proved to bean ideal setting for an enthusiastic audi-ence to experience the many intriguingpresentations by world leaders in med-ical toxicology at the 2004 North Ameri-can Congress of Clinical Toxicology(NACCT). The meeting began with a breakfastduring which the venerable Dr. BruceAmes (of Ames’ test fame) spoke aboutmicronutrients and public health. Dr.Ames proposed that daily multivitaminsmight more economically and effectivelyreduce the incidence of cancer thanEPA surveillance and remediation. Withall of us inspired to pop some multivita-mins, we went on to other lectures.During the European symposium, Dr.Nick Bateman discussed the role of con-tinuous veno-venous hemofiltration(CVVH) versus hemodialysis for toxicalcohols, theophylline, and salicylates.For hemodynamically stable patients,hemodialysis is favored over CVVH formore rapid removal of a toxin. In anoth-er interesting talk, Dr. Peter Meier-Abtdiscussed the emerging role of N-Acetylcysteine and silybin as antidotesfor Amanita mushroom ingestions.In a thorough evidenced-based review,Dr. Andrew Gee described digitalis andTCA–associated EKG changes. Heposited that bidirectional ventriculartachycardia is not pathognomonic fordigitalis toxicity. Among tricyclic antide-pressant overdose patients, an R wavein aVR > 3mm may more accuratelypredict the development of seizures orarrhythmia than QRS widening, QTcprolongation, or rightward terminal 40ms deviation. This session providedvaluable information on the validity ofthe abnormal EKG findings in two com-mon presentations. The 256 well-researched abstracts thatwere presented in oral or poster ses-sions represented the many aspects oftoxicology (J.Clin.Tox.42(5)2004). Ihave summarized several abstracts thatI found particularly interesting and ger-mane to Emergency Medicine.A new flavor of stuffing. Fourteenmethamphetamine body stuffers weredescribed by Rhyee et al. All were sym-pathomimetic upon ED presentation.Eight received charcoal and/or whole

bowel irrigation. Six were dischargedafter 2-9 (mean 5.2) hours of observa-tion. Seven were admitted, five of whomto the ICU. One developed rhabdomyol-ysis and remained intubated for threedays, while the others were dischargedwithin 48 hours. Further study will deter-mine the optimum observation periodfor methamphetamine stuffers, whosepresentations are increasingly common. Atropine alternatives. In the event of achemical mass casualty incident,atropine supplies could be rapidly con-sumed. Glycopyrrolate was equally effi-cacious as atropine (and more so thandiphenhydramine) for treatingorganophosphate toxicity in an animalmodel by Schaeffer et al. Escitalopram escapades. Olsen et alportrayed an isolated escitalopramingestion that resulted in a severe andprolonged serotonin syndrome. This isthe second such case of serotonin syn-drome with escitalopram alone, thoughsingle-agent serotonin syndrome casesare rare. Ho and colleagues reportedthat seizures (6.9%) and QTc prolonga-tion (3%) remain the most common seri-ous complications of 261 patientsexposed to escitalopram or citalopram. Kids aren’t just little toxic alcoholdrinkers… or are they? DesLauriersand colleagues conducted a two yearreview of 33 pediatric patients (1-10years) with suspected methanol or eth-ylene glycol ingestions. Only 64% hadan anion gap calculated, and 36% hadan osmol gap calculated. Prior to obtain-ing toxic alcohol levels, fomepizole wasrecommended in 5/12 (42%) cases andwas delayed in 3/5 because “the patientwas a child.” Methanol or ethylene gly-col toxicity was confirmed in 25% ofthese 33 patients. Poison Center rec-ommendations are inconsistently fol-lowed in pediatric overdoses.Forget about poppy seeds onbagels… what about coca leaf tea?Mate de coca, or coca leaf tea, does notcause sympathomimetic symptoms (perreport of five healthy subjects) but willcause a positive drug screen forcocaine. Two abstracts (Mazor et al andPerrone et al) demonstrated positiveurine drug screens and subsequentconfirmatory tests for benzoylecognine

and ecognine methyl ester. This shouldbe considered when discussing testresults with patients.Pediatric antiepileptic potpourri.Lamotrigine, at a level 5x therapeutic,caused two grand mal seizures in a 19month old boy (Thundiyil et al). An eight-fold overdose of tiagabine causedseizures one hour, one and a half hours,and three and a half hours post inges-tion (Kazzi et al). Topiramate overdosecaused four days of ataxia, slurredspeech, and hallucinations in a 3 yearold (Lin et al). Among another series oftopiramate exposures, the mean onsetof symptoms was two hours and tachy-cardia, GI symptoms, and lethargy pre-dominated. Only 2 of 76 (3%) of patientsseized (Marquardt et al). There is noconsensus on the duration of monitoringneeded for overdoses of these agents.Selling strychnine, auctioningarsenic. Cantrell shopped eBay® for 10months and found 121 poisonous prod-ucts, 63 of which contained arsenic,cyanide, phosphorus, pilocarpine, nico-tine, and strychnine. Multiple heavymetals were also available, for the rightprice. Clinicians must consider expo-sure to these somewhat uncommon poi-sons via this dangerous new commerce. QTc query. Medlock et al examinedseveral resources (including a popularPDA program, web-sites, full-text refer-ence databases, and a textbook) fortheir completeness and accuracy ofreporting of QTc prolongation. To pre-vent adverse drug effects or to ascribeQTc prolongation to a drug interaction,one must learn the various medicationclasses that cause QTc prolongationand utilize current references. Treat the patient, not the test. Ordon’t even send the test. Twoabstracts by Maloney and colleaguesunderscore the poor yield of compre-hensive toxicology screens among pedi-atric patients. The send-out comprehen-sive drug screen took 540 minuteswhereas a standard drugs-of-abusescreen took 98 minutes. Comprehen-sive testing led to a change in diagnosisof 1/94 patients, but the clinical man-agement would not have changed for

(continued on page 25)

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Advocacy – More Than a RightVernon Smith, MD Mayo ClinicJill Baren, MDUniversity of PennsylvaniaSAEM National Affairs Committee“Ten people who speak make more noise than ten thousand who are silent.” - Napoleon Bonaparte

With the rapid change in healthcare, health policy, reim-bursement issues, HIPAA, EMTALA regulations, resident workhours and changes in Residency Review Committee guide-lines, there is little doubt of the importance of staying informedof current issues. Physicians must have the opportunity to beinvolved in legislative, regulatory and non-government agencyadvocacy for themselves and on behalf of healthcare educa-tors.1 A study by Landers and Sehgal concluded that physicianadvocacy is effective and that policy makers are receptive toincreased physician input on a broad range of healthcare relat-ed issues.2

However, healthcare educators are often reluctant toengage in advocacy activity due to perceived barriers.3 Theseinclude “lack of time” and “lack of access to key individuals”. Toaddress some of these barriers, the SAEM National AffairsCommittee was charged with developing an Advocacy Net-work Plan (ANP) designed to keep members apprised of cur-rent regulatory, legislative and educational agency actions thatare open for comment or advocacy efforts. This plan is meantto empower SAEM members to actively participate in theadvocacy process. The ANP has recently been approved bythe SAEM Board of Directors and this article is intended toraise awareness of the membership of its implementation.

Many professional organizations have developed advocacynetworks including the American College of Emergency Physi-cians (ACEP) 911 Legislative Network and the American Med-ical Associations (AMA) in Washington.4,5 The SAEM ANP willbe complimentary to these established programs and willfocus on issues relevant to academic emergency medicinephysicians such as education, research, documentation, andteaching rules.

The advocacy network will use existing SAEM listservs tocommunicate with members. Issues of importance will beidentified and forwarded to the SAEM President and Board ofDirectors for approval. Following endorsement, a recipient listwill be determined based on the issue under consideration and

area of interest or expertise. A targeted email message high-lighting the issue and recommended member action will besent. The emails may contain suggested key points for a mem-ber’s response as well as contact information for various agen-cies (Congress, governmental and non-government agenciesor organizations such as ACGME, AAMC) enhanced by directweb links, if possible. An SAEM member can respond to theissue by writing an email, letter or printing the text providedand sending the response to one or more individuals, agenciesor organization leaders.

Advocacy is most effective when it is focused with a clearmessage6 and the policies (laws) that are ultimately selecteddepend largely upon who is most effective at mobilizing sup-port for their choice7. With the implementation of the ANP,SAEM will strengthen it’s ability to represent our specialty andits interests to policymakers.References

1. Caira NM, Lachenmayr S, Sheinfeld J, Goodhart FW, Can-cialosi L, Lewis C The health educator's role in advocacy andpolicy: principles, processes, programs, and partnershipsHealth Promot Pract 2003 Jul;4(3):303-13

2. Landers SH, Sehgal AR How do physicians lobby their mem-bers of Congress? Arch Intern Med 2000 Nov27;160(21):3248-51

3. Galer-Unti RA, Tappe MK, Lachenmayr S Advocacy 101: get-ting started in health education advocacy Health Promot Pract2004 Jul;5(3):280-8

4. ACEP 911 Legislative Network Available at:http://www.acep.org/1,28,0.html

5. American Medical Association In Washington Available at:http://www.ama-assn.org/ama/pub/category/4015.html

6. Zink BJ Advocating for Emergency Physician Advocacy SAEMNewsletter 2001 Jan/Feb;13(1)1

7. Peterson MA Motivation, mobilization, and monitoring: the roleof groups in health policy J Health Polit Policy Law1999;24:415-419

Academic Department Established at Brown UniversityBrown Medical School has

announced that the Section of Emer-gency Medicine was granted full depart-mental status effective July 1, 2004becoming the second ivy-league schoolwith a Department of EmergencyMedicine. Robert H. Woolard, MD, hasbeen named the Interim Chair of theDepartment of Emergency Medicine,having served as the Chair of the Sec-tion since 1992. There are four emer-gency departments in the Brown Medi-cal School system. The Rhode IslandHospital ED cares for 75,000 patients

annually and is a level 1 trauma center.The Hasbro Children’s Hospital EDcares for 45,000 patients annually andis a pediatric trauma center. The MiriamHospital ED is a community-teachinghospital and cares for 40,000 patientsannually. The Memorial Hospital ofRhode Island ED is a community-teach-ing hospital and cares for 32,000patients annually. The four-year resi-dency program, which was the firstEmergency Medicine Residency in theivy-league, has 48 emergency medicineresidents. The three-year Pediatric

Emergency Medicine Fellowship has 6fellows. Other fellowships are offered inInternational Emergency Medicine,EMS/Disaster, Injury Prevention, Medi-cal Simulation and Geriatric EmergencyMedicine. There are centers in MedicalSimulation, Injury Prevention and Disas-ter Medicine, as well as a basic sciencelaboratory within the Department ofEmergency Medicine. The Departmentlooks forward to continued growth withthe opening of a new 54,000 sq. foot“state-of-the-art” ED at Rhode IslandHospital in February 2005.

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Report from National Asthma Education and Prevention Program Carlos A. Camargo, MD, DrPHMassachusetts General HospitalSAEM Representative to NAEPP

The National Asthma Education and Prevention Program(NAEPP) had a busy year! The annual meeting was held inWashington, DC on December 8, 2003. Highlights of thismeeting are summarized below:

● The group affirmed the success of the “National Confer-ence on Asthma 2003” that was held in Washington, DCin June 2003. The meeting covered all aspects of asth-ma and included several speakers/moderators fromemergency medicine (e.g., Jill Baren, Carlos Camargo,Richard Nowak, Robert Sapien).

● Research on pharmacist-managed asthma programsindicates that pharmacists have the knowledge andskills to improve asthma outcomes for patients. The pre-senter summarized several successful interventionsand continued obstacles to implementation.

● The transition to non-CFC inhalers is occurring—sever-al formulations are already considered nonessential inthe United States and others are voluntarily being con-verted by manufacturers to HFA and DPI delivery sys-tems. Most controversial is albuterol because of poten-tial cost burden to patients. The FDA is scheduled topublish a final rule by March 2005.

● PACE (Physician Asthma Care Education) is an educa-tional program aimed at primary care providers. Resultsindicate increased use of written plans, increased use ofinhaled anti-inflammatory therapy, and reduced ED vis-its—all without requiring additional time by the physicianduring the patient visit. Several challenges still exist (eg,acceptance of “well” asthma visits).

● Research has identified important issues relative tophysician-patient communication that can influence apatient’s adherence to therapy. The presenter summa-rized these issues (eg, language, education, and cultur-al differences between patients and providers) andemphasized the importance of communication to med-ication adherence and, ultimately, health outcomes.

● An outreach and education program for high-risk chil-dren living in public housing is being implemented byAllies Against Asthma in Hampton Roads, VA. Womenare trained to be lay health visitors within their housingcomplexes. The women use a case-finding approach toidentify children with asthma and then, through a seriesof four home visits, provide education and referral serv-ices to improve and stabilize asthma care. Although theprocess of implementation has been well honed, clinicaloutcomes are still pending.

● Allies Against Asthma (http://asthma.umich.edu/) also

has developed a public education campaign that willlaunch in 2004. The centerpiece of the campaign is avideo that will be aired through local media outlets. Thevideo describes ways in which coalitions can be a use-ful asthma resource, and provides contact informationfor connecting viewers with asthma coalitions in theircommunity.

Allies Against Asthma also maintains an asthmaresource bank that allows users to search for educa-tional materials, program resources, evaluation/surveyinstruments, and coalition-related materials from alibrary of more than 400 items.

● More than 500 health care providers have passed theNational Asthma Educator Certification Board (NAECB)exam since its inception in September 2002(www.naecb.org). The first-time pass rate is 70–75 per-cent. Nurses and respiratory therapists make up thelargest proportion of health professionals taking theexam. A “Reimbursement” link on the NAECB homepage leads to a section dedicated to asthma coding,billing, and reimbursement information. An interactivefeature provides state-specific coding information andallows users to post tips on asthma education reim-bursement.

● An Expert Panel is in the process of updating guidelinesfor the management of asthma during pregnancy. Thefocus of the evidence review is pharmacologic manage-ment. The final report should be available in late 2004.

● The Centers for Disease Control and Prevention (CDC)continues to develop and improve the national asthmasurveillance system. Surveys that comprise the core ofasthma surveillance data include the National HealthInterview Survey (NHIS), Behavioral Risk Factor Sur-veillance Survey (BRFSS), and the National AsthmaSurvey (NAS). These tools offer information on thenational burden of asthma and should, over time, pro-vide more useful information for planning and evaluatingstate and local interventions.

● The Professional Education Subcommittee has agreedto partner with the CDC in the development of guidancefor prehospital management of asthma exacerbations. Adraft report will be available to all Committee membersin late 2004.

The next NAEPP Coordinating Committee meetings will beheld on September 20, 2004 and June 20, 2005. For moreinformation about the NAEPP, please check:www.nhlbi.nih.gov/about/naepp/

SAEM is grateful to Dr. Camargo for serving as the SAEM representative to NAEPP. After a number of years of service,Dr. Camargo has decided to resign as the representative. The SAEM Board of Directors invites interested members tosubmit nominations to serve as the new SAEM representative to NAEPP. Nominations must include a letter of interest

and CV and must be submitted electronically to saem@saem.org no later than Friday, December 3, 2004.

14

14th Annual Midwest Regional SAEM MeetingTom P. Aufderheide, MD Michael K. Kim, MD Medical College of WisconsinSAEM Midwest Regional Meeting Directors

The Department of EmergencyMedicine and Section of Pediatric Emer-gency Medicine, Department of Pedi-atrics at the Medical College of Wiscon-sin hosted the 14th Annual MidwestRegional SAEM Meeting in Milwaukee,Wisconsin, on September 9-10, 2004 atthe Wyndham Milwaukee Center Hotel.In attendance were 140 staff physicians,residents, and medical students, withrepresentatives from over 30 institutionsfrom locations as far away as Hawaii,Puerto Rico, and California. There were75 abstracts submitted. Of these, 60presenters accepted the invitation topresent their abstracts (10 oral and 50poster presentations).The meeting began the evening beforewith a catered symposium focused on“Building a Career in EmergencyMedicine Research” attended byapproximately 80 participants. Tom P.Aufderheide, MD, presented opportuni-ties for research in emergency medicalservices; Marc H. Gorelick, MD, MSCE,presented aspects of pediatric emer-gency medicine research; and StephenW. Hargarten, MD, MPH, discussedresearch in injury control. The nature ofa career in emergency medicineresearch, the scope of potential oppor-tunities, and methods for achievingcareer success were discussed. Thesymposium generated superb discus-sion and interaction with attendees.Glenn Hamilton, MD, SAEM President-Elect, opened Friday’s activities with aninsightful lecture and interactive discus-sion titled “SAEM: Thoughts on the Nearand Distant Future, and a Request forInput.” The 14th Annual MidwestRegional SAEM Meeting’s KeynoteSpeaker was Susan A. Stern, MD, who

presented a helpful and informative lec-ture on “Developing an AcademicCareer,” consistent with the theme ofthis year’s meeting. Many thanks toboth Dr. Hamilton and Dr. Stern for theirsuperb presentations, which helpedmake this such a successful event!Oral abstracts were presented in amorning and afternoon session andwere well received. Poster presenta-tions were separated into nine cate-gories with a maximum of six posters ineach category. There were moderatedposter sessions in morning and after-noon which generated questions,answers, and spirited discussion. Medical students, residents, and otherinterested participants enjoyed the con-current Ultrasound Workshop led byMary Beth Phelan, MD, James Mateer,MD, and Tim Heilenbach, MD. Smallparticipant groups at four skill stationsallowed each participant “hands-on”experience in ultrasound diagnostics.Stations offered experiences usingultrasound on a human model, an ultra-sound simulator with normal and abnor-mal findings, ultrasound guided periph-eral line placement, and foreign bodyidentification and retrieval.The conference concluded with theExcellence in Emergency MedicineResearch awards. Congratulations tothe following award winners:

Best Oral Presenter – FacultyCarlos A. A. Torres, MD, MPH, MSc,The Ohio State University, Columbus,Ohio“Substrate supplementation during lowflow reperfusion of the globally ischemicheart”

Best Poster Presenter – FacultyMichael C. Plewa, MD, St. VincentMercy Medical Center, Toledo, Ohio“Outpatient prescriptions from an emer-gency department: What do we writefor?”

Best Oral Presenter – ResidentMatthew Empey, MD, WashingtonUniversity Barnes-Jewish Hospital, St.Louis, Missouri“A prospective, randomized study toevaluate the antipyretic effect of thecombination of acetaminophen andibuprofen in neurological ICU patients”

Best Poster Presenter – ResidentAmer Aldeen, MD, NorthwesternUniversity, Chicago, Illinois“Clinical characteristics of emergencydepartment neutropenic fever”

Best Oral Presenter – StudentShane Allen, Medical Student, InjuryResearch Center, Medical College ofWisconsin, Milwaukee, Wisconsin“The association of seatbelts withreduced hospital charges, disability, anddeath in Wisconsin”

Best Poster Presenter – StudentMatthew T. Nugent, Medical Student,The Chicago Medical School, NorthChicago, Illinois“Validation of a verbal assessment toolof English competency for use in theemergency department”

The 15th Annual Midwest RegionalSAEM Meeting will be held in 2005 andwill be hosted by the Department ofEmergency Medicine, St. John Hospitaland Medical Center, Detroit, Michigan.

Nominations Sought for Resident Member of the SAEM Board of DirectorsThe resident Board member is elect-

ed to a one-year term and is a full votingmember of the SAEM Board ofDirectors. The deadline for nominationsis February 4, 2005.

Candidates must be a resident dur-ing the entire one-year term on theBoard (May 2005-May 2006) and mustbe a member of SAEM. Candidatesshould demonstrate evidence of stronginterest and commitment to academic

emergency medicine. Nominationsshould include a letter of support fromthe candidate’s residency director, aswell as the candidate’s CV and a coverletter. Nominations must be sent elec-tronically to saem@saem.org. Candi-dates are encouraged to review theBoard of Directors orientation guidelineson the SAEM website at www.saem.orgor from the SAEM office.

The election will be held via mail bal-

lot in the Spring of 2005 and the resultswill be announced during the AnnualBusiness Meeting in May in New York.

The resident member of the Boardwill attend four SAEM Board meetings;in the fall, in the winter, and in the spring(at the 2005 and 2006 SAEM AnnualMeetings). The resident member willalso participate in monthly Board con-ference calls.

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Board of Directors UpdateThe SAEM Board of Directors meets

monthly, usually by conference call. Thisreport includes the highlights from theAugust and September Board confer-ence calls.

The Board of Directors agreed todevelop a number of informationalresources to submit to the Institute ofMedicine. The topics will include:research, graduate medical education,undergraduate education, and the spe-cial role of academic emergency depart-ments.

The Board approved a proposal ofthe National Affairs Committee to devel-op an advocacy network (see relatedarticle in this issue of the Newsletter).The Board approved Dr. Terri Schmidt torepresent SAEM at a FDA panel on clin-ical design.

The Board reviewed a request toprovide a letter of support for a grant.The Board agreed that SAEM shouldnot write letters of support for grantsfrom individuals or institution specific

grants. The Board agreed that a policyincorporating this decision should bedeveloped.

The Board approved Dr. RogerLewis to serve as the SAEM represen-tative to the ABEM 25th AnniversaryCelebration that will be held in Novem-ber.

The Board approved a proposal towork with the other emergency medi-cine organizations to develop educa-tional sessions to be held during the2005 and 2006 AAMC Annual Meetings.

The Board approved the surveyinstrument proposed by the FacultyDevelopment Committee for the 2004-05 Faculty Salary Survey. The surveywill be sent to chairs and chiefs at insti-tutions with emergency medicine resi-dency programs in early October.

The Board reviewed proposed revi-sions to the SAEM Residency Catalogsubmitted by the Undergraduate Com-mittee and Graduate Medical EducationCommittees and submitted additional

suggestions and comments for consid-eration.

The Board approved the regionalmeeting application for the 2005 NewEngland Regional Meeting. Additionalinformation about the New EnglandRegional Meeting, and other regionalmeetings, is included in this issue of theNewsletter.

The Board approved a revised Sur-vey Policy, which is published in thisissue of the Newsletter. This documentwill serve as the Society's policy forfuture proposed surveys, not those thatare current objectives or are currentlyunder development. The Boardapproved a report submitted by the WebPage Task Force.

The Board approved a proposal fromthe Research Directors Interest Groupto conduct a survey of research direc-tors. SAEM will provide funding ofapproximately $500 to support the sur-vey.

Jahnigen Career Development Scholars AwardsDeadline: December 7, 2004

The Jahnigen Scholars programoffers two-year career developmentawards to support junior faculty in thespecialties of anesthesiology, emer-gency medicine, general surgery, gyne-cology, ophthalmology, orthopedic sur-gery, otolaryngology, physical medicineand rehabilitation, thoracic surgery, andurology. The award is intended to allowindividuals to initiate and ultimately sus-tain a career in research and educationin the geriatrics aspects of his/her disci-pline.

Each grant will provide two-year sup-port of $75,000 per year for salary andfringe benefits and/or the costs of doingresearch. In 2005, each scholar's insti-tution must provide a minimum match of$25,000 per year. The applicationshould delineate the source of thematching funding and the line itembudget should provide information onthe allocation of the matching funds insupport of the scholar’s work. Up to tenawards will be given in 2005. The Jah-nigen Award may not be used to supportindirect costs.

To be eligible, a candidate must:● Be a physician who is a US citi-

zen or permanent resident.● Be certified or board eligible to

practice in one of the ten special-ties listed above.

● Have a primary academicappointment in a US institution inone of the specialty departmentslisted above.

● Have completed his/her training(residency and/or fellowship) onor after June 30, 1995. Excep-tions to this limit will be consid-ered for compelling reasons andmust be reviewed and approvedprior to application submission.Such exceptions should berequested and justified in a letterto AGS received by November 5,2004, so that, if approved, a com-petitive application can be pre-pared and submitted on sched-ule.

For each Jahnigen Career Develop-ment Scholar application, two seniorfaculty members at the candidate's insti-tution must be selected to serve as

mentors to help guide the scholar'sresearch and career planning and pro-vide access to organizations, programs,and colleagues helpful to the applicant'sefforts. Although more than two men-tors may be selected, at least one mustbe from the department in which thecandidate has a primary appointmentand at least one must be from the geri-atric medicine program within the sameinstitution.

Letters of endorsement, includingspecific information on institutional sup-port for the Jahnigen Scholar applicant,should be provided by the dean, the rel-evant department chairperson, andeach mentor. In addition, three letters ofreference should be provided by otherfaculty members and/or senior profes-sionals with whom the applicant hasworked and who are well acquaintedwith the candidate's capabilities, accom-plishments, commitment and aspira-tions. The deadline for submission isDecember 7, 2004. For more informa-tion: http://www.americangeriatrics.org/hartford/2005_jahnigen.shtml.

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ACADEMIC RESIDENTNews and Information for Residents Interested in Academic Emergency Medicine

Can you be an EM resident and still experience “Wellness”?Adrienne Birnbaum, MDMarianne Haughey, MDAlbert Einstein College of MedicineFor the SAEM GME Committee

“Wellness” describes a state of psychological and physical wellbeing1.Physician wellness in EM has been defined as, “thoseskills, attitudes and beliefs that allow one to enjoy practicing EMfor a long period of time, while at the same time allowing balancein one’s life”2. The concept of physician wellness acknowledgesthat multiple stressors related to the practice of medicine threatenthis balance. Imbalance can lead to unhealthy feelings and behav-iors, emotional distress, burnout, and impairment. Just as health is more than the absence of disease, wellness ismore than the absence of distress, burnout, and impairment3.Physician wellness implies that the physician’s engagement inproviding quality care to patients and the pursuit of other profes-sional goals exist in harmony with other elements of life thatenhance general happiness and well-being such as healthy rela-tionships, friendships, spirituality, hobbies, and other interests.Can a resident experience “wellness” during residency?Residents share many common stressors during their training.Sleep deprivation, excessive patient load, patient mortality,uncompromising attending physicians, and peer competition arecommon sources of stress among all residents4. Additional stres-sors described for EM physicians include: the unhealthy effects ofshift work, difficult patients, violence in the ED, and exposure toinfectious disease1. EM residents may experience additionalstressors: ● negative interactions with other housestaff● competition with other residents for procedures and learning

opportunities● lack of experience with essential negotiation skills● low status in the hospital hierarchy due to the relative youth of

EM as a specialty● lack of time to rest, socialize, and eat optimally during busy

shifts● isolation from social support due to geographic and scheduling

constraints● loss of camaraderie resulting from shift work● briefness of relationships with ED patients● difficult interactions with ED staff 5

A survey of 1,100 EM residents suggested that women andunmarried residents report higher levels of stress and depressionthan their male and married counterparts6. Women with familiesdeal with the added stress of balancing motherhood with profes-sional life.Fortunately, a body of literature has emerged since the 1980’ssuggesting ways to reduce, identify, and manage physician stress,burnout, and impairment. Most strategies for achieving wellnessemphasize the development of a “life plan” with personal goalsthat appropriately value and prioritize those goals. Without such aplan, a young physician may make personal sacrifices duringtraining and postpone gratification indefinitely, with the assump-tion that life will automatically become re-balanced after gradua-tion7. The balance between professional and personal goals is

unique to each individual.What Are Some Signs of Unhealthy Behavior or Feelings?Burnout is a syndrome of emotional exhaustion, depersonaliza-tion, and sense of low personal accomplishment that leads todecreased effectiveness at work8. Symptoms of burnout can over-flow into one’s personal life, but unlike a more global state ofdepression, burnout is primarily related to feelings about work3.Symptoms of burnout may include:● loss of interest in work● feelings of fear, avoidance, isolation, anger, ultimately loathing

for work9

● fatigue, exhaustion, inability to concentrate, anxiety, insomnia,irritability

● increased use of alcohol or drugs10

● headache, back or neck pain, abdominal distress, nausea,malaise

● anxiety, divorce, broken relationships, and disillusionment3

Assessment tools may quantify burnout. The adult APGAR, a briefself-scoring instrument available on the ACEP website, was devel-oped by the ACEP Wellness Task Force as a screening and edu-cational tool11. Designed to rapidly assess and monitor physicianwellness, it is less unwieldy than other wellness inventories andmore global in scope. It consists of 5 questions, each measuringa component of wellness. These components are Access to emo-tions, satisfaction with life’s Priorities, commitment to personalGrowth, satisfaction with ability to ask for Assistance from others,and satisfaction with Responsibility for self. Scores for eachanswer are summed to yield an overall score assumed to reflectthe degree of wellness. The Maslach Burnout Inventory is alengthy questionnaire that is considered the gold standardassessment of burnout. The inventory identifies three componentsof burnout: emotional exhaustion, depersonalization, and person-al accomplishment8,12.Burnout may contribute to physician impairment, particularly whenaccompanied by illness (including mental or physical illness),aging, alcoholism, or chemical dependence13. Signs of impairmentcan be insidious and nonspecific: unkempt appearance, com-plaints by patients and nurses, arguments, bizarre behavior, emo-tional outbursts, irritability, depression, mood swings, unexplainedabsences, irresponsibility, incomplete work or medical error, acci-dents and injuries, excessive prescription writing, unusually highdoses or wastage of controlled substances, intoxication at socialevents, odor of alcohol on breath while at work, and withdrawalfrom the social milieu14. What strategies enhance wellness during residency andbeyond?Weiner asked physicians, “What methods do you use to solvedilemmas related to your physical, emotional and spiritual well-being?” Five general areas of wellness promotion used by thisgroup of physicians were identified: relationships, religion/spiritu-ality, self-care, work, and approaches to life. The “relationships”

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category included relationships with friends, family, colleagues,and community involvement. “Religion and spirituality” includedinvolvement in organized religion, as well use of meditation andprayer. “Self care” included hobbies, exercise, good nutrition,avoidance of alcohol and drugs, professional counseling andtreatment of depression. The “work” category encompassed qual-ities that made work meaningful and allowed the physicians toreceive satisfaction from work such as achieving goals.“Approaches to life” included general philosophical outlooksincluding being positive, maintaining balance and focusing onsuccesses15. Quill and Williamson reported self-care, relation-ships, limiting work and developing a life philosophy as healthyapproaches for managing stress7. In an investigation of burnout inan internal medicine residency program, Shanafelt reported thatresidents recommended "talking with family or a significant other(72%)" and "talking with other residents or interns (75%)” as effec-tive methods for managing stress4. If a physician becomesimpaired for any reason programs in each state are designed tohelp16.Maximizing wellness during EM residency trainingThese suggestions are not necessarily evidence based but are acompilation of suggestions taken from the literature and fromanecdotal experience:● Develop a personal philosophy and prioritize professional and

personal goals. Short-term objectives and activities shouldsupport these prioritized objectives. This exercise can guidejob selection as residency ends.

● Maintain healthy relationships by spending time with thosewho are supportive of you. Set aside time for the relationshipsand share your feelings. Time devoted to healthy relationshipscontributes to well being.

● Care for your physical health: make healthy food choices,make time for an exercise regime that you enjoy, maximize thequality of your sleep. Create a sleeping space that is quiet anddark enough to allow sleep during day or night, unplug thephone, and consider using eye covers, earplugs, or a soundmachine. Do not try to maintain a “day shift” life if you areworking nights.

● Avoid intoxicants to relieve the stresses of the ED. ● Incorporate a sense of spirituality into your day. Spirituality can

take many forms, such as meditation, and does not necessar-ily imply organized religion. Explore what works for you.

● Find something about each day at work that challenges you orbrings you joy. EM brings opportunities to save lives and pro-vides unique opportunities to connect with patients in times ofgreat need. You can help in small ways that can be rewarding.

● Schedule your time carefully. Consider how each activity con-tributes to your sense of well being and your “life plan”.

● Make hobbies a priority; record television shows if necessary,read for pleasure, listen to music.

● Remember that to err is human. Medical errors and adverseevents occur despite our best efforts. These events oftenresult in pain, shame, guilt, and regret. Pathologic copingmechanisms may lead to loss of self-confidence, ongoing dis-tress and even depression. Learn from your mistakes, talk toothers who can provide support and empathy and learn tomove on. Keep things in perspective and remember thatadverse events do not mean that you are inadequate as aphysician or person.

● Visit a therapist or psychiatrist if the stresses seem over-whelming. Talk to other physicians, family, and friends abouthow you are feeling.

● Appreciate your accomplishments during this time of tremen-dous personal growth. Set reasonable goals and don’t expecttoo much of yourself.

Residency is a time of great personal growth. It is also a time oflife when there are many challenges and many residents feeloverwhelmed. Practical strategies exist to help a resident to thrivepsychologically, physically, and educationally throughout this chal-lenging life period.

Recommended web-based resourceswww.acponline.org/careers/catalog_resources.htm The physician renewal project is an annotated catalog of resourcessupporting physician wellness.www.acep.org/library/pdf/wellnessBookIntro.pdfIncludes articles on planning for wellness in EM, stressors in EM,coping mechanisms for EM physicians, wellness for the EM resi-dent, and APGAR-an instrument to monitor wellness.www.saem.org/publicat/chap12.htmPrimarily directed toward faculty in an academic career, this articlehas many practical tips that will pertain to EM residents as well.

References1. Lum G, Goldberg R, Mallon W, et al: A Survey of Wellness

Issues in Emergency Medicine (Part 1). Ann Emerg Med1992;21:1250-1258.

2. Perina DG, Chisholm CD: Physician wellness in an academiccareer. http://www.saem.org/publicat/chap12.htm

3. Shanafelt TD, Sloan JA, Habermann TM. The well-being ofphysicians. Am J Med. 2003;114:513-518.

4. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and selfreported patient care in an internal medicine residency pro-gram. Ann Intern Med. 2002;136:358–367.

5. Ellison DM: Wellness for the Emergency Medicine Resident.http://www.acep.org/library/pdf/wellnessBookResidentWellness.pdf

6. Whitley TW, Gallery ME, Allison EJ, et al: Factors associatedwith stress among emergency medicine residents. Ann EmergMed 1989;1157-1161.

7. Quill TE, Williamson PR. Healthy approaches to physicianstress. Arch Internal Medicine. 1990; 150: 1857-1861.

8. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu RevPsychol. 2001; 52:397-422.

9. Vickman L: Stressors in Emergency Medicine. Burnout. Well-ness Book For Emergency Physicians http://www.acep.org/library/pdf/wellnessBookBurnout.pdf

10.Linda Gundersen: Physician Burnout. Ann Intern Med, Jul2001; 135: 145 - 148.

11.Bintliff S: The Adult APGAR: An Instrument To Monitor Well-ness. http://www.acep.org/library/pdf/wellnessBoodultAPGAR.pdf

12.Maslach C, Jackson S, Leiter M. Maslach Burnout InventoryManual. 3rd ed. Palo Alto, CA: Consulting Psychologists Press;1996.

13.Physician Impairment: ACEP Policy Statement.http://www.acep.org/1,636,0.html

14.Medical Society of the State of New York: Committee for Physi-cians’ Health: www.mssny.org/res_ctr/cph.htm

15.WeinerEL, Swain GR, Wolf B, Gottleib M. A qualitative study ofphysicians’ own Wellness-promotion practices. Western J ofMedicine. 2001; 174: 19-23.

16.Federation of State Physician Health Programs. Available at:http://www.ama-assn.org; or http://www.amaassn.org/ama/pub/category/5705.html

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Call for Papers2005 AEM Consensus Conference

"Research Ethics: Informed Consent and Research without Consent"Deadline: March 1, 2005

Clinical research hinges on the ability of investigators to identify, recruit and enroll human subjects into clinical tri-als. The process of informed consent for research participation is designed to protect potential research subjects byeducating them about the trial and their rights as participants, allowing them to ask questions regarding the studyand their role, and assisting them in making an informed decision about research participation.

The process takes time, and there is evidence that even when done under the most controlled clinical circum-stances, potential study subjects do not always fully comprehend or even recall the issues presented to them. In theemergency department, this possibility is even greater because of time pressures to enroll patients when study inter-ventions have narrow therapeutic windows, when patients have language and reading skills discordant with theinvestigators, and where investigators are often clinicians with competing attention demands.

An additional circumstance, faced by emergency and resuscitation researchers, involves patients who are eligiblefor enrollment into studies but who cannot provide consent because of their critical clinical condition. Current regu-lations for waiver of and exception from prospective informed consent are cumbersome and have not often been suc-cessfully applied. The methods for fulfilling the requirements of the regulations have not been well defined, and indi-vidual IRBs have different levels of comfort in allowing these studies to proceed. It is also not certain if the patientsafeguards built into these regulations, actually provide the protections they were intended to.

The 2005 AEM Consensus Conference will be held on May 21, 2005 as a pre-day session before the SAEM Annu-al Meeting in New York. The conference will address issues of informed consent for research participation as it isprovided and obtained in the emergency department, problems arising when informed consent is waived, and chal-lenges when attempting studies with exception from informed consent. It is our hope that the conference will resultin recommendations, a research agenda, and a call for action from the emergency research community on how toensure patient safety as research subjects while providing reasonable and practical guidelines for refining currentregulations on waiver of and exception from prospective informed consent.

Original contributions describing relevant research or concepts in this topic area will be considered for publicationin the Special Topics issue of AEM, November 2005, if received by March 1, 2005. Proceedings of the conferencewill also appear in the November Special Topics issue. All submissions will undergo peer review by guest editors withexpertise in this area. If you have any questions, please contact Michelle Biros at biros001@umn.edu. Watch theSAEM Newsletter and the AEM and SAEM websites for more information about the Consensus Conference.

SAEM Ethics Consultation Service Emergency physicians are faced

with countless ethical dilemmas. Wemake choices based not only on ourknowledge but also on our personalbeliefs and value systems. Occasional-ly, an ethical issue arises that is outsideour world view or consideration, or a sit-uation confronts us that makes usuncomfortable. We may lack the knowl-edge to make a reasonable choice, wemay be faced with something totally outof our experience, or we feel at a lossbecause we cannot determine the pos-sible options. We may witness an ethi-cally questionable act, may observeunprofessional and possibly harmfulactions, may disagree about the correct-ness of another’s decision, or may feelwe ourselves are being subjected toexploitation, abuse, or other unethicalbehavior. Such situations are frighten-ing; it is difficult to distinguish realityfrom perception, to know who can be

approached for advice, or whereresources can be found to assist indeveloping an appropriate response.

Some institutions have committeesor other authoritative bodies designed toexamine grievances, allegations of sci-entific misconduct or specific ethicaldilemmas in clinical practice. The adviceof these groups, however, may havelimited applicability to emergency medi-cine; they may not include emergencyphysicians, or have the expertise torelate to the unique aspects of the ethicsof emergency medicine. In addition,these groups are charged with develop-ing a response to a particular crisis thathas arisen locally. They are goal direct-ed and not necessarily able to provide athoughtful method to educate beyondthe concrete response to the problem athand.

For these reasons, SAEM has devel-oped an Ethics Consultation Service to

assist SAEM members with questionsconcerning ethical issues or decisionsthey must make during the course oftheir clinical, academic or administrativeresponsibilities. Opinions from theEthics Consultation Service will beoffered to SAEM members in a timelymanner; requests from nonmembers willbe considered on a case by case basis.The opinions rendered are not meant tobe part of an ‘appeal process.’ All com-munications will be anonymous andconfidential. However, because manyethical issues confronting emergencyphysicians are universal in their scope,and others may learn from the issuepresented, we hope to develop a seriesof articles for publication, assuming thatconfidentiality can be maintained. Allrequests, inquiries, or correspondenceshould be directed to saem@saem.org.

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Standardized Reporting Guidelines for Studies Evaluating Risk Stratificationof ED Patients with Potential Acute Coronary Syndromes

Gerard X. Brogan, Jr., MD North Shore University Hospital SAEM Representative to the ACS Standardized Reporting Guidelines Work Group

Researchers evaluating patients for the potential of acutecoronary syndromes have incorporated a wide range of eligi-ble patients, historical factors and outcome parameters intotheir studies. This had led to difficulty comparing results andconclusion of diagnostic and prognostic studies.1 The patients’selection criteria, time intervals, positive test and outcome def-initions vary greatly between studies and investigators.2 As aresult, the Emergency Medicine Cardiac Research and Edu-cation Group—International (EMCREG-I) initiated an effort tostandardize operational definitions and reporting of studiesinvolving Emergency Department patients with potential acutecoronary syndromes. The EMCREG work group also involvedrepresentatives from SAEM, the American College of Emer-gency Physicians, the American Heart Association and theAmerican College of Cardiology. The recommendations of thisgroup, supported by the endorsement of these other profes-sional groups, sought to integrate scientific rigor with practi-cality in an effort to increase the likelihood of obtaining scien-tifically valid data that may have an impact on the care ofemergency cardiac patients. The goal of the group was not todevelop an ideal study, but to convene a consensus panel todevelop standardized reporting criteria that would more easilyallow for comparison of studies.

Under the direction of W. Brian Gibler, MD, Chairman ofEMCREG-I and Judd E. Hollander, MD, Chair, ACS Standard-ized Reporting Guidelines Work Group, members of EMCREGmet in 2001 to draft the initial set of criteria that should be con-sidered for incorporation into this document. Over the ensuingmonths, committee members continued correspondence toshape a draft document. In May of 2002, a work group meet-ing was convened during which committee members method-ologically discussed each suggested criteria and how criticalknowledge of the individual parameter would be to interpreta-tion of individual studies. After discussion, the working groupdetermined whether each criteria should be considered as“reporting criteria, supplemental reporting criteria or not furtherconsidered for the document”. Ten broad areas were definedand supporting documentation for the consensus recommen-dations was prepared. In 2004, the final “proposed document”was presented to the SAEM Board of Directors for their evalu-ation and endorsement.

The 10 major reporting categories are:1. Inclusion/Exclusion Criteria: This allows the reader to

understand exactly the patient population studied byunderstanding inclusion/exclusion criteria.

2. ECG Interpretation: This section is designed to encourageinvestigators to report sufficient ECG information so thatthe reader can evaluate the study population appropriate-ly.

3. Demographic Patient Characteristics: A description of thestudy population and of the study sample is necessary tounderstand the relevance of the study to specific popula-tions.

4. Presence or Absence of Cardiac Risk Factors and Method

of Evaluation: For emergency physician in particular, onecan only rely upon patients self-reporting for many cardiacrisk factors. This section defines those risk factors and themethod of evaluation.

5. Emergency Department Presentation: Acute symptomsleading to presentation and the time from symptomonset until presentation and treatment should bedescribed.

6. Biochemical Marker Performance: This section encour-ages assay specific information be recorded so thatstudies can be compared based on the cardiac markersutilized and the platform upon which they were measured.

7. Patient Course: The patient course should be describedincluding both medications and interventions received byEMS, Emergency Department personnel and inpatientcare, including disposition.

8. Defining Outcomes: Clear definitions for AMI and ACS isdescribed in this section as well as adverse events andprocedures to be reported.

9. Follow-Up Period: This section defines minimum follow-upintervals that would allow for optimal evaluation of man-agement/interventional strategies.

10. Report Publish Scoring Systems: Reporting of scoringsystems utilized in risk stratification (i.e. Goldman, ACI-TIPI, etc.) is encouraged.

How would this document best be used? Investigatorsplanning clinical studies that involved risk stratification of EDpatients with acute coronary syndromes should report theitems that are considered core components (bolded items inthe document). These items are those that represent the min-imal amount of information for readers to compare studies withrespect to patient enrollment, patient description and clinicaloutcomes. In addition, reviewers evaluating studies for poten-tial publication are encouraged to utilize these criteria to deter-mine whether investigators have reported sufficient informa-tion so that the reader can place the study in the appropriatecontext and compare results to other similar studies. Finally,and consistent with the original intent of the reporting guidelineproject, practicing clinicians can then use the core criteria todetermine whether patients reported in clinical studies weresimilar to the patients they treat in their daily practice. It ishoped that this will facilitate appropriate incorporation of studyresults in medical practice.

It was an honor for me to interact with such an expert groupof emergency medicine researchers and to represent SAEM inthis endeavor. References

1. Bradford G, Shewakramani S, Hollander, JE. Incomplete DataReporting in Studies of Emergency Department Patients withPotential Acute Coronary Syndromes Using Troponins. AcadEmerg Med 2003; 10(9):943-947

2. Hollander, JE. Risk Stratification of Emergency DepartmentPatients With Chest Pain: The Need for Standardized Report-ing Guidelines. Ann Emerg Med 2004; 43:68-70

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Call for AdvisorsThe inaugural year for the SAEM

Virtual Advisor Program was a tremen-dous success. Almost 300 medicalstudents were served. Most of themattended schools without an affiliatedEM residency program. Their “virtual”advisors served as their only link to thespecialty of Emergency Medicine.Some students hoped to learn moreabout a specific geographic region,while others were anxious to contact

an advisor whose special interestmatched their own.

As the program increases in popu-larity, more advisors are needed. Newstudents are applying daily, and over100 remain unmatched! Please con-sider mentoring a future colleague bybecoming a virtual advisor today. Wehave a special need for osteopathicemergency physicians to serve asadvisors. It is a brief time commitment

– most communication takes place viae-mail at your convenience. Informa-tive resources and articles thataddress topics of interest to your virtu-al advisees are available on the SAEMmedical student website. You cancomplete the short application on-lineat http://www.saem.org/advisor/index.htm. Please encourage your col-leagues to join you today as a virtualadvisor.

Geriatric Emergency Medicine Benefits from John A. Hartford Foundation Funding

Lowell Gerson, PhDNortheastern Ohio Universities College of MedicineSAEM Geriatric Interest Group

The John A. Hartford Foundationsupports the “Increasing GeriatricsExpertise in Surgical and Related Medi-cal Specialties” program (Geriatrics forSpecialists). SAEM has been an activeparticipant from the beginning in 1994.The Foundation recently announced it iscontinuing its funding for a fourth phase.The award is for over $4.3 million forfour years. The funding will begin July 1,2005.

Ten participating specialties have beenworking and will continue to work toaccomplish three goals:

● Improve the amount and qualityof post-graduate geriatrics edu-cation received by residents inthe targeted disciplines;

● Identify and support specialty fac-ulty in promoting geriatrics train-ing and research within their ownprofessional disciplines; and

● Assist certifying bodies and pro-fessional societies in improvingthe ability of their constituenciesto care for elderly patients.

Phase IV will also have two new majorgoals:

● Complete the transition to a per-manent governance structurethat is committed to advancinggeriatrics within the specialtiesand which has the support of the

participating specialty societies.● Begin a planning process to inte-

grate geriatrics into the continu-ing medical education programsoffered by the specialties.

These Phase IV grants will be usedto continue successful activities andintroduce new initiatives. These includethe Dennis W. Jahnigen Career Devel-opment Scholars, Geriatrics Educationfor Specialty Residents (GESR), discre-tionary grants, an up-to-date bibliogra-phy of relevant literature and continuingeducation.

The Jahnigen Program provides anopportunity to develop new leaders andalso disseminate information about geri-atrics to the specialty. Phase IV will pro-vide for a continuation of the JahnigenScholars Program and conduct leader-ship skills training for present and pastScholars. This year the deadline for theapplications is December 7, 2004

The Geriatrics Education for Special-ty Residents (GESR) Program offers anopportunity to develop needed geriatriceducation curricula for specialtytrainees allowing them to acquire theknowledge and skills necessary to pro-vide quality care for their older patients.

The discretionary grants program willbe more directed in Phase IV. The dis-cretionary awards will be used to sup-port development or organizational

plans for institutionalizing geriatricswithin each specialty.

The bibliography initiative will sup-port junior faculty in maintaining anupdated review of the literature that willbe available on line. This will allow theopportunity to track research develop-ments in each specialty and engage jun-ior faculty who may potentially becomeleaders in the geriatrics elements of thespecialty.

Continuing medical education is anew initiative for Phase IV. The educa-tional mission for earlier phases was toincrease residents’ expertise. Incorpo-rating geriatrics into the specialty’s CMEprograms is a fitting and logical nextobjective. The grant will support imple-mentation of continuing medical educa-tion programs.

The number of older Americans isexpected to double during in the nextthirty years. The number of oldest-oldAmericans, those aged 80 years orolder, will increase from 9.3 million in2000 to 19.5 million in 2030. If lifeexpectancy continues to increase at thesame rate seen in the 1990s, the num-ber of oldest-old people could balloon to31.2 million by 2050. The effect this willhave on emergency care is staggering.The Geriatrics for Specialists programwill go a long way to equip us for thisfuture.

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Resident Group Discount Membership ParticipationKatherine Heilpern, MDEmory UniversitySAEM Secretary/Treasurer

On behalf of the Board of Directors, I would like to thank the residency programs that have elected to participate in the residentgroup discount membership. These 62 programs bring 2,060 resident members to the Society. This program provides residentswith invaluable exposure to all facets of academic emergency medicine. Each resident member receives subscriptions toAcademic Emergency Medicine and the SAEM Newsletter, plus a discounted registration fee to attend the Annual Meeting. Theparticipating programs are:

Albany Medical CenterAlbert Einstein Medical Center, PhiladelphiaAllegheny General HospitalBaystate Medical CenterBeth Israel Deaconess Medical Center, Harvard AffiliateBoston UniversityCarolinas Medical CenterChristiana Care Health SystemCooper HospitalDuke UniversityEastern Virginia UniversityEmory UniversityGrand Rapids MERC/MSUHenry Ford HospitalIndiana UniversityLoma Linda UniversityLong Island Jewish Medical CenterMaimonides Medical CenterMedical College of VirginiaMedical College of WisconsinMetroHealth/Case Western Reserve UniversityMichigan State University, KalamazooNewark Beth Israel Medical CenterNorth Shore UniversityNorthwestern UniversityOregon Health & Science UniversityPalmetto Richland Memorial HospitalPenn State UniversityRegions HospitalResurrection Medical CenterSt. John HospitalSt. Luke's Roosevelt Hospital Center

St. Vincent Mercy Medical CenterStanford UniversityState University at BuffaloState University at SyracuseStony Brook UniversitySUNY Downstate/Kings County HospitalSynergy Medical Education AllianceTexas Tech UniversityThomas Jefferson UniversityUniversity of ArizonaUniversity of ArkansasUniversity of California, San DiegoUniversity of ChicagoUniversity of CincinnatiUniversity of ConnecticutUniversity of MichiganUniversity of New MexicoUniversity of North Carolina - Chapel HillUniversity of PennsylvaniaUniversity of PittsburghUniversity of RochesterUniversity of Texas, HoustonUniversity of VirginiaWake Forest UniversityWayne State University/Detroit Receiving HospitalWayne State University/Sinai-Grace HospitalWest Virginia UniversityWilliam Beaumont HospitalWright State UniversityYale-New Haven Medical CenterYork Hospital/Pennsylvania State University

2004 SAEM Medical Student Excellence Award WinnersListed below are additional names of recipients of the 2004 SAEM Medical Student Excellence in Emergency Medicine Award.The intial list was published in the July/August issue of the Newsletter. This award is offered to each medical school in the UnitedStates to honor an outstanding senior medical student. This is the tenth year this award has been made available. Recipientsreceive a certificate and one-year membership to SAEM, including a subscription to the SAEM Newsletter and the SAEM jour-nal, Academic Emergency Medicine. Information about next year's Excellence in Emergency Medicine Award will be sent to allmedical school dean's offices in February 2005.

Albany Medical CollegeDaniel Pauze

Dalhousie UniversityAndrew Barker

University of MinnesotaKatie Vogt

University of PittsburghBrian D'Cruz

Western University of Health Sciences/College of Osteopathic Medicine of the PacificGregory Kogan

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EMF Grants AvailableThe Emergency Medicine Foundation (EMF) grant applications are available on the ACEP web site at www.acep.org. From thehome page, click on “About ACEP,” then click on “EMF,” then click on the “EMF Research Grants” link for a complete listing of thedownloadable grant applications. The funding period for all grants is July 1, 2005 through June 30, 2006 unless otherwise noted.

EMF Directed Research Reducing Medical Errors AwardThis request for proposals specifically targets research that isdesigned to reduce medical errors in the Emergency Depart-ment setting. Although all clinical proposals will be considered,the highest priority will be given to proposals that directly eval-uate interventions to reduce medical errors and utilize quanti-tative outcome measures to assess effectiveness. Proposalsmay focus on specific patient populations, disease processesor hospital system components. Studies that propose to onlyidentify errors without a plan to evaluate outcomes or investi-gate interventions will not be considered. Applicants mayapply for up to $100,000 funding. The funds will be disbursedsemi-annually over the two-year cycle. Deadline: December20, 2004. Notification: April 11, 2005.

Riggs Family/Health Policy Research GrantBetween $25,000 and $50,000 for research projects in healthpolicy or health services research topics is available. Appli-cants may apply for up to $50,000 of the funds, for a one- ortwo-year period. The grants are awarded to researchers in thehealth policy or health services area, who have the experienceto conduct research on critical health policy issues in emer-gency medicine. Deadline: December 20, 2004. Notification:April 11, 2005.

Resident Research Grant A maximum of $5,000 to a junior or senior resident to stimu-late research at the graduate level is available. Deadline:December 20, 2004. Notification: April 11, 2005.

Career Development GrantA maximum of $50,000 to emergency medicine faculty at theinstructor or assistant professor level who need seed moneyor release time to begin a promising research project is avail-able. Deadline: December 20, 2004. Notification: April 11,2005.

Research Fellowship GrantThis grant provides a maximum of $75,000 to emergencymedicine residency graduates who will spend another yearacquiring specific basic or clinical research skills and furtherdidactic training research methodology. Deadline: January10, 2005. Notification: April 11, 2005.

Neurological Emergencies GrantThis grant is sponsored by EMF and the Foundation for Edu-cation and Research in Neurological Emergencies (FERNE).The goal of this directed grant program is to fund researchbased towards acute disorders of the neurological system,such as the identification and treatment of diseases and injuryto the brain, spinal cord and nerves. $50,000 will be awardedannually. Only clinical applications will be considered - nobasic science applications will be accepted. Deadline:January 10, 2005. Notification: April 11, 2005.

Medical Student Research GrantThis grant is sponsored by EMF and the Society for Academ-ic Emergency Medicine (SAEM). A maximum of $2,400 over 3months is available for a medical student to encourageresearch in emergency medicine. Deadline: February 7,2005. Notification: April 11, 2005.

ENAF Team GrantThis request for proposals specifically targets research that isdesigned to investigate the topic of ED overcrowding. Propos-als may focus on a number of related areas, including: defini-tions and outcome measures of ED overcrowding, causes andeffects of ED overcrowding, and potential solutions to theproblem of ED overcrowding. The applicants must provide evi-dence of a true collaborative effort between physician andnurse professionals and must delineate the relative roles ofthe participants in terms of protocol development, data collec-tion, and manuscript preparation. A maximum of $20,000 willbe awarded. Deadline: January 10, 2005. Notification: April11, 2005.

Directed Research Acute Congestive Heart Failure Award This grant program is sponsored by the Emergency MedicineFoundation (EMF) and Scios, Inc. This request for proposalsspecifically targets research that is designed to improve thecare of patients who present to the Emergency Departmentwith acute congestive heart failure. Only clinical science pro-posals will be considered. Proposals may focus on methods offacilitating treatment through early diagnosis, intervention andtreatment of acute congestive heart failure patients. Deadline:January 10, 2005. Notification: April 11, 2005.

AEM goes to on-line submissions!The Editorial Board of AEM is

pleased to announce that on-line sub-mission is now available for AcademicEmergency Medicine via the ElsevierEditorial System (EES). The easiest wayto access the system is from the frontpage of the SAEM web site atwww.saem.org or directly athttp://ees.elsevier.com/acaeme/default.asp.

EES is a tool that enables Authors tosubmit articles on-line, reviewers to ref-eree on-line and editors to manage the

peer-review process via an on-line sub-mission and editorial system.

EES is an Internet-based tool thatcan be accessed from anywhere in theworld and works on multiple platforms.Available 24/7, the on-line submissionsystem uploads files directly from yourpersonal computer, and allows you totrack the progress of your paper throughthe peer-review process. On-line sub-mission and peer-review speeds up thewhole publication process.

All authors and reviewers are now

required to submit their manuscripts andreviews on-line. On-line Submission: AGuide for Authors is available at:www.elsevier.com/locate/eesauthorsguide. Reviewers should go to:www.elsevier.com/locate/eesreviewersguide to view Elsevier Editorial System:A Guide for Reviewers.

We welcome your feedback on theon-line submission site and value yourcontinuing contributions to AcademicEmergency Medicine as an author andas a reviewer.

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Survey PolicyThe Survey Policy was developed by the Board of Directors in August 2004.

Society members sometimes request that SAEM sponsor,and assist with, conducting surveys of all or selected Societymembers. While surveys can be a valuable research tool, thedesign, distribution, collection, and data analysis of surveysare very resource-intensive with regard to staff time andexpense for the Society, as well as time spent by SAEM mem-bers in completing the survey. Because the Society and itsmembers do not have unlimited resources the Board discour-ages such projects and therefore has developed the followingpolicy.

● All SAEM sponsored surveys must further the missionand goals of the Society.

● SAEM does not assist with or sponsor surveys fromnon-SAEM organizations or individuals.

● Only those surveys that directly address an objectivespecifically assigned to a committee or task force forthat particular year (current year objective) will be con-sidered. SAEM will not sponsor surveys that fail to meetthis criteria.

● A project proposal form must be submitted to the nation-al office for all proposed surveys (http://www.saem.org/inform/projpro.htm). The proposal should describethe goals of the survey, how these relate to the specificobjectives the committee was charged with, the target

audience, the proposed mechanism of distribution (mail-ing list, use of list-serv, web site posting, etc) and dataanalysis, and must include the survey instrument itself.All project proposals must also include a budget and anestimate of staff time. The Board will review such pro-posals with regard to how well the survey fits the objec-tives of the committee or task force, the appropriatenessand perceived ability of the survey tool to accomplishthe stated objectives, as well as the resource require-ments for implementation.

● Any survey that is approved by SAEM becomes theproperty of SAEM with all rights reserved. To beapproved, the SAEM Board may request revisions in thesurvey. Changes made to the survey after approval bythe Board must be re-submitted before the survey is dis-tributed. Reports, manuscripts, etc. that result from thesurvey must be reviewed and approved by the SAEMBoard before they can be generally distributed or pub-lished.

● A summary of the findings of all approved surveys mustbe submitted to the Board within 3 months of comple-tion.

● Interest groups may utilize their list-servs to survey theirown members with regard to relevant topics withoutsubmitting a proposal to the SAEM Board.

President’s Message (continued from page 1)ic method revolves around hypothesisgeneration, testing, error identification,rejection or refinement and renewal.The best efforts will only produce partialtruth, as there is no absolute certainty inscience. Skepticism entails criticalthinking, and without this we are vulner-able to "pseudoscience". Sagan notesthat pseudoscience frames hypothesesso that they are "invulnerable to anyexperiment that offers a prospect of dis-proof." Pseudoscience places heavyreliance on expert opinion and authority.Sagan's advice in this chapter is a wor-thy read for all of us in the academiccommunity, from basic scientist toadministrator.

Our medical students and residents,while tremendously intelligent, aren’tnecessarily good "skeptics". The sys-tem that has produced them hasrewarded memorization of facts, often atthe neglect of critical thinking. We canand should don our "scientist" personain the classroom and at the bedside.Troubling misconceptions are easy tofind, and worthy of discussion. Allowme to list a few:

● The difference between efficacyand effectiveness of treatments

● How statistical and clinical signifi-cance are often different.

● How correlation differs from cau-sation.

● The lack of a perfect diagnostictest.

● How no test can be better thanthe selected gold standard (whichmay not be the best standard).

● The meaning of our constantcompanion – uncertainty.

Even the "art" of caring is largelybased on social science principles thathave characterized how humans reactin predictable ways to stimuli and inter-action. Our relationship should be morethat of a colleague in learning than an"all-knowing expert." Concepts ratherthan isolated facts will likely havegreater impact. Our graduates mustremain "lifelong learners" (skeptics) nomatter what career path they choose.We need to mentor our scientist roleand prepare them for the challenges of"junk science" and pseudoscience thatawait them. As Sagan notes, "Themethod of science, as stodgy andgrumpy as it may seem, is far moreimportant than the findings of science."

The bottom line is that we've accept-

ed an additional layer of ethical respon-sibility through our decision to practicein the academic environment. We areresponsible for the "science" of our spe-cialty. We are responsible for assuringthat our current and future patients reapthe benefits of that science. And wemust be diligent in preparing the futureof our specialty. Why seek a careerrequiring more time and more responsi-bilities at less pay? Perhaps the reasonis that as academics, we are both teach-ers and life-long learners ourselves. Weenjoy learning, being challenged, anddoing our best to continually improveourselves, our EM practice, our stu-dents and colleagues, and (most of) ourpatients. Can I show you the hard dataabout how we as academic emergencyphysicians make a difference years,decades, or generations from now? No.On this, you simply must be a believer.Though I may not have an abundanceof evidence, about this, not even I am askeptic.

Sagan, C: The Demon-Haunted World:Science as a Candle in the Dark. NewYork, Random House, 1995.

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The Top 5 Most-Frequently-Read Contents of AEM – September 2004Most-read rankings are recalculated at the beginning of the month. Rankings are based on hits received by articlesarchived on AEMJ.org.

Michael W. Donnino, Varnada Karriem-Norwood, Emanuel P. Rivers, Ajay Gupta, H. Bryant Nguyen, Gordon Jacobsen, JamesMcCord, Michael C. Tomlanovich Prevalence of Elevated Troponin I in End-stage Renal Disease Patients Receiving Hemodialysis Acad Emerg Med Sep 01, 2004 11: 979-981. (In "BRIEF REPORTS")

Andrew K. Chang, Gary Schoeman, MaryAnn Hill A Randomized Clinical Trial to Assess the Efficacy of the Epley Maneuver in the Treatment of Acute Benign PositionalVertigo Acad Emerg Med Sep 01, 2004 11: 918-924. (In "CLINICAL INVESTIGATION")

David C. Brousseau, J. Paul Scott, Cheryl A. Hillery, Julie A. Panepinto The Effect of Magnesium on Length of Stay for Pediatric Sickle Cell Pain Crisis Acad Emerg Med Sep 01, 2004 11: 968-972. (In "BRIEF REPORTS")

P. Richard Verbeek, Ian W. McClelland, Alexis C. Silverman, Robert J. Burgess Loss of Paramedic Availability in an Urban Emergency Medical Services System during a Severe Acute RespiratorySyndrome Outbreak Acad Emerg Med Sep 01, 2004 11: 973-978. (In "BRIEF REPORTS")

Craig D. Newgard, Jerris R. Hedges, Melanie Arthur, Richard J. Mullins Advanced Statistics: The Propensity Score--A Method for Estimating Treatment Effect in Observational ResearchAcad Emerg Med Sep 01, 2004 11: 953-961. (In "SPECIAL CONTRIBUTIONS")

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SAEM Consulting Service Report and InformationGlenn C. Hamilton, MDWright State UniversityChair, SAEM Consulting Service

The SAEM Consulting Service completed six consultationsduring the 2003-2004 academic year, many at academic med-ical centers applying for new residency programs. With theirpermission, here is feedback from two of the sites:

“I would rate your consultant’s visit as an A+. He man-aged…to identify the key issues and broad themes wewould need to address with the RRC site visitor, and heastutely picked upon the spirit and the soul of the pro-gram.” Mark S, Smith, MD, Professor and Chairman,Washington Hospital Center and Georgetown Universi-ty School of Medicine.

“We found the consultant to be very prepared with goodinsight and reasonable recommendations. It was partic-ularly helpful when he provided a ‘disinterested party’view when discussing funding and departmental statuswith our Chair of Surgery.” Deana Young, Assistant Pro-fessor, University of Nevada School of Medicine

The SAEM Consulting Service is well prepared to offer its con-siderable capabilities to interested parties in our specialty.Although a variety of services are available, our primaryexpertise is in the following:

1. Establishment of an EM residency: This consult is inadvance of application to the ACGME and RRC-EM forconsideration of a new EM residency. The consultation willassess the suitability and potential of the site for residencytraining and assist in the development of the program infor-mation forms required by the ACGME.

2. “Mock” survey prior to RRC-EM site survey: this serviceserves as a preparatory guide for new programs or as a“dress rehearsal” for re-accrediting residencies preparingfor their official site survey by the RRC-EM. This is a use-

ful process for making sure the issues of potential concernby the RRC-EM are addressed, and convincing institution-al administration of the benefits of EM and its continuedsupport.

3. Program Information Form (PIF) Review: This new serviceis a detailed review of the PIF for new or re-accrediting pro-grams in advance of submission to the RRC-EM.

4. Research Consultation: This relatively new aspect of theservice helps programs develop a research program suit-able to their environment.

5. Faculty Development: EM remains one of the few special-ties that requires faculty development as part of its pro-gram requirements. Programs that are initiating or havingdifficulty in this area may request a faculty developmentconsultation to assist in planning effective program for theirfaculty.

Consultations are done by experienced individuals who areprogram directors, academic chairs, and/or those who haveserved as RRC-EM site surveyors. Usually one or two indi-viduals participate in the site visit consultation depending uponthe needs of the institution. The individuals are selected withinput from the institution and the consult service. Fees are$1,250 per individual per day plus expenses. An additional$500 is paid to SAEM to support the administrative aspects ofthe Service. PIF reviews are $750.

The SAEM Consulting Service has played a significant role insustaining the quality of many EM residencies and assistingnumerous program directors in developing and creating solu-tions to their problems. We look forward to assisting interestedinstitutions in addressing their resident program or academicdevelopment needs. Please contact me directly atglenn.hamilton@wright.edu (937-395-8839) or through SAEMsaem@saem.org for further information and assistance.

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Medical College ofGeorgia

Faculty Position

The Department of Emergency Medicine has one openingfor full-time Emergency Medicine attending. Must beboard certified or board eligible in emergency medicine.Experience in emergency ultrasound is highly desirable.Be part of an emergency ultrasound section with an ultra-sound fellowship and highly productive ultrasoundresearch team. Opportunities also available in DisasterMedicine, Tactical Medicine, Wilderness and InternationalMedicine. Established emergency medicine residencyprogram with nine residents per year. Spacious ED facili-ties. New ten bed ED Observation Unit. New contiguouschildren's hospital and beautiful pediatric ED. Over75,000 visits per year. Level 1 trauma center for pediatricand adult patients. Augusta is an excellent family envi-ronment and offers a variety of social, cultural and recre-ational activities. Compensation and benefits are excel-lent and highly competitive. Contact Richard Schwartz,MD, Chair and Associate Professor, Department ofEmergency Medicine, 1120 15th Street, AF 2036,Augusta, GA 30912; 706-721-3548,rschwart@mail.mcg.edu . EOE

any case. Comprehensive drug testing beyond the drugs-of-abuse screen increases length of stay without contributing tothe care of pediatric patients.New pharmaceuticals are frequent causes of fits. Areview of 2003 California Poison Control System cases oftoxin induced seizures implicated the following agents (indecreasing order of frequency): buproprion, diphenhy-dramine, tricyclic antidepressants, tramadol, amphetamines,isoniazid, and venlafaxine. These newer epileptogenicagents should be considered in the differential of toxininduced seizures.In summary, the NACCT furthered my interest in Toxicologyby imparting novel and clinically useful information, revealingcurrent and future research endeavors, and affording me theopportunity to meet and discuss Toxicology with physiciansfrom several nations. All emergency physicians who attendthe NACCT will be rewarded with insight into overdoses onnew pharmaceuticals, practical treatment of unusual toxinsand envenomations, and evidence-based Toxicology infor-mation.I want to thank Dr. Louise Kao and Dr. Dan Rusyniak for sup-porting my application, the SAEM and ACMT membership forfunding the Spadafora Scholarship, and Dr. Leslie Dye forproviding me this invaluable educational experience.

Toxicology Research Symposium…(continued from page 11)

Emergency Medicine Faculty Position Thomas Jefferson University

The Department of Emergency Medicine (EM) at Thomas Jefferson University (TJU) isseeking board-certified or board-prepared academic physicians to join its well-estab-lished faculty. Current faculty now teach 36 EM residents in our long-standing EM 1-3 year residency and approximately 235 medical students each year in our mandatory4th year EM clerkship for medical students at Jefferson Medical College (JMC).

The emergency departments at TJU Hospital and Methodist Hospital (MH) together seeapproximately 90,000 patients annually. TJU Hospital is a Level I Trauma Center andRegional Spinal Cord Center. The MH ED, currently under expansion and renovation toinclude a CT scanner, is the primary community affiliate for our EM training program.

TJU Hospital is the primary teaching hospital for Jefferson Medical College and hometo residencies in every medical field. This physician would join 23 faculty memberswith strong clinical, research, teaching and patient satisfaction interests. TheDepartment supports 2 productive and nationally recognized basic sciencelaboratories, as well as an active clinical research program. Academic rank, salaryand benefits would be commensurate with experience.

Located in Center City Philadelphia, between Independence Hall and the theaterdistrict, TJU enjoys a reputation as one of the best hospitals and medical colleges inthe east, and is the major academic institution of the Jefferson Health System (JHS).Philadelphia has much to offer culturally, educationally and socially, plus provideseasy access to New York, Washington, DC, the ocean and the mountains.

TJU is an Equal Opportunity Affirmative Action Employer and strongly encouragesapplications from women and minorities.

Please submit curriculum vitae and confidential letter of interest to:

Theodore Christopher MD, FACEPChairman, Department of Emergency MedicineThomas Jefferson University11th and Walnut Sts., T239Philadelphia, PA. 19107theodore.christopher@jefferson.eduphone:215-955-6844fax: 215-503-5686

University of California San FranciscoFaculty Research Position

The Division of Emergency Medicine at the UCSF MedicalCenter is seeking candidates with a career goal of externallyfunded emergency medicine research for a position in the In-Residence series at the assistant professor level. The MedicalCenter has the busiest teaching hospital inpatient service in SanFrancisco, 576,000 outpatient visits, and is rated by U.S. News& World Report as one of the ten best hospitals in the U.S. TheED census is approaching 40,000 visits a year not includingurgent care patients seen in separate adult and pediatric clinics.ED has extremely high acuity and complexity, 24-hour access tosubspecialty consultation in most disciplines; an established real-time web based patient clinical research enrollment program, aswell as being fully credentialed for ultrasound use. A completerenovation of the physical plant will be completed in 2005.

A residency in EM is planned based at this hospital, and thisposition has the potential of also assuming the role of researchdirector for the program. There is a long tradition of researchand leadership in EM, and collaboration with other faculty inother departments. Quality of the intellectual experience andresources are unmatched, as is the physical and cultural environ-ment of the Bay Area. The successful candidate will have anexisting track record of research and publication that will lead tosuccessful funding in the first few years of appointment. UCSFis an affirmative action/equal opportunity employer.

Contact Michael Callaham M.D. at Box 0208, University ofCalifornia San Francisco, San Francisco, CA 94143-0208 ormlc@medicine.ucsf.edu

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FACULTY POSITIONSNORTH CAROLINA: University of North Carolina at Chapel Hill - EMSFellowship: A two-year fellowship in Emergency Medical Services. Facilitiesinclude a Level I Trauma Center, state-of-the-art Emergency Department with65,000 annual visits, active aeromedical program with two BK-117 helicoptersand four ground transport units, novel county-based EMS service, andEmergency Medicine residency. The fellow will obtain a Master’s degree whilebeing exposed to county and state systems management and research. TheUniversity of North Carolina is an Equal Opportunity Employer and welcomescandidates from diverse backgrounds. The applicant must have a MD/DO med-icine (or have similar experience). Send written inquiries to: Jane Brice, MD,MPH, University of North Carolina-Chapel Hill, Department of EmergencyMedicine, CB#7594, Chapel Hill, NC 27599-7594 to receive additional infor-mation.

OHIO: The Ohio State University - Assistant/Associate or Full Professor.Established residency training program. Level 1 Trauma center. Nationally rec-ognized research program. Clinical opportunities at OSU Medical Center andaffiliated hospitals. Send curriculum vitae to: Douglas A. Rund, MD, Professorand Chairman, Department of Emergency Medicine, The Ohio State University,146 Means Hall, 1654 Upham Drive, Columbus, OH 43210, emailDailey.1@osu.edu, or call (614) 293-8176. Affirmative Action/EqualOpportunity Employer.

OREGON: TOXICOLOGY FELLOWSHIP: Oregon Health & Science University– Two-year Toxicology Fellowship. Fellowship includes EM residency program,EM observation unit to admit Tox patients, weekly Tox didactic conferences,Toxicokinetics course, Pediatric EM and PEDs Tox. We also have linkages withEMS, HAZMAT, AHLS course, certificate program or MPH in research, and pes-ticide surveillance program. The Oregon Poison Center serves Oregon, Nevada,Guam and Alaska, and receives 70,000 calls/year. For a full description see ourwebsite: http://www.ohsu.edu/som-EmergMed/fellowship/tox/index.htm. For anapplication please call 503-494-8600 or email Dr. Zane Horowitz at horowiza@ohsu.edu

TENNESSEE: We are recruiting faculty interested in becoming expert clinicalresearchers. Vanderbilt offers a Masters in Clinical Investigation and a Mastersof Public Health; either can be earned in combination with fully compensatedreduction in clinical responsibilities over 12 – 18 months. Please consideradvancing your career in academic emergency medicine, earning a mastersdegree and working at one of the best and friendliest emergency medicine pro-grams in the country. Please reply to Corey M. Slovis, M.D., Chairman,Department of Emergency Medicine, Vanderbilt University, 703 Oxford House,Nashville, TN. 37232-4700. Email: corey.slovis@vanderbilt.edu. Vanderbilt isan equal opportunity employer.

WASHINGTON, DC: Washington Hospital Center (WHC), GeorgetownUniversity Hospital (GUH), Franklin Square Hospital (FSH), and UnionMemorial Hospital (UMH) in the Washington, D.C. – Baltimore, MD corridorseek physicians board-certified or residency-trained in emergency medicine tojoin their faculty. WHC is the largest Washington, DC hospital, seeing more than67,000 annual visits; GUH is a renowned academic institution; and FSH andUMH emergency departments in Baltimore are very busy. Contact Mark Smith,MD, FACEP, Chairman of Emergency Medicine, at 202-877-0808, fax 202-877-2468 or write to him at the Washington Hospital Center, Department ofEmergency Medicine, 110 Irving Street, NW, Washington, D.C. 20010.

DEPARTMENT OF EMERGENCY MEDICINETOXICOLOGY FELLOWSHIP

The University of Cincinnati seeks candidates for a two-yearfellowship in medical toxicology consisting of inpatient andoutpatient clinical consultation, environmental and occupa-tional toxicology, regional poison center experience, labora-tory and clinical research and experience in hyperbaric med-icine. Three medical toxicologists serve as faculty. Clinicalexperience is derived from an adult emergency room whichis the regional level I trauma center with more than 90,000visits annually and the second busiest pediatric emergencydepartment in the country (83,000 annual visits). NIOSHand EPA have headquarters in Cincinnati and a NIOSHmedical toxicologist is involved in training the fellow. The fel-low takes call for the poison center, conducts inpatient andoutpatient toxicologic consultations, and learns to use hyper-baric medicine for carbon monoxide poisoning and otherindications for which it is used. The option exists to obtainadditional training in occupational medicine leading to Boardeligibility. Candidates should have completed residencytraining in emergency medicine, pediatrics, internal medi-cine, or occupational medicine, and must be eligible forBoard Certification in one of these specialties. Submit letterof interest and CV to Curtis P. Snook, MD, Director,Toxicology Fellowship, University of Cincinnati, Departmentof Emergency Medicine, PO Box 670769, Cincinnati OH45267-0769; phone (513) 558-5281; emailsnookcp@ucmail.uc.edu.

EMERGENCY MEDICINEAcademic Positions

Available in the

Department of Emergency Medicineof

Allegheny General Hospital, Pittsburgh, PA

Practice Emergency Medicine in Western Pennsylvania’sMost Dynamic Emergency Department

✩ Emergency Medicine Residency Training Program✩ Level I Trauma Center✩ Level I HAZMAT Receiving Facility✩ 20% Pediatrics✩ Medical Toxicology Treatment Center✩ Fellowships - EMS, Sports Medicine, Administration, Research,

Toxicology, Patient Safety✩ Salary Commensurate with Experience

Contact:Fred Harchelroad, M.D.via Michelle Malsch, Executive Asst.(412) 359-3961mmalsch@wpahs.org

✩✩ West Penn Allegheny Health System, an Equal Opportunity Employer ✩✩

The SAEM Newsletter is mailed every other month toapproximately 6000 SAEM members. Advertising is limitedto fellowship and academic faculty positions. The dead-line for the January/February issue is December 1,2004. All ads are posted on the SAEM website at no addi-tional charge.

Advertising Rates:Classified ad (100 words or less)

Contact in ad is SAEM member $100Contact in ad non-SAEM member $125

Quarter page ad (camera ready)3.5" wide x 4.75" high $300

To place an advertisement, email the ad, along with contactperson for future correspondence, telephone and fax num-bers, billing address, ad size and Newsletter issues inwhich the ad is to appear to: Carrie Barber at carrie@saem.org

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University of PittsburghThe Department of Emergency Medicine offers fellowshipsin the following areas:

• Toxicology• Emergency Medical Services• Research• Education

Enrollment in the Graduate School is a part of all fellowshipswith the aim of obtaining a Master’s Degree. In addition,intensive training and interaction with the nationally-knownfaculty of the Department of Emergency Medicine, withexperts in each domain, is an integral part of the fellowshipexperience. Appointment as an Instructor is offered and fel-lows assume limited clinical responsibilities in theEmergency Department at the University of PittsburghMedical Center and affiliated institutions. Each fellowshipoffers the experience in basic and/or human research andteaching opportunities with medical students, residents andother health care providers. The University of Pittsburgh is anEqual Opportunity Employer, and will welcome candidatesfrom diverse backgrounds. Each applicant should have anMD/DO background or equivalent degree and be board certi-fied or prepared in emergency medicine (or have similarexperience). Please contact Donald M. Yealy, MD, Universityof Pittsburgh, Department of Emergency Medicine, 230McKee Place, Suite 500, Pittsburgh, PA 15213 to receiveinformation.

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Cook CountyHospital

Department of Emergency Medicine

Faculty Position

The Department of Emergency Medicine at Cook CountyHospital is seeking energetic and motivated candidates for afaculty position. Applicants must be residency trained andboard certified / eligible in Emergency Medicine. TheDepartment of Emergency Medicine has 54 residents in a PGYII-IV format and 26 full time faculty. The EmergencyDepartments care for 120,000 adult, 30,000 pediatric and 5000Level I trauma patients each year. A new 463 bed CookCounty Hospital was completed in December, 2002 with a stateof the art ED electronic information system. The departmentoffers a very competitive benefit package and protected time topursue educational, administrative and research projects.Faculty appointments are at our medical school affiliate, RushMedical College.

Interested candidates should contact: Jeff Schaider, MD,FACEP, Associate Chairman, Department of EmergencyMedicine, Cook County Hospital, 1900 West Polk Street 10thfloor, Chicago, IL 60612, Telephone - 312-864-1985,jschaider@ccbh.org

The University of ChicagoDepartment of Medicine

Section of Emergency Medicine

The Section of Emergency Medicine seeks full-timeacademic faculty members. Academic rank andsalary commensurate with background and experi-ence. Candidates must be BC/BE in EmergencyMedicine and eligible for medical licensure in theState of Illinois. Excellent teaching skills requiredWe currently have 14 faculty, 42 residents, and anoverall ED volume of 76K. We are involved inregional and international aeromedical transport anddirect one of the country’s busiest EMS systems. Wealso direct a resuscitation research center, a healthservices research group, and an informatics pro-gram.. We offer significant protected time and sup-port for those interested in research. Send a curricu-lum vitae to James Walter, M.D., Chief, Section ofEmergency Medicine, University of Chicago 5841South Maryland, MC 5068, Chicago, IL 60637 or e-mail to jwalter@medicine.bsd.uchicago.edu. TheUniversity of Chicago is an AffirmativeAction/Equal Opportunity Employer.

Emergency Medicine Faculty Position

The Department of Emergency Medicine at the Boston University School ofMedicine (BUSM)) seeks academic faculty members. Positions are availableat Boston Medical Center (BMC) which is a Level 1 Trauma Center with127,000 visits annually. The Department of EM serves as an independentacademic department within BUSM and BMC.

The department has a nationally recognized, well-established residencyprogram with academic faculty appointments through BUSM. BMC is themedical control and academic base for Boston EMS. In addition, we have anactive research section with particular focus on public health, administration,EMS and cardiovascular emergencies. Candidates must be ABEM boardcertified or eligible and must demonstrate a commitment to the training ofemergency medicine residents. Competitive salary with an excellent benefitspackage.

Further information contact: Jonathan Olshaker MD, Professor and Chair,Department of Emergency Medicine, Boston Medical Center, 1 BMC Place,Boston MA 02118-2393. Tel: 617-414-5481; Fax: 617-414-7759; E-mail:olshaker@bu.edu. An Equal Opportunity/Affirmative Action Employer.

Emergency Medicine Faculty Position

The Department of Emergency Medicine at the BostonUniversity School of Medicine (BUSM)) seeks academic facultymembers. Positions are available at Boston Medical Center(BMC) which is a Level 1 Trauma Center with 127,000 visitsannually. The Department of EM serves as an independent aca-demic department within BUSM and BMC.

The department has a nationally recognized, well-establishedresidency program with academic faculty appointments throughBUSM. BMC is the medical control and academic base forBoston EMS. In addition, we have an active research sectionwith particular focus on public health, administration, EMS andcardiovascular emergencies. Candidates must be ABEM boardcertified or eligible and must demonstrate a commitment to thetraining of emergency medicine residents. Competitive salarywith an excellent benefits package.

Further information contact: Jonathan Olshaker MD, Professorand Chair, Department of Emergency Medicine, Boston MedicalCenter, 1 BMC Place, Boston MA 02118-2393. Tel: 617-414-5481; Fax: 617-414-7759; E-mail: olshaker@bu.edu. An EqualOpportunity/Affirmative Action Employer.

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UNIVERSITY OF COLORADODIVISION OF EMERGENCY MEDICINE

The Division of Emergency Medicine at the University of ColoradoHealth Sciences Center in Denver, Colorado, is seeking full-time emer-gency medicine faculty to join our dynamic and growing Division.Responsibilities include clinical practice, teaching of emergency medicineand other housestaff, as well as scholarship. Clinical and basic researchwill be supported based on applicants’ interest. Faculty applicants must beresidency trained and board certified in emergency medicine with prefer-ence given to applicants who are fellowship trained.

The University of Colorado’s Fitzsimons Campus is the only completelynew academic medical center to be built in more than a generation. Whencompleted, Fitzsimons Campus will house the University of ColoradoHospital, the Children’s Hospital, the VA Medical Center, the Universityof Colorado Schools of Medicine, Dentistry, Nursing and Pharmacy, andtwo new biomedical research towers. Fitzsimons is unique in its integra-tion of public and private biotechnology.

The Emergency Department at Fitzsimons will be a state-of-the-art, acute-care clinical facility as well as a laboratory for the development of newtechnologies and pathways in emergency care.

Compensation is competitive. Minorities and women are encouraged toapply. The University of Colorado is committed to diversity and equalityin education and employment. Please send (e-mail preferred) curriculumvitae and a brief description of career interest and goals by December 1,2004, to:

Ben Honigman MDHead, Division of Emergency MedicineUniversity of Colorado School of MedicineB-215Denver, Colorado 80262Benjamin.Honigman@uchsc.edu

Full-time academic faculty position. Includes excellent academic support,appointment at Harvard Medical School, unparalleled researchopportunities, competitive salary, and an outstanding comprehensivebenefit package.

Brigham and Women’s Hospital is a major Harvard affiliated teachinghospital, level I trauma center, and the base hospital for the four yearACGME accredited Brigham and Women’s Hospital/MassachusettsGeneral Hospital Harvard Affiliated Emergency Medicine ResidencyProgram. The Department of Emergency Medicine cares for over 54,000ED patients per year, and the 43 bed ED includes a 10 bed EDObservation Unit, a 5 bed rapid assessment cardio/neuro unit and anadvanced informatics system. The department is also home toSTRATUS, a comprehensive medical simulation training center. Thedepartment has a robust International Emergency Medicine Program andoffers international EM fellowships.

The successful candidate must have successfully completed a four yearresidency training program in emergency medicine or a three yearprogram followed by a fellowship, and be board prepared or boardcertified in emergency medicine. Interest and proven ability in EmergencyMedicine research and teaching are essential. Please send inquiries andCV to Ron M. Walls, MD, FACEP, Chairman Department of EmergencyMedicine Brigham and Women’s Hospital 75 Francis Street, Neville House

Boston, Massachusetts 02115. E-mail rwalls@partners.orgBWH is an Equal Opportunity/Affirmative Action Employer

Brigham and Women's HospitalHarvard Medical School

Faculty Position

ACADEMIC EMERGENCY MEDICINEFELLOWSHIP

Due to the expanding need for Academic Emergency Physicians the University of Florida & Shands Teaching Hospital, Department ofEmergency Medicine are seeking emergency medicine residency trained or board certified emergency physicians as applicants for our AcademicEmergency Medicine Fellowship at the University of Florida Gainesville.This teaching hospital emphasizes active involvement with emergencymedicine residents and medical students. Qualified applicants will be board certified in emergency medicine; preferred applicants will have ademonstrated academic career interest. More than a research fellowship, this 2-year program includes training in education, research, EMS and administration in academic emergency medicine. Fellows will have the opportunity to complete work for M.S. in Interdisciplinary Biomedical Science. Fellows will also perform as Faculty while developing bedside clinical teaching and supervision skills in the ED. Shands at UF is the hub of a multi-hospital network. Shands at UF Emergency Medicineprovides county EMS direction, interhospital hospital transport includingthe ShandsCair aero-medical service, and provides medical support teams for NASA shuttle launches and landings. Great compensation, great benefits package, great city!

Our Department is committed to improving diversity in academicemergency medicine; women and minorities are encouraged to apply. University of Florida is an Equal Opportunity Employer.

Please send personal statement and CV to:

Kevin L. Ferguson, MD, FACEP, Director of Graduate Medical Education, University of Florida, Department of Emergency Medicine

P O Box 100186, Gainesville, FL 32610-0392

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The Division of Emergency Medicine at the University of UtahSchool of Medicine in Salt Lake City, Utah offers a two-yearResearch Fellowship in Emergency Medicine, effective July 2005.The University of Utah is the primary medical teaching and researchinstitution in the state. This program allows for concentrated trainingand experience in research to prepare the fellow for a career in aca-demic emergency medicine. Successful completion of the fellowshipwill include a Masters of Science in Public Health (MSPH) degree.Participants will be given a junior faculty position in the Division ofEmergency Medicine; however, clinical responsibilities will be limit-ed. Areas of research can be performed in a variety of emergencymedicine-related fields, including basic science, EMS, injury control,pediatrics, toxicology, trauma, etc. Compensation for this program isvery competitive and includes all educational fees and expenses.Applications must be completed by February 1, 2005. If you areinterested in applying or need more information, please contact:

Erik D. Barton, M.D., M.S., FACEPDivision Chief and Fellowship DirectorUniversity of Utah School of Medicine

1150 Moran Bldg, 175 N Medical Drive E, Salt Lake City, UT 84132(801) 581-2417, Fax: (801) 585-6699

erik.barton@hsc.utah.edu

Division of Emergency Medicine FellowshipNewark Beth Israel Medical CenterAn Affiliate of the St. Barnabas Health Care System

Department of Emergency Medicine

EM Teaching Attending Position

We are seeking a dynamic, experienced clinician BC EMto join our diverse, energetic faculty. Fully accreditedEM residency training thirty emergency physicians.82,000 patients per year, one-third children. We are ded-icated to teaching, research, and clinical excellence andseek to deliver the highest quality emergency medicalcare in an way that patients leave with an experienece ofbeing cared for and valued as human beings. Very com-petitive salary and benefits. Please submit resume andletter of interest via mail, fax, or e-mail:

Marc Borenstein, MD, FACEP Chair and Residency Program DIrector

Department of Emergency Medicine Newark Beth Israel Medical Center

201 Lyons Avenue Newark, New Jersey 07112

973-926-7562 office 973-282-0562 fax

mborenstein@sbhcs.com

Take Pride. Take Ownership. Deliver Excellence. Patients 1st.

Faculty PhysicianDepartment of Emergency Medicine

We are seeking qualified candidates for a faculty posi-tion within the Indiana University Emergency MedicineResidency training program at the Methodist Hospitalsite. The successful candidate will join a highly motivat-ed and energetic staff and will enable expansion of thecurrent double, triple, and quadruple faculty coverage.

The Indiana University Emergency Medicine ResidencyProgram has 51 categorical and 10 EM-Peds residentsbased at two large urban hospitals with a combinedannual census of over 200,000 patients. The programsponsors fellowships in Medical Toxicology and Out ofHospital Care (EMS), and works closely with the IUInformatics Fellowship. This position includes an excel-lent compensation and benefit program. Faculty appoint-ment is available at rank commensurate with experienceand productivity.

A letter of interest and Curriculum Vitae should be sub-mitted to:

Charles M. Shufflebarger, MDEmergency Medicine and Trauma Center1701 North Senate BoulevardIndianapolis, Indiana 46202

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Call for Abstracts9th Annual SAEM New England

Regional MeetingApril 27, 2005

Shrewsbury, Massachusetts

The Program Committee is now accepting abstracts forreview for oral and poster presentations. The meeting willtake place April 27, 2005, 8:00 am – 3:30 pm at theHoagland-Pincus Conference Center in Shrewsbury, MA.For information: www.umassmed.edu/conferencecenter/. The deadline for abstract submission is Wednesday,January 5, 2005 at 3:00 pm Eastern Time. Only elec-tronic submissions via the SAEM online abstract submis-sion form at www.saem.org will be accepted. Acceptancenotification will be sent mid-March 2005. Send registration forms to: Linda Quattrucci, ResearchAssistant, Department of Emergency Medicine; RhodeIsland Hospital, Coro West, Suite 106, One Hoppin Street,Providence, RI 02903. Email contact is lquattrucci@lifespan.org.Registration Fees: Faculty = $100; Residents/Nurses =$50; EMTs/Students = $25. Late fee after April 8, 2005 =add $25. Make checks payable to Brown Medical School,Department of Emergency Medicine.

Call for AbstractsSoutheastern SAEM Regional Meeting

April 8-9, 2005Chapel Hill, NC

The 2004 Southeastern Regional SAEM Meeting will beheld at the Friday Center in Chapel Hill, North Carolina onApril 8-9, 2005. The program committee is now acceptingabstracts for review for oral and poster presentations.Abstracts may be submitted electronically via the SAEMweb site at www.saem.org until January 5, 2005 at 5:00pm Eastern Time. Please use the SAEM submission formfound at www.saem.org.There will be oral and poster research presentations, ses-sions for medical students, hands on workshops, roundtable discussions with leaders in Academic EmergencyMedicine, keynote presentations by Dr. Glenn Hamiltonand Dr. Ian Stiell, and time to socialize with colleagues inthe southeast. Registration: medical students and residents are particu-larly encouraged to attend, and receive a discounted reg-istration fee: $50 (medical students) and $75 (residents ornurses). Registration for attending physicians is $125.For assistance with registration contact: Julie Vissers at(866) 924-7929 or (503) 635-4871 or via fax: (404) 795-0711 or email jvissers@theairwaysite.com.

Call for AbstractsWestern SAEM Regional Meeting

April 9-10, 2005Marina Del Rey Marriott

Marina Del Rey, California

The program committee is now accepting abstract sub-missions for poster and oral plenary sessions. Acceptedposters will be previewed on Saturday April 9, 2005 andmoderated poster sessions will be on Sunday, April 10.There will also be an oral plenary session for the region’sbest 4 or 5 abstracts. The deadline for abstract submis-sions is January 31st at 5pm PST. Only electronic sub-missions using the SAEM online abstract submission format www.saem.org will be accepted. Acceptance notificationwill be sent mid-March, 2005.

This conference’s didactic segments will focus onunderstanding and managing the role of uncertainty inmultiple aspects of clinical and academic EM practice. Formore information, contact Dr. Pam Dyne atpdyne@ucla.edu. The conference will conclude with anfun and interactive game-show format of audience partici-pation.

Please send registration forms to: Mr. Wayne Hasby,Residency Coordinator, UCLA/Olive View-UCLA EM Res-idency, 924 Westwood Blvd., suite 300. His email is whas-by@mednet.ucla.edu.

Registration fees: $125 for faculty, $50 for residents,nurses, and paramedics, and $10 for medical students.Please make checks payable to UCLA Division of Emer-gency Medicine.

Call for Abstracts5th Annual New York State

SAEM Regional Meeting April 3, 2005Brooklyn, NY

The program committee is now accepting abstractsfor review. All accepted abstracts will be for oralpresentation. The meeting will take place on Sun-day, April 3, 2005, 8:00 am-4:00 pm at StateUniversity of New York, Downstate Medical Center,450 Clarkson Avenue, Brooklyn, NY 11203.

The deadline for abstract submission isJanuary 5, 2005 at 3 pm Eastern Time. Onlyelectronic submissions via the SAEM onlineabstract submission form at www.saem.org will beaccepted. Acceptance notifications will be sent inlate February.

Registration forms are available from Richard Sin-ert, DO, Department of Emergency Medicine, Box1228, SUNY-Downstate Medical Center, 450 Clark-son Avenue, Brooklyn, NY 11203 ornephron1@bellatlantic.net

Registration Fees: Faculty--$35; Other health careprofessionals--$30; Fellows/residents $25 Charge.Late fee after Tuesday, March 1, 2005: add $10.For questions or additional information, call 718-245-2973.

Call for Abstracts2005 Annual Meeting

May 22-25, 2005New York, New York

Deadline: January 5, 2005

The Program Committee is accepting abstracts for review for oral and poster presentation at the 2005 SAEM AnnualMeeting. Authors are invited to submit original research in all aspects of Emergency Medicine including, but not limitedto: abdominal/gastrointestinal/genitourinary pathology, administrative/health care policy, airway/anesthesia/analgesia,CPR, cardiovascular (non-CPR), clinical decision guidelines, computer technologies, diagnostic technologies/radiology,disease/injury prevention, education/professional development, EMS/out-of-hospital, ethics, geriatrics, infectious dis-ease, IEME exhibit, ischemia/reperfusion, neurology, obstetrics/gynecology, pediatrics, psychiatry/social issues, researchdesign/methodology/statistics, respiratory/ENT disorders, shock/critical care, toxicology/environmental injury, trauma,and wounds/burns/orthopedics.

The deadline for submission of abstracts is Wednesday, January 5, 2005 at 5:00 pm Eastern Time and will bestrictly enforced. Only electronic submissions via the SAEM online abstract submission form will be accepted. Theabstract submission form and instructions will be available on the SAEM website at www.saem.org in November. For fur-ther information or questions, contact SAEM at saem@saem.org or 517-485-5484 or via fax at 517-485-0801.

Only reports of original research may be submitted. The data must not have been published in manuscript or abstractform or presented at a national medical scientific meeting prior to the 2005 SAEM Annual Meeting. Original abstracts pre-sented at national meetings in April or May 2005 will be considered.

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

Board of DirectorsCarey Chisholm, MDPresident

Glenn Hamilton, MDPresident-Elect

Katherine Heilpern, MDSecretary-Treasurer

Donald Yealy, MDPast President

Leon Haley, Jr, MD, MHSAJames Hoekstra, MDJeffrey Kline, MDMaria Raven, MDRobert Schafermeyer, MDSusan Stern, MDEllen Weber, MD

EditorDavid Cone, MDDavid.Cone@yale.edu

Executive Director/Managing EditorMary Ann Schroppmschropp@saem.org

Advertising CoordinatorCarrie BarberCarrie@saem.org

“to improve patient care byadvancing research andeducation in emergencymedicine”

The SAEM newsletter is published bimonthly by the Society for AcademicEmergency Medicine. The opinions expressed in this publication are those of the

authors and do not necessarily reflect those of SAEM.

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

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Newsletter of the Society for Academic Emergency Medicine