NEWSLETTERNewsletter of the Society for Academic Emergency Medicine January/February 2003 Volume XV, Number 1

PRESIDENT’S MESSAGE

My ChangingPerspective on theMedical LiteratureMuch has been written on the

evolution of the medical literature.The primary, research-based clinicalliterature is rapidly growing both involume and in sophistication. Withrigorous methodology, clinicalresearch studies are more likely toyield results that are unbiased, can

be applied in clinical practice, and will improve the effective-ness of emergency medical care.

The effect of published research on the quality of clinicalcare depends on several factors, however. The first is thequality of the research itself. In this context, the term qualityincludes many or all of the considerations taught in the para-digm of evidence-based medicine, including the definition ofthe research question, the patient population, the definition ofoutcome, and methods to reduce sources of bias. The secondfactor, however, is the mind set and expertise of the physicianreading the article. Much of the evidence-based medicineparadigm and the literature surrounding journal clubs focuseson education to ensure the physician-reader is able to appro-priately assess the methodologic quality of a clinical researchstudy and identify threats to validity. The underlying assump-tion is that the quality of the research is the principal determi-nant of clinical impact.

I believe however, that there is a natural evolution in per-spective regarding the medical literature, which significantlyinfluences one’s assessment of the value of an individual pub-lication and one’s willingness to incorporate the results intoclinical practice. My hope is that by describing my own evolu-tion in this regard, some may gain a little perspective on theevolution of their own attitudes towards the medical literature.

The first stage in my evolution as a reader was the “con-fused-awe” stage. During my tenure as a medical student, Iwas a faithful subscriber to the New England Journal ofMedicine, but only because it seemed like I should subscribe.I would frequently skim through the articles, or at least theabstracts, in a state of confused awe. I was in awe of theauthors who could study and write about the bewildering arrayof topics covered, and confused because none of it made anysense to me whatsoever. To this day, I am impressed when-ever a clinical evaluation states that a medical student wasable to assimilate the primary literature and apply it to patients

Roger J. Lewis, MD, PhD

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SAEM NEWSLETTER

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saem@saem.org

www.saem.org

Call for AEM ReviewersDeadline: March 1, 2003

The editors of AEM, the official journal of the Societyfor Academic Emergency Medicine invite interestedSAEM members to submit nominations to serve as peerreviewers for Academic Emergency Medicine, the offi-cial journal of the Society for Academic EmergencyMedicine. As an indicator of familiarity with the peer-review process, the medical literature, and the researchprocess in general, peer-reviewers are expected tohave published at least two peer-reviewed papers in themedical literature as first or second author. Some ofthese papers should be original research work.Alternatively, other scholarly work or experience will beconsidered as evidence of expertise (i.e., informaticsexperience demonstrated by network/data-base/desk-top development).

AEM peer-reviewers are invited to review specificmanuscripts based on their area(s) of expertise. Oncea reviewer has accepted an invitation to review a manu-script, the reviewer is expected to complete the reviewwithin 14 days of receipt of the manuscript.

In order to provide feedback to reviewers, reviewersreceive the consensus review from each manuscriptthat they review. In addition, each review is evaluatedby the decision editor in the areas of timeliness, assess-ment of manuscript strengths and weaknesses, con-structive suggestions, summarizing major issues andconcerns, and overall quality of the review. Scores arecompiled in the AEM database. Each year the Editor-in-Chief designates Outstanding Reviewers for publicacknowledgment of excellent contributions to the peer-review process. Most appointments as peer reviewerare for three years. Reviewers whose consistently failto respond to request to review, who are unavailable toperform reviews, or who submit later or incompletereviews may be dropped from the peer reviewer data-base at any time, at the discretion of the Editor-in-Chief.

Individuals interested in being considered forappointment as an AEM peer reviewer must send a let-ter of interest including areas of expertise as defined onthe reviewer topic survey and a current CV. The review-er topic survey can be found at www.saem.org/inform/resurvey.htm. All applications should be submit-ted electronically to aem@saem.org by March 1, 2003.

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All SAEM members interested inserving on an SAEM committee or taskforce in 2003-2004 (appointments willbe May 2003 through May 2004) mustcomplete a Committee/Task ForceInterest Form by February 1, 2003. Thisyear the Committee/Task Force InterestForm has been developed as an onlinesubmission form on the SAEM web siteat www.saem.org

SAEM committees and task forcesare the “engine” that drives the organi-zation. It is through the work of thesecommittees and task forces that theSAEM mission is advanced, the qualityof the Annual Meeting maintained andimproved, and many of the new ideaswhich strengthen our organization aredeveloped and nurtured.

Being appointed to a SAEM commit-tee or task force is both an opportunityand a commitment. It is an opportunityto improve the world of academic emer-gency medicine and to influence thedirection of the Society as a whole.Because there are frequently moremembers who wish to serve on commit-tees/task force than available positions,it is expected that each member apply-ing for a position is prepared to make asignificant commitment towards com-pleting the work of the committee.Members should only apply to becomea member of a SAEM committee/taskforce if they are willing and able to com-mit substantial time and energy.

It is important that members beaware that the goals and objectives ofeach committee/task force are not setby the committees themselves, but areguided by the five-year goals and objec-tives of the Society and defined by theBoard of Directors. The SAEM Boardsets the goals and objectives to ensurea coordinated set of activities and toreduce duplicate efforts. Thus, commit-tee/task force members must be pre-pared to put their efforts towards thecompletion of predefined goals andobjectives. As outlined below, however,there is significant opportunity to influ-ence the goals and objectives to thecommittees through feedback to eachcommittee chair or to the Board directly.

Members should be aware that one-half or more of the goals and objectives

for each committee/task force arerepeated each year. For example, onecan anticipate that an objective for theProgram Committee will always be tocoordinate the Annual Meeting and toselect abstracts and didactic proposalfor presentation. However, each yearcurrent committee/task force chairs andmembers are urged to submit newobjectives for consideration by theBoard and President-elect as theydevelop the objectives for the next year.

How are new committee/task forcemembers selected? First, each commit-tee chair is asked to evaluate the per-formance of each currentcommittee/task force member.Members are evaluated in terms of theirproductivity, work effort, responsivenessto requests, and overall contribution tothe function of the committee/task force.Approximately one-third of each com-mittee/task force membership is rotatedoff each year, based on both the chair’sevaluation and on the number of yearseach member has served on the com-mittee/task force. This rotation isextremely important to ensure that asmany SAEM members as possible havean opportunity to participate in theSociety’s efforts. For this reason, ingeneral, SAEM members will beappointed to serve on a single commit-tee/task force at one time.

All prospective committee/task forcemembers, whether currently on a SAEMcommittee/task force or with no priorexperience, are required to complete aCommittee/Task Force Interest Form inorder to be considered for reappoint-ment or new appointment. The Formmust be accompanied by a current CV.

The Interest Form should include theapplicant’s motivation for joining thecommittee/task force, ideas regardingareas in which they may contribute tothe committee/task force, and any otherinformation the applicant deems rele-vant. In evaluating these applications,the President-elect looks for evidence ofenthusiasm, focus, realism, new ideas,and commitment. Applications are gen-erally much stronger if they demonstratean understanding of SAEM’s mission,the five-year plan for the organization,and the current year’s goals and objec-

tives for the individual committee/taskforce. All of this information is availableon the SAEM web site atwww.saem.org.

Among some SAEM members thereis an unfortunate perception that beingappointed to a SAEM committee/taskforce requires being a member of someinner circle. On the contrary, each yearthe President-elect makes a concertedeffort to appoint members who have notpreviously had an opportunity to serve,as part of an ongoing effort to developnew leadership talent in the Society.Because the President-elect cannotknow all members equally well, theinformation provided in theCommittee/Task Force Interest Formand the CV is weighted heavily in theselection process. This helps ensurefairness, opportunity, and a well-bal-anced committee/task force member-ship.

It cannot be emphasized enough thatfirst-time appointment to acommittee/task force in SAEM is mostlikely when a complete and thoughtfulInterest Form is submitted.Reappointment to a committee/taskforce is most likely when the memberhas been an active and productivemember of a current committee/taskforce.

2003-2004 Committee and Task Force Appointments: The Selection Process and How to Apply

Donald Yealy, MDUniversity of PittsburghSAEM President-elect

Members of SAEM whowish to be considered

for appointment orreappointment to aSAEM committee ortask force in 2003-04must submit an onlineCommittee/Task Force

Interest Form byFebruary 1, 2003. TheForm is now availableon the SAEM web site

at www.saem.org.

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SAEM Research Fund – The Greater Context of GivingBrian J. Zink, MDUniversity of Michigan Medical CenterChair, SAEM Financial Development Committee

The initial response to the SAEMmember appeal for the SAEM ResearchFund has been very positive.Contributions from members have beenunprecedented, with several memberscontributing at the Professor, or highestlevel of giving. Still, those who havedonated to the SAEM Research thus farrepresent only a tiny minority of activemembers. Two essential componentsto giving are having the resources todonate, and believing in the cause thatis represented. As physician wageearners, nearly all of us have the meansto contribute at least some small portionof our income to the SAEM ResearchFund. The issue at hand therefore, isbelieving in the cause.

As each member decides whether itis worth contributing to the SAEMResearch Fund, it may be useful to lookat this cause in a larger context.Emergency Medicine as a specialty hasfinally come of age, both in the commu-nity and academic environment. Wecan look across the country and findhigh quality, residency-trained emer-gency physicians staffing manyEmergency Departments, strong resi-dency programs that are attracting thebest and brightest medical students,strong and vigorous professional organ-izations, and a strong and innovativespecialty board. Our journals are wide-ly read and cited, our scientific meetingsare well attended, and we have a strongvoice and presence in national healthcare policy. The only realm whereEmergency Medicine has lagged behindis in research. This is not for lack ofawareness of the importance ofresearch to academic success. Thirtyyears ago our academic founders artic-ulated that a credible research basewould be an integral component of theacademic development of EmergencyMedicine. But, we have struggled tomatch our academic peers in terms ofresearch training, productivity andbuilding a strong group of independentEmergency Medicine senior investiga-tors. We have certainly made somestrides in recent years. SomeEmergency Medicine investigators havebeen successful in securing long termNIH funding and wide spread recogni-tion for the quality of their research.However, as a field, our success is spot-

ty, and funded research opportunitiesfor young emergency physicians, andsupport for junior level investigators isnot plentiful. The Emergency MedicineFoundation has helped by fundingresearch for many years. The SAEMResearch Fund was developed to pro-vide more training grants for emergencyphysicians. With our two-year,$150,000 research training grants, wehope to provide the boost that youngacademic emergency physicians needto become successful researchers.Currently only two people are able toget this support each year – we wouldlike to see that number increase as theResearch Fund grows.

An even bigger context to consider isthe benefit that emergency medicineresearch can have for our patients.Beyond training emergency physiciansand providing grant funding, theResearch Fund is about helping thelegions of people we treat every day inour Emergency Departments. Thepromises of new drugs, new devices,practice standards, social and epidemi-ological interventions, and discoveriesof the basic mechanisms of disease, willall be empty unless they are carefullyresearched by emergency physicians.The SAEM Research Fund will providethe training so that emergency physi-cians are leading the way in researchthat will benefit emergency patients.

Another larger context is a historicalone, gleaned from interviews that I havebeen doing with the founders of emer-gency medicine. When we look at thecomplexity of our days, and the magni-tude of our academic work, it seemsthat we are giving to the field in anunprecedented manner. But, our forefa-thers in emergency medicine practiceand academics set the standard for giv-ing to the field. Although they are toomodest for me to include their names,consider what they gave. In the earlydays of forming the specialty, one earlyleader worked 56 clinical hours perweek. In his “spare time” he organizedand led the early organizational meet-ings, contacted people from the AMAand other national organizations, andtraveled extensively to promote the for-mation of Emergency Medicine. Thesetravel expenses came out of his ownpocket, and in today’s dollars would

amount to about 4 months of an aver-age academic emergency physician’sannual salary. In order to allow for thisamount of travel, the emergency physi-cian colleagues of the early EM leadersalso had to give. They were often askedto fill in shifts, work double shifts, andotherwise hold down the fort while theleaders were away.

In the academic realm the early lead-ers were also sacrificing a great deal.Many of them were fighting two vigor-ous battles at once. One was to justifyand maintain their existence in hostileacademic medical center environments.The other was to build an academicspecialty amidst similar hostile forces ona national level. Many of these earlyleaders had interests in research, teach-ing, and other areas of academic medi-cine. However, they gave up their indi-vidual interests and aspirations in orderto create an environment where theirsuccessors could flourish. In doing so,many of them ignored their own careerdevelopment, and especially in the areaof research were unable to live out theirdreams. Even those who were neverinvolved in research now reflect on it.One early leader, who was instrumentalin the establishment of quality emer-gency medicine residencies and teach-ing, but not research, in response to aquestion about how emergency medi-cine has changed over the years said:... “I think that things ...that havepleased me most about emergencymedicine is the kind of people who havegone into it, and what has been accom-plished as far as investigators work...we have taken our practice and exam-ined it. We have examined at the benchand we’ve examined it in the clinicalwork place. We’ve done it in a way thatmany other specialties much larger,more powerful have not ... I think thatthat probably more than anything makesme very proud that we have sought outour best practices and tried scientificallyand objectively to determine what bestpractice is. It has benefited patient careimmeasurably.”

The purpose of pointing out thetremendous passion and sacrifices ofour founders is not to heap shame orguilt on current academic emergencyphysicians – we have different chal-lenges. It is to emphasize that today it

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Call for NominationsAEM Editorial BoardDeadline: March 1, 2003

Michelle Biros, MD, MS, Editor-in-Chief, invites nominations for potential members of the Editorial Board of AcademicEmergency Medicine. A limited number of individuals will be appointed to the Editorial Board to begin three-year terms,beginning during the SAEM Annual Meeting in Boston in May. Preference will be given to those who have demonstratedprevious service to the Journal, especially those with a track record of peer review and active participation in the Journal.Editorial Board member responsibilities include:1. Perform peer review of at least three manuscripts per year. 2. Assist in peer review of additional manuscripts on an ad hoc basis.3. Contribute commentaries as requested by the Editor or Senior Associate Editors. These may be on specific articles or

concepts. It is expected that each Editorial Board member will contribute at least one commentary during their tenure onthe Board.

4. Attend the Editorial Board meeting held during the SAEM Annual Meeting.5. Respond to e-mail communications regarding the workings of the journal, through the Editorial Board list-serv.6. Participate in, and complete, tasks assigned by task forces and committees created to investigate or develop specific poli-

cies or procedures and topics of the Journal and its operations. Provide on-going reports of the progress of these tasksas requested.

7. Represent AEM among peers, their institutions, at meetings, conferences, exhibits, etc. Suggestions include distributingcopies of the Journal, soliciting and submitting articles, providing contacts for potential peer reviewers, staffing the AEMBooth, and nominating additional members to the Editorial Board.

Other involvement that is requested but not mandatory:8. Service as a guest decision editor.9. Assist decision editors in manuscript processing.10. Attend a second Editorial Board meeting, usually held during the ACEP Scientific Assembly. Nominations must be submitted electronically to aem@saem.org by March 1, 2003. Nominations must include the follow-ing materials:1. A letter of interest.2. Names and contact information of two academic references.3. An updated curriculum vita. Energetic and qualified individuals are strongly urged to consider submitting a nomination to serve on the AcademicEmergency Medicine Editorial Board. AEM owes much of its success and development to the active participation of theSAEM membership as peer reviewers, Editorial Board members, and decision editors.

SAEM Research Fund (Continued)

is much easier for us to have an impacton the development of our specialty inthis last great area of research. We nowhave the structure, resources, andtrainees who are eager to do research.All we need is the funding to make it

happen on a scale that will eclipse any-thing we have ever seen before in emer-gency medicine. As you considerwhether to give to the SAEM ResearchFund, look at your emergency patients,and reflect for a moment on the people

who made your career possible – itshould then be an easy decision. Tomake a contribution to the ResearchFund, go to www.saem.org and click on“to contribute to the Research Fund” orcall 517-485-5484.

SAEM/ACMT Michael P. Spadafora Medical Toxicology ScholarshipDr. Michael P. Spadafora was an

academic emergency physician andmedical toxicologist who was a memberof SAEM and the American College ofMedical Toxicology (ACMT) and wasdedicated to resident education. Afterhis death in October 1999, donationswere directed to SAEM for the estab-lishment of a scholarship fund toencourage Emergency Medicine resi-dents to pursue Medical Toxicology fel-lowship training. ACMT has graciouslyagreed to donate matching funds.

Two recipients will be chosen toattend the North American Congress of

Clinical Toxicology (NACCT), which willbe held September 4-9, 2003 inChicago. Each award of $1250 will pro-vide funds for travel, meeting registra-tion, meals, and lodging. Any PGY-1 or2 (or PGY-3 in a 4 year program) in anRRC-EM or AOA approved residencyprogram is eligible for the award. Thedeadline for application is May 1, 2003.Scholarship recipients will beannounced at the annual SAEM andNACCT meetings. Each recipient willalso be required to submit a summary ofthe ACMT scientific symposium and theACMT practice symposium for publica-

tion in the SAEM Newsletter and theInternet Journal of Medical Toxicology.

Applications must be submitted elec-tronically to saem@saem.org andinclude:

1. Curriculum Vitae of applicant2. Verification of employment and let-

ter of support from the applicant’sprogram director

3. Letter of nomination from an activemember of SAEM and/or ACMT

4. 1-2 page essay describing theapplicant’s interest and back-ground in Medical Toxicology

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Report from the AAMC: Improving the Nation’s HealthJames Hoekstra, MDOhio State UniversityDavid P. Sklar, MDUniversity of New MexicoSAEM representatives to the AAMC

On November 10-13, 2002, in SanFrancisco, the Association of AmericanMedical Colleges (AAMC) held its annu-al meeting. The theme of the meetingwas “Improving the Nation’s Health.” Inhis Chair’s Address, Dr. RalphSnyderman spoke eloquently aboutwhat he termed the “next health caretransformation,” from acute and episod-ic care to “prospective care.” He envi-sioned a health care system of thefuture which would take our presentknowledge of genomics, proteomics,and metabolomics, and apply it to indi-viduals to predict risk of many chroniccardiovascular, neoplastic, and neu-rodegenerative diseases. This data-base of risk predictors could be used to“prospectively” plan a life-long medicaland psychosocial treatment program toprevent disease. He described thepresent national health care system asreactive, sporadic, physician directed,poorly integrated, and expensive. Withthe nation’s baby boomers reachingretirement age, the present health caresystem does not have the financial orfacility capacity to deal with the load ofacute illness that will be present in thenext decade. As such, only with the fullapplication of our scientific knowledgeof chronic disease states in the area ofprevention, can we stem the tide of anaging population.

Dr. Jordan Cohen, in his President’sAddress, echoed the thoughts of Dr.Snyderman, calling on the nation’s med-ical schools to renew the public’s trust inphysicians. He pointed out that patientsstill trust their doctors, even though theydon’t trust insurers, health systems, orthe institutions of medicine. He calledon physicians to make health care safer,to change the culture of GME to providesafe working conditions for residents, tomanage conflicts in clinical research, torestructure the nature of health caredelivery to provide “prospective” care,and to prepare tomorrow’s doctors topractice in an environment of prospec-tive and preventive care. Heannounced the creation of an Institutefor the Improvement of MedicalEducation to help accomplish this task.

There was a palpable shift in thehealth care emphasis at this year’sAAMC meeting. There is no doubt that

the AAMC sees the future of medicine indisease prevention and the prospectivecare of chronic diseases. There werenumerous sessions surrounding the top-ics of incorporating public health anddisease prevention into the medicalschool curriculum, as well as into ourhealth care systems. The implicationsof this shift in the AAMC’s direction onemergency medicine are unclear. If theAAMC is right, however, there may be ashift in emphasis at the research fund-ing level in the near future. Allianceswith funding agencies and academicdepartments that promote or study pub-lic health, injury prevention, and risk fac-tor detection or modification maybecome more important for emergencymedicine research as we move into thenext decade. We can’t afford to sit byand miss the boat.

There were a few other prominentthemes at AAMC which deserve men-tion. Professionalism remained aprominent topic, as medical schools andGME programs struggle to define it anddevise systems to evaluate it. GMEcore competencies and the evaluationmethods used to provide 360-degreeassessment of resident performancealso remained a concern for attendees.The effects of resident work hours limi-tations remained foremost in manyattendees' agendas, with a number ofsessions devoted to this issue.Although the limitations do not directlyaffect EM residents in the ED, theeffects on off-service rotations or EDspecialty coverage remain to be seen.There were also several sessions on theuse of simulators (mannequins and vir-tual reality) technology on resident edu-cation. This appears to be a promisingmethod of assuring procedural compe-tency without jeopardizing patient care.Finally, there was discussion regardinga recent lawsuit brought against theNRMP, the AAMC, and various special-ty societies alleging noncompetitivepractices concerning the residentmatch. This anti-trust lawsuit, whethermeritorious or not, will undoubtedly costthe AAMC and its constituencies thou-sands of dollars to defend. Its ramifica-tions on the future of the match and res-ident recruitment, as we have come toknow it, is unclear. The AAMC is hoping

for financial help from all its academicpartners as it gets ready to defend thecase.

A number of sessions centered onthe concept of “consumerism,” which isdefined broadly as the empowerment ofpatients to make decisions regardingtheir own care. Patients are presentedwith quality and price indicators oneverything from medications to proce-dures to hospitals. They can then maketheir own choices regarding their care.Since insurers are moving more andmore to tiered systems of health carereimbursements with adjustable co-pays, it is inevitable that patients mustbe provided the data to make thesedecisions. The implications of this pay-ment system for acute or emergent careare unclear, since the lack of patientchoice in emergent situations oftenmakes informed decisions impossible.

SAEM and the AACEM jointly spon-sored a well-attended 3-hour session onNovember 10. Bob Derlet, MD, BrentAsplin, MD, and Mark Henry, MD, led adiscussion on “ED Overcrowding:Effects on Medical Education.” Dr.Derlet introduced the concept of EDovercrowding, shared some of the rea-sons for overcrowding, and speculatedon the effects of overcrowding on resi-dent and medical student education. Dr.Asplin discussed legislative, regulatory,and process-centered interventions thathave been introduced to alleviate hospi-tal under-capacity, and their effective-ness at decreasing ED boarding ofadmitted patients. Finally, WilliamPetasnick, the President-elect of theCouncil of Teaching Hospitals, providedhis views regarding hospital capacity,ED boarding, and the interventions thathe felt would provide the best chance foralleviation of this issue. Dr. Henry led adiscussion in which there was a remark-able synergy notable between the emer-gency physicians in attendance and Mr.Petasnick regarding this issue. Whatresulted was an excellent session, anda chance for emergency medicine toform an allegiance with a powerfulgroup of administrators who apparentlyshare our views on this issue.

In the second session, JohnMoorhead, MD, presented the results ofthe ED Workforce Study, which was

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CDC Advisory Committee for Injury Prevention and ControlRonald F. Maio, DO, MSUniversity of MichiganSAEM representative to CDC National Center for Injury Prevention and Control Meeting

On November 7, 2002, I was invitedto attend the Advisory Committee forInjury Prevention and Control for theCDC's National Center for InjuryPrevention and Control (NCIPC) inAtlanta, Georgia. Other invited guestsfrom Emergency Medicine included:Bob O'Connor from Christiana Hospitalin Delaware and Bob Schafermeyerfrom Carolinas Medical Center in NorthCarolina. Representatives from TraumaSurgery included: Wayne Meredith fromWake Forest University, Ron Maier fromHarborview Medical Center, and DaveHoyt from University of California SanDiego.

We had been asked to attend thismeeting to help the Advisory Committeeand Sue Binder, the Director of theCDC's National Center for Injury Controland Prevention, to develop research pri-orities for acute care within the center.Acute care resides within the Division ofInjury and Disability Outcomes andPrograms (DIDOP). The newly appoint-ed division head is Dr. Joe Sniezek.

In discussing the budget for theInjury Prevention and Control Center ofthe CDC, Dr. Binder noted that thebudget for 2003 was going to decreaseby about 3%. She went on to say thatthere will be cuts for funding all the dif-ferent activities that the Center sup-ports, including acute care. She saidthat one of her main goals to accomplishat this meeting was to identify importantareas and potential "low-hanging fruit"for future research funding. Shethought that a major way for increasingfunding for the Center's activities will beto demonstrate the importance andimpact of the research that it is funding.Another area that she was very con-cerned in addressing was the area ofbioterrorism and emergency operations.The CDC is increasing the funds forbioterrorism and emergency operationsin 2003 by 800%. Funding has gonefrom approximately $182 million in fiscalyear 2002 to over $1.5 billion in fiscalyear 2003. Although the CDC hasemphasized biological agents in itsresearch activities, Dr. Binder wants todetermine how her center might play arole in addressing threats from radiolog-ic or chemical related acts of terrorism,and also the effect of multiple casualtiesfrom conventional weapons. Dr. Binderalso went on to say that even if funding

within the Injury Control Center is limit-ed, that she and her colleagues couldwork to help facilitate injury relatedresearch that would be funded by othergovernmental agencies, in particular theNIH. For example, Dr. Binder acknowl-edged the importance of laboratory-based large animal research and clinicalstudies on acute trauma physiology, yetstated that these were areas that itwould be unlikely for the CDC to ade-quately fund.

Drs. Hoyt, Maier and Meredith repre-sented trauma surgery, and morespecifically, the American College ofSurgeon's Committee on Trauma. Dr.O'Connor represented NAEMSP, Dr.Schafermeyer represented ACEP, and Irepresented SAEM. Prior to beginningdiscussions, three presentations weremade regarding acute care for injury.Dr. O'Connor addressed issues relevantto prehospital care, Dr. Schafermeyerdiscussed issues relevant to emergencydepartment care, and Dr. Maier dis-cussed issues relevant to trauma sur-gery. These presentations were verybrief and addressed previous and cur-rent work in these areas, as well asareas that need to be addressed infuture research. Dr. Maier emphasizedthe importance of continuing to do eval-uation and research on determining thebest way to deliver trauma care, in par-ticular improving the distribution andeffectiveness of trauma systems. Dr.Schafermeyer underscored the impor-tance of how overloading of the emer-gency department and inadequacy ofresources limits the effectiveness of ourcurrent emergency systems to obtainand sustain any surge capacity toaddress terroristic events occurring frombioterrorism activities or from the effectsof weapons of mass destruction. Dr.Schafermeyer also went on to under-score the role that emergency medicineis playing in its implementation of pri-mary injury prevention interventions inthe emergency department. Dr.O'Connor emphasized the role thatEMS prehospital care plays in respond-ing to any terroristic activities. He alsodiscussed the role that prehospital careproviders can play in injury preventionactivities that dovetail with their normalclinical work. All three speakers sug-gested that rather than develop a com-pletely new system to address terroristic

events that the country should build andstrengthen its current EMS and traumasystem infrastructure.

It became clear as the discussionsproceeded that identifying research pri-orities for acute care within the NCIPCwas not going to easily be determined inone session. We were therefore invitedto participate in another meeting regard-ing acute care research priorities thatwill be held in April 2003. Furthermore,Dr. Binder said she is looking for a teamleader in acute care to be assigned tothe DIDOP to assist Dr. Sniezek indeveloping research and a researchagenda. She said that this individualcould come on at a part-time employ-ment and would not have to give up theircurrent position. The CDC would pay apart or all of this individual's salary, attheir current rate, in order to get assis-tance in developing an acute careresearch agenda.

I would encourage members ofSAEM and particularly members of theInjury Prevention or Trauma interestgroups to contact Dr. Sniezek: JosephSniezek, MD, Centers for DiseaseControl & Prevention, 4770 BufordHwy., Mail Stop F41, Atlanta, GA30341. Or call (770) 488-4031, or fax(770) 488-4338 or email atjsniezek@cdc.gov.

If anyone has any concerns or com-ments, please do not hesitate to contactme at ronmaio@umich.edu.

Improving the Nation’sHealth (Continued)

published in Annals of EmergencyMedicine. He eloquently presented thecomplexity of this issue, and the largenumber of factors that can effect work-force predictions. He was cautiouslyoptimistic regarding emergency medi-cine opportunities in the future, and rec-ommended modest increases in ourcapacity of emergency medicine trainingslots. Interestingly, the AAMC recentlyconducted a similar workforce studyanalyzing the physician workforceacross all specialties. Their results werevery similar, concluding that they weren’treal sure about their findings, but theythink there may be an undersupply ofphysicians in the near future.

Board of Directors Update and 2003 Budget

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The SAEM Board of Directors meets monthly. Three timesa year, this is done ‘in person’, at the SAEM Annual Meeting,the ACEP Scientific Assembly, and the CORD Navigating theAcademic Waters Conference. The remaining meetings aredone via conference call. This article will cover the Board’sactivities during its meeting during the ACEP ScientificAssembly on October 7 in Seattle and the November Boardconference call.

The agenda during the meeting in Seattle focused on finan-cial issues. The Board reviewed a number of proposals sub-mitted by the Financial Development Committee. The Boardagreed to formally split the Society’s financial resources intothree separate entities: operating budget, reserve account,and Research Fund. The Board agreed that the reserveaccount will be established in an amount representing sixmonths of the annual operating budget. The Board alsoagreed that at the end of each year the Board will transferfunds in excess of the six month reserve account to theResearch Fund.

The Board endorsed a proposal to investigate using a pro-fessional money manager for the Research Fund. TheFinancial Development Committee will develop proposals thatwill be presented to the Board during the February Boardmeeting. The Board also agreed with the FinancialDevelopment Committee’s proposal to identify a financialdevelopment individual to assist with the development of theResearch Fund. It is expected that the Board will interviewpotential financial development officers during the FebruaryBoard meeting.

The Board reviewed and approved a draft 2003 operatingbudget as follows:

REVENUEDues: $1,086,725Annual Meeting: $420,000Journal/Newsletter: $215,000Sales/Service: $26,500 TOTAL: $1,748,225

EXPENSESalaries/Wages: $315,000Administration*: $199,000Meetings**: $273,000Journal/Newsletter: $510,000Representation/Support: $45,000TOTAL: $1,342,000

*Includes health insurance, payroll taxes, employee pen-sion plan, postage and printing, telephone/fax/conferencecalls, accounting, photocopying, computer consultants, bankcharges, and office maintenance.

**Includes SAEM Annual Meeting and regional meetings,as well as expenses associated with the AAMC AnnualMeeting and the ACEP Scientific Assembly.

The Board reviewed and approved a draft 2003 ResearchFund budget with revenue of $75,000 and expenses of$346,500. This budget assumes funding of one grant recipi-ent in the following grant programs: Research Training,Institutional Training, Scholarly Sabbatical, NeuroscienceFellowship, EMS Fellowship, and Geriatric Grant. The budgetalso includes 7 recipients of the SAEM/EMF Medical StudentResearch Grants and 6 Emergency Medicine Medical Student

Interest Group grants. The Board agreed that the financial decisions of the Board

will be reported to the membership, including a year-end finan-cial report. A year-end 2002 financial report will be included inthe February/March issue of the Newsletter.

The Board also reviewed and approved a five-year contractbetween SAEM and Hanley & Belfus, Inc., the publisher ofAEM. It was noted that SAEM will be provided with a copy ofthe program, Editorial Manager, which will allow authors tosubmit manuscripts to AEM online, and will allow AEM to trackmanuscripts online. The new version of Editorial Manager willprobably not be available until mid-2003.

The Board selected a slate of nominees to be forwarded tothe American Board of Emergency Medicine. The Boardselected Jim Adams, MD, and Brian O’Neil, MD, to representSAEM at the Stroke Symposium sponsored by the NationalInstitute of Neurological Disorders and Stroke. The Boardapproved the appointment of Judd Hollander, MD, and SueStern, MD, to serve as the SAEM representatives to theEmergency Medicine Foundation beginning January 1, 2003.The Board elected Kate Heilpern, MD, to serve as the Boardmember representative to the 2002-03 NominatingCommittee. The Board approved the appointment of SteveMeldon, MD, as the SAEM alternate representative to theSection on Surgical and Related Specialties of the AmericanGeriatric Society.

The Board approved the development of a brief surveyregarding members’ federal funding history to be sent via e-mail to the membership, along with the announcement of theNovember/December issue of the Newsletter.

The Board reviewed the proposal of the Ethics Committee,chaired by Catherine Marco, MD, which included a list of top-ics for development of a position paper or statement. TheBoard selected the issue of informed consent.

The Board approved the proposal by the Question andAnswer Task Force, chaired by Stephen Thomas, MD, to postthe question and answer bank on the SAEM web site, once itwas completed.

The Board approved Dr. Chisholm’s proposal for the con-tinued development of the Resident Mentoring Program. A for-mal program will be presented on May 28, the day before theAnnual Meeting, beginning at 5:00 pm. The program willinclude a dinner for the members of the Board, the commit-tee/task force chairs, and the residents appointed to the 2002-03 committees and task forces.

The Board agreed to develop a membership drive aimed atthe chairs of departments and divisions of emergency medi-cine. The Board approved Washington, DC as the site of the2008 Annual Meeting.

The next Board of Directors meeting will be held onSaturday, February 22 in Arlington, Virginia during the CORDNavigating the Academic Waters Conference. All membersare invited to attend this and any Board meeting.

Check the SAEM web site forinformation on the 2003 AnnualMeeting. Watch for the updates

beginning Janaury, 2003.

8

Federally-Funded Principal Investigators in Emergency MedicineClifton Callaway, MD, PhDUniversity of PittsburghSAEM Research Committee

Obtaining federal support for aninvestigation is often considered anindex of successful research develop-ment. Department chairs, deans, andpolicy makers often focus on federalfunding when gauging the maturity anddepth of research efforts in our special-ty. Who and what has been successful-ly funded also provides examples forother investigators about centers ofexpertise and successful funding strate-gies. For those reasons, the SAEMResearch Committee has attempted tocompile a consolidated list of federallyfunded emergency medicine research.

This list was first published in theJanuary/February 2002 Newsletter, andincluded 37 NIH-funded projects. Thislist now includes 48 NIH-funded projects(14 career development awards and 34project grants). This updated listincludes some projects we missed, aswell as several new projects that werefunded in 2002. For completeness, wealso list projects that are terminating in2002 (one career development grantand one project grant). Detailed infor-mation about NIH-funded projects canbe viewed in the CRISP database avail-able at www.nih.gov.

In response to publication of the orig-inal list, we received numerous queriesabout other funded research. In manycases, SAEM members serve as co-investigators or site investigators.Because it is difficult to group all co-investigators together (as their degreesof effort on projects vary widely), wechoose to report only principal investi-gators (who bear overall responsibilityfor projects). Quantifying the level offederal support for emergency medicineco-investigators is an ongoing project.

The list of non-NIH federal grants issmaller. These grants are less easilytracked than NIH grants, as there is nocentral database to search. At thispoint, we still rely on word-of-mouth andself-report. However, the CDC andDOD are important sources of largeresearch funding, and we will begin toinclude our growing list of principalinvestigators as a separate category.

Centers for injury control researchare funded in large part through theCDC. We note that several emergencyphysicians not only draw project supportthrough these organizations, but alsoare core leaders or directors for thesecenters. Data about these research

projects are available through NationalAssociation of Injury Control ResearchCenters (www.naicrc.org). The ProjectBank at that site provides listings of pre-vious and ongoing projects. Additionalinformation about CDC-funded projectsis listed at www.cdc.gov/ncipc/res-opps/extra.htm.

In November, all SAEM membersreceived an email asking whether or notthey have received research fundingfrom federal, state, or other sources.They were also asked whether theyhave served on a grant review commit-tee. During the coming months, theResearch Committee will contact thosemembers who responded in order to getmore detailed information. This activitywill allow us to develop a more completepicture of where we derive the fundingto support research in our specialty, andproperly emphasize the importance andprestige of the many non-governmentsponsors.

If you wish to provide informationabout your own funding successesand/or experience in grant review com-mittees, please email your contact infor-mation to the Research Committee viasaem@saem.org.

(continued on page 9)

Fellowship, Clerkship, and Residency Catalog Updates Requested The Emergency Medicine Fellowship

and Undergraduate Rotation Lists onthe SAEM web site are very popular.These lists are updated continuously,but it is difficult to ascertain if any insti-tutions are being missed. If your institu-tion has an emergency medicine fellow-ship or offers a clerkship, please take a

few moments to review these sites andcontact SAEM at saem@saem.org withcorrections or additions. TheFellowship List can be found atwww.saem.org/services/fellowsh.htmand the Undergraduate Rotation Listcan be found at www.saem.org/rotation/contents.htm

The Residency Catalog is alsoundergoing its annual update.Residency directors are encouraged toupdate their institution’s listing prior tothe upcoming interview season. TheResidency Catalog can be found atwww.saem.org/rescat/contents.htm

I am writing on behalf of the Societyfor Academic Emergency Medicine(SAEM), its more than 5,000 membersand the patients they serve at over 130teaching hospitals. SAEM is also amember organization of the Associationof the American Medical Colleges(AAMC) Council of Academic Societies.

For over 30 years, teaching physi-cians have been obligated to comply

with Medicare documentation require-ments when they bill for a Medicareservice involving a resident. At issue,over the years, has been the involve-ment of the teaching physician duringsuch service and the documentationthat must be provided to support thelevel of service billed to Medicare.SAEM strongly supports appropriatephysician service documentation for all

of the patients to whom we provideemergency medical care. In the past wehave stated to CMS (then HCFA) thatMedicare patients should have accessto high quality care and that such carebe appropriately documented in theirmedical record. However, when theissue of teaching physician documenta-tion was discussed with HCFA, we stat-ed that the regulations were overly bur-

SAEM Responds to CMS Medicare Part B Teaching Position PolicyOn December 3 SAEM sent the following letter to Thomas Scully, the Administrator of the Center for Medicare and MedicaidServices. The letter was developed by the National Affairs Committee, chaired by Robert Schafermeyer, MD.

(continued on page 10)

Principal Investigator Award Title Institution Award Number

Career Development Awards (14)Alessandrini, Evaline Predicting vaccine status and ED used in medicaid newborns Children’s Hospital of Philadelphia 1K23HD001320Asplin, Brent Emergency department crowding: causes and consequences Health Partners Research Foundation 1K08HS013007Bazarian, Jeffrey Epidemiology of traumatic brain injury University of Rochester 1K23NS041952Bunney, E.B. Electrophysiology of cocaine, ethanol and cocaethylene University of Illinois, Chicago 5K01DA000285Callaway, Clifton Brain ischemia and MAP kinase activation University of Pittsburgh 5K02NS002112Jay, Gregory Immunoprobes for lubricin from human synovial fluid Brown University 5K08AG001008Klawitter, Paul Redox regulation of metabolism in hypoxic diaphragm Ohio State University 5F32HL010216Porter, Stephen Informative’ technology: linking parents and providers Children’s Hospital of Boston 1K08HS011660Quinn, James A network of research sites to study clinical wound care UCSF 5K23AR002137Rothman, Richard ED guidelines for evaluation of febrile intravenous drug users Johns Hopkins University 1K23RR016070 Vanden Hoek, Terry Oxidants in myocardial preconditioning University of Chicago 5K08HL003779Wright, Robert Neurochemical and genetic markers of lead toxicity Brown University 5K23ES000381Young, Kelly Mentored patient-oriented career development award UCLA - Harbor 1K23RR016180Younger, John Lung injury, perfluorocarbons and hemorrhagic shock University of Michigan 5K08HL003817

Project Grants (34)Crain, Ellen Team tageting the environment and asthma management Yeshiva University 5U01AI039900Ma, Xin-Liang Peroxynitrite in Cardiac Ischemia/Reperfusion Injury Thomas Jefferson University 1R01HL063828Becker, Lance Apoptosis and oxidants after murine cardiac arrest University of Chicago 1R01HL071734Becker, Lance Optimizing heart and brain cooling during cardiac arrest University of Chicago 1R01HL067630Bernstein, Edward Randomized trial of the brief negotiated interview Boston University 5R01DA010792Boyer, Edward Relationship between the internet and illicit drug use University of Massachussetts 5R21DA014929Callaway, Clifton Hypothermia and gene expression after cardiac arrest University of Pittsburgh 1R01NS046073Camargo, Carlos Diet and chronic obstructive pulmonary disease Brigham and Women’s Hospital 5R01HL063841D’Onofrio, Gail Emergency physicians’ brief intervention for alcohol Yale University 1R01AA012417Eisenberg, Mickey Heart attack survival kit project King County EMS 5R01HL063136Gorelick, Marc PEAT: pediatric emergency assessment tool Children’s Hospital of Wisconsin 5R03HS011395Green, Gary Coronary thrombosis and risk in the emergency department The Johns Hopkins University 1R01HL069746Hoffman, Stuart Effects of dihydroepiandrosterone on brain injury Emory University 1R03HD040295Kellermann, Arthur Progesterone treatment of blunt traumatic brain injury Emory University 1R01NS039097Krause, Gary Suppression of protein synthesis in reperfused brain Wayne State University 5R01NS033196Li, Guohua Alcohol and general aviation Johns Hopkins University 5R01AA009963Li, Guohua Pilot aging and aviation safety Johns Hopkins University 5R01AG013642Maitra, Subir GLU6PASE and 6P2K/FBASE gene regulation in sepsis SUNY, Stony Brook 5R01GM058047Neumar, Robert Calpain-mediated injury in post-ischemic neurons University of Pennsylvania 5R01NS039481Olson, James Mechanisms of gene dysregulation in HD Wright State University 1R01NS042157Olson, James Mechanisms of cellular taurine transport in brain edema Wright State University 5R01NS037485Pancioli, Arthur Combination approach to lysis in acute ischemic stroke study University of Cincinnati 1P50NS044283Regan, Raymond Effect of inducible antioxidants on hemoglobin toxicity Thomas Jefferson University 1R01NS042273Rothman, Richard Evaluation of febrile IV drug users guidelines for

emergency management Johns Hopkins 2M01RR000052Stein, Donald Progestrone after traumatic brain injury Emory University 1R01NS038664Stein, Donald The effects of progesterone and its metabolites on TBI Emory University 1R01NS040825Sullivan, Jonathon Cell survival in brain reperfusion Wayne State University 1R01NS041919Thom, Stephen Specialized center of research in hyperbaric oxygen therapy University of Pennsylvania 5P50AT000428Thom, Stephen CO poisoning in the context of a reperfusion injury University of Pennsylvania 5R01ES005211Vanden Hoek, Terry Preconditioning against a source of reperfusion oxidants University of Chicago 1R01HL068951Wears, Robert Center for safety in emergency care University of Florida, Gainesville 5P20HS011592Yealy, Donald An empiric risk stratification rule for heart failure University of Pittsburgh 1R01HS010888Young, Kelly VP 63843 in treatment of enteroviral meningitis in

adolescents & adults UCLA-Harbor 5M01RR000425Zink, Brian Short-term training in health professional schools University of Michigan 5T35HL007690

Non-NIH Federal Grants (10)Barbee, R. Wayne New metabolic engineering strategy for shock. Virginia Commonwealth University DARPABrown, Michael Asthma surveillance and intervention in hospital

emergency departments Michigan State CDC Denninghoff,Kurt Eye oximeter for trauma care University of Alabama Birmingham Office of Naval ResearchDenninghoff,Kurt Comprehensive youth violence center University of Alabama Birmingham CDCHargarten, Stephen Analysis of violence related fatalities and injuries in Wisconsisn Medical College of Wisconsin CDCMaio, Ronald Computer based intervention to prevent alcohol use/misuse

in adolescents University of Michigan CDC McCarthy, Melissa measuring children’s health post-traumatic brain injury Johns Hopkins University CDCStern, Susan Optimizing resuscitation for the casualty with combined

hemorrhagic shock and traumatic brain injury University of Michigan Office of Naval ResearchWilliams, Janet WV Fatality Assessment Control and Evaluation (FACE) Program West Virginia University CDC/NIOSHWilliams, Janet Injury Control Training and Demonstration Center (ICTDC) West Virginia University CDC/NIOSH

9

10

SAEM Comments on Definition of Under-represented MinoritiesOn December 12 SAEM sent the following letter to the Advisory and Staff Committees on the Definition of Under-RepresentedMinorities (URM) of the AAMC. The letter was developed by Glenn Hamilton, MD, on behalf of the Board of Directors.

The Society for AcademicEmergency Medicine is appreciative ofthe opportunity to comment on therecently published discussion documentand alternative policy option developedas part of the review of the definition of"under-represented minorities" by theAAMC.

SAEM as an organization representsalmost 5000 physicians, residents andmedical students involved in the teach-ing and research of emergency medi-cine. These individuals are a significantportion of the 63 academic departmentsand 125 residency programs integratedclosely with the 125 medical schools inthe United States. These sites care for asignificant number of the more than 100million people seen in this country'semergency departments, many of themunder-represented minorities. The spe-cialty of emergency medicine all too wellrepresents the disparities and concernsraised as part of this definition review.Less than 15 percent of its residents-in-training would be categorized as under-represented minorities. We are a signif-icant stakeholder in the training andclinical care of under-representedminorities and share the AAMC's long-standing commitment to diversity.

Our Board of Directors strongly sup-ports the adoption of the Alternative 5thPolicy Option, to replace the URM defi-nition with a new designation, those"under-represented in medicine." Thisnew definition recognizes the funda-mental regional orientation of medicaltraining, and would encourage medicalschools to track racial and ethnic popu-lations in proportion to the general pop-ulation. This definition would alsoencourage a similar monitoring of thesegroups at the graduate medical educa-tion level. Both levels of academic train-ing would be challenged to establishlongitudinal tracking that would allow fordisparities to be addressed based onboth speciality and regional communityneeds.

We are most supportive of the pro-posed diversity plan outlined for AAMCinstitutions and the AAMC. We haveparticular interest in the efforts towardimproving the development, recruitmentand retention of both under-representedminority faculty and students. We arecurrently hosting a number of focusgroups nationwide to specifically deter-mine the rationale for African Americanand Hispanic medical students who areconsidering emergency medicine as a

future career choice. In addition, we are developing a

case-based cultural competency cur-riculum to assist patient care under-standing in our graduate medical edu-cation programs as well as potentiallyintegrating these cases and principlesinto undergraduate medical education.Our journal, Academic EmergencyMedicine, is sponsoring a consensusconference on "Disparities inHealthcare" to be held in May 2003.This revised and broadened definitionwill assist us in developing our ownresearch agenda and implementationfor change strategy.

We applaud the current efforts of theAAMC, and the careful deliberation ofthe staff and advisory committees overthe last two years. This thoughtfulapproach has allowed considerableinput and, importantly, generated a new"5th option," one which we heartilyendorse.

We look forward to the final report ofthese committees, and more important-ly, toward a sustained effort on the partof the AAMC and our own Society toexpand the awareness of diversity inour society and assist in correcting thecurrent disparities that exist in health-

densome and did not promote access tohigh-quality care. Instead, the regula-tions focused on the medical record asthe most important component of thepatient visit, rather than quality of themedical care and supported by reason-able documentation.

The rule issued by HCFA in 1995and effective in July 1996 providedsome clarification but also increased theduplication of entries in the medicalrecord. We do not believe that this ruleenhanced care to the patient or allowedour teaching physicians to make effi-cient use of their time with either thepatient or the resident. This rulerequires that after the resident evaluat-ed the patient in the presence of or joint-ly with the teaching physician, the resi-dent and the teaching physician bothhad to document each component ofthe evaluation. This contributed nothingto quality patient care and was respon-sible for significant redundancy in thepatient’s medical record. Our

Residency Review Committee of theAccreditation Council for GraduateMedical Education (ACGME) also has arequirement that an attending emer-gency physician must be present in theemergency department (ED) 24 hours aday, which makes this redundancy ofdocumentation even more superfluous.

Overall the direction in which CMS ismoving, as it considers revisions toSection 15016 of the Carrier Manual ofInstructions, is a positive step in reduc-ing the regulatory burden of theMedicare program requirements andwill provide a clearer direction for teach-ing physicians. I have had the opportu-nity, along with my colleagues, to reviewthe revised scenarios reflecting currentclinical situations involving residentsand teaching physicians and the exam-ples of documentation to accuratelyreflect the practices of teaching physi-cians. Generally, the use of the scenar-ios and examples of documentation arehelpful in telling us what documentation

is needed. The proposed changesreduce the need for duplicative entrieswhich teaching physicians are nowrequired to perform while assuring ade-quate documentation of the presenceand participation of the teaching physi-cian.

It will be important for CMS to devel-op other examples that address areasof continued confusion particularly theuse of medical students as scribes andthe ability of teaching physicians to referto medical student documentation formore than the review of systems andpast medical and social history. Wewould welcome the opportunity to workwith CMS to clarify these scenarios inorder to make them more applicableand adaptable.

Again, on behalf of SAEM I appreci-ate the effort of CMS in the revisions ofthe Medicare Carrier’s Manual, Section15016 and look forward to discussingour other concerns with you in the nearterm.

CMS Medicare (Continued)

11

Funding of Postdoctoral Training in Clinical Epidemiology and Health Services Research: Merging Good Ideas with Solid Methods

Lawrence A. Melniker, MDNew York Methodist HospitalSAEM Research Committee

Following the 2002 SAEM AnnualMeeting, and especially after participat-ing in the Research Committee’s paneldiscussion on unfunded grant applica-tions, it became clear that my researchhad become far more complex than myunderstanding of research methodolo-gy, grantsmanship, and management.With much encouragement from manyquarters, I applied for the two-yearMaster of Science Program in ClinicalEpidemiology and Health ServicesResearch at the Weill Graduate Schoolof Medical Sciences of CornellUniversity. Soon after my acceptanceinto the program, I was offered anAHRQ-funded two-year fellowship posi-tion and, with the blessing of my chair(and my wife), became a research fel-low on July 1. Mary Charlson, MD, andCarol Mancuso, MD, are the co-direc-tors of the fellowship program.

The Cornell program started with anaptly named “Intensive SummerSession.” We were given nine coursesin seven weeks of daily afternoon class-es. It was tough, but truly fascinatingand a great foundation upon which tobuild. A total of at least 30 credits ofcourse work will be completed by theend of the first year. The emphasis isalways on the fellow’s or graduate stu-dent’s area of research interest. Theprogram concludes with the writing anddefense of a Masters thesis by March ofthe second year, and the preparation ofone or more grant applications in thefinal spring semester.

Coincidently, Edward A. Panacek,MD, MPH, was honored at the ACEPResearch Section luncheon on October7 in Seattle, and after the award pres-entation, Dr. Panacek made some veryinsightful and provocative remarks. Heexpressed his strong belief that whilebench research was vital, the mainthrust of emergency medicine researchshould be in the area of clinical out-comes assessment. He urged emer-gency physicians to collaborate morefrequently with general internists, andwas emphatic about the need for emer-gency physicians to undergo advancedtraining in clinical epidemiology andhealth services research. It was anextraordinary experience, hearing Edpreach what I just now am trying to

practice.Why am I devoting my time and

effort to realize what Dr. Panacek hasrecommended? There are a number ofimportant reasons including:1. There is a substantial deficiency of

clinical outcomes research in emer-gency medicine. Recently, using themedical subject headings “exp out-comes assessment” and “exp emer-gency medicine,” a search of theCochrane, Embase, and Medlinedatabases yielded only 55 publica-tions of studies assessing clinicaloutcomes of emergency departmentpatients since 1966 (5 case reports,12 retrospective reviews, 1 retro-spective study, 25 literature reviews,6 prospective, observational trialsand 2 RCTs). The percentage of our“standard” clinical practice that isrooted in scientific evidence is small.In the setting of increasingly limitedresources, the delivery of evidence-based care has never been moreimportant.

2. There is a substantial dissociationbetween good ideas and solidresearch methodology. At the SAEMresearch session, members withexperience on NIH study sectionsraised concerns regarding a fre-quently observed dichotomy: clini-cian-generated projects which pro-pose interesting research hypothe-ses but are methodologically flawed,versus non-clinician-generated stud-ies with impeccable methods but lessappealing hypotheses. Currently,graduate medical education, as it isdelivered in the United States, doesnot adequately train physicians in therigors of scientific research method-ology, nor does it provide the expert-ise to secure funding for suchresearch.

3. Advanced training in clinical epidemi-ology and health services researchcan provide the skill set needed todevelop, organize, obtain funding for,and execute highly sophisticatedresearch projects that result in clini-cally useful findings and improvedpatient care. Conducting the trainingin a general internal medicine milieuis an added advantage for the emer-gency physician. Not only is the fac-

ulty a collection of experts in themany facets of the area of study, butdeveloping research protocols andwriting grant applications in this set-ting necessitates a level of clarity indescribing specialty- and project-specific concepts and nomenclaturethat otherwise might not be appreci-ated. Without such clarification posi-tive study section evaluations areless likely.AHRQ has increased its funding for

advanced research training by 50%since 1994 to $600 million in 2001, andcurrently funds postdoctoral researchfellowships at 20 centers around thenation. A listing of the institutions anddescriptions of the programs offeredcan be found at www.ahrq.gov/fund/training/t32.htm. If you are recommend-ing advanced research training to othersor are considering it for yourself, go tothe URL listed, and feel free to email meat: lam9004@med.cornell.edu.

NewsletterSubmissionsWelcomed

David C. Cone, MDYale UniversityEditor, SAEM Newsletter

SAEM invites submissions to theNewsletter pertaining to academicemergency medicine in the followingareas: 1) clinical practice; 2) educa-tion of EM residents, off-service resi-dents, medical students, and fellows;3) faculty development; 4) politics andeconomics as they pertain to the aca-demic environment; 5) generalannouncements and notices; and 6)other pertinent topics. Materialsshould be submitted electronically,preferably by e-mail tosaem@saem.org. Be sure to includethe names and affiliations of authorsand a means of contact. All submis-sions are subject to review and edit-ing. Queries can be sent to the SAEMoffice or directly to the Editor atdavid.cone@yale.edu.

12

SAEM Sponsors Federally Funded Alcohol Screening Program; MembersReceive Free Materials To Screen Patients

SAEM is once again pleased toannounce that it will sponsor the fifthannual National Alcohol Screening Day(NASD) held on April 10, 2003. As partof the program, SAEM members willreceive, at no charge, materials toscreen patients for alcohol problems, aswell as educate patients about alcohol’seffect on medical conditions and druginteractions.

Addressing a range of alcohol prob-lems from at-risk drinking to alcoholdependence, the materials are gearedat helping Emergency Department staffidentify and manage patients with exist-ing or developing alcohol problems.NASD is a program of Screening forMental Health, a nonprofit organization,in partnership with the National Instituteon Alcohol Abuse and Alcoholism(NIAAA) and the Substance Abuse andMental Health Services Administration.Because of the federal support, the pro-gram is free to all health care providers.

Registered providers receive a kit ofready-to-use education and screeningmaterials, including brochures, educa-tional flyers, videotape and screening

forms. Sites also receive step-by-stepinstructions for planning and conductinga screening event and a publicity guide.The materials are designed to be usedeither of two ways. Clinicians are invit-ed to conduct a special outreach eventon National Alcohol Screening Day,(April 10) or incorporate the screeningsinto their day-to-day EmergencyDepartment procedures and screen reg-ularly scheduled patients.

There are approximately 100 millionemergency department visits each year.As many as 30% of these ED patientspresent with alcohol related problems,and patients from racial and ethnicminorities and those who lack access toother health services are over-repre-sented in this group. Hospital EDs offera concentrated opportunity not availableelsewhere for alcohol abuse screening,brief counseling and referral, or, in otherwords, a teachable moment for contem-plating change in behavior. The ED isan ideal setting to meet people withharmful or hazardous drinking with atargeted intervention. By participating inNational Alcohol Screening Day, clini-

cians can help improve overall patientcare in ED settings.

Since its inception in 1999, NASDhas provided thousands of health carefacilities, treatment centers, mentalhealth clinics, colleges, and primary andspecialty care providers with a ready-made, easy-to-use program for con-ducting free, voluntary alcohol screen-ings with referrals for individual evalua-tion and treatment. Over the last fouryears, NASD has attracted over150,000 people to the event, screeningsome 100,000 individuals and educat-ing friends and family about signs,symptoms, available treatments, andwhere to seek counseling and help.

To participate, sites can registeronline by going to www.nationalalco-holscreeningday.org or by calling theNASD office at (800) 253-7658. Toreceive a registration form or for moreinformation about National AlcoholScreening Day, contact OneWashington Street, Suite 304, WellesleyHills, MA 02481, or call (800) 253-7658,or fax (781) 431-7447.

Patient Safety Curriculum Now AvailableKaren Cosby, MDCook County HospitalSAEM Patient Safety Task Force

The SAEM Patient Safety TaskForce is pleased to announce the devel-opment of web-based teaching materi-als on Medical Error and Patient Safety.The Task Force has worked to defineappropriate curriculum content and sug-gested teaching guidelines. The materi-als are posted on the SAEM web site atwww.saem.org.

The content is divided into sections

addressing the scope and reality ofmedical error, models of error, cognitiveerror and medical decision-making, andsystem causes of harm. The materialsinclude case studies, interactive teach-ing exercises, and guidelines for incor-porating the content into existing emer-gency medicine curricula. The materialis targeted primarily for emergencymedicine resident education but can be

adapted to medical students, faculty, aswell as students in other disciplines. Acomprehensive list of references andrecommended reading materials isincluded. An abbreviated version of thecontent will be published in an upcom-ing edition of Academic EmergencyMedicine. We encourage educators totake advantage of these materials.

Ethics Curriculum Available OnlineCatherine Marco, MDSt. Vincent Mercy Medical CenterChair, Ethics Committee

Now available on the SAEM web siteat www.saem.org is a downloadableslide set of Ethics Cases, designed forEmergency Medicine programs to usefor ethics discussions. The casesaddress a wide variety of professionaland ethical issues, including physicianimpairment, autonomy, interactions withpharmaceutical companies, managed

care issues, confidentiality, honesty, andmany others. The cases were devel-oped by members of the SAEM EthicsCommittee, and are downloadable inMicrosoft PowerPoint format, and areavailable for free use by EmergencyMedicine teaching programs. Alsoavailable on the SAEM web site is theEthics Curriculum, a manual of study

topics, cases, and discussion questions.Continued additions to the online cur-riculum materials are being developedby the Ethics Committee, and will beavailable in the future. Questions orcomments may be directed to:saem@saem.org or cmarco2@aol.com.

13

President’s Message (Continued)on their service. I am also occasionallyskeptical that this is, in fact, the case.

My next phase might be termed thenaïve phase. During early residency,when some of the primary literatureactually started to make sense andseem relevant to me, I saved each pieceof literature potentially relevant to emer-gency medicine and placed them inlarge stacks, because the lesson fromeach article might be important to mesome day. My belief in the fundamentalimportance of each article was occa-sionally shaken when I noticed thatsome of the articles tended to contradicteach other. The stacks never got filed.

As I entered the world of academicmedicine, however, I found that a naïveapproach to the medical literature didn’twork. My superficially confident state-ments regarding the effectiveness of

one treatment over another, or the supe-riority of one test over another, usuallybased on a single article that I had justread, were often met with commentssuch as “that was a small retrospectivestudy” or “that study used a historicalcontrol group” or some other method-ologic criticism.

As many before me have learned, Isoon realized that the best defenseagainst making such embarrassingstatements was to evolve from a naïvestate to a hypercritical one. It is theexistence of this hypercritical state,which I believe is not uncommon amongacademicians, that motivated me towrite this column. As a hypercriticalreader, I was soon armed with manystock methodologic criticisms such as“the sample size was too small,” “theydidn’t correct for multiple comparisons”

or, my favorite, “they overfit the data.” Ifound that in the academic world, inwhich one never wants to appear naïve,it was much safer to criticize every pos-sible methodologic weakness of a study,rather than admit that the resultsseemed plausible, useful, and that Iplanned (God forbid) to change my clin-ical practice based on the article.

Some academic physicians neverget past this hypercritical state. Thehypercritical state is comfortablebecause no one dares argue in supportof an article that, we all know, might becontradicted by a more sophisticatedand larger study in the future.Furthermore, methodologic weakness-es in clinical research are important.Studies that are poorly randomized,inadequately masked, or whose analy-ses are poorly planned are likely to lead

(continued on page 22)

Resident Group Discount Membership ParticipationCarey Chisholm, MDIndiana 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 resi-dent group discount membership. These 74 programs bring 2,267 resident members to the Society. This program provides res-idents with 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:

Akron General Medical CenterAlbert Einstein Medical CenterAllegheny General HospitalBaystate Medical CenterBoston Medical Center Brigham and Women's / Massachusetts

General HospitalCarolinas Medical CenterCase Western Reserve

University/MetroHealth Christ Hospital Christiana Care Health SystemCooper HospitalEast Carolina University Eastern Virginia Medical CenterEmory University George Washington University Hennepin County Medical CenterHenry Ford HospitalHoward UniversityIndiana University Johns Hopkins University Long Island Jewish HospitalLouisiana State University - Baton

RougeMaimonides Medical CenterMaricopa Medical Center Mayo Clinic

Medical College of Virginia Medical College of WisconsinMichigan State University-Kalamazoo New York Methodist HospitalNewark Beth Israel Medical CenterNorth Shore University HospitalNorthwestern University Ohio State University Oregon Health and Science UniversityPalmetto Richland Memorial HospitalRegions HospitalResurrection Medical CenterSaginaw Cooperative Hospitals Inc.Spectrum Health-Grand Rapids/MERCSt. John Hospital St. Luke's - Roosevelt Hospital CenterSt. Vincent Mercy Medical CenterStanford University/Kaiser PermanenteState University of New York at BuffaloState University of New York at Stony

BrookState University of New York Health

Science Center at SyracuseState University of New York

Downstate/Kings County HospitalTexas Tech UniversityThomas Jefferson UniversityUniversity of Alabama at Birmingham

University of Arizona University of ArkansasUniversity of California, San DiegoUniversity of ChicagoUniversity of Cincinnati University of ConnecticutUniversity of Louisville University of MichiganUniversity of New MexicoUniversity of North CarolinaUniversity of Pennsylvania University of Pittsburgh University of RochesterUniversity of Texas at HoustonUniversity of Virginia University of WashingtonWake Forest University Wayne State University/Detroit Medical

CenterWayne State University/Sinai-GraceWest Virginia UniversityWilliam Beaumont HospitalWright State UniversityYale-New Haven Medical Center York Hospital / Pennsylvania State

University

ACADEMIC RESIDENTNews and Information for Residents Interested in Academic Emergency Medicine

Edited by the SAEM GME Committee

Systems-Based Practice Core Competency – The Problematic One?Michael S. Beeson, MD, MBASumma Health System,Chair, SAEM Graduate Education Committee

As most GME educators and many residents are aware, theACGME instituted a requirement effective July 1, 2002, stat-ing that residents obtain competency in six areas:

• Patient Care• Medical Knowledge• Practice-Based Learning and Improvement• Interpersonal and Communication Skills• Professionalism• Systems-Based Practice

The ACGME states that “…programs must define the specif-ic knowledge, skills, and attitudes required and provide edu-cational experiences as needed…” (ACGME OutcomeProject) The ACGME has effectively ended all residencytraining modeled after a traditional apprenticeship. All resi-dency programs must now provide education and evaluationof all six core competencies. Only two of the six are special-ty-specific: Patient Care and Medical Knowledge. The otherfour are general competencies not necessarily related to anyspecific specialty. The importance of this is that multi-spe-cialty or institution-wide approaches to education and evalu-ation of the remaining four competencies may provide an effi-cient method of satisfying this requirement.

Review of the six core competencies reveals that out of thesix, only one may be a somewhat new area that must befocused on. Even if not directly taught, most residency pro-grams have traditionally placed emphasis on evaluation ofPatient Care skills, Medical Knowledge, Practice-BasedLearning and Improvement (the ability to adapt to self-evalu-ation and new knowledge), Interpersonal andCommunication Skills, and Professionalism. Of the six corecompetencies, Systems-Based Practice is the one thatrequires new resources for teaching and education. This arti-cle will review this core competency, and look at potentialways to address the education and evaluation of it.

The ACGME defines Systems-Based Practice as “…actionsthat demonstrate an awareness of and responsiveness to thelarger context and system of health care and the ability toeffectively call on system resources to provide care that is ofoptimal value” (ACGME Outcome Project). The OutcomeProject goes on to state that residents must be taught andevaluated on the following topics:

• Understand how their patient care and other profes-sional practices affect other health care professionals,the health care organization, and the larger society andhow these elements of the system affect their ownpractice

• Know how types of medical practice and delivery sys-tems differ from one another, including methods of

controlling health care costs and allocating resources• Practice cost-effective health care and resource allo-

cation that does not compromise quality of care• Advocate for quality patient care and assist patients in

dealing with system complexities• Know how to partner with health care managers and

health care providers to assess, coordinate, andimprove health care and know how these activities canaffect system performance

These five aspects of Systems-Based Practice can be sum-marized as interdependency of medical practice, differencesin medical care delivery systems, cost-effective care, patientadvocacy, and collaboration. Each of these five aspectsrequires the health care provider to realize that their medicalpractice is not in a vacuum. The next question is: how toteach these skills to our residents?

Interdependency of Medical PracticeEmergency Medicine, perhaps more than other specialties, isdirectly affected by virtually all aspects of the overall healthcare system. Likewise, the extent that an individual emer-gency department is integrated within the overall local healthcare system and community will have a direct impact on thequality of care a patient receives. The most obvious exampleis the ease and length of time it takes for a follow-up appoint-ment to be obtained following an ED visit.

Differences in Medical Care Delivery SystemsEmergency Medicine is affected by the health care system asa whole, as well as the local medical delivery systems inplace. Depending on the patient’s insurance status, theremay be restrictions on the type of medications that are cov-ered. Managed care entities may have strict controls on testsand medications, in an overall attempt to control costs. It isimportant that residents be taught these differences, as wellas the underlying reasons behind what may appear to bearbitrary dictations of professional practice. To be truly effec-tive, emergency physicians should be activists in patientadvocacy within these organizations. Residency educationshould include methods to demonstrate effective patientadvocacy.

Cost-Effective CareEmergency Medicine has been engaged in the study of cost-effective care since nearly its inception. The major EMorganizations have been extremely proactive in this pursuit.Part of this is related to the overall perception that EM is anexpensive alternative to traditional primary care. We shouldbe teaching our residents methods to determine costs of careand continuing quality improvement methods to decrease

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these costs while maintaining quality of care. This shouldbe ideally integrated into the study of costs within the healthcare system as a whole, with system-wide approaches todecreasing costs.

Patient AdvocacyEmergency Medicine can be and is proud of its tradition ofbeing the safety net of the health care system. In order tobe effective patient advocates within a local health caresystem, system-wide and community resources must bedefined for vulnerable populations such as the elderly, thehomeless, and the indigent. The health care system iscomplex, and the resources seem to continually shrinkeven as the demand for these resources increase.Emergency physicians can play a significant role in helpingto define the resources that are needed.

CollaborationIn order for all of the above Systems-Based Practiceaspects to be implemented, collaboration must occur inorder to cross the boundaries of traditionally well-definedspecialties. The paradigm shift from specialty-specific careto system-wide care requires collaboration among all stake-holders. Residents must be exposed to this, and seeexamples that they can take with them when they beginpractice in their own health care setting.

Methods to Teach Systems-Based PracticeHow then do you teach these different aspects of Systems-Based Practice? The first answer lies with attitudestowards health care as a whole. Residents must beexposed to a caring faculty that practice beyond the bound-aries of the emergency department. The frustrations thatcan occur as a clinic begins shifting patients to the ED as itapproaches closing hour must be turned into a constructivecollaboration to improve patient care, without the delay of apatient going to that clinic near the closing hour. This dif-ference in attitude will impress upon the resident the needto look for constructive solutions, rather than dwell on non-productive complaints.

The second answer lies with developing ongoing projectsthat residents can get involved with that address variousaspects of Systems-Based Practice. These projects maybe PGY level specific, or may occur on specific rotations,such as an administrative month. There are always prob-lems referred to the department chairman or ED directorthat require study of an issue and usually a collaborativeapproach to improve or resolve. Projects can be identifiedthat result from this process that residents can work on.These projects can address various aspects of Systems-Based Practice, including interdependency of medical prac-tice, differences in medical care delivery systems, cost-effective care, patient advocacy, and collaboration.

The weekly conference series provides an excellent forumfor Systems-Based Practice topics. Potential topics includehealth care economics, health care delivery systems, teambuilding techniques, the role of EM in health care, systemand community health care resources for vulnerable popu-

lations, and resource management in EM. These topicsprovide an excellent venue for hospital and communityleaders to give their perspectives, perhaps leading to betterunderstanding of the current and potential roles of the ED.

ConclusionThe core competency of Systems-Based Practice presentsa relatively new and structured aspect of residency educa-tion that must be addressed. Interdependency of medicalpractice, differences in medical care delivery systems, cost-effective care, patient advocacy, and collaboration must beaddressed. This core competency can benefit EM to a sig-nificant extent in that it can instill into residents a sense ofactivism towards patient advocacy. Residency programswill need to develop ways to address this core competency,and can potentially improve their local health care deliverysystem as a whole in the process. Ultimately, the long-termeffect will be to graduate emergency physicians who will beactivists within their own practice situations, leading toimproved health care delivery within their health care sys-tem.

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CPC Competition SubmissionsSought

Submissions are now being accepted from emergencymedicine residency programs for the 2003 Semi-Final CPCCompetition to be held May 28, the day before the SAEMAnnual Meeting in Boston. The deadline for submission ofcases is February 3, 2003 with an entry fee of $250. Casesubmission and presentation guidelines will be posted onthe CORD website at www.cordem.org and it is anticipatedthat online submission will be required.

Residents participate as case presenters, and programsare encouraged to select junior residents who will still be inthe program at the time of the Finals Competition. Eachparticipating program selects a faculty member who willserve as discussant for another program’s case. The dis-cussant will receive the case approximately 4-5 weeks inadvance of the competition. All cases are blinded as tofinal diagnosis and outcome. Resident presenters providethis information after completion of the discussants presen-tation.

The CPC Competition will be limited to 50 cases select-ed from the submissions. A Best Presenter and BestDiscussant will be selected from each of the five tracks.The Best Presenter and Best Discussant recipients willreceive a plaque and $250.

Winners of the semi-final competition will be invited toparticipate in the CPC Finals to be held during the ACEPScientific Assembly in October in Boston. A Best Presenterand Best Discussant will be selected. Both will receive aplaque and $500.

The CPC Competition is sponsored by ACEP, CORD,EMRA, and SAEM. If you have any questions, please con-tact CORD at cord@cordem.org, 517-485-5484, or via faxat 517-485-0801.

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Medical Student Excellence in Emergency Medicine AwardEstablished in 1990, the SAEM

Medical Student Excellence inEmergency Medicine Award is offeredannually to each medical school in theUnited States and Canada. It is award-ed to the senior medical student at eachschool (one recipient per medicalschool) who best exemplifies the quali-ties of an excellent emergency physi-cian, as manifested by excellent clinical,interpersonal, and manual skills, and adedication to continued professional

development leading to outstanding per-formance on emergency rotations. Theaward, presented at graduation, con-veys a one-year membership in SAEM,which includes subscriptions to theSAEM monthly Journal, AcademicEmergency Medicine, the SAEMNewsletter and an award certificate.

Announcements describing the pro-gram and applications have been sentto the Dean's Office at each medicalschool. Coordinators of emergency

medicine student rotations then selectan appropriate student based on thestudent's intramural and extramural per-formance in emergency medicine. Thelist of recipients will be published in theSAEM Newsletter.

Over 100 medical schools currentlyparticipate. Please contact the SAEMoffice if your school is not presently par-ticipating.

Call for PapersAEM Consensus Conference: Disparities in ED Health Care

Deadline: March 1, 2003

The Editors of Academic Emergency Medicine announce the 2003 AEM Consensus Conference on"Disparities in Health Care" to be held on May 28, 2003 in Boston, the day before the SAEM Annual Meeting. Disparities inhealth care are likely to present both within the ED decision making process and in the larger health care system. The USemergency departments might be important sources of information about both facets. However, disparities need to berecognized in order to be addressed.

Do inequalities exist in our treatment of emergency patients? If so, under what circumstances, at what level and for whatreason? In the larger health care system there is evidence that people of color and women do not always receive the samelevel of care. Are such disparities real? When, why, how, do disparities occur? Who is at risk of receiving less than optimalcare? What is the degree of disparity? How can disparity be eliminated? In a larger sense, what are the best ways topromote a highly reliable system of low variability? Do we teach our residents to deliver disparate care? How does thegreater healthcare system contribute to real or perceived disparities in ED management? Are disparities sometimes due tosystems incompetence? Is there a relationship between the degrees of inequality and degrees of system incompetence?How can we study these questions? What measures can be used? Most emergency physicians assume that there shouldbe no disparities in health care. If the general public holds this belief as well, why has our society not insisted upon thedevelopment of an equitable system of health care?

The goals of the conference will be to examine the presence, causes, and outcomes related to disparities of health careas they occur in emergency departments, and determine the degree to which forces from outside have an impact on ourpatients. The conference will aim to describe means of defining, assessing, measuring, and researching disparities thatmay occur in emergency care. The hope is to establish a research agenda for further assessment of these, and otherrelated questions. The conference is a logical progression in the AEM consensus series, which has included "Errors inEmergency Medicine," "The Unraveling Safety Net, " and " Assuring Quality."

We therefore issue this Call for Papers related to the topic of Disparities in ED Health Care. Submitted manuscriptsmust be received at the AEM editorial office by March 1, 2003. Electronic submission to aem@saem.org of the originaland a blinded copy is required. Also include a cover letter indicating that the submission is in response to this Call.Accepted papers will be published in the late fall of 2003, along with Proceedings from the Consensus Conference.Questions can be directed to Michelle Biros biros001@umn.edu or Jim Adams jadams@nmh.org.

SAEM

Nominations Sought for Resident Member of the SAEM BoardThe 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 3, 2003.

Candidates must be a resident duringthe entire one-year term on the Board(May 2003-May 2004) and must be amember of SAEM. Candidates shoulddemonstrate evidence of strong interestand commitment to academic emer-

gency medicine. Nominations shouldinclude a letter of support from the can-didate’s residency director, as well asthe candidate’s CV and a cover letter.Nominations must be sent electronicallyto saem@saem.org. Candidates areencouraged to review the Board ofDirectors orientation guidelines on theSAEM web site at www.saem.org orfrom the SAEM office.

The election will be held via mail bal-

lot in the Spring of 2003 and the resultswill be announced during the AnnualBusiness Meeting in Boston, May, 2003.

The resident member of the Boardwill attend four SAEM Board meetings:at the ACEP Scientific Assembly, at theCORD Navigating the Academic Watersconference, and at the 2003 and 2004SAEM Annual Meetings. The residentmember will also participate in monthlyBoard conference calls.

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Call for AdvisorsThe inaugural year for the SAEM

Virtual Advisor Program was a tremen-dous success. Almost 300 medical stu-dents 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 anadvisor whose special interest matchedtheir own.

As the program increases in popular-ity, more advisors are needed. New stu-dents are applying daily, and over 100remain unmatched! Please considermentoring a future colleague by becom-ing a virtual advisor today. It is a brieftime commitment – most communica-

tion takes place via e-mail at your con-venience. Informative resources andarticles that address topics of interest toyour virtual advisees are available onthe SAEM medical student web site.You can complete the short applicationon-line at http://www.saem.org/advisor/index.htm. Please encourage your col-leagues to join you today as a virtualadvisor.

Call for SubmissionsInnovations in Emergency Medicine Education Exhibits

2003 Annual MeetingDeadline: February 17, 2003

The Program Committee is accepting Innovations in Emergency Medicine Education (IEME) Exhibits for consideration ofpresentation at the 2003 SAEM Annual Meeting, May 29-June 1 in Boston. Submitters are invited to complete an applica-tion describing an innovative new educational methodology that they have designed, or an innovative educational applica-tion of an existing product. The exhibit should not be used to display a commercial product that is already available and beingused in its intended application. Exhibits will be selected based on utility, originality, and applicability to the teaching setting.Commercial support of innovations is permitted but must be disclosed. IEME exhibits will not be published in AcademicEmergency Medicine with other abstracts, but will be published in the on-site program. However, if submitters have con-ducted a research project on or using the innovation, the project may be written up as a scientific abstract and submitted forscientific review in the appropriate subject category by the January 7 deadline.

The deadline for submission of IEME Exhibit applications is Monday, February 17, 2003 at 5:00 pm Eastern Time. Onlyonline submissions using the form on the SAEM web site at www.saem.org will be accepted. For further information orquestions, contact SAEM at saem@saem.org or 517-485-5484 or via fax at 517-485-0801.

Emergency Medicine Foundation UpdateDonald M. Yealy, MD University of PittsburghRobert Neumar, MD, PhDUniversity of PennsylvaniaSAEM representatives to EMF

During the ACEP Annual ScientificAssembly, the EMF Board of Trusteesmet. The agenda covered fund-raising,recent research funding decisions, andinter-organization relationship issues.

The current assets and funding liabil-ities were reviewed by the Board, andfollowed by a broad discussion of mech-anisms to increase individual and corpo-rate donations, along with asset man-agement issues to enhance the currentand future reserves. Like all fundingorganizations, EMF is dedicated tomaintaining their mission in a challeng-ing financial environment. Future effortsare being planned to target corporatedonors using directed/topic appeals,

and individuals using both dollar andother gifts (including dedicating portionsof one’s will, life insurance or otherassets to EMF). Working groups arecurrently exploring these possibilitiesand will report to the Board in the future.

The relationships with theEmergency Nurses Association andSAEM were reviewed, followed by amotion to approve the recent grants rec-ommended for funding by the EMFScientific Review Committee. The latterpassed unanimously, with the recipientsdata available through the EMF website.

The Board approved a $75,000 grantto fund a mentored clinical scientist

each year, providing a true ‘bridge grant’for those in the early phases of an inves-tigative career preparing for a K or Rseries federal grant. The Board took noaction on one external unsolicited fund-ing request pending further data gather-ing, and declined a second unsolicitedrequest for funding. The Board alsoapproved a grant of $35,000 to helpEMF participate in an American HospitalAssociation coordinated study on theeffects of EMTALA on emergency med-ical care.

The meeting was adjourned, withmore agenda items available for discus-sion at the next conference call inDecember 2002.

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Call for PhotographsDeadline: February 17, 2003

Original photographs of patients, pathology specimens, gram stains, EKG’s, and radiographic studies or other visual dataare invited for presentation at the 2003 SAEM Annual Meeting in Boston. 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 x14, 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 should be submitted as glossy photos, not as x-rays. For EKGs send an original and a digital image. The backof each photo should contain the contributor’s name, address, hospital or program, and an arrow indicating the top.Submissions should 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 web site at www.saem.org and must be sub-mitted electronically. The case history is limited to no more than 250 words. If accepted for display SAEM reserves the rightto edit the submitted case history. Submissions will be selected based on their educational merit, relevance to emergencymedicine, quality of the photograph, the case history and appropriateness for public display. Contributors will be acknowl-edged and photos will be returned after the Annual Meeting. Academic Emergency Medicine (AEM), the official SAEM jour-nal, may invite a limited number of displayed photos to be submitted to AEM for consideration of publication. SAEM willretain the rights 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.

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.Occasionally, an ethical issue arisesthat is outside our world view or consid-eration, or a situation confronts us thatmakes us uncomfortable. We may lackthe knowledge to make a reasonablechoice, we may be faced with some-thing totally out of our experience, or wefeel at a loss because we cannot deter-mine the possible options. We may wit-ness an ethically questionable act, mayobserve unprofessional and possiblyharmful actions, may disagree about thecorrectness of another’s decision, ormay feel we ourselves are being sub-jected to exploitation, abuse, or otherunethical behavior. Such situations arefrightening; it is difficult to distinguishreality from 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 the EthicsConsultation Service will be offered toSAEM members in a timely manner;requests from nonmembers will be con-sidered on a case by case basis. Theopinions rendered are not meant to bepart of an ‘appeal process.’ All commu-nications will be anonymous and confi-dential. However, because many ethicalissues confronting emergency physi-cians are universal in their scope, andothers may learn from the issue pre-sented, we hope to develop a series ofarticles for publication, assuming thatconfidentiality can be maintained. Allrequests, inquiries, or correspondenceshould be directed to saem@saem.org.

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EMF Grants AvailableThe Emergency Medicine Foundation (EMF) grant applicationsare available on the ACEP web site at www.acep.org. The fund-ing period is July 1, 2003 through June 30, 2004.

Career Development GrantA maximum of $50,000 to emergency medicine faculty at the

instructor or assistant professor level who needs seed money orrelease time to begin a promising research project. Deadline:January 15, 2003. Notification: March 2003.

Research Fellowship GrantA maximum of $75,000 to emergency medicine residency

graduates who will spend another year acquiring specific basicor clinical research skills and further didactic training researchmethodology. Deadline: January 15, 2003. Notification:March 2003.

Neurological Emergencies GrantThis grant is sponsored by EMF and the Foundation for

Education and Research in Neurological Emergencies(FERNE). The goal of this directed grant program is to fundresearch on acute disorders of the neurological system, suchas the identification and treatment of diseases and injury to thebrain, spinal cord and nerves. $50,000 will be awarded annu-ally. Deadline: January 15, 2003. Notification: March 2003.

Medical Student Research GrantThis grant is sponsored by EMF and the Society for

Academic Emergency Medicine (SAEM). A maximum of $2,400over 3 months is available for medical students to encourageresearch in emergency medicine. Deadline: February 3,2003. Notification: March 2003.

SAEM 2003 Research GrantsEMF/SAEM Medical Student Research GrantsThis grant is co-sponsored by the Emergency MedicineFoundation and SAEM. It provides up to $2,400 over 3months to encourage research in emergency medicine.More than one grant is awarded each year. The medical stu-dent must have a qualified research mentor and a specificresearch project proposal. Deadline: February 3, 2003.

Geriatric Emergency Medicine Resident/Fellow GrantThis grant is made possible by the John A. HartfordFoundation and the American Geriatric Society. It providesup to $5,000 to support resident/fellow research related tothe emergency care of the older person. Investigations mayfocus on basic science research, clinical research, preven-tive medicine, epidemiology, or educational topics.Deadline: March 3, 2003.

Further information and application materials can beobtained via the SAEM web site at www.saem.org.

Call for AbstractsSoutheastern Regional SAEM Meeting

April 11-13, 2003Jacksonville, FL

The program committee is accepting abstracts for oraland poster presentations. Abstracts may be submittedelectronically via the SAEM web site at www.saem.org orby email to se.saem@jax.ufl.edu until January 10,2003.

There will be oral and poster research presentations,round table discussions with leaders in academic emer-gency medicine, keynote presentations by nationallyrecognized emergency physicians, and hands on edu-cational sessions, all in a relaxed atmosphere in sight ofthe Atlantic Ocean!

Registration: medical students and residents are partic-ularly encouraged to attend, and receive a discountedregistration fee of $50 (medical students) and $75 (resi-dents). Registration for attending physicians is $110. Toregister, contact: Ms. Everlena Owens • phone: (904)244-4106 • fax: (904) 244-4508 • email everlena.owens@jax.ufl.edu

Rooms have been reserved at the host hotel, the SeaTurtle Inn http://www.seaturtle.com/ • phone (800) 874-6000 or (904) 249-7402, for $140 – $180 per night.Mention the SE SAEM conference to receive the dis-counted rates. Spouses and children are welcome. Thebeach is the main attraction.

Call for Abstracts6th Annual SAEM

Western Regional MeetingApril 5 & 6, 2003

Mayo Clinic ScottsdaleScottsdale, AZ

The 2003 meeting will include lectures by renownedspeakers, oral and poster presentations and a specialclinical and basic research breakout track sessions.Deadline for abstract submission: January 31,2003 via the SAEM online abstract submission form atwww.saem.org.

Hotel reservations can be made at the CourtyardMarriott-Mayo Clinic in Scottsdale ($99/night, phone1-480-860-4000) and transportation from the airportmay be arranged. Contact: Marie Kirkendolph orChristopher Lipinski, MD, Department of EmergencyMedicine, Maricopa Medical Center, 2601 EastRoosevelt Street, Phoenix, AZ, 85008; phone (602-344-5418) or email: Marie.Kirkendolph@hcs.marico-pa.gov. The deadline for conference registration isMarch 14, 2003.

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SAEM

Call for Abstracts2003 Annual Meeting

May 29-June 1Boston, MassachusettsDeadline: January 7, 2003

The Program Committee is accepting abstracts forreview for oral and poster presentation at the 2003SAEM Annual Meeting. Authors are invited to submitoriginal research in all aspects of EmergencyMedicine including, but not limited to: abdominal/gas-trointestinal/genitourinary pathology, administrative/health care policy, airway/anesthesia/analgesia,CPR, cardiovascular (non-CPR), clinical decisionguidelines, computer technologies, diagnostic tech-nologies/radiology, disease/injury prevention, educa-tion/professional development, EMS/out-of-hospital,ethics, geriatrics, infectious disease, IEME exhibit,ischemia/reperfusion, neurology, obstetrics/gynecology, pediatrics, psychiatry/social issues,research design/methodology/statistics, respirato-ry/ENT disorders, shock/critical care, toxicology/envi-ronmental injury, trauma, and wounds/burns/orthope-dics.

The deadline for submission of abstracts isTuesday, January 7, 2003 at 3:00 pm Eastern Timeand will be strictly enforced. Only electronic sub-missions via the SAEM online abstract submissionform will be accepted. The abstract submission formand instructions are available on the SAEM web siteat www.saem.org, For further information or ques-tions, 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 manu-script or abstract form or presented at a nationalmedical scientific meeting prior to the 2003 SAEMAnnual Meeting. Original abstracts presented atnational meetings in April or May 2003 will be con-sidered.

Abstracts accepted for presentation will be publishedin the May issue of Academic Emergency Medicine,the official journal of the Society for AcademicEmergency Medicine. SAEM strongly encouragesauthors to submit their manuscripts to AEM. AEM willnotify authors of a decision regarding publicationwithin 60 days of receipt of a manuscript.

Call for NominationsSAEM Elected Positions

Deadline: February 5, 2003Nominations are sought for the SAEM elections which willbe held in the spring of 2003. The Nominating Committeewill select a slate of nominees based on the following cri-teria: previous service to SAEM, leadership potential,interpersonal skills, and the ability to advance the broadinterests of the membership and academic emergencymedicine. Interested members are encouraged to reviewthe appropriate SAEM orientation guidelines (Board,Committee/Task Force or President-elect) to consider theresponsibilities and expectations of an SAEM electedposition. Orientation guidelines are available atwww.saem.org or from the SAEM office.

The Nominating Committee wishes to consider as manycandidates as possible and whenever possible will selectmore than one nominee for each position. Nominationsmay be submitted by the candidate or any SAEM memberand should include the candidate’s CV and a cover letterdescribing the candidate’s qualifications and previousSAEM activities. Nominations must be submitted elec-tronically to saem@saem.org and are sought for the fol-lowing positions:

President-elect: The President-elect serves one year asPresident-elect, one year as President, and one year asPast President. Candidates are usually members of theBoard of Directors.

Board of Directors: Two members will be elected tothree-year terms on the Board. Candidates should have atrack record of excellent service and leadership on SAEMcommittees and task forces.

Resident Board Member: The resident member is elect-ed to a one-year term. Candidates must be a resident dur-ing the entire term on the Board (May 2003-May 2004)and should demonstrate evidence of strong interest andcommitment to academic emergency medicine.Nominations should include a letter of support from thecandidate’s residency director.

Nominating Committee: Two members will be elected totwo-year terms. The Nominating Committee selects therecipients of the SAEM awards (Young Investigator,Academic Excellence, and Leadership) and develops theslate of nominees for the elected positions. Candidatesshould have considerable experience and leadership onSAEM committees and task forces.

Constitution and Bylaws Committee: One member willbe elected to a three-year term, the final year as the chairof the Committee. The Committee reviews theConstitution and Bylaws and makes recommendations tothe Board for amendments to be considered by the mem-bership. Candidates should have considerable experi-ence and leadership on SAEM committees and taskforces.

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Call for Abstracts6th Annual SAEM

Mid-Atlantic Regional MeetingMarch 15, 2003

George Washington University HospitalWashington DC

Abstracts are invited for this one day conference in theheart of Washington DC. All accepted papers will be pre-sented orally, giving researchers at all levels a specialopportunity to share their work and findings. In addition,there will be round table discussions with leaders in aca-demic emergency medicine, medical student sessions,and a unique forum to meet with representatives of theNational Highway Traffic Safety Administration and dis-cuss research opportunities.

The deadline for abstract submission is February 1,2003 via the SAEM online abstract submission form atwww.saem.org

Hotel reservations can be made at One WashingtonCircle, across the road from the conference site (202-466-1868). Please mention the meeting to obtain thediscounted rate.

For information contact: Jeremy Brown MD or DaveMilzman MD, Dept of Emergency Medicine, GeorgeWashington University, 2150 Pennsylvania Ave NW,Suite 2B-417 Washington, DC 20037. 202-741-2911 orjbrown@mfa.gwu.edu.

Registration Fees: Faculty-$75; Residents/Nurses-$35;Medical Students/Physician Assistants-$25; EMTs/para-medics-$10

Deadline for conference registration is February 28,2003.

Call for Abstracts3rd Annual

New York State Regional SAEMMeeting

April 9, 2003Metropolitan Hospital Center

The program committee is now accepting abstractsfor oral and poster presentations. All abstracts mustbe submitted electronically via the SAEM website atwww.saem.orgThe deadline for abstract submission is 5:00 pmEastern Standard Time, Tuesday, January 21,2003.Location: Metropolitan Hospital Center, 1901 FirstAvenue, New York, NY 7:30 am – 4:30 pm.

Registration fees: Faculty - $55; Residents/Nurses -$35, Medical Students - free. Registration deadlineis March 26, 2003. Make checks payable to: NewYork Medical College. Mail to: Metropolitan HospitalCenter, 1901 First Avenue, Rm. 2A20, New York,NY 10029.

Keynote Speaker: Carlos A. Camarago, Jr, MD,DrPH, Director, EMNet Coordinating Center,Massachusetts General Hospital, will speak on thetopic of Asthma Research in Emergency Medicine.

Contact: Hazel Hunt, administrative coordinator,New York Medical College (Metropolitan)Emergency Medicine, 212-423-6684, fax: 212-423-6383, hazel_hunt@nymc.edu

Executive Leadership in Academic Medicine Program for WomenThe Hedwig van Ameringen

Executive Leadership in AcademicMedicine (ELAM) Program for Womenis now seeking applicants for its 2003-2004 class of approximately 45 Fellows.ELAM offers extensive educational, net-working and mentoring opportunities insupport of women leaders who aspire tothe highest administrative ranks at aca-demic health centers.

The year-long curriculum mixes tra-ditional executive seminars and work-shops on topics pertinent to AHC man-agement with group projects and indi-vidual assignments aimed at developingpersonal leadership. The programencompasses in-depth, case analyses,self-assessments, experimental learn-

ing, small group activities, and interac-tions with leaders in academic medicineand dentistry. The program culminatesin a 1.5 day Forum on Emerging Issues,where program Fellows, their Deansand other invited guests gather with topexperts to explore a timely, substantiveissue facing AHC leaders. During theyear, Fellows attend three educationalsessions of 5-7 days each, two at a sub-urban setting outside of Philadelphia,held in the fall and spring, and one coin-ciding with the November annual meet-ing of the Association of AmericanMedical Colleges. In addition, Fellowswork on independent and group assign-ments between sessions.

Candidates must be at associate

professor rank or higher, and mustdemonstrate significant administrativeresponsibilities and potential foradvancement to top levels of academicadministration. In addition to nomina-tion from the Dean, candidates submitan application form and letters of rec-ommendation from their supervisor andone other senior colleague. Submissiondeadline is February 1, 2003. Brochureand application details are available onthe ELAM web site atwww.drexel.edu/elam. For an applica-tion or additional information contactDeidra Lyngard, Assistant Director at(215) 842-6041.

22

President’s Message (Continued)

to results which are falsely positive.Conversely, studies that are too small orhave poorly-chosen endpoints are morelikely to yield results that are falselynegative. In my mind, however, themost difficult task is to appropriatelyweigh the effect of inevitable method-ologic weaknesses when evaluating thevalue of a newly-published clinicalstudy. Not all methodologic weakness-es are equal in their importance, nor areall flaws fatal. In fact, because manyclinical problems in the emergencydepartment are inherently complex, andtherefore difficult to study, much of themost useful clinical literature is funda-mentally imperfect from a methodologicpoint of view.

What then, is the next stage in evo-lution for a reader of the medical litera-ture? I believe the next stage is charac-terized by a wary open-mindedness.

One must be open-minded to the factthat a newly-published study might trulywarrant a change in one’s own clinicalpractice, regardless of how long onehas been practicing. One should alsobe open-minded to the fact that manylong-held beliefs may, upon carefulinvestigation, be found to be untrue.However, one must also be wary of thefact that poorly designed studies can, attimes, yield results that are misleadingor just plain wrong. The challenge isrecognizing both the former and latterevents, which requires distinguishingamong those methodologic flaws whichare minor or might limit broad generaliz-ability, from those that are truly fatal orinvalidating.

As I read the medical literature now,I am increasingly optimistic about thequality and effectiveness of emergencymedical care. I am also impressed with

the tremendous effort required toanswer even simple clinical questions ina convincing manner. Within bothemergency medicine-specific journalsand general medical journals, there isan increasing quantity and quality ofclinical research directly applicable tothe care of patients in the emergencydepartment. By having an open-mindand, simultaneously, being cognizant ofmethodologic quality issues which affectthe reliability and validity of studies, oneis in the best possible position to applynewly-published knowledge to improvethe care of patients in the emergencydepartment.

(Editor’s Note: Dr. Lewis is the SeniorStatistical Editor for AcademicEmergency Medicine and a consultingreviewer for a number of other medicaland statistical peer-reviewed journals.)

SAEM Makes Important Changes in Membership CriteriaCarey Chisholm, MDIndiana UniversitySAEM Secretary-treasurer

For many years active membershipin SAEM required a university facultyappointment or a special request forapplicants who did not have a facultyappointment. This was widely interpret-ed by potential members to mean thatSAEM membership was limited to indi-viduals with a faculty appointment.

However, this past May the SAEMmembership, as recommended by theBoard of Directors, approved a changein the Constitution and Bylaws as fol-lows: “Candidates for active member-ship shall be individuals with anadvanced degree (MD, DO, PhD,

PharmD, DSc., or equivalent other doc-toral degree) who hold a universityappointment or are actively involved inemergency medicine teaching orresearch.”

The Board agreed, as did the hun-dreds of SAEM members who voted toapprove this amendment, that thischange better reflects the reality ofSAEM membership….those individualsdedicated to academic emergency med-icine. Many ideal future members teachor perform research at settings outsideof a university or medical school, suchas community based physicians or

those working at federal governmentalagencies.

The SAEM Board would like toencourage current members to “get theword out” that full membership in SAEMis not limited to those with a formal fac-ulty appointment. Please let your col-leagues know that their participationand membership in SAEM is desiredand welcomed. Membership applica-tions are available on the SAEM website at www.saem.org and published inthis issue of the SAEM Newsletter.

CORD/AACEM Faculty Development Conference: Navigating the Academic Waters

February 22-24, 2003 - Washington, DCFaculty development continues to be

one of the most carefully scrutinizedareas by the RRC-EM. Due to the rela-tive growth of our specialty, coupled withrapid growth of residency programsover the past 10 years, many youngerfaculty struggle to develop needed per-sonal, management, teaching, andresearch skills required for successfulcareer advancement. CORD andAACEM have conjointly developed aseminar entitled: "Navigating the

Academic Waters: Tools for Educatorsof Emergency Medicine. This confer-ence was first held in November 1996and received high praise from atten-dees. The conference is designedspecifically for the unique needs of jun-ior Emergency Medicine faculty and willaddress essential elements necessaryfor success in an academic environ-ment including research development,bedside teaching, negotiating skills, res-ident evaluation, mentoring and clinical

teaching, as well as time and personalmanagement. This course nicely aug-ments the ongoing efforts made bySAEM in the area of faculty develop-ment. Young faculty or senior residentsinterested in an academic career shouldcontact the CORD/AACEM office at517-485-5484 or the CORD web site atwww.cordem.org. Registration is limitedto 125 people.

Medical Student/Resident Subcommittee Progress ReportBrian Euerle, MDUniversity of MarylandSAEM Program Committee

I am pleased to provide a progressreport on the work of the MedicalStudent/Resident Subcommittee of theAnnual Meeting Program Committee.

This year’s Medical Student Forumwill be held on Saturday, May 31, 2002.Students are encouraged to attend asmuch of the rest of the SAEM AnnualMeeting as possible, in order to maxi-mize their exposure to emergency med-icine.

The Medical Student Forum hasproven to be a very popular event at theAnnual Meeting, with increasing num-bers of students attending each year.The schedule for the 2003 Forum hasbeen finalized, and features experi-enced educators, residency directors,and department chairs from across thecountry as speakers. A session ofbreakout groups is featured which willallow the students to select a topicwhich is of special interest, and discussthis in a small group session.

In addition to hearing informative lec-tures on topics such as the residencyapplication and selection process, stu-dents will have significant exposure toresidency directors. This occurs duringthe lunch with program directors inattendance, as well as the residencyfair/reception at the conclusion of theday.

The Chief Resident’s Forum contin-ues to be scheduled as a pre-day event,and will be held on Wednesday, May 28,2003. In this session, upcoming chiefresidents from across the country gath-er together with their peers for a day-long event designed to prepare them forthe demands of chief residency. A vari-ety of lectures are provided, as well astwo small group sessions which coveradministrative and ethical problems.Besides the formal educational process,many attendees benefit from meetingeach other and discussing commonproblems and solutions. Many residen-

cy programs have found it beneficial tosupport their upcoming chief residents’attendance at the Chief Resident’sForum, as well as the SAEM AnnualMeeting. It is greatly appreciated by theresidents and can serve as a “reward”for their upcoming year of service.

The subcommittee has also devel-oped two didactic sessions. The first isthe annual Spivey Lecture, which isgiven in the memory of Dr. Bill Spivey.This year we are privileged to have Dr.Peter Rosen speaking on “ Research inEmergency Medicine: It’sPhysiognomy”. The lecture will be ofinterest to all members of the Society.The other didactic is entitled “Evaluatingan Academic Position” and will featureDr. Marcus Martin as the moderator.There will be a panel of experiencedchairs who will be able to discuss theapproach a graduating resident shouldtake when looking for a position in aca-demic emergency medicine.

23

Call for Abstracts7th Annual New England Regional

SAEM MeetingApril 9, 2003

Shrewsbury, MassachusettsKeynote Speaker: Peter Rosen, MD, FACS, FACEP

The Program Committee is now accepting abstracts forreview for oral and poster presentations. The meetingwill take place April 9, 2003, 8:00 am-4:00 pm, at theHoagland-Pincus Conference Center in Shrewsbury,MA; www.umassmed.edu/conferencecenter/

The deadline for abstract submission is Tuesday,January 7, 2003 at 3:00 pm Eastern Standard Time.Only electronic submissions via the SAEM onlineabstract submission form at www.saem.org will beaccepted. Acceptance notifications will be sent in lateFebruary 2003.

Send registration forms to: Tania Strout, RN, BSN,Department of Emergency Medicine, Maine MedicalCenter, 47 Bramhall Street, Portland, ME 04102. E-mailcontact is strout@mmc.org

Registration Fees: Faculty-$100; Residents/Nurses-$50;EMTs/Students-$25. Late fee after March 21, 2003: add$25. Make checks payable to Maine Medical CenterDepartment of Emergency Medicine.

Call for Abstracts13th Annual Midwest Regional

SAEM MeetingSeptember 19, 2003

Saginaw Cooperative Hospitals, Inc.Saginaw, MI

The Program Committee is now accepting abstracts forreview for oral and interactive poster presentations. Themeeting will take place September 19, 2003, 8:00 am –5:00 pm, at Curtis Hall on the campus of Saginaw ValleyState University, Saginaw, Michigan.

The deadline for abstract submission is Monday, July14, 2003, by 3:00 p.m. EDT. Only electronic submissionsvia the SAEM online abstract submission form atwww.saem.org will be accepted. Acceptance notificationswill be sent in late July.

Registration forms are available from Melinda Wardin,Department of Emergency Medicine, Saginaw CooperativeHospitals, Inc., 1000 Houghton Avenue, Saginaw, MI48602. E-mail contact is mwardin@schi.org

Registration Fees: Faculty--$75; Residents/Nurses--$30;EMTs/Students—No Charge. Late fee after September 12,2003: add $25.

Visit our website for updated information: www.schi.org

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We are owned and operated by emergencymedicine physicians. As an EMP physician, you are also an equity owner. You control your future.

EMP provides equity ownership, the mostattractive compensation package in the industry, career growth, geographic flexibilityand extraordinary job security.

If you are residency trained in emergency medicine, contact Dominic J. Bagnoli, Jr, MD,FACEP at 800-828-0898 or email us atcareers@emp.com to be part of… The Best inEmergency Medicine.

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24

FACULTY POSITIONSCOOK COUNTY HOSPITAL, CHICAGO, IL: The Department of EmergencyMedicine is seeking energetic and motivated candidates for a facultyposition. Applicants must be residency trained and BC/BE in EM. TheDepartment has 54 residents in a PGY II-IV format and 26 faculty. The EDscare for 115,000 adult, 30,000 pediatric and 5000 Level I trauma patientseach year. A new 463 bed Cook County Hospital will be completed in thefall of 2002. The department offers a very competitive benefit package andprotected time to pursue educational, administrative and research projects.Contact: Jeff Schaider, MD, FACEP, Department of Emergency Medicine,1900 West Polk Street 10th floor, Chicago, IL 60612; Telephone (312) 633-5451; email jschaider@ccbh.org

INDIANA UNIVERSITY SCHOOL OF MEDICINE, Department of EmergencyMedicine is recruiting a clinician teacher to provide care at the public hos-pital ED located on the medical center campus. Wishard Hospital is a LevelOne-Trauma Center, base for one of the country’s busiest pre-hospital emer-gency transport services, and regional burn center. The ED recorded 105,000visits in 2001. Wishard complements Methodist in providing clinical expe-riences for IUSM EM residents. Enthusiasm for medical education, facilita-tion of clinical research and excitement for patient care in a busy public hos-pital ED are expectations. Residency training and certification/preparation inEM are required. Rank and tenure are dependent upon qualifications. Applyto Jamie Jones, MD (jhjones@iupui.edu) or Rolly McGrath, MD(rmcgrath@iupui.edu), Fax (317) 656-4216. IU is an EEO/AA Employer,M/F/D.

MINNESOTA: Academic Emergency Medicine Faculty - Excellent opportu-nity for EM residency-trained, BC/BE Emergency Medicine faculty to join ourprogressive academic EM group at Regions Hospital, a Level I Trauma andBurn Center in St. Paul. Numerous opportunities in clinical research, healthservices research, EMS, Informatics, Toxicology, and education. Established3-year emergency medicine residency. ED volume: 65,000. Must have or beeligible to attain Minnesota and Wisconsin medical licensure. Forward CVto: HealthPartners Medical Group, Attn: Sandy Lachman, PhysicianRecruitment Coordinator, Mail Code 21110Q, P.O. Box 1309, Minneapolis,MN 55440-1309. Fax (952) 883-5395. For more information, emailsandy.j.lachman@healthpartners.com or call 800-472-4695. EO Employer.

OREGON: The Oregon Health & Science University, Department ofEmergency Medicine is conducting an ongoing recruitment campaign for tal-ented faculty members. Entry-level clinical faculty members at the instruc-tor and assistant professor level. Preference given to those with fellowshiptraining (especially in pediatric emergency medicine) or equivalent experi-ence. Knowledge of emergency medicine as a faculty discipline is expect-ed. Please submit a letter of interest, CV, and the names and phone numbersof three references to: Jerris Hedges, MD, MS, Professor & Chair, OHSUDepartment of Emergency Medicine, 3181 SW Sam Jackson Park Road,CDW -EM, Portland, OR 97239-3098.

SAINT LOUIS UNIVERSITY, a catholic, Jesuit institution dedicated to edu-cation, research and healthcare, is seeking qualified applicants for full-timefaculty positions in the Division of Emergency Medicine. The EmergencyDepartment sees approximately 30,000 patients yearly and is a Level ITrauma Center staffed by dedicated academic Emergency Medicine facultyin the School of Medicine. Applicants must be EM board certified or eligi-ble. Applications containing a letter of interest and curriculum vitae shouldbe sent to Chris Brooks, M.D., Director, Emergency Medicine Division, SaintLouis University, School of Medicine, Saint Louis University Hospital, 3635Vista Avenue at Grand Boulevard, St. Louis, MO 63110-0250. Saint LouisUniversity is an affirmative action, equal opportunity employer, and encour-ages applications from women and minorities.

UNIVERSITY OF KENTUCKY: The Department of Emergency Medicine at theUniversity of Kentucky is recruiting full-time faculty members at the assistantor associate professor level. The desired individual must be BP/BC in emer-gency medicine. Academic tenure track and clinical non-tenure track posi-tions available. The EM residency has full accreditation. The EmergencyDepartment at the UK Hospital is a level I trauma center with 40,000 annu-al visits. The department has nine full-time faculty. Contact: J. StephanStapczynski, MD, Department of Emergency Medicine, UKMC, 800 RoseStreet, Room M-53, Lexington, KY 40536-0298, Phone: (859) 323-5908,Fax: (859) 323-8056, or Email: jsstap01@uky.edu. We are an EOAAE.

WASHINGTON HOSPITAL CENTER AND GEORGETOWN UNIVERSITYHOSPITAL in Washington, D.C., and Franklin Square Hospital in Baltimore,MD are seeking physicians board certified or residency trained in emergencymedicine to join their faculty. Our department is both traditional and cuttingedge: traditional in that we believe that the provision of medical care is a

Molecular Brain Resuscitation Fellowship

The Molecular Brain Resuscitation Laboratory at theUniversity of Pennsylvania is offering a two-yearresearch fellowship to Emergency MedicineResidency graduates interested in studying themolecular mechanism of acute neuronal injurycaused by stroke, cardiac arrest and head trauma. Thistraining program is part of a multidisciplinarycollaboration between NIH-funded laboratories inthe Departments of Emergency Medicine,Neurosurgery, Neurology and Pharmacology. Thefellowship is supported by an Institutional TrainingGrant from the Society for Academic EmergencyMedicine. Fellows will be enrolled in the NeuroscienceGraduate Program enabling them to pursue a PhD inNeuroscience. Clinical duties are limited to 4 EDshifts/month. Salary ~95K. Start date July of 2003.

Send letter of interest and curriculum vitae to:

Robert W. Neumar, MD, PhDHospital of the University of PennsylvaniaDepartment of Emergency Medicine3400 Spruce StreetPhiladelphia, PA 19087Voice: (215) 898-4960Fax: (215) 573-5140Email: rneumar@mail.med.upenn.eduWebsite: http://www.uphs.upenn.edu/em/brain/

25

sacred trust; cutting edge in that we are committed to using the mostadvanced information technology to improve clinical care. Contact MarkSmith, MD, FACEP, Chairman, at (202) 877-0808, fax (202) 877-2468 orwrite to him at Washington Hospital Center, Department of EmergencyMedicine, 110 Irving Street, NW, Washington, D.C. 20010-2975.

The SAEM Newsletter is mailed every other month to the 5,500 members ofSAEM. Advertising is limited to fellowship and academic faculty positions.Deadline for receipt: February 1 (March/April), April 1 (May/June), June 1(July/August), August 1 (September/October), October 1 (November/December), and December 1 (January/February). Ads received after thedeadline can often be inserted on a space available basis.Advertising Rates:Classified Ad (100 words or less)Contact in ad is SAEM member ..............................................................$100Contact in ad non-SAEM member ..........................................................$1251/4 - Page Ad (camera ready)3.5" wide x 4.75" high ............................................................................$300To place an advertisement, e-mail or fax the ad, along with contact personfor future correspondence, telephone and fax numbers, billing address, adsize, and Newsletter issues in which the ad is to appear to: Carrie Barber atcarrie@saem.org, via fax at (517) 485-0801. For more information orquestions, call (517) 485-5484.

All ads posted on the SAEM web site at no additional charge.

Open Rank: The University of Cincinnati Departmentof Emergency Medicine has a full-time academicposition available with research, teaching, and patientcare responsibilities. Candidate must be residencytrained in Emergency Medicine with boardcertification/ preparation. Salary, rank, and trackcommensurate with accomplishments and experience.The University of Cincinnati Department of EmergencyMedicine established the first Emergency Medicineresidency training program in 1970. The Center forEmergency Care evaluates and treats 86,000 patientsper year and has 44 residents involved in a four yearcurriculum. Our department has a long history ofacademic productivity, with outstanding institutionalsupport.

Please send Curriculum Vitae to:

W. Brian Gibler, MDChairman, Department of Emergency MedicineUniversity of Cincinnati Medical Center231 Albert Sabin WayCincinnati, OH 45267-0769

Phone: (513) 558-8086Fax: (513) 558-4599E-mail: Diane.Shoemaker@uc.edu

Residency Vacancy ServiceThe SAEM Residency Vacancy Service wasestablished more than ten years ago to assistresidency programs and prospective emergencymedicine residents. The Residency Vacancy Serviceis posted on the SAEM web site at www.saem.org.Residency programs are invited to list theirunexpected vacancies or additional openings bycontacting SAEM. SAEM monitors and updates thelistings. Prospective emergency medicine residentsare invited to review these listings and contact theresidency programs to obtain further information.Listings are deleted only when the residency programinforms SAEM that the position(s) are filled.

Keep Your Membership MailingsComing!

Be sure to keep the SAEM office informed of changesin your address, phone or fax numbers, and especiallyyour e-mail address. SAEM sends infrequent e-mailsto members, but only regarding SAEM issues or activi-ties. SAEM does not sell or release its mailing list or e-mail addresses to outside organizations. Send updat-ed information to saem@saem.org

The Department of Emergency Medicine atthe University of Michigan is seeking one – twofaculty members in the Instructional or TenureTrack. We are looking for individuals commit-ted to developing an academic and researchcareer in emergency medicine. Prior researchexperience desired but not required. We areparticularly interested in attracting candidateswho are women or members of underrepresent-ed minorities, although we are certainly inter-ested in attracting the most qualified candi-dates.

The recruited faculty member will be pro-vided with appropriate senior mentorship aswell as research start-up funds and will haveadequate protected time to develop a researchprogram. Interested candidates should contactDr. William Barsan, Chair, Department ofEmergency Medicine at wbarsan@umich.eduor by phone (734) 936-6020. The University ofMichigan is an equal opportunity employer.

26

Indiana University School of Medicine

Research DirectorDepartment of Emergency Medicine

We are seeking qualified candidates for the position of Director ofResearch. The Director will assume the leadership of an established,successful program. The Director will oversee current projects, men-tor resident and junior faculty projects, and perform new laboratory orclinical projects. In addition, the Director will provide support for theResearch Division's Assistant Directors for Clinical Trials and forResident Scholarly Activities. Experience in securing extramuralgrants is mandatory. Substantial protected time is provided to accom-plish these goals.

The Indiana University Emergency Medicine Residency Program isbased at two large urban hospitals with an annual census of over200,000 patients. Support within the program includes two researchassociates, and statistical and clerical support. The Department spon-sors fellowships in Medical Toxicology and Out of Hospital Care(EMS), and works closely with the IU Informatics Fellowship. Twoof our current faculty are enrolled in a Masters of Clinical Researchprogram. The research program is also supported by the university'sresearch department and a large private research institute, and enjoysa strong track record of collaborative efforts. This position includes ahighly competitive salary and benefit program. Faculty appointmentis available at rank commensurate with experience and productivity.

A letter of interest and Curriculum Vitae should be submitted to:

Charles M. Shufflebarger, MDEmergency Medicine and Trauma Center1701 North Senate BoulevardIndianapolis, Indiana 46202Email: cshuffle@clarian.org

Department ofEmergency Medicine

University ofFlorida/Jacksonville

We are actively recruiting 9 Board Certified or BoardEligible Emergency Medicine Physicians in an excit-ing opportunity to expand our Department at a com-munity-based hospital in the greater Orlando-Tampa area. Newly renovated 24,000 square footemergency department, 33 patient care baysincluding a 7 bed minor care area, 3 x-ray suites, aradiology viewing area, ample work space, and alarge waiting area, that serves a growing volume of45,000 patient visits per year. In addition to a salaryline of approx. $120 per hour, we offer the full rangeof University of Florida state benefits that includehealth, life, disability insurance, vacation & sickleave, 403B retirement plan with immediate vesting,and sovereign immunity occurrence medical liabilityinsurance. Individuals will be appointed at the rankof Clinical Assistant Professor or Clinical AssociateProfessor. Interested? Mail your letter of interestand CV to Dr. Kelly Gray-Eurom, Dept. ofEmergency Medicine, University of Florida HealthSciences Center, 655 W. 8th Street, Jacksonville,Florida 32209. Application deadline is 6/1/03 withanticipated start date of 7/1/03. EOE/AA Employer.

Fellowship inCardiovascular Emergencies

University of Virginia Department of Emergency Medicine inconjunction with the Division of Cardiology is pleased toannounce the creation of a new Fellowship in CardiovascularEmergencies. This innovative clinical fellowship is intended toprovide additional training for BC/BE emergency physicians inclinical management and research in the specialized area ofcardiovascular emergency. The Fellow will also receive directexperience in the operations and administration of an ED-basedchest pain observation and diagnostic unit.• 4,000 patients evaluated in CPC annually• Outcomes research related to use of advanced imaging, serumcardiac markers and observation protocols in the CPC• One-year curriculum emphasizes CPC patient evaluation,research methodology training, exposure to basicechocardiography & nuclear imaging techniques, and CPCadministration• Opportunity for certification in exercise stress testing• Faculty appointment as Clinical Instructor• Must have completed residency in EM and be board-certified/prepared prior to July 2003Please submit a letter of interest and CV to:

Chris Ghaemmaghami, MDDirector, Chest Pain Center, UVa Health SystemPO Box 800699, Charlottesville, VA 22908-0699

Phone: (434) 982-1999 Email: cg3n@virginia.edu

27

Brigham and Women’s Hospital/Harvard Medical School

Full-time academic faculty position

Includes excellent academic support, appointment atHarvard Medical School, unparalleled research opportu-nities, competitive salary, and an outstanding compre-hensive benefit package.Brigham and Women’s Hospital is a major Harvard affil-iated teaching hospital, level I trauma center, and the basehospital for the four-year ACGME accredited Brighamand Women’s Hospital/Massachusetts General HospitalHarvard Affiliated Emergency Medicine ResidencyProgram. The Department of Emergency Medicine caresfor over 55,000 ED patients per year and includes a state-of-the-art 9 bed ED Observation Unit. The departmenthas a robust International Emergency Medicine Programand offers international EM fellowships.The successful candidate must have successfully com-pleted a four year residency training program in emer-gency medicine or a three year program followed by afellowship, and be board prepared or board certified inemergency medicine. Interest and proven ability inEmergency Medicine research and teaching are essential. Please send inquiries and CV to Ron M. Walls, MD,FACEP, Chairman Department of Emergency MedicineBrigham and Women’s Hospital 75 Francis Street, RoomPBB-100 Boston, Massachusetts 02115. Emailrwalls@partners.org

PROGRAM DIRECTORThe Department of Emergency Medicine at the University ofTexas Houston Medical School is soliciting applications forthe position of program director. Applicants must be residencytrained and board certified in emergency medicine and shouldhave a portfolio of scholarly accomplishments and a stronginterest in education.

The emergency medicine residency training program at TheUniversity of Texas Houston Medical School is a three-yearprogram with 10 residents per class. The program has justreceived full accreditation for the next three years. Ourprimary teaching hospital is Memorial Hermann Hospital. The emergency department has an annual volume ofapproximately 55,000 patients and is one of the nation’sbusiest level I trauma centers. Duties of the program directorinclude oversight of the residency program and of otherdepartmental educational activities.

Interested applicants should send a curriculum vitae and a list of professional references to Dr. Brent King Chairman,Department of Emergency Medicine, The University ofTexas Houston Medical School, 6431 Fannin St. MSB. 6.264,Houston, TX 77030.

The University of Texas is an Equal Opportunity, Affirmative Action Employer. Minorities andwomen are strongly encouraged to apply. This is a security-sensitive position and thereby

subject to Texas Education code §51.215.

CHILDREN'S HOSPITAL OF NJ atNEWARK BETH ISRAEL

MEDICAL CENTER

The Division of Pediatric Emergency issearching for full time faculty position to joinour team. We care for 28,000 pediatric patientsannually in an urban setting and are dedicatedto clinical excellence, education and patientsatisfaction. Children's Hospital of New Jerseyhas dually accredited residencies in bothemergency medicine and pediatrics andprovides excellent opportunities clinically,academically and administratively.

Motivated candidates will receive excellentsalary and benefits package and will be a partof a growing and dynamic group. Interestedcandidates should be BC/BE in PediatricEmergency Medicine. Consider Newark BethIsrael! For more information, contact NeilSchamban, MD, FACEP, Director, PediatricEmergency Medicine by phone (973) 926-3463,email: NSchamban@SBHCS.com, or fax (973)282-0562.

ATLANTA, GA

DEPARTMENT OF EMERGENCY MEDICINE

Due to continued growth, we anticipate openings for full-time academic emergency physicians in both research andclinician-educator tracks. Emory offers a dynamic andprofessional environment with special strengths in patientcare, teaching, community service, EMS, toxicology, clin-ical and laboratory research, and public health. Excellentsalary and benefits. Applicants must be residency trainedand/or board certified in EM. Emory is an equal opportu-nity/affirmative action employer. Women and minoritiesare encouraged to apply. For further information visit ourweb site at http://www.emory.edu/em or contact:

Arthur Kellermann, MD, MPH, Professor and ChairDepartment of Emergency Medicine

1365 Clifton Rd., Suite B-6200Atlanta, GA 30322

Phone: (404) 778-2600 Fax: (404)778-2630Email: Paula Bokros - pbokros@emory.edu

Emory is an equal opportunity/affirmative action employer

Board of DirectorsRoger Lewis, MD, PhDPresident

Donald Yealy, MDPresident-Elect

Carey Chisholm, MDSecretary-Treasurer

Marcus Martin, MDPast President

James Adams, MDGlenn Hamilton, MDKatherine Heilpern, MDJames Hoekstra, MDJudd Hollander, MDDonald J. Kosiak, Jr., MDSusan Stern, 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 Academic EmergencyMedicine. The opinions expressed in this publication are those of the authors and donot necessarily reflect those of SAEM.

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

PresortedStandard

U.S. PostageP A I D

Lansing, MIPermit No. 485NEWSLETTER

Newsletter of the Society for Academic Emergency Medicine

SAEM NEWSLETTER

Call for NominationsDeadline: February 3, 2003

Nominations are sought for the Hal Jayne Academic Excellence Award and the Leadership Award. These awards will be pre-sented during the SAEM Annual Business Meeting in Boston. Nominations for honorary membership for those who havemade exceptional contributions to emergency medicine are also sought. The Nominating Committee wishes to consider asmany exceptional candidates as possible. Nominations may be submitted by the candidate or any SAEM member.Nominations should include a copy of the candidate’s CV and a cover letter describing his/her qualifications. Nominationsmust be sent electronically to saem@saem.org. The awards and criteria are described below:

Academic Excellence AwardThe Hal Jayne Academic Excellence Award is presented toan individual who has made outstanding contributions toemergency medicine through research, education, andscholarly accomplishments. Candidates will be evaluated ontheir accomplishments 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 journals

B. Other research publications (e.g., review articles, bookchapters, editorials)

C. Research support generated through grants and con-tracts

D. Peer-reviewed research presentationsE. Honors and awards

Leadership AwardThe Leadership Award is presented to an individual who hasdemonstrated exceptional leadership in academic emer-gency medicine. Candidates will be evaluated on their lead-ership contributions including:1. Emergency medicine organizations and publications.2. Emergency medicine academic productivity.3. Growth of academic emergency medicine.

2003 Annual MeetingMay 29 - June 1Boston Marriott

Copley PlaceBoston, MA

2004 Annual MeetingMay 16 - 19

Wyndham PalaceResort

Orlando, FL

2005 Annual MeetingMay 22 - 25

Hilton New YorkNew York, NY

2006 Annual MeetingMay 18 - 21

San Francisco MarriottSan Francisco, CA